A little over a year ago, the Competition and Market Authority (CMA) launched a market review into the supply of veterinary services for household pets in the UK, which, after consultation, progressed into a full market investigation on 23 May 2024. This came as no significant surprise to the professionals within the veterinary industry, given the increasing noise surrounding the costs of veterinary care.
The current economic climate leaves little wriggle room for unexpected vet bills, and given the recent budget, costs aren’t likely to go down. There has been much to-ing and fro-ing about corporatism being responsible for increasing fees, but is it really as simple as that?
There has been much to-ing and fro-ing about corporatism being responsible for increasing fees, but is it really as simple as that?
Before I go on, I must contextualise my viewpoint and add that this is a very personal view based only on my experiences. I am a first opinion equine clinician working in practice. Until very recently I worked in independent practices, but six weeks ago, somewhat apprehensively, I moved to a large, corporate-owned equine hospital. I was anticipating copious policies and rigid restrictions on what could and couldn’t be used in my day-to-day work. I braced myself for the much-talked-about hike in service and product fees.
Not an age-old narrative
The reality has been far from this. Overall, fees for services are comparable, while the charges for most medicines are significantly less. Naturally, the buying power corporatism affords provides the opportunity for lower-cost sales; however, the narrative shared widely is that corporate giants, and by default those veterinary professionals choosing to work for them, are all so focused on making profits that such cost benefits are not passed on to the client. In fact, my experience is that the drive for evidence-based veterinary practice over the popularist theory of cost-based approaches is increasingly apparent regardless of practice owner. Clearly, the big, bad corporate giant versus the underdog independent is not as simple a narrative as is often told.
I don’t know any veterinary surgeon or nurse who chose their career to make their fortune. Most are truly vocational professionals, feeling drawn to the profession to make a difference. However small that difference may feel, whether at individual, collective or even global levels, every contribution matters. Nevertheless, the drive to join the profession does not preclude the right to earn a good salary, nor for business owners to make a profit. There seems to be an increasing sense of criticism, even condemnation, of veterinary fees; somehow the concept of successful veterinary business has been inappropriately reframed as “profiting from animal suffering”.
There seems to be an increasing sense of criticism, even condemnation, of veterinary fees; somehow the concept of successful veterinary business has been inappropriately reframed as ‘profiting from animal suffering’
In 2019, the RCVS conducted a national survey enquiring about veterinary service provision and trust in the profession. The report states that 94 percent of the general public trusted or generally trusted (43 percent and 60 percent, respectively) veterinary surgeons(RCVS, 2019). In the same survey, 70 percent of animal owners described veterinary costs as fair, with 32 percent describing good/excellent value for money. Most interestingly, there was no alteration in satisfaction, trust and the perceived value of money between 2015 and 2019 (RCVS, 2019).
I wonder how the figures would look today. My personal experience of discussing costs (client charges, drug/equipment costs and salaries) with owners reflects the disconnect between public perception and our reality, with owners regularly assuming vets make a six-figure salary, and that there are vast profit margins on the sale of drugs. Sadly, the truth is far from this. In 2024, the median annual salary package for full-time vets was £57,050 (SPVS, 2024). As for the perceived profit from medicine sales, many veterinary medicines are sold online for less money than their wholesale purchase price, resulting in an increasing supply of prescriptions, or minimal-profit sales.
Social licence to operate
The ongoing discussion around social licence to operate (SLO), particularly within equestrianism, gives pause for thought. The pillars of public acceptance, and thereby SLO, include shared values, legitimacy, competence, credibility, confidence and transparency: all relying on trust. Based on my reflections, I believe one of our profession’s greatest weaknesses is the lack of transparency. Open dialogue, sharing both the hidden and not-so-hidden costs of clinical practice, would certainly be eye-opening, and likely create a more empathetic challenge, where the challenge is due. Most importantly, finding ways to demonstrate our shared values, notably those driving us to provide ethical and welfare-focused veterinary services, is essential to maintaining SLO in the veterinary industry.
Finding ways to demonstrate our shared values, notably those driving us to provide ethical and welfare-focused veterinary services, is essential to maintaining social licence to operate in the veterinary industry
Rarely are veterinary professionals comfortable conversing about costs. Charges are discussed with the disclaimer: “I’m sorry, but it’s £x for today’s consultation.” When my drainage system was replaced in our new home, I didn’t receive the invoice with an apology. The company knew its value and delivered a great service, along with the bill. However, we are sorry because we know that despite doing our very best to relieve the suffering of the animal and worry for the owners, the bill comes with the cost of stress, both to our clients and ourselves, and without a guarantee of cure.
The costs conferred by us on the owners are an inevitable source of financial stress, whether representing value for money and a successful outcome or not. But what is the cost to the clinician of providing truly ethical veterinary care? We only have to look at the recent trial by social media for the vets at Canvey Island, sadly not an isolated incident, to understand how far-reaching the emotional cost of such care can be.
Should we and can we?
Asking ourselves “Should we…?”, before moving on to “Can or how do we…?”,is essential to keep the public trust and to continue to uphold the shared values in how we work day-to-day. In a profession that is ever-growing in knowledge and skills, it is understandable that we need to engage regularly and with enthusiasm about how we apply these to our patient care.
Much of what we can offer in animal care is remarkable and the desire to push boundaries is undoubtedly enticing. Whether we are considering new, groundbreaking techniques or generational practices, we would do well to ask not only ourselves, but all stakeholders – should we? A key point I reflect on is: “For whose benefit is this procedure/care?”
Whether we are considering new, groundbreaking techniques or generational practices, we would do well to ask not only ourselves, but all stakeholders – should we?
There are times it may not be primarily for the animal; but by having an open, honest discussion, we can identify areas of concern and if the outcome is we should, then we are best prepared to address how we achieve the best welfare in the process. The single most valuable lesson from witnessing the awful treatment of both the Canvey Island staff and the owners was admiration for their consistent and relentless delivery of ethical veterinary care in the face of true adversity. The cost for them was far, far too high, but I suspect knowing ethical and morally just decisions were made, the price just may have been worth it.
Final thoughts
My hope is that the more transparent the veterinary profession becomes and the more we share our values and what we mean by ethical veterinary care, the lower the emotional cost of delivering it becomes
Advocating for animals under our care as the primary goal often creates moral conflict and carries a significant emotional cost. Certainly, I have found that by having a more openly ethical approach with my clients, I have felt my own personal costs reduce. My hope is that the more transparent the veterinary profession becomes and the more we share our values and what we mean by ethical veterinary care, the lower the emotional cost of delivering it becomes.
