LIKE Dracula in a 1950’s Hammer House of Horror film, the idea of a new VSA keeps on rising from the dead. No matter how many stakes are driven through its heart, the concept refuses to die and another sequel has to be made.
One might have thought that the definitive statement by Lord Rooker, Minister of State at DEFRA, that the Government had no intention of promoting a new Act or the heartfelt comment by Bob Moore, past president of the RCVS, that “he would rather do back to back bovine caesarean sections in the middle of the night than appear before EFRAcom again” would have finally nailed down the coffin lid.
Far from it. Even before the blood had been mopped up from the EFRAcom debacle, the RCVS had formed a new Veterinary Legislation Group (VLG), with a remit to find a way forward without the need for primary legislation.
The VLG reported to the June meeting of RCVS Council which voted by the narrowest of margins (the president’s casting vote) to adopt its conclusions as the basis for further consultation.
Once again Dracula walks amongst us. But rather than reaching for the garlic or hoping that the spectre will simply go away, we need to thoroughly analyse what is proposed and what might reasonably be achieved. But first we must ask: is this something we need to do at all?
In my home town of Sunderland there is an old adage, “If it ain’t broke, don’t fix it.” So before contemplating change we should first consider if the 1966 Act is failing.
The Act was a major stepping stone for our profession. Although imperfect, it has served both public and profession extraordinarily well. It has created an environment in which the public expect high standards of care from qualified, regulated professionals. In return the profession has shown a high degree of responsibility in regulating itself, delivering high quality care, 24 /7 emergency services, CPD and a Practice Standards Scheme.
The influx of veterinary graduates every year from all parts of the EU and beyond is a testament to the healthy state of veterinary practice in the UK, even in these “credit crunch” days.
When the public have been surveyed it has been found that, by and large, they are happy with their vets and have confidence in them. How often has a client said to you, “If only I could get service like this from my GP”? So the pressure for change is not being consumer driven.
What is the problem then? The greatest deficiency of the 1966 VSA is its disciplinary mechanisms. It provides that only members of RCVS Council can sit on the Disciplinary Committee (DC) or the Preliminary Investigation Committee (PIC). There is no provision for lay people to sit on the PIC and only limited opportunity for lay involvement in the DC.
Further, the current arrangement leads to the accusation that the RCVS is law maker, prosecutor, judge and jury – which is difficult to refute. Not a happy state of affairs.
It must be said that the College has made strenuous efforts to ensure the integrity and independence of its disciplinary mechanisms and is confident that they are fully compliant with the Human Rights Act. It is, however, generally accepted that the roles of standard setting and adjudication of complaints should be separated.
What has given some purpose to the debate is an obscure law called the Legislative and Regulatory Reform Act 2006. This enables the Government, by means of a statutory instrument, to amend Acts of Parliament without the need for primary legislation. The Act was introduced as part of the “better regulation” agenda and it is pertinent to note that the objective was to repeal unnecessarily onerous regulations rather than to increase regulatory burdens.
To this end the Government has built in a number of important safeguards. Legislative Reform Orders (LRO) cannot interfere with an individual’s established rights nor will they be used to bring about “highly controversial” changes. They may only increase a regulatory burden in one area if there is a counterbalancing decrease in another.
The Veterinary Legislation Group has identified two areas of the 1966 VSA which could (it is thought) be changed by LRO. One is the membership of the disciplinary and preliminary investigation committees, the other is the constitution of the RCVS Council itself.
What needs to be understood is that this is no academic debate. An LRO can be pushed through Parliament rapidly and subject only to the scrutiny of the Legislative Reform Committee. Indeed, under the “negative resolution” procedure, the LRO automatically becomes law within 40 days unless Parliament specifically votes against it. There is some danger that we might actually get what we ask for.
It seems that an LRO could resolve the problem of the membership of the DC by giving RCVS Council the power to establish a new disciplinary tribunal manned by specifically trained individuals who are not members of Council. It is thus unfortunate that the Veterinary Legislation Group has linked this positive way to resolve the DC problem to a more radical change in the structure of the RCVS Council.
The need to change the constitution of RCVS Council is unclear. One might think that any such proposals would begin by analysing what we expect Council to do and how many Council members are needed to achieve it. Instead, the reasoning begins from the frequently stated premise: that veterinary medicine should be regulated in the same way as “other health-care professions” and goes on to imply that the public interest requires a new structure for RCVS Council.
Neither of these contentions can be supported with evidence. Why should a profession as distinct (unique) as the veterinary profession be regulated in the same way as those who practise medicine, work largely for the Health Service and are paid from general taxation? We should not forget that the RCVS is not analogous to the General Medical Council: it has always (predating its statutory role) been a “body corporate”, composed of its members. Thus, the RCVS has a developed leadership role more akin to one of the medical Royal Colleges than the GMC.
At face value the proposals seem innocuous. A council of 30 members (currently 40) with between 30% and 50% lay people, only one university representative, a veterinary nurse, and the rest of council veterinary surgeons of whom 50% will be elected. But do the maths.
Fifteen lay members plus a VN and a university member leaves 13 places for veterinary surgeons. Presumably the CVO will be one of those, leaving 12. Half to be elected equals six seats. This constitutes a reduction of democratically accountable members from the current 24 to six overnight.
Benefit
Most will see the benefit of involving lay members in managing the interface between the public and the profession but given that the DC and PIC will both be able to recruit directly from the laity, what is the justification for reserving 50% of Council seats for appointed lay members?
Who will appoint the 24 unelected members? You’ve guessed it – DEFRA. RCVS Council will be little more than yet another unaccountable government quango much like the VMD and will no doubt be equally out of touch with the reality of practice.
Does anyone genuinely believe that this is what the public wants or deserves? Is this not the end of the veterinary profession as a learned, independent, self-governing body? Would not those pioneering vets led by Thomas Turner who petitioned in 1844 for our first Royal Charter and established veterinary medicine as a great profession, be horrified to learn that this generation of veterinary surgeons is prepared to tolerate such a travesty?
Whilst not standing in the way of progress, we must be sure that any new structure for the governance of the profession is exactly that – progress. We should look to increase the democratic accountability of the RCVS, not decrease it. We should not be lulled into accepting State control, rather we should seek to maintain a close connection between those working at the grass roots and the regulator.
In recent weeks we have witnessed an astonishing collapse in confidence in government institutions; as a result, the maintenance of a strong, independent and self-regulating profession has never been more in the public interest.
Just as the public eventually tired of the formulaic Hammer House of Horror Dracula, there is a limit to the number of times that the RCVS can marshal its troops to seek a new VSA. With each defeat comes a loss of credibility.
I would suggest, therefore, that a well-targeted but above all achievable reform of the disciplinary mechanisms is a more pragmatic, indeed more “veterinary” way forward.
