CMA: response to Issues Statement published

We have now published our formal response to the Issues Statement published by the Competition and Markets Authority (CMA) on 9 July 2024 regarding its market investigation into veterinary services for household pets.

Our summary statement is set out below, and our full response with specific comments is available to download (PDF document).

CMA call for vet/VN advisers

Update (07/0824)
The CMA has extended its application deadline to 5pm on Friday, 9 Aug 2024 and will now also accept proposals by email to: [email protected]

The CMA has also asked us to inform the professions that it is looking to appoint between two and six vets and vet nurses for an advisory panel, to provide advice to the CMA Inquiry Group during its market investigation into veterinary services.

The CMA states:

"The role of the vet/VN advisers would be to provide the Group with insight and analysis on an ad hoc basis on matters relating to practising as a veterinary surgeon or a veterinary nurse.

"Engaging specialist input on veterinary matters would assist the Group in fully understanding the veterinary industry and help bolster the robustness of any analysis undertaken. Having the panel on standby would enable the Group to obtain this input in a timely manner.

"We are seeking experienced registered veterinary surgeons and veterinary nurses who are currently working in clinical practice in the veterinary sector or have worked in clinical practice within the last 12 months."

The full invitation to tender is available online and the deadline for applications is 5pm on Friday, 9 August 2024.

Summary Statement

As highlighted in our previous responses to the CMA, we are supportive of this Market Investigation and appreciate the opportunities for improved consumer protection that it could bring, while being mindful of the risk of unintended negative impact on animal health and welfare, and public health.

At the outset, it is worth remembering that standards of animal health and welfare and veterinary care in the UK are globally recognised as being very high. This is testament to the hard work of veterinary practitioners, educators, policy makers and researchers, and the part that we play in creating a strong framework for success.

The UK public are very passionate about the health of the animals for which they care, and the size and emotional heft of the ‘postbag’ that the CMA has received is testament to that. The 'public interest' in this case is therefore not just about the impact on pet owners’ pockets, but also upholding these high standards for the UK nations.

We believe that the key change required to bring about improvements to consumer protection, standards within veterinary practice, and support for veterinary professionals working within clinical practice, would be for us to implement a scheme of mandatory practice regulation. To achieve this, new legislation is required.

We have been pushing for such legislation for many years, as the Veterinary Surgeons Act 1966 (VSA) is out of date – a point well understood in the Issues Statement.

In addition to mandatory practice regulation, our proposals for new veterinary legislation would give us the opportunity to make other important changes, which would bring benefits to animal health and welfare, in the public interest.

Many of these would also be in consumers’ interest, although this does not always intersect with animal health and welfare, or the wider public interest (for example, in relation to One Health issues – see comment ref paragraph 90 in part two).

Amongst other things, our proposals for new veterinary legislation include:

a. Regulation of the ‘vet-led team’. This would mean the inclusion under our regulatory umbrella of appropriately-trained professionals, such as physiotherapists, working under the direction of a veterinary surgeon. This will protect animal health and welfare, provide greater assurance for animal owners and keepers about the standards to which groups of people supporting the health of their animals would be held, and provide a single point of contact if things go wrong.

b. The transformation of our complaints and disciplinary system, in line with best regulatory practice, to give a more modern fitness to practise model. This will better support the public interest as well as being proportionate for veterinary professionals.

c. Strengthening and developing the role of veterinary nurses, which will bring benefits to animal owners through a greater range of services being offered in both primary care and referral settings.

For more information, read our full set of proposals

However, we recognise that new legislation of the size and scope needed to effect such change may take some time to achieve. Our approach has always been proactive and, alongside lobbying for this important legislation, we do as much as we can within our existing powers, without overstepping.

Examples of this include:

a. The introduction of the voluntary Practice Standards Scheme. This sets, maintains and promotes high standards of veterinary care in the UK’s clinical practices, for the benefit of the consumer, as well as animal health and welfare.

b. The establishment of the Register of Veterinary Nurses under our Royal Charter. This ensures high standards are met amongst veterinary nurses, and the public have an avenue via which to raise concerns, should that be necessary.

c. The setting up of the independent Veterinary Client Mediation Service (VCMS). This is fully funded by the RCVS, to offer clients and veterinary professionals an alternative dispute resolution service that is free at the point of use.

d. Making completion of the Veterinary Graduate Development Programme (VetGDP), a professional responsibility. This ensures that the meeting of high standards is well supported from day one, and practitioners have the skills and knowledge they need to meet the needs of the public.

e. Including mandatory continuing professional development as part of the Code of Professional Conduct for veterinary surgeons and veterinary nurses. This ensures veterinary professionals keep their skills and knowledge up to date.

f. The introduction of the Charter Case Committee. This deals with complaints that exceed our threshold for serious professional misconduct, but at the lower end. As a result, these complaints could be dealt with more quickly and compassionately, without a full disciplinary hearing.

g. The introduction of our Health and Performance Protocols. These aim to protect animals and the interests of the public by supporting veterinary professionals whose fitness to practise may be impaired because of adverse health, or ongoing concerns about their professional performance.

There is always more we can do, and current activities are underway to improve the information available to animal owners, to clarify guidance to veterinary professionals, and to better understand areas of tension between the two.

We are also working on initiatives to improve recruitment, retention and return in the veterinary workforce, via our Workforce Action Plan. For example:

a. Establishing the Veterinary Clinical Career Pathway project, which is looking to better define clinical roles in practice; support and celebrate excellence in general practice; and develop more flexible routes to specialism.

b. Lobbying the government to change the visa-linked salary requirements, so that overseas-graduating vets can play a part in important food safety and public health work, and also within the clinical practice team.

c. Supporting the Veterinary Schools Council in persuading the government to increase funding for UK veterinary schools, so they do not have to take on so many overseas students in order to financially support insufficiently funded UK student places. This would have a positive impact on the veterinary workforce, as UK graduates are more likely to stay in the UK.

d. Building relationships with overseas veterinary schools, with a view to directly accrediting their degree programmes.

e. Modernising our Statutory Membership Examination, for those veterinary surgeons who do not have a degree recognised by us, to improve accessibility and increase the numbers eligible to join our Register.

f. Supporting those returning to their professions via the RCVS Academy.

g. Considering reasonable adjustments and focused licensure, to widen the pool of those applying to veterinary school.

These initiatives will take time to show results.

The veterinary services market is complex and although ensuring consumers get a good financial deal, with relevant choice and transparency, is of course important, it is vital that this is not achieved at the expense of animal health and welfare.

Although they may promise short-term benefit, there may be unintended consequences of the implementation of measures that work in simpler markets, which could impact negatively on animal health and welfare in the longer term.

There could also be an impact on other types of clinical practice, such as equine, production animal and exotics, and consequences for One Health and public health.

In summary, we are supportive of the CMA’s investigation and feel it highlights the clear need for new veterinary legislation and greater scope for us to regulate veterinary service delivery in all its forms. We have pushed as far and as creatively as we can within the boundaries of current legislation.

Mindful of some of the matters the Issues Statement raises, we have for some time had a focus on outcomes-focused education, innovation and workforce, although this work will take time to yield results.

We remain keen to better understand what additional consumer and competition remedies the CMA may wish to see put in place, and will support the delivery of these, where feasible and appropriate.

Ultimately, we are mindful of the paramount importance of animal health and welfare, and the sustainability of access to veterinary care.

We would urge the CMA to consider these important factors when coming to their conclusions.