Memorandum submitted by Richard Stephenson
(Vet 05)
I note the call for submissions to the House
of Commons Environment Food and Rural Affairs Committee in the
Veterinary Record Vol 161 No 2 page 39.
I have been a member of the College for 20 years
and I am an active practitioner in full-time equine work. I am
a partner in a 16-man practice with both small animal (pet) and
equine services. I append a brief professional CV.[1]
By and large I believe that the RCVS has an almost impossible
task and does its best to try to and discharge it. The current
VSA has served both public and profession well for four decades
however it now requires some degree of reform to bring the regulation
of the profession into the 21st century. It should not be forgotten
that the current system provides a powerful regulator at virtually
no cost to the general public or the government.
Given that it is unlikely that any public funding
will be forthcoming to assist in regulation it must be kept in
mind that the costs of any new structure will ultimately have
to be carried by the consumer in the form of increased veterinary
fees—this is likely to be very unpopular.
I should like to confine this submission to
the regulatory activities of the college and in particular the
Disciplinary Committee (DC) and the Preliminary Investigation
Committee (PIC). Following several recent controversial cases
I have taken an interest in this aspect of the work of the College—although
these comments are made as an "outsider" to the system.
I will make some brief observations as to the role of the RCVS
in general.
PARTICULAR VETERINARY
PROBLEMS
It seems to me that regulation of the veterinary
profession is becoming more problematic as we become more diverse.
In some respects there is more difference between branches of
our profession than there would be between dentists and doctors.
Yet the same people try to regulate all parts of the profession.
This causes a problem with the PIC. This committee is composed
of three officers of the College and three other members of council.
There are two lay observers (who currently have no statutory standing).
Six people can not hope to cover the whole range of the profession
and as a result very expensive errors have occurred. The case
of Margarida Correia v RCVS illustrates this very clearly.
A misconduct charge being brought against Miss Correia whose failure
to diagnose a non displaced tibial fracture in a horse was said
to be so disgraceful as to warrant sanction. To a small animal
practitioner missing a tibial fracture would seem a fairly elementary
error. In equine practice the diagnosis can be very challenging
or in the case of a none displaced fracture virtually impossible.
After a four-day hearing and a year of extreme stress for Miss
Correia the case was dismissed. It was obvious to anyone with
appropriate knowledge that the charges could in no circumstances
amount to "disgraceful misconduct". I would suggest
that the PIC should be expanded to include respected specialists
who could be called upon to assist in managing such cases. It
is right that democratically elected members of council should
be represented on the PIC and hold the deciding share of the votes
but the net should be cast wider to ensure that each branch of
the profession is represented by an expert. This must certainly
be the case if issues of competence are to be determined.
THE DC
The current committee is composed of members
of Council. This is unacceptable. The committee acts in a judicial
capacity and as such should be selected from suitable persons
to perform such duties. The present system seems to be good at
delivering the correct verdict—it is in the exercise of
its sanctions that things have gone wrong in the past. Most recently
in the Susie Mcleod v RCVS appeal to the Privy Council.
LACK OF
TRAINING AND
EXPERIENCE
The problem here is that if DC members are to
be properly trained and to sit regularly enough to gain experience
the amount of time that needs to be committed (already said to
be 52 days per year) is likely to be off putting to most rank
and file members of the College (or indeed independent lay people).
Would it not be better to restrict the committee to findings of
fact (ie to perform the function of a jury) and leave sentencing
to a properly qualified legal assessor or for there to
be a proper indicative sanctions guide enforced by the legal assessor.
The legal assessor should "chair" all hearings of the
DC. This should produce a greater consistency of disposal. The
practice of members of the committee cross examining witnesses
should also be actively discouraged and used in only the most
exceptional of circumstances under the direct control of the legal
assessor. In the civil courts Judges seem very reluctant to question
witnesses directly. In a recent RCVS DC case the respondent was
cross examined by Counsel for the college, his own counsel and
all seven committee members—this is clearly unfair. If the
DC is to be seen as independent then no member of council should
be present. This leads to the question of how then should members
of the DC be selected. Direct election? Appointment by a committee
of Council? The committee should have a majority of veterinary
surgeons (or it will not command the respect of the profession)
but should also have lay representation. The current practice
of having seven members present (rather than the five required
by law) is intimidating to witnesses and respondents alike. The
committee should be composed of no more than four plus the legal
assessor. A unanimous verdict should be required (so no need for
an uneven number as at present) in all decisions. At least two
members of the committee actually sitting should be from a similar
branch of the profession as the respondent.
APPEALS
This is another difficult area. Currently the
only mechanism for an Appeal against the RCVS is via the Privy
Council. If appealing is too easy every member subject to any
form of discipline will appeal clogging the system up or resulting
in it being totally ineffective. Never the less the right to an
appeal is a central tenet of Justice effectively denied by the
vast expense of even a one day hearing before the Privy Council
(currently around £32,000 for each side). Members of the
RCVS currently receive no financial help from the Veterinary Defence
Society for Appeals and therefore the current DC is largely unaccountable
to anyone (except the richest of members). I have no idea if an
appeal to a lower court would be any cheaper—but should
perhaps be investigated.
FINES
The lack of a full range of disposal hampers
the work of the DC. Penalties seem to swing from the draconian
to the ludicrously lenient. The FRC (Farriers Registration Council)
Registrar in his submission to the RCVS "consultation"
on a new VSA suggested that the committee should have the power
to raise fines (presumably backed up with the sanction of removal
in default). I feel this would enable the DC to deal realistically
with many minor offences which currently seem to go largely unchecked.
I am disappointed that the RCVS did not adopt this excellent suggestion
from the FRC.
CONDUCT AND
COMPETENCE
The RCVS proposals for a new VSA suggest the
creation of a conduct and "competence" board which will
be lay dominated. In my view the competence of members with regard
to specific cases should be tested in the civil courts
as for any other profession. Where a pattern of negligent actions
emerges then the RCVS should have power to intervene but only
once the civil courts have dealt with the matter.
UNFIT BY
VIRTUE OF
A MEDICAL
CONDITION OR
ADDICTION
There seems to be many sad cases of veterinary
surgeons who abuse alcohol or are otherwise medically unfit to
practice. The college should be empowered to suspend such members
or impose conditions on their continued practice and not have
to wait until a serious complaint is made. This would require
expert medical evidence to be presented.
ROLE OF
RCVS AND ELECTION
OF COUNCIL
The RCVS should remain as the standard setter
and central body of the profession with membership being compulsory.
The Council should be reduced in size by limiting the university
representation to one member per university. Agriculture now plays
a small part in the activities of the profession and I would suggest
that the Chief Veterinary Officer should be invited to attend
Council meetings but not to be a voting member. The Privy Council
should continue to appoint a further three lay people.
The elected members should be elected on a regional
basis to try and make the college less remote from its membership.
SUMMARY
— The PIC to be much larger with
sub committees of experts in each veterinary discipline. Oversight
by a committee with lay representation but accountable to RCVS
council via elected members.
— The DC NOT to be composed of
RCVS council members. An RCVS appointments committee to select
members of the DC based on ability to include lay representation.
— Committee to sit in smaller
numbers to facilitate rapid decision making, chaired by a legal
assessor.
— Committee to determine verdict
but to be led by legal assessor in determination of the sentence.
— At least two members of the
committee to be from a related veterinary discipline to the respondent.
— Increased power and range of
disposal—including if necessary substantial fines.
— Power on receipt of expert medical
evidence to suspend on medical grounds.
— A published indicative sanctions
guide.
— Power to award costs to members
wrongly accused of misconduct.
— Review of Appeals procedure
to ensure adequate accountability of the DC.
— RCVS to retain its role as the
standard setter for the profession.
— Reduce the size of council by
getting rid of the duplication in university representation.
August 2007
1 Not printed. Back
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