Much to discuss by expanded council - Veterinary Practice
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InFocus

Much to discuss by expanded council

RICHARD STEPHENSON
an elected member of the RCVS
council, provides his recollections
of the deliberations at the latest
council meeting – and the mass of
documents to be considered

THE November meeting of council is very much the start of a new term. Freshly elected members take their seats for the first time (well OK there weren’t any of them – Professor Sandy Trees had sent an apology) and new appointees from the universities make their first appearance. Of note was the introduction of two new places on the council for Nottingham University, swelling the ranks of the solemnly black-gowned councillors to 42 (although four were absent). The November meeting is also the first occasion on which the new president chairs a meeting and it is always interesting to see if he or she is able to give the debate some direction or if things will get a bit ragged as usual. The build-up to each council meeting is always hectic with papers arriving, reports to be considered, weighty consultation documents to peruse, and streams of e-mails clogging up the “inbox” – but the run-up to this meeting was like none that I have encountered before. On the Saturday prior we received confidential copies of the McKelvey report into the “overspends”; we had already had a copy of the equally confidential “past presidents plus two” report into the committee structure of the RCVS to be read in conjunction with McKelvey. In addition there was the “performance protocol” and the new draft Guide to Professional Conduct, both extremely important matters in their own right. If that was not enough there was also the VNC decision for the RCVS to stop being an awarding body. All this was in addition to the normal workload of the council. The big bombshell, however, was delivered on the Friday before the meeting when the College received the resignation of the registrar, who is leaving us at the end of the year to pursue other interests after 15 years at Belgravia House. It had already been decided to start the meeting at 9am rather than the more convenient 10am and so it was some slightly bleary-eyed councillors who crowded into the chamber (as usual heated to tropical levels) and awaited the arrival of the new president and officers. With a huge agenda I settled in for the long haul and was pleasantly surprised by the uncustomary efficiency with which the council conducted its public business. As usual things got off to a sombre start as a minute’s silence was observed to commemorate those members of the college who had departed this life since the last meeting. Glasgow graduates like me were particularly sad to read the obituary circulated for Professor Bill Jarrett whose work dominated that institution for so many years. Then it was down to business. The president paid tribute to the retiring registrar (who was not present due to a prior appointment); he pointed out that she had overseen many changes at the College and taken the institution forward. The assistant registrar was standing (or sitting) in for her and would answer any legal questions as required.

The budget

It was announced that the RCVS was heading towards a small £26,000 surplus on the year’s operations out of a total budget of almost £8 million. Once again, despite a freeze in retention fees, income was above budget due to increasing numbers of members. There were a number of questions from Mr Partridge regarding the VN department budget and its relationship to the awarding body. The situation seems to me to be very complex, made more so by the imminent separation of the awarding body from the RCVS. Mark Elliott asked why staffing levels at the College were increasing (doubled since his first term): was it necessary? Peter Jinman (senior vicepresident) replied that the demands on the staff were increasing all the time. Government required responses to consultations and legal processes that were simple 10 years ago had become much more complex.

Student fees and social responsibility

The council had overwhelmingly adopted a resolution tabled by myself to establish a working party into the effects of raised tuition fees on recruitment to the profession and the effects this might have on social diversity within it. The officers were tasked to investigate this. A lengthy and detailed report had been prepared by the head of education but overall the officers had concluded that at present the matter was best left with the EPSC who would review the situation annually. The final report produced is in fact a very detailed document teeming with useful information and I was pleased to be able to welcome it. I was assured by the chairman, Professor Stuart Reid, that he would make sure that the situation was reviewed annually and the president confirmed that this would be a standing item on the agenda. I recommend that anyone interested in the subject looks the paper up on the College website – there is an enormous gap between what the press has reported and the reality of the situation.

Complaints resolution working party

The suggestion here is that the College should develop a mediation service to assist in the resolution of complaints between members of the public and the profession where those complaints are not deemed to be sufficiently serious to warrant disciplinary action. The College already uses its PIC investigators to visit and discuss problems with both complainants and respondent vets and frequently these visits result in a resolution of the complaint: even when they don’t the complainants are usually satisfied that they have been listened to. The working party recommended that wider consultation was desirable and that a pilot study was necessary before proceeding further. This was approved without debate.

Disciplinary committee

The council approved changes to the membership of the disciplinary committee
after the resignation for personal reasons (illness of husband) of the chairman, Caroline Freedman. Professor Peter Lees was elected without debate and I’m sure will bring a steady pair of hands and years of experience in veterinary education to the job.

Governance review group

This group expressed concern about the fact that there is no limit on the number of occasions a member of council may stand for re-election – with a few members sitting for extended periods of time (sometimes over a decade). There is no limit in the VSA but the group suggested that the council could adopt a “convention” limiting the numbers of terms. This had been discussed at the planning and resources committee meeting but was rejected. I must admit to having changed my mind on the subject. Initially I felt that a convention should be adopted in the code of practice to limit the terms of office of members but having talked this through with colleagues I am convinced that it is a democratic process and we shouldn’t restrict the choice of the voters. If they don’t want a candidate after “x” many times, they don’t need to vote for him or her! The Group had also suggested that the council should form a small management board of no greater than 12 to discharge most of its function. This was liable to be more effective than the whole council meeting three times per year – a sentiment with which it is difficult to disagree.

Future of RCVS awarding body (veterinary nursing)

It has been decided that the RCVS should cease to be the awarding body for the VN qualification. This will eliminate any potential conflict of interest between the RCVS being both regulator (setting the standards and monitoring them) and also being the awarding body (i.e. the body being regulated).

The advisory committee

The new chairman, Clare Tapsfield- Wright, introduced the report. She declared that there were no “shrinking violets” on her committee, that debate had been “robust” and she was modelling her chairing style on Anne Robinson! There were still ongoing concerns about lay TB testing but lines of communication had opened up with DEFRA. Dr Bertie Ellis said that there should be a level playing field and if this was no longer to be considered an act of veterinary surgery, then the certification of tests shouldn’t be considered to be veterinary certification. A new protocol was submitted for consultation. This “clinical performance protocol” is the follow-on to the earlier “health protocol” and develops an alternative means to the disciplinary committee for dealing with cases where members are being shown to fall far below what are considered to be reasonable standards of clinical competence. The College receives numbers of complaints every year frequently concerning the same individual veterinary surgeons. Often, taken as an individual case the complaint, although fairly bad, does not cross the higher threshold of being serious professional misconduct. The question for the PIC is often: when do multiple similar cases become cumulatively serious professional misconduct? In some cases it is clearly identifiable that a small number of individuals are accidents waiting to happen and currently the RCVS often waits until a serious infringement of animal welfare occurs before being able to take action (often despite the individual concerned receiving frequent “advice” from the PIC). The protocol would enable the PIC to ask members to give undertakings to the College to rectify clinical deficiencies such as by doing extra CPD, appointing a mentor or refraining from certain types of practice. Failure to give undertakings could either result in the case(s) being referred to the DC or such refusal being put on file potentially to be used in evidence if a problem should subsequently be reported to the RCVS. In my view the protocol is a good thing. It would enable the RCVS to exercise a more pastoral approach to members with genuine clinical competence problems and should result in the more efficient management of problem veterinary surgeons. It will now go to the wider public for consultation.

New Guide still under development

This is a much shorter document than the current Guide to Professional Conduct and none the worse for that. I was disappointed that we have backed away from expecting UK vets to be able to communicate in English (except possibly in Wales) with a watered down statement about adequate communication skills.

Education and specialisation committee

Main item here was the specialisation working party report, the most important recommendation being a second tier of practitioner between the GP and the specialist, possibly known as an “advanced practitioner”. The committee had also decided to continue to insist on an English language requirement for all entrants to the statutory examination. Bertie Ellis delivered a lengthy and humorous oration on why he felt that exemptions to the English language test should be allowed – his daughter qualified in Grenada and has subsequently had to take the English language test along with other similar English-speaking UK citizens. Council was unmoved but I look forward to Bertie’s next contribution on the subject.

Planning and resources committee

The council has had some difficulty with approving the minutes of this committee on the last two occasions due to the ongoing controversy surrounding the overspends – with some members taking the highly unusual step of voting against their adoption. The debate this time was perhaps less heated but was not helped by some references in the minutes to a question that had been asked at the AGM concerning the pay levels of senior staff at the College.

Preliminary investigation committee

It was reported that the Health Protocol was already being effective with four veterinary surgeons currently being helped via the scheme; one had now been released from the protocol having made satisfactory progress and two members were being assessed currently. It is not a soft option but a constructive one. Two further cases had been referred to the DC and there are now eight awaiting a hearing. There had been 22 announced visits and six unannounced visits between June and October. The College continues to assist police and trading standards in enforcing breaches of the VSA. Currently four individuals are being or have been investigated and two cases of lay people posing as
veterinary nurses have been reported. The senior investigator had been to Hungary and Slovakia to check the integrity of two names on the register. The case reported was somewhat humorous: it concerned an aggrieved client who objected vociferously to paying for a “free” T4 test on her cat. No amount of explanation has satisfied her and she still feels outraged that the vet charged for a “free” test. Well you simply can’t win them all! I do recall a similar complaint in my practice concerning an invoice worded, “humanely destroy horse with a free bullet”, necessitating a change to a more tactful invoice text. Once again the committee highlighted the dangers of Baytril overdoses in cats which result in permanent blindness. I have been surprised how often this crops up in complaints to the College and it’s certainly one to watch out for in
practice. After a brief report on the work of the disciplinary committee, council had concluded its business by 11.20am (record time) and then went into private session from which we were not finally to emerge until 4.30pm!

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