Government Response
Introduction
We welcome the Committee's inquiry into the need
to replace the Veterinary Surgeons Act 1966 (VSA). We broadly
agree with most of the Committee's recommendations and in particular,
with the need for the veterinary profession to work together to
establish a greater consensus on the way forward.
In his oral evidence to the Committee, Lord Rooker
explained that within the current spending round, Defra can not
spare the additional resource that would be needed to take forward
a wider review of the VSA and the preparation of a White Paper.
Unfortunately, this remains the case.
The Committee has recommended that Defra work with
the veterinary profession as part of a joint working party to
develop a draft Bill by the end of 2008. There is a fair degree
of agreement between Defra and the RCVS on the broad aims of their
proposals. The Committee's inquiry has clearly identified where
greater consensus within the veterinary profession is needed.
It would be helpful if the RCVS could facilitate further discussion
and develop its ideas. The BVA too, has an important role in ensuring
that any proposals for regulatory change are workable and proportionate
and that the impact on small business is fully understood and
costed.
The RCVS already have a VSA Working Party and the
onus lies with the College to decide how it wants that group's
remit and membership to evolve. Defra has limited resource available
to devote to the VSA and this is largely committed to maintaining
the current Act. However, we wish to remain engaged in the on-going
discussion with the veterinary profession. The extent to which
we can do so depends very much on the resource needed for other
VSA related work. For example, the implementation of the Services
Directive in the UK in respect of wider veterinary services.
There are areas where the veterinary profession could
develop its ideas with limited Defra involvement (i.e. the structure
of Council, the case for mandatory CPD and practice standards).
There are other areas, in particular, defining a risk based approach
to regulation and the regulation of other veterinary service providers,
where Defra's full involvement would be essential. These questions
may therefore need to be deferred until we are able to allocate
sufficient resource to take this work forward.
We therefore propose that once the RCVS and BVA have
had time to reflect on the outcome of the Committee's findings,
that their respective Presidents meet with the Chief Veterinary
Officer to discuss their plans and decide to what extent Defra
can help.
The Committee has also identified the need to press
ahead changes to the disciplinary arrangements, in advance of
broader regulatory reform. As indicated in our detailed comments,
we are not convinced that piecemeal reform of the VSA is the best
way forward. The issue here is more than simply removing the disciplinary
arrangements from the RCVS Council and placing them with another
body. The whole process needs to be reviewed and possibly linked
to a new Council responsibility of monitoring and assessing veterinary
surgeons fitness to practice.
Recommendation 1
We were disappointed that, given the amount of
time and the level of consultation which has already taken place
on the profession's governance, the RCVS had not yet sorted out
the detail involved in its reform proposals. We believe that a
profession of its size and importance should by now have had drafted
a new Bill as a way of firming up its proposals and to help to
persuade Defra of its need for action towards new legislation
in this area.
The Committee's inquiry has demonstrated that there
is much to be done before a Bill could be presented to Parliament.
The Committee's inquiry into the Veterinary Surgeons Act (VSA)
has been helpful in that it has taken the debate beyond first
principles and highlighted the potential impact of any new regulatory
burdens on small businesses.
When considering the Committee's recommendations,
it is important to recognise that Defra envisages that any successor
to the VSA would need to encompass providers of wider veterinary
services. Whilst the RCVS will be a key partner in helping to
design a framework for the regulation of veterinary service providers,
there is a very diverse group of stakeholders to be consulted
with a broad range of opinion on the best way forward. The RCVS
may therefore wish to prioritise those areas where it can develop
its ideas on behalf of the veterinary profession.
A new regulatory framework which includes veterinary
service providers would impact on the role of the RCVS. The relationship
between the RCVS and possible new regulatory bodies would need
to be established.
Recommendation 2
Whilst there is general support for the greater
inclusion of lay members on the Council of the RCVS, the Royal
College must develop a clear plan for the structure of its proposed
new Council under a new Act. The proportion of lay membership
should be no less than 40% and professional members of the Council
should be both appointed and elected. It is entirely appropriate
that members of the profession should meet the costs of their
own regulatory body through registration fees. The RCVS should
analyse the additional costs likely from the creation of its new
structures, in addition to the other changes it has proposed,
and how these will affect the average veterinary practice and
its customers.
In our written evidence, we said that lay membership
of Council should be significantly higher than it is now but that
there should remain a veterinary professional majority. We agree
that it would be helpful for RCVS to develop detailed proposals
for a reconstituted Council for veterinary surgeons, based on
these views and those of the Committee.
It is essential that any detailed proposals that
are produced by the RCVS include a robust assessment of the costs
and benefits. Defra may be able to provide some assistance on
how an Impact Assessment might be developed.
Recommendation 3
The resources for work on a White Paper for the
new primary legislation for the veterinary profession are unlikely
to be available before 2011. Whilst this is a disappointment,
the Royal College of Veterinary Surgeons should use this time
now available to elaborate and clarify its proposals in greater
detail, to consider further the case for those of its proposals
which do not have general support within the profession, and to
assess the potential cost of its proposals for regulating professional
standards to the profession and to the consumer. We find it surprising
that the RCVS Council was unaware of the decision taken by Defra
to halt work on the new primary legislation. Defra appears to
have raised the profession's expectations that a new Act would
be introduced in the near future. Defra should ensure that in
future its working relationship with the RCVS is improved.
Defra's decision not to progress with the proposed
White Paper was made at a very late stage, as the Lord Rooker
considered his oral evidence to the Committee. The RCVS were informed
immediately the decision was taken. We worked closely with the
RCVS as we considered the Committee's detailed questions that
it posed last year. We appreciate that the Department's subsequent
decision not to proceed with a White Paper will have come as a
disappointment and a surprise to the RCVS.
However, we believe that the Department continues
to enjoy a good working relationship with the RCVS. Lord Rooker
visited the RCVS on 6 May and discussed the VSA in some depth.
Defra will continue to engage with the RCVS on a wide range of
issues. Nigel Gibbens (Chief Veterinary Officer) will continue
the regular and on-going dialogue enjoyed by previous CVO's and
the RCVS Presidential team.
Recommendation 4
We agree wholeheartedly with the Department's
assessment of the drawbacks of the present disciplinary system.
It is not satisfactory for customers who have a genuine case for
complaint about the professional standards of a vet to only have
recourse to the civil law, without any appeal to a regulatory
body.
Defra agrees with this recommendation. However, when
considering how we might replace the current disciplinary system,
there are some fundamental questions to be addressed.
- What type of complaints should
be investigated?
- Who considers the complaints,
what proportion should be vets and how should they be appointed?
- What powers and sanctions might
be applied?
- What system of appeal should
be made available?
- How should the disciplinary
process link to any new Council function of monitoring a veterinary
surgeon's on-going fitness to practice?
- Should there be a veterinary
ombudsman with oversight of the system?
- How much will the new system
cost to administer and how will it be funded?
We recognise that the RCVS is uncomfortable with
widening the scope of the current disciplinary system as this
goes beyond the traditional scope of a regulator. But public expectations
have changed dramatically and this change must be taken into account
when developing a new complaints system.
There needs to be a period of reflection by the veterinary
profession on these questions. Defra will contribute to the debate,
however, as mentioned in our response to recommendation 6, we
are not convinced that piecemeal change to the VSA is necessarily
the best way forward. Not least, because we believe Council's
responsibilities for monitoring veterinary surgeons fitness to
practice would need to be clarified before designing a new disciplinary
procedure.
Recommendation 5
We agree that there ought to be a wider range
of sanctions available to the Royal College of Veterinary Surgeons
in order to give greater flexibility and proportionality to the
operation of the complaints procedure.
We agree with this recommendation. It would be helpful
if the RCVS and British Veterinary Association could jointly develop
an initial approach to extending the range of sanctions. However,
complaints are currently taken forward only when a veterinary
surgeons conduct is considered to be disgraceful in a professional
respect. As indicated in our response to the preceding recommendation,
agreement needs to be reached on extending the basis on which
complaints can be investigated. Once this is agreed, consideration
can then be given to widening the range of sanctions.
Recommendation 6
There is a pressing need for the disciplinary
process for veterinary surgeons to be updated. We agree that there
ought to be a separation between the RCVS Council, which sets
the rules for the profession, and the Disciplinary Committee,
which adjudicates complaints on the basis of those rules. This
should not wait until 2011. The RCVS should hold further discussions
with Defra on whether changes to the process could be achieved
through a more modest legislative proposal than would be required
for the wholesale reform of its procedures. For example, a Private
Member's Bill drafted with advice from Defra could be taken through
by a Member of Parliament sympathetic to the RCVS proposals. Meanwhile,
the RCVS should continue to improve its current procedures through
administrative reforms which can be achieved within the current
legislative framework.
Defra is willing to consider any detailed proposal
that might come forward from the veterinary profession and also
to explore legislative options for updating the disciplinary process.
However, availability of resource remains a constraining factor
for Defra and detailed work would need to come from the veterinary
profession.
There is general agreement on the separation of the
standard setting and adjudication responsibilities of Council.
However, any proposal to replace the current disciplinary arrangements
for veterinary surgeons is likely to be the subject of keen debate
with a key factor for some being whether the veterinary profession
should retain responsibility for adjudicating complaints against
its own members. Our view is that the profession should retain
this responsibility but that safeguards should be included to
ensure any new system has the confidence of the animal owning
public.
Whilst we recognise the importance that the Committee
place on this issue, our preference would be to develop a new
disciplinary process that is part of a new regulatory framework
for veterinary services. We may ultimately need to decide between
a less than perfect system built into the existing Act, or wait
until resource is available to replace the existing Act and develop
a more complete and robust disciplinary system.
Recommendation 7
The RCVS's case for a mandatory practice standards
scheme does not appear to be proven or to have the support of
the wider veterinary profession. The RCVS should for the present
focus its energies on promoting its voluntary scheme to the profession
to demonstrate the potential benefits to veterinary surgeons who
do maintain high standards of a mandatory system.
We agree with this recommendation. The main driver
behind the RCVS proposal for a mandatory practice standards scheme
has been to draw corporate practice within its sphere of influence.
We do not believe that a satisfactory case has been put forward
that demonstrates that the growth of corporate practice will lead
to a conflict of interest for veterinary surgeons. Even if this
risk exists, we would want to see other options developed that
are less burdensome on business.
Throughout the debate on the need for a mandatory
scheme, very little has been said about the standards actually
delivered by veterinary practices. In any service sector, there
is bound to be a wide range of quality of the services provided.
We need an honest debate about the standards of service delivered
to customers by veterinary practices, backed up with firm evidence.
This debate would need to decide whether we need to impose minimum
standards on small businesses or whether we can rely on a voluntary
system of practice standards and market forces?
Recommendation 8
We accept that continuing professional development
is good practice, but the RCVS still has a long way to go to convince
the profession of the need for mandatory continuing professional
development and revalidation. We support some form of mandatory
requirement in principle, but the College, together with other
bodies in the veterinary profession, should consider carefully
the potential impact of these proposals on smaller practices and
prepare an analysis of the likely costs for consideration as part
of the work towards a new Act.
We agree with this recommendation. This is an area
where the veterinary profession should concentrate its deliberations.
Most practices will recognise that they need to invest in the
professional skills and knowledge of their most important resource
- their staff. The key question appears to be to what extent a
regulator can pro-actively ensure that practicing veterinary surgeons
keep up a minimum level of CPD. How do we ensure that any system
of re-validation would be truly effective and not simply a paper
exercise?
Recommendation 9
There appears to be general agreement that the
veterinary nurse profession has evolved to a stage where it warrants
its own statutory framework of regulation. We recommend that the
Royal College of Veterinary Surgeons and the Veterinary Nurses
Council develop their proposals further to present a clear structure
for future consideration. However, there is no clear view across
the animal care professions on how other "para professionals"
ought to be regulated, but the balance of opinion, which we support,
is in favour of some form of regulation to protect animals and
their owners against the depredations of the wholly unqualified
practitioners of potentially harmful treatments. There is more
work to be done by Defra, the RCVS and the veterinary and animal
health professions on Defra's proposal for a risk-based approach
to a new veterinary services legislative framework.
We agree that RCVS and Nurses Council should develop
proposals for the regulation of veterinary nurses.
The regulation of para-professionals is a central
issue when considering replacement of the Veterinary Surgeons
Act. We would want to take into account the extent to which the
current restrictions on veterinary practice inhibits the development
of veterinary care services and ensure we put in place a risk
based but more flexible regulatory framework.
A fundamental requirement for the regulation of para-professionals
must be that they are suitably trained and that their competence
is assured.
However, the scale of regulation for para-professionals
has to be proportionate to risks involved and the size of the
sector concerned. The extent to which para-professionals should
work under veterinary direction or supervision or whether they
may work independently and perhaps in competition with veterinary
surgeons would also need to be clarified.
This is a complex area and the current pressure on
Defra resource means we do not envisage being able to progress
these issues in the current spending round period.
Recommendation 10
Defra's decision to walk away from work on a White
Paper has left the revision of the Veterinary Surgeons Act 1966
in a mess. Whilst Defra's budgetary pressures may not enable it
to complete all the functions that would currently be required
to introducing a new Veterinary Surgeons Act, its decision to
halt work completely on the new legislation is untenable. However,
the Royal College of Veterinary Surgeons has not done enough itself
to provide a clear picture of its proposals for a new statutory
framework for the regulation of the profession. The Royal College
must provide greater detail to the profession, and other interested
parties, about its proposals for a new Council and disciplinary
structure. In order to take its proposals further, the Royal College
must also analyse the cost of its proposals to the profession
and to the consumer. The main purpose of any new legislation must
be to protect the consumer, but the veterinary profession must
not be overloaded with unnecessary regulation.
Defra regrets the delay that will be caused by its
decision not to devote additional resource to enable a review
of the Veterinary Surgeons Act to take place. However, the Department
is faced with many pressing issues, our resources are finite and
increasingly, we have to make difficult decisions about our priorities.
We believe the decision we have taken regarding the Veterinary
Surgeons Act, though regrettable, is correct.
Recommendation 11
It is unlikely that a complete overhaul of the
regulatory structure will occur before 2011 unless the veterinary
profession irons out its differences and decides what it wants.
We believe that a working party comprising Defra, the Royal College
of Veterinary Surgeons and the British Veterinary Association
should share the costs of developing a new Bill by the end of
2008 with a view to its being introduced to the House in mid 2009.
The profession must take the matter into its own hands and as
a priority coalesce round some specific proposals to amend the
disciplinary process for veterinary surgeons. This is generally
agreed to be the area of the existing legislation most in need
of updating.
The development of a new Bill represents a significant
project, and Defra cannot commit to a major review of these issues
during the current spending round. If the RCVS and BVA wish to
develop proposals jointly, the Department will do its best to
provide advice and guidance where it can. However, we see little
prospect of a draft Bill being prepared within the timescale envisaged
by the Committee. It is debatable whether the development of a
draft Bill, without the full involvement of Defra, is the best
way of defining the professions proposals for reform.
Department for Environment, Food and Rural Affairs
July 2008
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