Memorandum submitted by Tony Rose and
Mark Slingsby (Vet 32)
1. The above Act is considered by many who
work with horses as being out of step with the current veterinary
workplace. Many related professions have emerged within the last
fifteen years, one such profession is Equine Dentistry as practiced
by Non-Veterinary Surgeons. The above Act gives little or no direction
as to the content of such practice or the qualification required
to practice
2. Therefore there is a requirement in a
new Act for clarification of the above situation. There are at
this time approximately 100 non-veterinarian equine dental personnel
(Equine dental technicians) who have sat and passed examinations
in equine dentistry. These exams have been set by three dental
associations including the joint British Equine Veterinary Association
(BEVA) and British Association of Equine Dental Technicians (BAEDT).
The exams are voluntary and have yet to be ratified by DEFRA.
There are many more non examined personnel offering equine dental
services. These non examined individuals are not compelled to
undertake apprenticeships or examinations as already stated and
may have no training.
3. This situation has built up over the
last 15 years and exists because the horse owning public has sought
a full time specialised provider of equine dental services. The
nearest human parallel example would be the town dentist rather
than the town doctor who also occasionally does dentistry if such
a situation existed. It is estimated that today 70% of routine
equine dental work is provided by examined Edts and also non examined
individuals. Edts have to carry out the majority of their dentistry
without sedation. Veterinary Surgeons have sought to improve their
dentistry skills but are compromised by multi tasking and are
therefore are only ever part time providers of equine dentistry.
Veterinary surgeons are often unable to carry out any dentistry
without sedation. The horse owning public is well aware of this
situation regarding the lack of skill base in the general equine
veterinary profession.
4. Equine dentistry may be defined as the
practice of routine dental maintence, remedial corrections and
non surgical intra oral extractions. The majority of routine work
is carried out using hand instruments on unsedated horses, however,
some horses require intravenous sedation and this is presently
administered by a veterinary surgeon. Remedial work often requires
the use of power equipment and intravenous sedation is therefore
required and is again administered by a veterinary surgeon. Similarly
non surgical extractions usually require intravenous sedation
again administered by a Veterinary surgeon. Many veterinarians
request the assistance of Edts in complex dental cases. Under
the present situation the horse owner has to pay for the veterinary
surgeon's time, drugs, professional advice and travel in addition
to the fee of the Edt.
5. In short Equine dental technicians provide
dental care for horses and this is an aspect of veterinary care
that should be regulated. The regulation of Edts whilst it may
involve veterinary surgeons should not be left to the Equine veterinary
profession alone as both compete for the same work. Regulation
should mirror that of the Farriers Council and should include
horse owning lay persons. Such a Council should work in conjunction
with the RVCS to provide examinations, best practice direction
and continuing education requirements for Edts. At present the
decision making process with regard to the practice of veterinary
care on equines is heavily loaded toward the veterinary surgeons
interests with little input from the horse owning public. The
inclusion of lay people on a Equine dental regulation committee
would go some way to rebalance this anomaly.
6. It is important that in these modern
times that the veterinary profession falls in line with the medical
profession and has lay people in positions capable of influence
on policy making committees. This should occur to ensure the public
have influence in a multi billion pound industry which at present
is regulated internally.
7. With regard to the power of delegation
of specified procedures by the RVCS. It is hoped that with regard
to equine dentistry that a Equine Dental Regulatory Board is established
as proposed above. The RVCS should recognise equine dental qualifications.
It should have a position on such a board and be involved with
the clarification of procedures relating to equine dentistry.
8. In addition to its role on a Equine Dental
Regulatory Board, the RVCS should also be directed to provide
a course, examination and regulation of non-veterinarians including
Edts and Farriers to administer intravenous sedation to equines.
The present monopoly of sedation by the veterinary profession
provides an unnecessary and heavy financial burden to the horse
owner.
It should be noted that the cost of veterinary
supply of sedation often adds £85 to £120 to an owner's
bill in addition to the Edts or farriers fee.
The cost price of the drugs used in such circumstances
often amounts to no more than £15 to £20 per horse.
The provision of such a course would considerably
reduce the cost of treatment and the need for return visits for
the purpose of intravenous sedation for treatment. It would improve
the level of dental care as sedation is required in probably 20%
of cases. It is not uncommon that owners decline additional work
requiring sedation because of the additional cost of veterinary
supply of sedation. In appropriate cases it would reduce the risks
associated with unsedated dentistry and farriery work. It would
lead to fewer repetitive strain injuries and allow longer working
lives for both Edts and Farriers.
There can be no doubt that such a situation
would not occur within the NHS. Primary health care trusts would
not wish to pay a Doctor and a nurse if the nurse could go on
an appropriate course thus considerably reducing the cost to the
public purse. Similarly Paramedics today have appropriate courses
to meet the demands of their work.
9. The requirements for such a course could
be as follows. The participant should have passed his or hers
professional exam ie dental or farrier, should have been in practise
for six years and have four letters of good character. The course
should be of a practical length with appropriate examinations
and costs. Intravenous sedation supplied by Edts should only be
allowed in respect of fractious horses and for power instrument
work. Both farriers and Edts should liaise with a veterinary surgeon
and should only sedate in respect of their work.
10. At this point it should be remembered
that a veterinary surgeon does not spend five years in university
just to sedate a horse.
SUMMARY
1. Equine Dentistry as practised by non
veterinarians is presently without regulation. Equine Dentistry
should be regulated as per the Farriery Profession.
2. Equine dental technicians are demanded
by the horse owning public and often assist the veterinary profession.
3. An Equine Dental Regulatory Board with
members including the RVCS and lay persons should be established
together with a clearly defined professional role for the EDT.
4. Sedation for the purpose of dentistry
and farriery work is supplied by the Veterinary profession.
5. The RVCS should run a course to train
Edts and farriers to intravenously sedate horses for the purpose
of dental and farriery work on fractious horses or in the case
of dentistry, power tool work.
6. Such a course would considerably reduce
cost to the horse owning public and with the appropriate training
would not increase risk to the horse.
7. Such a course would reduce repetitive
strain injuries and increase safety.
September 2007
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