Select Committee on Environment, Food and Rural Affairs Written Evidence


Memorandum submitted by Mr Mike Christian, BVM&S MRCVS (W15)

  Brief C-V Currently a partner in one of the largest farm veterinary practices in Cumbria having spent 17 years in mixed rural practice. Spent 6 months on secondment to MAFF at the Carlisle DECC during FMD.

SUMMARY

  This is a timely review of farm veterinary services. I would submit that the current trends in veterinary practice are likely to accelerate rapidly in response both to present levels of farm income and imminent changes in veterinary practice.

  In this submission I have briefly covered the following areas:

  1.  The current provision of veterinary services and how they are financed.

  2.  Current trends and their likely impact on veterinary services.

  3.  The effect of the reduction in large animal clinicians on health and welfare standards and on surveillance.

  4.  The feasibility of the Animal Health and Welfare Strategy.

  5.  The impact on the SVS.

  6.  The future and possible outcomes.

1.  THE CURRENT PROVISION OF VETERINARY SERVICES AND HOW THEY ARE FINANCED

  The income for rural farm veterinary practice that provides the majority of veterinary services to the agricultural industry has traditionally come from 5 major areas.

    —  Clinical services.(Examining and diagnosing individual animals, calvings, lambings individual surgery, routine fertility, dehorning and castrating. Traditional "On Farm" Professional Fee work)

    —  LVI income from DEFRA/MAFF in the eradication of Notifiable Disease: Tuberculosis, Brucellosis, Anthrax, etc. Many practices also were involved with Meat Hygiene and inspections at abattoirs.

    —  The dispensing of pharmaceuticals.

    —  The provision of veterinary advice on farm management and welfare.

    —  The majority of veterinary partnerships are mixed practices: a consideration must be given to the fact that small animal work makes up a variable proportion of the work and income to veterinary practice.

  It is my opinion that clinical farm animal practice, the examining and diagnosing of individual animals is already uneconomic for both the veterinary surgeon and the farmer. It is only happening because of the cross subsidy of the professional fees by other income, and because of the good will of most farmers to give animals a chance.

  As the harsh economics are coming home to vets and farmers this is rapidly becoming, with James Herriot, a part of rural history.

2.  CURRENT TRENDS AND THEIR LIKELY IMPACT ON VETERINARY SERVICES

  What are the current trends within agriculture and veterinary practice and what effects will that have?

  Both in agriculture and farm veterinary practice there are trends that can be identified, how fast, how far these trends will go is difficult to predict, but my own experience is that change when it comes, change is often slow at starting but then dramatic in its speed. The effect of decoupling and other EU decisions on agriculture are unknown but the current trends are likely to continue.

  In agriculture farm size has to continue to grow. As farms make less and less per animal, they have to spread costs over larger and larger numbers. The individual value of each animal continues to drop in real terms, efficiency and mechanisation continues to increase. Chicken farms are now routinely 100,000 animals plus. Since foot and mouth disease the average dairy herd size has increased from 90 to 114 an increase of 20% which talking to many dairy farmers is only going to increase as more herds are going to be 300+ animals. These increases are usually with out an increase in labour on the farms. This means the care of individual animals is likely to be less important, but the care of the overall heath of the herd much more.

  In veterinary practice the major changes are likely to be from the Competition Inquiry in to the cost of pharmaceuticals. The subsidy of professional fees by sales of pharmaceuticals has been an increasing trend since the late 60's. Then professional fees were subsidised by the large-scale eradication schemes by MAFF who paid very good fees to get the vets on the farm and help eradicate the Notifiable Diseases.

  The competition inquiry is recommending that pharmaceuticals be dispensed by pharmacies as well and that prescriptions be provided free of charge. Which private organisation is going to provide a service free of charge has yet to be ascertained, but the current level of income derived from pharmaceuticals is not going to be sustained. This inevitably means that the cross subsidy will disappear and farmers will have to pay the full cost of veterinary clinical service, and it will not be economic to do so.

  At the same time the costs of providing veterinary services continues to rise.

The cost of veterinary time is continuing to rise. Students are now graduating with debts of £15-20K because of the loss of grants and payment of tuition fees. This means there will need to be a further raise of £2-3K per annum to pay veterinary assistants to match the status quo. Farm animal practice already pays assistants less than companion animal practices despite offering a less favourable "On Call" rota.

  In the short term following FMD many practice principals worked additional On Call to make the rota acceptable to attract assistant vets. Where this is viable in the short term, in the long term it is not acceptable. As partners profit becomes commensurate to the salaries they have to pay to veterinary assistants they will be aiming to increase charges for clinical work or look to other avenues for decreasing costs/increasing turnover.

  Providing an out of hours emergency cover is not economically practical for vets. (except in the big cities where practices join together to provide an emergency clinic.) Currently there is an RCVS obligation to provide 24hour cover, but the RCVS is not involved in the commercial pricing of services.

  As the value of individual animals continues to drop in real terms then the cost of treating individual animals becomes less and less viable. Where there is no cross subsidy for out of hours work it will become untenable.

  As many mixed practices have a dwindling farm animal side that is less financially attractive, many will decide to concentrate on the companion animal side of the business.

  In a lot of mixed practices, it is a senior partner who will do the largest amount of the farm work. This means the younger vets will not have the case load to become experienced and confident in farm work. There is a cohort of practitioners in this situatuation heading towards retirement in the near future, will the practice continue to be involved with farm work?

  As fewer practices become involved with farm veterinary services, the cost of travel to the more distant farms has to rise beyond the already accelerated rate.

  All this means that farm veterinary practices will lose income from clinical services and from pharmaceutical sales. They will have to move more towards the pig/ poultry model of providing veterinary advice and charging for it.

  Vets have already moved out of nutritional advice leaving this field to nutritional experts. The reason for this is that most nutritional advice is provided "free" to the farmer by the firms who then put that cost into the feeds that are sold to the farmers. This cross subsidy of fees by sales is apparently acceptable where the subsidy of veterinary fees by pharmaceuticals is not.

  This model is beginning to appear in other areas. Whereas vets provided most mastitis control, the dairies who buy the milk are now providing "free" or subsidised advice to farms on cell counts and high bacterial counts. (Including bacteriology with a variable back up and quality of advice)

  NMR and other recording agencies are already offering fertility information on their recording products, and it is a short step to actually providing the fertility work.

  I believe that these factors will contribute to a dramatic decrease in farm animal clinicians in the next five years.

3.  THE EFFECT OF THE REDUCTION IN LARGE ANIMAL CLINICIANS ON HEALTH AND WELFARE STANDARDS AND ON SURVEILLANCE

  As the number of clinical veterinarians reduces then there will be much less on farm surveillance.

  This means that outbreaks of novel or unusual diseases is much less likely to be noticed or recorded at an early stage.

  The routine care for the animals will be done by stockmen under veterinary guidance.

  The guidance will probably be by quarterly or six monthly or annual visits and by herd health plans.

  Individual animals are much more likely to be treated ad hoc by the stockmen, rather than by veterinary surgeons. The quality of this treatment in some cases may be adequate but in most will be poor. The significance of symptoms or illness may not be appreciated. Diagnosis and treatment seen as a high cost and used as a last resort. Any outbreak of disease will be well developed and losses occurring before veterinary advice is sought.

  As herd sizes increase and labour decreases, then the attention to individual animals must reduce, with a drop in welfare standards.

  Ill animals are likely to be culled quicker, as limited manpower becomes more important. The use of vets as additional expert man power for calvings/ lambings will be seen as too expensive.

  The demands of the system must mean that high heath status is important, with routine vaccination and herd health policies being put in place.

  DEFRA seems to set high regard to laboratory diagnosis results as a form of surveillance. Most of the common problems are diagnosed/treated with out the resort to laboratory aids. Fertility, lameness, mastitis, pneumonia, PGE, are rarely referred to the lab except where treatment is not working. Most samples are taken/referred by vets in practice. Fewer vets would mean fewer samples.

  The lack of veterinary advice to ill pigs and ill sheep on farms at Heddon-on-the-Wall shows how the lack of a clinical veterinary service can lead to in the terms of delay and spread of disease.

  The local knowledge of the current LVI system is an invaluable asset that is in danger of being thrown away. The idea that a farm is a box which can be assigned a number in Page Street and dealt with as a single entity is a problem that has still not been resolved. The complexity of many of the local farming links through trade, working together, machinery, shared grazing, fell rights, and family ties cannot be reduced to a computor screen on DCS.

4.  THE FEASIBILITY OF THE ANIMAL HEALTH AND WELFARE STRATEGY

  In my opinion they are not. I was hoping to cover this more fully but lack of time has prevented me.

5.  THE IMPACT ON THE SVS

  The impact on the SVS is likely to be slow to be realised.

  The SVS is not known for its ability to meet challenges or streamline its systems.

  As the number of vets involved in farm work decreases it will have to provide more of its own resources to tackle tasks currently done by LVI's.

  The more flexible private practice takes up the challenge of getting backlogs in testing done and can respond to new challenges for example the licensing brought in during FMD. Private practice can fit the work around other duties. Whereas if it is going to be done by the SVS it will be more expensive to take on vets to do these tasks alone.

  The SVS was notoriously unreliable in its work allocation during FMD, the record being sending five vets to the same farm on the same day has yet to be beaten!

  Though I hope it would be a lot better in normal circumstances, there are still problems with the allocation system that can only be put right by local knowledge.

  In areas where there are few farm animals there may well not be LVI's willing to carry out the routine testing for Notifiable Disease. Who is going to provide veterinary cover for these? Both for clinical caseload and for the LVI work.

  There will not be vets available to second to DEFRA for the next FMD or exotic disease outbreak. The contingency plan confidently states that resources for 20 TVI's are to be kept at each centre in case of an outbreak of Notifiable Disease, with out addressing where these will come from. There will not be 20 TVI's available at short notice. During March 2001 the majority of vets at the Carlisle DECC were LVI's.

6.  THE FUTURE AND POSSIBLE OUTCOMES

  The picture I have painted is what in my opinion will happen if the government allows the situation to develop. I would hope that there would be some "joined up government" when decisions are to be made in response to the Competition Inquiry Report.

  There are a mixture of outcomes that are possible:

    —  The numbers of vets in farm animal practice will reduce. This can be minimised by maintaining the cross subsidy of professional fees for providing clinical services, either directly by DEFRA work in surveillance or other Notifiable Disease work and/or from pharmaceutical sales. (The option of increasing fees is not possible.)

    —  Veterinary services will be provided by other means. Eg Vets working for feed firms/ Dairies/ manufactures/retailers to ensure a welfare/surveillance standard; Consultancy firms providing fertility/mastitis/specialised advice.

    —  DEFRA/ Local Authority will have to provide vets for notifiable disease testing/surveillance tasks.

    —  Developing the French model of farm cooperatives employing vets for their own farms.

    —  The pig/poultry model of regular advisory visits, but minimal involvement in the day to day running or with individual animals.

  Only the first of these provides for the continuation of the successful LVI structure. The other outcomes mean a loss of clinical veterinary services.

The loss of clinical services means a drop in welfare standards and the loss of on farm surveillance.

  Farm veterinary services are in a transitional time facing economic challenges, changes in agriculture, increased regulation and increased competition for the pharmaceutical and services they provide. There will be increased competition between practices as they try to meet the higher expectations of new veterinary graduates starting their careers, and providing a cost effective service to the rural community.

28 April 2003



 
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