Environment, Food and Rural Affairs Committee
Oral evidence: Vet Shortages, HC 497
Tuesday 12 March 2024
Ordered by the House of Commons to be published on 12 March 2024.
Members present: Steven Bonnar; Ian Byrne; Rosie Duffield; Barry Gardiner; Dr Neil Hudson; Selaine Saxby; Cat Smith.
In the absence of the Chair, Dr Neil Hudson was called to the Chair.
Questions 1 - 94
Witnesses
I: Emily Miles, Chief Executive, Food Standards Agency; Dr Christine Middlemiss, Chief Veterinary Officer, Government Veterinary Services; Professor Stuart Reid, Principal, Royal Veterinary College, and Malcolm Morley, Senior Vice President, British Veterinary Association (BVA).
Written evidence from witnesses:
- DEFRA
Witnesses: Emily Miles, Dr Christine Middlemiss, Professor Stuart Reid and Malcolm Morley.
Q1 Chair: Welcome everyone to today’s Environment, Food and Rural Affairs Select Committee session. This one-off session is on the veterinary sector. It is a one-off session, but it fits in very well with many parallel inquiries and threads that we have been looking at from food security, the food supply chain, biosecurity, trade, the mental health inquiry and also land-based educational inquiries. Last week the Committee visited Harper Adams University. We were privileged to go around the new Harper and Keele Veterinary School and were impressed with what is going on there.
My name is Neil Hudson. I will be chairing today’s session. First, I should declare a close personal and professional interest in the subject area, as I am a veterinary surgeon myself and a fellow of the Royal College of Veterinary Surgeons.
I would like to introduce our witnesses. If we start with Professor Stuart Reid. First, could you say who you are, where you are from and what you represent? That would be great.
Professor Reid: I am Principal President of the Royal Veterinary College. I am here principally representing the Royal Veterinary College, but I also chair the Veterinary Schools Council in the United Kingdom.
Dr Middlemiss: I am the UK Chief Veterinary Officer, and England chief veterinary officer. I represent all four Administrations internationally. I am also head of profession across Government for veterinary surgeons that work in government.
Emily Miles: I am Chief Executive of the Food Standards Agency, which works in England, Wales and Northern Ireland.
Malcolm Morley: I am Vice President of the British Veterinary Association. We represent nearly 20,000 vets across all sectors.
Q2 Chair: Thank you very much for giving up your time to be with us today. We have quite a wide-ranging session. It was started as a way of looking at veterinary shortages, but we are going to be looking at a lot of issues facing the veterinary sector. We have a lot to cover and what I would ask our four witnesses is, if you agree with the rest of the panel, say that so we don’t necessarily have to have duplicate answers and then we can get through a lot.
The first question has actually changed slightly because today we have the publication of the Competition and Markets Authority’s initial review of veterinary services, and I know that Malcolm has probably been doing the media round all day on this. It has published its initial findings and has recommended that it will do a more formal market investigation moving forwards. The authority is going to consult on that and do a deeper review from there. There are some take-home messages that it has put forward, but first I want to ask the panel their thoughts in terms of the development today. We will be delving into the issues in some of our lines of questions, so initially just some brief remarks as to what you think about the CMA findings today. If I could kick off with Malcolm, please.
Malcolm Morley: In any sector, external review has to be welcomed. We often have a different perspective, but we have seen a spectacular number of not only animal owners but vets respond to this. We recognise that there are elements of all the bullet points that it has raised that need to be addressed. I think that the key point for this House is the last bullet point, which says the regulatory framework is outdated and may no longer be fit for purpose.
Q3 Chair: We will explore that in terms of updating and renewing legislation moving forward. Emily, do you have any comments on it?
Emily Miles: The Food Standards Agency outsources our provision of vets. We spend over £50 million a year on vets with a private provider and we are just going to retender that in the next year, so we are very interested in there being a healthy market for vet services and absolutely support the point about the Veterinary Surgeons Act and the relative situation.
Chair: Thank you. Christine.
Dr Middlemiss: As a user of veterinary services, a member of the profession and Chief Veterinary Officer, I recognise much of what the CMA has commented on. I think further exploration is valid, and I absolutely support the revision and update of the Veterinary Surgeons Act, to consider regulation practices but, also, to make it contemporary legislation for our profession.
Chair: Thank you very much. And Stuart.
Professor Reid: This is going to be easy: I agree.
Q4 Chair: Great. Thank you. That is great. This inquiry was set up initially to look at the veterinary shortages angle and I have a quote from the CMA Chief executive, Sarah Cardell, speaking about the review. She said, “We have heard concerns from those working in the sector about the pressures they face, including acute staff shortages, and the impact this has on individual professionals.” So, these will be some of the issues we may be able to explore as we go through this session.
If I can start with Christine. In 2018, you told the former iteration of the EFRA Committee that the workforce shortage in the veterinary profession was about 11%. Do you have a feel for what the size of that shortage is now, both in percentage and in real terms, and how has that changed in any direction in the last six years?
Dr Middlemiss: I do not have a huge greater handle on it. I do not think it has got less, reduced from 11%, and is probably a bit greater because of events that have happened, including the increased requirement for vet roles in certification post-Brexit. We have had increased disease outbreaks. I know in government we have been calling on private vets. Then we had pandemic puppies and a huge number of other things that colleagues have been busy with, on top of what was already quite a pressurised system.
It is interesting to look back at how many vets have been registered since the last Veterinary Surgeons Act in 1966. We have 8,000 vets on the register. When there was the last EFRA Committee inquiry, as I understand, and the Veterinary Surgeons Act, we had about 22,000. We now have about 30,000 vets but the profile of the profession, how we work and what we are required to do has changed. Those are people available to work or on the register, but it doesn’t necessarily mean that we have that many full-time vets working.
Q5 Chair: How do we get a feel for exactly how many vets we do need in this country? This has been looked at over many years. Decades ago they said, “We are going to be thinking about reducing the number of vet schools”. We actually found that we weren’t training enough vets and in the last few years we have new vet schools, well needed and much needed vet schools coming online. As a country, how do we know how many vets we need, both for companion animals, cats and dogs, but also the farm animal sector and public health research? How do we know?
Dr Middlemiss: It is difficult because, as I said, things arrive that you are not expecting. You have your standing workforce carrying out routine business as usual but also, as we saw, increased work with, for example, pets coming from Ukraine and pandemic puppies. Looking forward and trying to scenario plan for eventualities is hard and, of course, it is at least five years to go through vet school. Trying to match all that up is really difficult, and a workforce plan would be to look at that.
Q6 Chair: We are going to come on to that in the next section from Cat. We probably all agree that we do not have enough vets and we do have a shortage.
If I can turn to the rest of the panel: what is your experience of the shortage of vets and how is it affecting your particular lines, whether it is within vet schools in terms of training but also provision? In a vet school you have provision of clinical services as well. Malcolm, you represent the veterinary profession, and Emily, you focus on food hygiene and public health. In your experience, how are the shortages affecting your lines of the profession?
Professor Reid: Certainly, recruiting specialists is a very different part of that market. We may come on to talk about that in detail, but in terms of the generalities, if I could draw some parallels with what is happening in the United States, I think their grip on their understanding of the workforce in general is perhaps a little bit better developed.
The US Bureau of Labor Statistics is suggesting that the veterinary job market is going to grow by 19% by 2031, and the prediction there is that there are going to be between 15,000 and 18,000 jobs unfilled, a shortage in that time. Added to that—and I think we cannot do this without talking about veterinary nurses and veterinary techs—in that setting they talk about a 30-year horizon on fixing the shortfall if resourcing and the training of veterinary technicians and nurses does not improve. I think the closest parallel market we can see would be looking at North America. We certainly have a shortage, but I think they have defined what their shortage is a little better.
Q7 Chair: Thank you. Emily, what is the FSA view on how the shortage is affecting you?
Emily Miles: There was a point in 2021—so, just after Brexit—when we had to alert abattoirs to the fact that we might not be able to cover every single shift with a vet because at the time we were concerned about a shortage of official vets from our service delivery partner. Our service delivery partner has rectified that situation. We did not have to prioritise particular abattoirs or particular shifts in the end, but that is always the risk that I feel I am sitting on. When you have, in effect, an £8 billion meat industry, £2 billion of exports, all of that relies on a vet signing off the animal welfare and the animal health in an abattoir and that is what we are playing with.
In abattoirs across the country—there are roughly 270 abattoirs—we have 268 vets, 99% of whom are from overseas. Just three of them were trained in the UK, so 99% are from overseas. In the last year, attrition from that cohort has been at 33%, which has gone up on previous years. In 2022 it was 22%. We are doing a huge amount to attract more UK trained vets into the profession. I can say more about that later as to why it is difficult.
Chair: Yes, we can explore that.
Emily Miles: In effect, there is clearly a shortage, and we are struggling to retain vets.
Q8 Chair: We are going to get on to retention as well. Malcolm, can I ask you to address that, but could you also follow up with how the workforce pressures and shortages vary between the different sectors of the veterinary profession that the BVA represents, whether that is large animal, small animal or whatever? How is it impacting your members?
Malcolm Morley: That is a great question because whatever the shortage, it is not equally distributed and the likelihood—although we do not have specific data on it—is that if you want to employ a small animal vet in an urban area in the south-east, you are going to find that much easier than if you are trying to employ a vet in a remote and rural part of the UK, particularly in OV work. That is another area where we have heard there are particular challenges around this.
Chair: “OV” meaning official veterinarian.
Malcolm Morley: Exactly, working in slaughterhouses and supporting public health as well as animal health and welfare. We have seen a real shift in the demographic of our profession because, pre-Brexit and the pandemic in 2018, we recruited more friction to that.
Chair: We are going to explore that a bit more in terms of overseas vets and registration from there. If I can move on to the next question now from Cat Smith, please.
Q9 Cat Smith: Looking at the issue of supply of domestically trained vets—and maybe I can start with Christine—do vets qualify annually in the UK at the moment and how much does the training capacity need to increase to meet the workforce demands? Do you have any numbers you are able to give the Committee on that?
Dr Middlemiss: I think Professor Reid, the leader of the Vet Schools Council, will have those figures more detailed than I have them.
Q10 Chair: Before you answer that, Stuart, could you explain to the public and to the Committee a bit more about the Vet Schools Council and what it is?
Professor Reid: It is the body that represents UK veterinary schools. We have no regulatory authority. We work together to provide the very best we can in veterinary medical education.
Chair: Thank you.
Professor Reid: If we talk about enrolments, I think that is the most salient issue for this Committee given that we are looking at the future. In 2023-24 the number that enrolled in total in this country was about 1,766. That includes the two new schools. That is the Aberystwyth School that feeds into the Royal Veterinary College, and the new school in the University of Central Lancashire, so 1,766. I do not have the figure that says what that shortfall is, but you can add your 19% and 11%—or whatever we decide is the case—to show the shortfall. That is total enrolments. Those total enrolments are up 4% on the position four years ago.
On the composition of those enrolments in terms of wanting to come on to understand the home students and other—which I will just refer to as “other” when I am talking about anything other than home students—that number has been increasing slowly but not dramatically.
Q11 Cat Smith: Are you able to say anything at all, Professor Reid, about the shortage and the need to increase the number of enrolments? There is obviously a need to increase the number of people able to educate and train. How would one go about increasing the training capacity in that network and would that be a particular challenge?
Professor Reid: If I could answer that one, I probably wouldn’t be sitting here. The reality is that most of us are working at capacity. The specialist facilities that are required, the teaching facilities and, of course, the staff-student ratios are important considerations on all of those. In this country we have seen two new schools open recently. In North America there are 10 new schools, or thereabouts, opening at the moment.
What we need to recognise, though, in pulling that lever of increasing capacity is at least a five-year horizon from the day they open, and planning would probably be two years before that. So, there is a long way to go before we start filling that deficit.
Q12 Cat Smith: You said about the increase in North America. To what extent is the shortage that we have here a domestic issue and how much of this is reflected in similar economies overseas?
Professor Reid: I think where the profession is similar it is pretty much the same in North America, here, Australasia and increasingly in Europe. I look to colleagues for—
Q13 Cat Smith: Would anyone disagree on the panel and want to offer a different perspective? No. Then should the Government be collecting more workforce data, because it strikes me that we are a little bit hazy on the details here? Should we be collecting more data for the betterment of the profession and how could collecting better data improve efforts to tackle the shortages?
Dr Middlemiss: I agree that we could have better data. We have been working on that with RCVS and BVA through various surveys and things. No one organisation owns all the data. That is part of the problem. When you lose people from the profession in effect you lose that data as well. The Royal College is developing more of an understanding of the workforce, and we share that but, yes, it could be a lot better.
Q14 Cat Smith: Who would be the obvious lead organisation to collect data?
Malcolm Morley: It is worth pointing out that the Royal College of Veterinary Surgeons is undertaking a workforce modelling piece of work at the moment and, although different organisations hold data about it, we are feeding into that. This is a very collaborative piece of work that we are keen to support.
Cat Smith: Thank you so much. I will hand back to the Chair because I think Steven has some questions to follow on from that.
Chair: Yes, thank you. We have started looking at the recruitment and training. We are going to be exploring training a bit further, but we wanted to get onto the retention of vets and “team vet” and Steven is going to ask questions along those lines.
Q15 Steven Bonnar: Obviously we have heard the challenges are very real. There are challenges for the expert services in the United Kingdom, so how successfully are we retaining domestically trained vets in the workforce? That is for Christine and Malcolm.
Dr Middlemiss: We could be better. So, 45% of our leaders have been in in the profession for four years or less. That includes 21% with less than one year’s experience. We have a relatively high dropout rate.
Q16 Steven Bonnar: Malcolm, anything to add to that?
Malcolm Morley: Yes, I am going to give you some pretty tough statistics here. BVA undertakes a survey called Voice of the Veterinary Profession. In 2021 we asked vets how they rate working in the veterinary profession on the following aspects. It was quite telling because many of the things that are inherent in being a vet they rated very highly: their interest, working with colleagues.
But at the very bottom of it we ask them: how do you rate workplace stress on a scale of excellence to terrible? When questioned, exactly two thirds said their workplace stress was either not very good or terrible, and exactly one quarter said that their workplace stress was terrible. That is a pretty striking statistic. I think some of that is inherent to being a vet. I enjoy being a vet, but it is a challenging place working in that triad of vet, owner and patient.
BVA is looking hard at this. We have a big initiative under the umbrella of good veterinary workplaces, trying to find all the solutions to that, championing things like flexible working, which keeps people in the profession. We talk about making the work fit the workforce, not trying to shoehorn the workforce into the work. Indeed, we have an upcoming workplace accreditation scheme called Great Workplaces.
We have to take notice of that figure, and this is not something that any one organisation is going to be finding the solutions to, including ourselves and the Royal College of Veterinary Surgeons. Thinking about how the new Veterinary Surgeons Act can support this is absolutely vital.
Dr Middlemiss: But it should not become self-fulfilling. Stress and the poor work-life balance was the top reason that people gave for dropping out to the 2019 Royal College survey. We have a shortage of vets but now we have more pets, we have disease outbreaks, but we are obliged to provide the service.
Q17 Steven Bonnar: The stress levels are long-established within farming and agriculture, so thanks for laying that out for us today. I think that the panel will be glad to hear that, worrying as it is. Are there any other key drivers that are causing vets to leave the profession, other than being overworked, stretched, underpaid and often marginalised, left alone, if you like?
Dr Middlemiss: We should recognise that the demographics of the profession have changed. There are a lot more women. Inevitably, some are going to potentially not be in work—or not be full time, I should say, if they have children and things. Also, recognising male colleagues’ paternity leave and things, so the demographic changing of the profession, which is a good thing but inevitably, if there is a certain amount of work to be done, and you need staff to do it, it contributes to that.
Emily Miles: I am thinking about this as a slice of the profession, so the public health bit rather than the overall profession question. Obviously, there may be some vets who leave the public health work to go into other parts of the profession, but what we find is that people leave because of pay, because they want to progress elsewhere so they can get increased pay or role design elsewhere.
Also, with our foreign national vets who have trained abroad, the ones who have left—I said there was a 33% turnover in the last year—our service delivery partner does exit interviews with them. One third of them left because they were not able to achieve the English level that the Royal College sets of level 7. They went off and redid their exams. They had to go back home, get another visa and come back in. Three or four of them came back in—that is the top reason—but 14% went to a new job, 11% just wanted to go home, 6% had health reasons. So, there are a range of reasons. The English language piece is quite important and perhaps we can come back to that later.
The pay issue in the public sector is much more constrained. For example, we can match the starting salary of a vet in the private sector with the public sector when they graduate, but actually to do a public health vet role there were two British trained vets who started a couple of years ago with our service delivery partner. They were not able to keep up with the graduate development programme that the RCVS requires of them if they want to operate in clinical practice in those first couple of years. So, they left after a couple of months. It was just too much work to do.
What they wanted to do was come back into public health later when, actually, we cannot match the sort of salary that you might get five years into the profession in the private sector. The private sector might pay £60,000 at that point. If we were paying £50,000 at that point, we are doing well. It might be more like £40,000 and that is constrained by the public purse, by pay rules and, also, by how much money the FSA can spend with its service delivery partner.
Q18 Steven Bonnar: We were speaking to the FSA yesterday and it told us it had managed to recruit one vet recently and that was at trainee level. Currently it is a challenging situation, but it has the potential to reach critical levels. With that in mind, what steps could the Government and the veterinary profession itself take to increase job satisfaction, to increase wellbeing and, obviously, keep retention within the sector? That goes to Malcolm or Emily.
Emily Miles: If I could take that first. There are things that can be done within the role design in the public health space. For example, what we are trying to do—our service delivery partner is doing this—is not just have you in an abattoir five days a week. If you are in two or three days a week or we can have different, more flexible contracts so you are working term time and not holidays, more part-time work, that is more possible in our sector than perhaps it might be in the private sector. So, there is a role design piece.
There are then some other things that would make a huge difference. There is a financial investment piece needed in terms of pay. We will be taking a submission to the Treasury about vet pay in the next spending review. If we are going to increase the pay of vets, it falls either to the taxpayer or to the industry. We have to charge, and, at the moment, we charge out about 70-odd per cent of the cost of the official controls. That would be something that would make a difference too.
You are not going to solve the public health veterinary issue without solving the broader veterinary numbers in the round, and this needs a long-term approach.
Malcolm Morley: One thing I hope we are going to be talking about a lot today is the veterinary team, not just vets. One of the things that constrains us at the moment is that we do not have the veterinary team to support us in the way that we could, particularly in remote and rural practice. Currently, we need veterinary technicians who can work alongside vets in the farm animal sector. That is not possible under the current Veterinary Surgeons Act without secondary legislation or a new Veterinary Surgeons Act.
We need to be championing the role of veterinary nurses. This is a profession that is saying that one of the reasons we need a new Veterinary Surgeons Act is to champion the role of those allied professionals, and that is a really striking thing. When you look at human healthcare and how much of that is delivered by colleagues, we are a long way behind.
Emily Miles: Can I illustrate that with a couple of examples? In an abattoir, the vet works very closely with meat hygiene inspectors. The meat hygiene inspector is an allied professional. Their role is set out in the Official Controls Regulations, but they could do a broader range of things. If the Veterinary Surgeons Act were reformed to describe the vet differently, that would enable the meat hygiene inspector to pick up more animal welfare issues.
It is the same at the port. You have environmental health officers at the port. The vet is overseeing checks and so on. Again, they could have a much better team working together there.
Steven Bonnar: Thank you. Chair, I am finished.
Q19 Chair: Thank you. Stuart, did you want to come in on that?
Professor Reid: I would just emphasise something that Emily said. We are not going to sort one bit of the profession unless we sort it generally. I cannot emphasise that enough. From where I am sitting, the difficulty is that there are aspects of the profession and employment where I do not think any 18 or 21-year-old comes in with that as their career destination in mind, and so the more attractive, the more lucrative are always going to get first dibs when it comes to employment of employees. We simply have to sort the bigger problem rather than a specific area.
Chair: Thank you very much. Selaine, I think you wanted to come in.
Q20 Selaine Saxby: I have a follow-up question. I have had the pleasure of spending more time with vets in the last couple of weeks than I normally do and, anecdotally, I have picked up—talking to some of your female vets—some of the issues around maternity cover and childcare arrangements. Is that anything that you have picked up in the data or whether there were steps to ensure that young women, young mums, are able to continue in practice?
Malcolm Morley: As far as the British Veterinary Association is concerned, we are championing two elements of that. One is flexible working, and the other is a return to work, encouraging workplaces to consider how they can bring people back into the workplace. What is interesting is that, if you look at the top four reasons for flexible working, caring, whether that is for children, elderly relatives or animals—because many vets have animals—it is actually number three. Things to balance that workplace stress to try to find a work-life balance is pretty high on the list as well. You raise an important question: the challenge is that it is also reducing our full-time equivalent workforce.
Emily Miles: Can I add another thing? We just ran an extramural studies programme for vet undergraduates. We had about nine of them come to the FSA for a week. All of them are women—
Q21 Chair: Can you explain to the public what extramural studies means?
Emily Miles: Work experience.
Chair: It is a formal requirement that vet students have to do during their degree. Stuart, did you want to—
Professor Reid: Perfect, Chair.
Emily Miles: So we had these nine women come and they were astonished to discover that in the public health world some of the roles that we have, like auditors who are directly employed by the FSA, could work part-time; they could work remotely potentially. That became an attractive thing as they were thinking about their career. I would hope there would be male vets who would also be attracted by that because obviously we want men to be doing childcare too.
The other thing I would say that comes up anecdotally for us is about the workplace culture in slaughterhouses and in cutting plants. We have this with female meat hygiene inspectors as well. It can be a very male environment. It can feel a little bit old fashioned. We have plenty of female official vets, but there can be friction issues and that is not an attractive thing. There is something about making the culture of the places where they work, their slaughterhouses, the cutting plants as well, being appropriate for them.
Q22 Chair: Thank you, Selaine. While we are on the subject of retention, I would like to explore some of the stresses and strains on the “team vet” as well a bit further. We took very powerful evidence in our mental health inquiry from James Russell from the BVA, and also Rosie Allister, who has done a lot of work in terms of researching mental health issues in the profession but down into the student body as well. Sadly, as we know, vets have a higher incidence of mental ill health and also, sadly, thoughts and suicide itself.
Could you articulate to the inquiry some of the pressures that people face in the frontline? Christine, you mentioned that in the pandemic many people took on puppies and pets and it put a lot of pressure on the veterinary sector. I think I am right in saying that the BSAVA, the small animal arm of the profession, reported that the majority of their survey respondents said that they had received some form of abuse from their clients in that couple of years period.
Malcolm, could you articulate to us the pressures that vets are facing in the frontline, whether that is with disease outbreaks or upset clients? I am sure the CMA findings about pricings have not been without stress for the veterinary profession. The public are now saying, “You vets, you are charging us too much money”, when that, perhaps, is not exactly the case in all instances.
Malcolm Morley: Yes. We have to remember that this CMA review is about veterinary practices, not the people who are working in them, who are often motivated by delivering a high level of animal welfare.
In BVA surveys looking at abuse of vets, both online abuse and in-person abuse—I am afraid I do not have the figures off the top of my head—there is a significant level. The main professional indemnity insurer of the veterinary profession has seen their need to provide advice calls to vets going up year on year as the number of complaints goes up. I think these are societal issues that are wider than just the veterinary profession. Our role is trying to provide workplaces that can keep and retain people while working in a stressful environment that we just have to recognise.
Q23 Chair: The profession itself is trying to mitigate and offer support. The Royal College of Veterinary Surgeons has the Mind Matters Initiative and there is the Vetlife charity that provides support to “team vet” as well. Do we need to get more of that to support everyone in the veterinary sector?
Malcolm Morley: I think Desmond Tutu said that if we have to keep pulling people out of the river, we should go upstream and look at why they are falling in. It is great that we have Vetlife, which is there and is a charity that supports vets with mental health and other problems, but we want to go upstream and try to support people. As far as we are concerned, one of the main things is trying to change the culture of veterinary practice to be supportive.
Q24 Chair: If we go upstream, Stuart, up into veterinary education, could you articulate to us what vet schools are doing to try to help their student bodies through, and to give them coping and resilience strategies moving forward? What is the role of the veterinary education sector here?
Professor Reid: It takes an entire village to raise a child and that is the way we think about how we support our students. They are often out in the professional environment. It is what they see. It is what they experience. We know that part of the problem we have is ensuring that they are in a supportive environment, whether they are within the universities, where there are very well-established advice and support systems, or whether they are out in the professional community, and in what they see and experience not just in professional extramural studies but in preclinical or animal husbandry, as well as their exposure to a farming environment and other industries where it is a different world as well.
It is ensuring that we have the right levers in place to effect good-quality—“regulation” is the wrong word—quality control and to make sure that we are providing them with the safe environment. That is not easy when, as I say, we have no direct levers to pull in those two particular environments.
Dr Middlemiss: I just want to note that working within Government as a vet is not without pressure either. When you look at colleagues in the field who have had three avian influenza outbreaks winter after winter and bluetongue now, they are the same people responding in the same areas.
The Association of Government Vets undertook a survey a couple of years ago asking people about their wellbeing and so on, and being on the frontline, being the person who says, “We have to cull not just that animal but all of your animals”, is a stressful place to be in. We are much better at supporting them than we were in 2001 but there will inevitably be some people in that situation, and we have to equip them to deal with those difficult conversations.
Q25 Chair: That is in the acute disease outbreaks but also in the intermittent testing. We took evidence from James Russell about TB testing and the stresses on the vets and the farmers in that situation while you are waiting for the results, and if you have a reactor. That is something you recognise?
Dr Middlemiss: Exactly, yes.
Emily Miles: It is the same in slaughterhouses as well. As the vet, if you are overseeing the slaughter and you think that a certificate of competence for the slaughtermen needs to be withdrawn, that can have a material effect on the business. If you are saying that approval of the premises is not safe because of food hygiene concerns, that can be detrimental to the business as well. Inevitably, you end up in conflict with the business, which is very concerned about its own livelihood.
That is what we ask of our vets. We do not pay them loads to do it. We ask them to protect animal welfare and public health in that way. That is tension we need to put into the system for them to take that regulatory role, but it causes stress. I am sure MPs here will have had letters from abattoirs complaining about vet action, as I do as well. It is a small proportion where you have those very tense relationships on the ground; I think we mostly have very collaborative relationships with parts of the meat industry.
I do think it gets improved with that role variety point I made. If someone is able to be doing a number of different tasks across the veterinary public health piece and not doing the same thing every day, that helps. Also, the more experienced vets find it easier. If we can retain them, if they can be in those roles for five years or 10 years, it will get better. Some of the things we are talking about systemically will help.
Chair: These are points well made, that the stresses and strains are in all arms of the profession: in frontline clinical practice, in education and extramural placements but also, as you say, in the abattoir network in terms of pressure on the vets to call the food as being safe to be eaten. In 2001, it was a very brave vet in an abattoir in Essex to say, “This is foot and mouth”, a disease we have not seen for decades, and make that brave decision to call it. That is a very stressful thing to do. We should not underestimate the pressures on professionals in the frontline.
I am going to move now on to overseas vets. I will move to Rosie, please.
Q26 Rosie Duffield: This is mostly to Christine and Malcolm. How many vets are joining the UK workforce from overseas each year and how has this changed since 2018? Malcolm has already mentioned the huge difference in numbers pre-Brexit and post-Brexit. I just wonder if they are joined together.
Dr Middlemiss: I do not have the figures in front of me. I can come back with the number of overseas vets joining, but prior to 2018 around 25% of our Royal College registrations were from the EU and 10% from the rest of the world. It has been a significant number.
Malcolm Morley: When we think about overseas vets, we need to break this down into vets who are coming with mutually recognised qualifications into the UK, what those qualifications are now and what they will be in the future, and also vets who are coming from other countries where we do not recognise their qualifications and think about how what the barriers to them might be. There are some quite complex issues to delve into here.
Q27 Rosie Duffield: Thank you. I will go on to that, hopefully. What steps could the Government take to increase the attractiveness and accessibility of practising in the UK to foreign veterinary professionals, such as pay and conditions, direct accreditation of EU vet schools, UK-EU veterinary agreement and things like that? Malcolm, do you want to elaborate on that?
Malcolm Morley: Yes. Coming back to my breakdown of it, if we think about vets from the EU with mutually recognised qualifications, it may seem easy, but previously they could come to the UK and then they could start looking for a job. They now have to look for a job from outside the UK, apply for a visa, meet the salary threshold and meet a language examination. We know from human behaviour that if you put friction and barriers in the way of things, people do not do it. It is all very well for us to say that people can still do this. Yes, but we have put a lot of friction in the way.
In terms of vets coming from overseas without mutually recognised qualifications, they have to sit—rightly—the statutory membership exam at the Royal College of Veterinary Surgeons. That is key to maintaining our standards. At the same time, we have to recognise that at the moment that exam is only once a year, and you have to pass the whole thing. If you fail the module in small animals, you have to then do the entire examination the next year without resitting part of it.
The RCVS has already proposed a statutory instrument to modernise the statutory membership exam for overseas vets and that could make a big difference. At the moment, we are very grateful for the fact that refugee and asylum seeker vets, of whom there are surprising number, can sit that examination free of charge. It is otherwise a charge of £2,500, and there are no past papers and no fixed syllabus. This is a massive barrier.
Q28 Rosie Duffield: Thank you. Emily, did you want to come in?
Emily Miles: Yes, please. Thank you. If you compare pre-Brexit, before EU exit, vets from EU member states did not require a working visa, did not have to meet specific language requirements and benefited from automatic mutual recognition of their professional qualification. As Malcolm said, they now have to fulfil working visa arrangements.
We are very fortunate to benefit from an arrangement that the Royal College has made for temporary registration, which is where vets who have not met their level 7 English language requirements—they tend to have level 6 instead—can practice for a temporary period. If they fail their level 7 language exam after 18 months, which is the deadline by which RCVS says they need to go through that, they immediately lose their visa and have to leave the country. Then they have to retake the exam and apply again for a visa in order to come back in. It is quite high jeopardy.
Just to add to this, while they are here they need to get their driving licence because they will need to drive. They get a temporary stay and can use an international driving licence, but they have 18 months to sort out their own domestic driving arrangements, and if they have not come from an accredited vet school they have to pass this statutory exam. There is a lot. It is not just what the Government do around the migrant salary point; it is also the RCVS arrangements that act as a barrier.
What would make a big difference for us? We are keen to wean ourselves off this temporary registration piece if we can. The Royal College has given us until the end of this year to do that and we have reduced the number of official vets who are here as temporary registrants from around 40% down to about 19%. We are trying to come down from that.
The issue is that we have a pipeline of foreign-trained vets who we are now bringing in as meat hygiene inspectors, to work for a couple of years so that they can improve their English language requirement. That sounded like a fantastic plan until the Government put in their salary requirement for a visa. Meat hygiene inspectors tend to get paid about £28,000 or £29,000 a year on average. The migrant salary cap is £38,000.
We are suddenly in a position where we will be saying to the Royal College that either we will have to pay a huge additional amount for meat hygiene inspectors for this vet track—as we call it—for people who are here, or you will need to change your language requirement, or we will need to have temporary registration for longer, none of which is a very appealing arrangement.
We feel a bit stuck with that at the moment and are trying to find a way through. If we do end up paying more for the meat hygiene inspectors who are coming on that vet track, who are trained vets from overseas but not yet Royal College accredited, it will be millions of pounds more, which again is paid for by the taxpayer or by the meat industry in charging.
Q29 Rosie Duffield: Gosh. Okay. Thank you.
This is a question for anyone who wants to jump in. What assessment have you made of the potential impact of introducing the immigration salary list in April 2024 on the recruitment of vets from overseas?
Emily Miles: I can expand a little bit more. For vets themselves, who tend to be paid above £38,000, it should be okay. The pipeline of vets that we have been relying on is the thing that feels in jeopardy. What I would like, if possible, is an exemption for meat hygiene inspectors from that salary cap. I think that would be the simplest way of solving the issue. If not, the financial consequences are in the millions if we push the meat hygiene inspector salary up, unless RCVS changes its requirements about what a qualifying vet can be.
Q30 Rosie Duffield: Thank you. The RCVS only just voted, didn’t it, to stop the—
Emily Miles: Last summer, yes. It was incredibly generous to us because we found ourselves in a very difficult position in 2021 and at very short notice it created this temporary registration scheme, which we relied on enormously in 2022. As I said, we had around 45% of our vets relying on it.
Last year RCVS said, “Look, this is meant to be a temporary scheme. You need to come off it”. We have spent the last six months trying to get this pipeline in place and we were having some good success. We are down to 19% and we felt like we were making some progress. We are also finding that if we bring in vets with level 6 English rather than level 5 English, they are standing more of a chance of getting level 7 when they come to it.
Q31 Rosie Duffield: Thank you. Does anyone else want to jump in?
Dr Middlemiss: I want to pick up the pipeline point. It is a pipeline for the whole of the profession, not just for vets working in food safety. Many vets will come in as meat inspectors or as vets working in FSA. They may move on to the Animal and Plant Health Agency—we have hugely benefited from that—and they may move on to practice. It is a pipeline for the whole of the profession.
Q32 Rosie Duffield: Thank you. Stuart.
Professor Reid: I need to say that this would not be ubiquitous, but there is an issue around interns and residents for training in specialist aspects of the profession who are not necessarily paid at the level that is now being suggested. I know there are different models in different schools, and I cannot speak for schools other than mine, but ours are registered as students, which is a way around that. That is not true: they are also qualifying for a degree. I know that some schools will find it difficult to get residents and interns in on the current recommendations.
Just on a previous point, the figures that you were asking for about registrants from different parts of the world—I knew I had it somewhere—show that in 2018 there were somewhere like 1,100 from the EU, 950 or so from the UK and 250 from the rest of the world. I do not have it bang up to date but in 2022 there were 1,200 from the UK, 500 from the EU, less than half of the EU’s previous figure, and 250 from the rest of the world, which remained fairly constant.
Q33 Rosie Duffield: Thank you. Malcolm, did you want to come in?
Malcolm Morley: I want to pick up another very important theme that I think we need to be exploring today. One is looking after the people who we have now, and the other is thinking about what the profession is in the future. If I could summarise that in one word, it is diversity. If you have a monoculture of people it is not as sustainable. By bringing some of these vets in from overseas we bring in diversity and different ways of thinking and I think that is of huge value to our profession.
Rosie Duffield: Absolutely. Thank you very much.
Q34 Chair: Can I come back in on accreditation and mutual recognition? Again, I declare an interest. I was trained up to be a visitor to vet schools by the Royal College of Veterinary Surgeons. Stuart will be very familiar with this, in terms of vet schools being visited by the Royal College of Veterinary Surgeons, the European accrediting authorities, and the American accrediting authorities if those vet schools are accredited by them. It is a global profession.
That accreditation and mutual recognition process is being unpicked now. What does that mean for the vet schools and our supply of people working in this sector? If the Royal College has voted to end this mutual recognition of European degrees, the visits are going to be decoupled, are they not, in terms of how we accredit our institutions across, say, Europe? What does that mean for the future of the profession?
Professor Reid: If I might, I think there are three terms we have to be clear about: harmonisation, which are things that sound good together but are not necessarily the same, like a melody; mutual recognition, which is very clear in how that would be interpreted; and direct accreditation. There may be other models out there, but I would suggest those are the three.
As society evolves, there are different pressures in different parts of the world on different aspects of our professional delivery, and therefore standards do vary from time to time. We had a period of relative stability where it was not so much mutual recognition; it was harmonisation, and therefore the visits could occur at the same time and generally—not always—led to a similar conclusion of the visitors.
Certainly, from a school’s point of view, it was useful having that coincident. As those standards start to drift apart for whatever reason—good and bad, I suggest—it is difficult to have the visitations at the same time and it does take you to different streams.
Globally, because disease does not recognise political boundaries, it is good to have similar standards. Ideally, in some critical areas, identical standards would be helpful. That is not the case across the globe, but I know that our regulator, RCVS, has worked hard to try to maintain not only those relationships but the standards. It has to come back to the standards. If the standards are drifting in a way that is unacceptable to us, there has to be an intervention and it has to be different. Maybe we can work together to bring those more closely together again.
Q35 Chair: Thank you. Emily.
Emily Miles: The accreditation that RCVS uses, it has declared that it is going to bring to an end within five years. It wants to replace it with direct accreditation of individual universities rather than going through a scheme, which is fine. We will need to know, less than five years away, which universities we can go and target for recruitment. Ideally, that accreditation would be happening in the next couple of years so that we can start building up that pipeline again for meat hygiene inspectors and vets coming in. I think RCVS, in its written submission to you, said that it needed money to do that accreditation and that was a gap. There is a real issue there for us.
The other thing that would make a big difference—just to draw the thread back—is what Malcolm was saying about the exam. If you are not from an accredited university you can do the exam, but if the exam is only running once a year and is not modular and you have to do all of it again and so on, that also becomes a challenge. If we could solve that problem too, that would help.
Q36 Chair: Thank you. We were talking earlier about vets and meat inspectors on the frontline in abattoirs. Over the last couple of years we had a crisis in the pig sector, where we potentially had a shortage of vets and meat inspectors but also processors and specialist butchers. We had the tragic situation of thousands of pigs being dammed back on farms because they were not able to be slaughtered in slaughterhouses, and the awful scenario of pigs being slaughtered on farm and just killed. They were healthy pigs.
Coming back to the mental health impacts on the people who had reared those animals and the people who had to put them down as well, in terms of horizon scanning, are we sure something like that cannot happen again, where we would end up with animal health and welfare issues and mental health issues as well? Is that something that we are resilient to try to mitigate against?
Emily Miles: With both poultry and pigs there is that potential issue where the turnover on farm is quite rapid. If you have livestock backing up on farm, the animal welfare issues get quite serious quite quickly.
In the next year or two, we have a number of risks on the horizon that could cause us not to have enough vets in abattoirs. For instance, if we cannot afford to pay what the market is demanding we pay for vets or for meat hygiene inspectors, then we will not be able to recruit enough and that will be a problem. If we are not able to get Royal College accreditation in the way we need, that will be a problem. We are trying to mitigate all those risks with the work we are doing, which we have already described, but if any of those things become true, then we are not going to have enough vets. These are quite critical short-term issues.
Q37 Chair: That is the inspectors. What about the specialist butchers and the processors? We were short of them as well, weren’t we?
Emily Miles: Yes. That is not so much my purview. Christine may have a view on some of that.
Dr Middlemiss: It depends a lot on market forces as well, and how the cost and income balance ties up for the processing chain. Many of these for pigs and poultry are integrated chains. They are relying on export for parts of the pig that make little money in this country. If we had African swine fever, for example, and we lost all trade to China, that would have a massive impact on the value of that overall pig, that business, and downstream impacts, as we have heard.
Chair: We might get on to that later on, some of these global issues that could impact as well. We are going to move back into education. Over to Selaine, please.
Q38 Selaine Saxby: Thank you and good afternoon. Stuart, how well equipped are vet schools to meet the staffing and specialism needs we face at present, and what more could be done to support them?
Professor Reid: We are very fortunate to have good quality veterinary schools in this country. You will not hear me talking any of them down.
One of the issues that we have, as we see the expansion in the number of schools, is who is going to do the teaching and training that is required. Now, some of the accrediting bodies in the past have required that education be provided by a specialist. That is softening across the globe, and we are now able to make use of or employ people who are perhaps not specialists in their training in terms of discipline specialisation but are, obviously, properly trained educators. I think we are in a reasonable place at the moment.
However, as I say, when you have expansion of the number of schools in North America and we have three new ones in this country, I think that is going to come under some scrutiny in the very near future. That is reflected in the number of applicants we would have for any one of our senior, particularly specialist clinical positions.
Q39 Selaine Saxby: What is the ratio of applicants to positions?
Professor Reid: It will vary by school but, to be honest, sometimes we are fortunate if we get two qualified individuals for a specialism in a clinical area.
Q40 Selaine Saxby: Thank you. Malcolm, is there anything you wanted to add on that?
Malcolm Morley: I would just like to touch on this diversity issue as well. In the past we have seen all the vet schools delivering a similar model of veterinary education. Increasingly, there is a diversity of models of veterinary education. We have another new vet school in SRUC coming online next year, which will push that further.
This is not just about diversity of education, though. It is the diversity of the people who come into veterinary degrees. When we think about vets, we need some of the brightest, most academic people there are. We also need people who are happy to work in remote and rural practice, to be part of that rural community, and who want to be out calving a cow at 2 am. They are different people from some of the most academic people who we are already selecting.
I would argue that widening participation is not just a good thing to have because we want individuals to be able to become vets; it is a real imperative for our profession to be thinking about doing that. I have had a vet student doing work experience with me who did not have any A-levels. They looked at alternative pathways. Many of the vet schools already have widening participation schemes. This is really important, as well as diversity of models of education.
Professor Reid: Can I just come back in on that one? One of the issues—and it takes us back almost full circle—is that many of the education models that have been promoted in recent years in different parts of the world, where there has been an attempt to attract people from less traditional backgrounds and more remote backgrounds into veterinary education, have not delivered what was intended. The people have not stayed. It is how you then get a qualified individual to stay in that environment.
There are some good models emerging where loan forgiveness, supplementary payments and all manner of things are helping that to happen, but people still will drift to where the remuneration and working conditions are better. I am not saying everybody, but certainly the models that have been set up previously have not delivered in the way that was intended.
Emily Miles: The vet school offer is demonstrably not working for public health vets because we do not have the graduates coming into the profession. Just as some examples, probably one of the better vet schools at doing public health training on the undergraduate degree is Bristol, and the FSA board visited Bristol Vet School in December last year and spoke about what it does.
The vets are getting training every year on some of the theory, they get one week in an abattoir towards the end of their course, they might see one or two species being slaughtered, and that is it. Compare that to a Spanish training programme where you might get three months’ public health veterinary training, all of that exposure in abattoirs and the chance to see that. There is something about the design of the course being different.
It is then also a cultural issue about whether people are exposed to that potential career path and are interested in it. Again, our service delivery partner now attends all of the vet schools and the graduate fairs, trying to tempt people in.
Just to give you some statistics from last year, in 2023 they took the details of 433 people at each of those grad schools and then contacted them all post-event through their recruitment team, and not a single one wanted to apply to be an official vet. I think that goes to some of the structural issues I described. There is the graduate development programme that RCVS requires of you and in the first couple of years you have some things to do. That just must not be working if you have all of those vet graduates not interested in applying to the public health official vet scheme after they finish.
Q41 Selaine Saxby: Thank you. Stuart, I am going to come to you with another question if you want to bolt this bit on. The RCVS has reported that 45% of leavers from the profession were practising for four years or less, as we have touched on. Could vet schools themselves be doing more to encourage students to stay in the sector and prepare them for the realities of working as a vet? I know we have already had some suggestions on this but is there anything you would like to add on?
Professor Reid: Could we be doing more? We can always be doing more, but can I just take it back one step? One might argue that the public health industry is not matched to the qualities of our graduates, rather than the course not serving the needs of that particular sector of the profession. Paying people more and having working conditions that they want to subscribe to is a big part of that.
As I say, new graduates at the age of 18 who enter into veterinary school, or whatever age they might be, do not generally come in wanting to work in public health. That is a reality. I do not know many people who go into their programmes of study in any profession and know exactly what they are going to be doing at the other end of it. There is work to be done, absolutely.
I invite you to visit the other schools as well, Emily, because I think there is quite a lot going on there and those who have EAEVE accreditation will meet the same standards as those Spanish schools.
Could we be doing more? Sorry, could we go back to your subsequent question, which I just have forgotten?
Q42 Selaine Saxby: What more could we be doing within the actual schools to prepare people for the reality of being a vet?
Professor Reid: There is a very strong extramural studies programme. The RCVS has been very generous in its willingness to work with the Vet Schools Council to try to make that a quality-assured process for the students. There has been this “learn on the job, see practice as something of yesteryear”, and now there is a much better and closer alignment with learning objectives, students in the working environment.
To Emily’s point, we absolutely want to see people seeing extramural studies in all aspects of the professional working environment including public health—all aspects.
Q43 Selaine Saxby: Thank you. Emily, Malcolm, is there anything you would like to add on that?
Malcolm Morley: One common theme that we have seen in media interviews today around the CMA review is the need to provide contextualised care for animals. Contextualised care is thinking about their owners and the circumstances of those animals. New grad vets absolutely need to be equipped with that, not only to be able to look after people and animals but for their own wellbeing in the profession. If they come out with high ideals—their role models are orthopaedic surgeons and medicine specialists rather than first opinion vets—they often feel a lot of guilt about not being able to deliver that level of care. We need to ensure that they are prepared for it.
Q44 Selaine Saxby: Thank you. Finally, what steps are the Government and other stakeholders taking to encourage and support vets who have left the profession to return, and what more do you think could be done in that area?
Dr Middlemiss: Having data around this is difficult because once you are not on the register you are very difficult to contact to find out these things. It is great to hear about exit interviews and things from that. We need to understand more about why people are leaving. We see in government a lot about the flexibility of working, the actual job roles and what it is you are there to do, that it is not about necessarily ticking boxes and legislation.
As an example, I have never used my vet brain so much since I have worked within government, not just as a chief vet, to make such a difference. We do not sell it well enough. There is a lot more we could do in that space on those points.
Q45 Selaine Saxby: Thank you. Is there anything that anyone else wanted to add?
Malcolm Morley: Yes. This is a big piece of work for the British Veterinary Association, thinking about supporting return to work. We have produced a return to work toolkit recently. We feel that it is not about telling vets, “You need to do it”, but showing them good examples of where it does work well. That is something that we have been doing and I think it is an imperative. If we can encourage a lot of our most experienced vets and support them to return, then that is key.
Emily Miles: Last year in 2023 we raised the pay above our normal pay settlement by £3,000 a year for our operating vets inside the FSA, and our service delivery partner did the same, with a little bit more per annum. There has been a salary increase to try to make it more attractive. I do not think it is going to be enough going forward, and that goes back to my point about either the Treasury or the meat industry being prepared to pay quite a bit more for this sort of service.
Selaine Saxby: Thank you. Thank you, Chair.
Q46 Chair: Thank you, Selaine. Just backing up what Stuart said about the work that all the vet schools across the UK are doing in terms of veterinary public health and exposing their students, there is some excellent work at the Royal Vet College. As a Committee, we saw at first hand when we visited Harper and Keele last week that it is developing a very strong veterinary public health programme. There is some good work being done in the veterinary education sector.
Before I go on to Ian, I want to come back to Stuart briefly. Sometimes the findings of our sessions come down to dollars and cents, pounds and pence, and we need more money to sort the situation. You touched on the concept of loan relief and debt relief for students. To train to be a veterinary student is an expensive undertaking for that student in terms of going to vet school for four, five or six years, doing extramural studies in your holidays, that side of things, and accruing a large debt. That is one thing I wanted to ask you about: debt relief if people go into certain sectors.
From your viewpoint as the head of the biggest vet school in the country, it is not a cheap profession to teach, either. It is a very expensive course. We saw that at Harper Adams and Harper and Keele. This is practical, vocation-based training that is expensive to run, with clinics and specialist staff.
Can you give us a feel for how much it costs to train a vet student, what you get from the Government in terms of a UK student coming in and paying fees, and then what you have to do as a vet school to potentially take in international students, who are paying a greater fee, to allow your vet schools to function? Can you give us some feel for that? I know it is a bit of a big question.
Professor Reid: Thank you for the opportunity. It always comes down to the unit resource. As you all know, since 2017-18 the tuition fee has been frozen in England and Wales, and teaching funding has only risen by 4%.
If you go back to financial year 2012-13, our costs—I am giving you the Royal Veterinary College costs here, although I do not imagine they will be that different and I will tell you why in just a second—have gone up between 15% and 18%. Our funding has gone down, depending on how you choose to do your accountancy, by between 15% and 30%. That gap is enormous.
In England and Wales in total we get about £20,000—grant plus the tuition fee—per student. That figure was quoted by Times Higher Education in 2013 as the most expensive course to deliver, and there is no NHS, so all of the clinical cost has to be borne by the university or the university partners. It is even worse in Scotland. They only get £17,500. That is tough.
If you look at audited costs as best we have them, it is costing us per student somewhere between £27,000 and £32,000, and we are getting £20,000. It is not a sustainable business.
If we come on to the split of international and home students, you will see why there might be a drift towards getting international accreditation. It is not that international students are displacing home students. They are actually allowing us to take home students. If we take fewer international students—or, sorry, students paying unregulated fees, I will be clear about that—then we will be taking fewer home students as well. That is the harsh reality. It will vary by school: anything between £35,000 and £45,000 will be the unregulated fee. I do not have the specifics for any one school other than my own. You can see that there is a tricky balancing act to play here.
We are fortunate. Just to be clear, while I said it could be as low as 30% down in real-terms funding, because we are regarded as internationally “outstanding”—I think is the word—we do get a specialist top-up grant from the Office for Students as a specialist institution. Other universities will not get that. They will have to get it from their other courses.
Q47 Chair: It is very expensive for you to deliver the training. Then, for the students coming in, you talked about the concept of loan relief as well. People are talking about that in the medical profession, for dentists and doctors, if they can work in the NHS for X number of years. Is that something that the veterinary profession should be looking at, to say that if you work in farm animal practice or veterinary public health that would be something that we could support?
Professor Reid: If it is a five-year programme and you are spending about £10,000 on your tuition and spending about £10,000 or more, depending on the part of the country, you are at £20,000. That is £100,000. I know there are student loans, but it is still debt, let us be clear.
I know the Royal College of Veterinary Surgeons—I am a member there on the education committee but not part of the council—has put in a written submission to you. I think it has described very well the different types of debt relief, because there are many, and certainly in other parts of the world they are being used to fairly good effect.
For example, in my own area, in education, I think if you make 120 payments—around 10 years’ worth of contributions—and you have been working for, say, the public sector or the university sector, the rest of your loans would be forgiven at that point. That is just one example; there are others and I think you have that in a paper.
Chair: Thank you very much. Does anyone want to come in on the finances at all before we go on to legislation? We are all champing at the bit about reform of the Veterinary Surgeons Act. I am teeing up Ian Byrne for some legislation now.
Q48 Ian Byrne: Thanks, Chair. You have all touched on it before, the need for the new legislation, but I am interested in a comment Christine made, “Our outdated legislation is holding us back and is preventing us from having a sustainable and world leading veterinary system within the UK.” You are not sitting on the fence there, which I like to see. What could we do to improve the legislation? I will ask you first, Christine.
Dr Middlemiss: Lots of things. As I think we have touched on already, one of the key things is this very prescriptive direction about who can do things to animals, which can be a vet—and we know that is heavily regulated and defined—or a farmer or a person in their employ. We have vet nurses, who are regulated. It makes it difficult in the space of veterinary technicians for other people to be part of that vet team and support. That is one of the critical things to address.
Q49 Ian Byrne: Would you like to come in, Malcolm?
Malcolm Morley: Yes. One of the most striking things at this moment in time is that you have a representative body like BVA and a regulator like the Royal College of Veterinary Surgeons, and you could barely put a piece of paper between us in terms of what we think a new Veterinary Surgeons Act needs to look like. The Royal College of Veterinary Surgeons has some legislative reform proposals that would make a perfect backbone for a new Veterinary Surgeons Act. It supports things like forward-looking fitness to practice. At the moment it is very backward-looking and punitive. It supports the regulation of veterinary practices, which is such a talking point with the CMA review today.
We do have to look at the unintended consequences. I think this needs to be a Bill around a narrow scope, a Veterinary Services Act rather than something that ends up being wider, but certainly a Veterinary Services Act rather than a Veterinary Surgeons Act to support that veterinary team.
Q50 Ian Byrne: Work has been done on that? You have touched on potential draft legislation, ready to go.
Malcolm Morley: Absolutely. The Royal College of Veterinary Surgeons’ legislative reform proposals are very tightly defined.
Q51 Ian Byrne: Okay. Emily?
Emily Miles: There is a link between the Official Controls Regulations, which the EU created and that we follow, and the Veterinary Surgeons Act, because the Official Controls Regulations specify that a vet must do certain things. If any meat business wants to export their meat to the EU—for most carcasses the fifth quarter will go to the EU, the offal and so on—they need to follow the Official Controls Regulations piece.
We are not going to be able to influence the EU’s rules because we are not part of the EU, but we can influence what a vet is in our own domestic legislation and what we have is too narrow. We do have very good vet-led teams in abattoirs where the vet oversees the meat hygiene inspector. We have proved that it works, and we think we could do even more. I gave the other example of environmental health officers at the port, where the vet could do that. I am impressed at how much work has happened to develop the proposed reforms and the Veterinary Surgeons Act. I think it is just a question of parliamentary time.
Q52 Ian Byrne: Thank you. Stuart, would you like to add something?
Professor Reid: It cannot happen soon enough. If you look at where there has been massive change in regulation in other professions, it is usually because something bad has happened. It would be good to do it before something bad happens.
Q53 Ian Byrne: That is a really good point. Christine, what steps are you taking to develop the new Veterinary Surgeons Act and have your proposals been received in any way by the current Government?
Dr Middlemiss: We have worked cross-level with the Royal College on its developing Act. In the meantime we work on statutory instruments to address gaps where we can, but we have been doing that for a long time and we are running out of road on that. Whenever we have new Ministers, in discussion, we present proposals for having a new Veterinary Surgeons or Veterinary Services Bill.
Q54 Ian Byrne: That is ready to go now, to have the debate within this place on that legislation and how that would work? You are confident that it is there. That is interesting.
What short-term changes could the Government make to support the profession while we wait for the benefits of these reforms? You touched on the SIs. Are there any recommendations we could make within this area?
Dr Middlemiss: We have heard about accreditation of vet schools and how that will work, and funding required to help that to support the EU pipeline of vets. There are things around debt relief to be explored. There is a lot that we can still think about.
Malcolm Morley: There are two quite specific things. One is that the Royal College of Veterinary Surgeons wants to modernise the statutory membership examination. It has proposed a statutory instrument for that. It is an extraordinary situation where it does not have the freedom to do that. We should absolutely be supporting that.
The other is that the British Cattle Veterinary Association has proposed to DEFRA an exemption order for veterinary technicians to be able to support farm vets, particularly working in cattle practice. At the moment, somebody who is employed by a vet cannot undertake the same procedures as a farmer can themselves. It is quite a technical nuance, and an exemption order for veterinary technicians would go a long way to supporting farm vets.
Q55 Ian Byrne: Excellent, thank you. Malcolm, obviously we are in the middle of a general election year. Are these discussions getting had with all parties across the piece?
Malcolm Morley: Absolutely. This is a live piece of conversation for us across all the parties, talking about the importance of a new Veterinary Surgeons Act. We would love to see it on parties’ manifestos for the next election. I hope that the CMA review may be the catalyst to achieve that.
Ian Byrne: All right. Thank you, Malcolm. Thanks, Chair.
Q56 Chair: Thank you, Ian. I wanted to come back to biosecurity and that role in protecting our food supply chain. First, to Christine and Emily, we have touched on this a bit earlier, but can you articulate to people watching this what role veterinary surgeons and “team vet” play in safeguarding biosecurity and our food supply chain, and where you feel this workforce is particularly under pressure as we speak now?
Dr Middlemiss: We play an absolutely critical role in a whole range of ways. Our risk for biosecurity is diseases coming in. We need to have import requirements and health certificates, checking of those and checking of animals that come in. Then we need to make sure that once animal products are here, people are compliant with the regulations around them. Then we have our vets in APHA, supported by vets in practice through our contracted vets, who carry out ongoing surveillance checks on animals and respond to suspect notifiable disease outbreaks. Then you get into the food aspects, thinking about food going on our shelves and export of food.
There is the knowledge and expertise they bring, clinical skills, there is an understanding of regulation and processes, and there is that assurance and verification as members of a profession who have to work to certain standards. It is a critical part of assuring the public and trade partners that the standards that we said we would meet are met.
That is more within our public health sector. There are vets in practice looking after animal health and the welfare of individual animals on farm level every day.
Emily Miles: What she said, but also, if you think about the sorts of things a vet is doing at a port, they are overseeing physical checks. Again, it is set out in regulation what a vet must do. They are checking the certification that vets from abroad have done for export health certificates. If there is a rejected consignment, they are the ones who have to sign that off and do the rejecting.
This goes back to the question of the definition of a vet. You could have environmental health officers doing some of those things, but the thing about a vet is that they are a regulated profession. It is their independence in the certification process that is so important. They are personally accountable for that certificate. It is not just an institutional thing; it is them as a person and as a professional. That is an incredibly important part of the safety, reliability and trust that we have in our food. The same thing happens in abattoirs. We massively rely on that independent, professional, individual guarantee to food safety and the UK’s food standards benefit around the globe from that professional guarantee.
Q57 Chair: That person is holistically trained in epidemiology, preclinical science and clinical medicine to be able to do a clinical examination as well.
Emily Miles: All those things, and they have to follow the professional bodies’ expectations about certification.
Q58 Chair: Stuart, do you want to come in?
Professor Reid: I totally agree with Emily. I think sometimes we forget that the most difficult job to do in the world is to be the general practitioner at the coalface. They are the eyes and ears. Whether you are in food animal practice, whether you are in inspection, whether you are in companion animal practice, whether it is picking up foot and mouth disease or potentially Covid in a cat, whatever it might be, they are the eyes and ears. It is the most difficult job to remain observant and attuned at all times. Then, when things do go wrong, we are pretty good at testing and tracing as well, just as a by the by.
Q59 Chair: Thank you. Back to you, Christine, what are the things that keep you up at night in terms of biosecurity risks? We have talked about avian influenza, bluetongue and African swine fever, and then—lower-level numbers—things like Brucella canis coming into the country in dogs that potentially can be spread to people. What are the threats that you see as the chief vet that you are worried about and that we need to be vigilant about?
Dr Middlemiss: There is constant and ongoing challenge on our doorstep. African swine fever, for example. We are at medium risk of incursion overall but at high risk of incursion through human-mediated ways, people bringing in non-compliant products. We have vector-borne disease outbreaks on the continent, on our doorstep. We expect bluetongue again this summer and for it to have quite a significant impact in terms of numbers. There is epizootic haemorrhagic disease in France and sheep and goat pox as well.
However, we import from around the world. Yes, we do our due diligence, audit and things, but, as we know, disease can spread. Healthy animals can start shedding disease. We move food quickly around the world and you are exposed to what is happening further away and disease.
That is very much thinking about livestock, but it applies to companion animals as well. You mentioned Brucella canis and we see an increasing number of pets in the last few years who have come in with Brucella canis. Rabies is still present around the world. We have a strong regime, but we have rabies report cases. Every year, a number of dogs show clinical signs that could be rabies and need be investigated. Luckily, they have not been, but we have to constantly, 24/7, be able to respond to those, and that is relying on the clinical expertise of the vets going out to see these animals.
Q60 Chair: We are hanging on at the moment. Do we have the veterinary capacity if we are threatened by more of these diseases coming in? We have spoken about the Animal and Plant Health Agency needing a complete refurbishment and we are urging Government to do that. That is something that you would be keen for us to keep pushing on, would it?
Dr Middlemiss: Absolutely. The Weybridge Animal and Plant Health science and testing main facility grew over a number of years and a number of disease outbreaks. Different departments were built as we responded to different diseases and there has not been ongoing investment in the infrastructure. It is very tired now and we are at risk currently of bits of it being taken out of service while they are repaired.
That is just for the disease situation we are in now. If we look forward—there was the recent medical report about the impact of climate change on human health—we need a facility and structure that is fit for purpose in 20, 30, 40, 50 years’ time.
Q61 Chair: Malcolm, did you want to come in?
Malcolm Morley: One of the great challenges is that whether it is avian influenza or bluetongue, we need to recognise that these diseases being around is part of our normal. We should not see that as exceptional. The impact that has on vets in private practice, as well as Government vets, is significant. It has impacts on things like delivery of the TB programme if there is real pressures on Government vets delivering that. That is the challenge, to have a workforce within the Government vets that is able to deal with these diseases, because they are an inevitability.
Q62 Chair: You are an equine vet, and on equine vets’ radar there are exotic diseases like African horse sickness and West Nile virus, which practitioners are being vigilant about. Heaven forbid, sometimes—
Malcolm Morley: This is normal veterinary work. We have to be vigilant for diseases in whatever sector and we need to recognise that that is normal veterinary work rather than exceptional.
Q63 Chair: Just coming back on to biosecurity and how we protect our borders, now we have left the European Union, there is the opportunity to tighten up that biosecurity. We have more control of that. Part of that is the border target operating model. As a Committee, we have been looking at that very closely. We went down to Dover a few months ago and we have had ongoing discussions with the Department on that. To what extent do you feel that that target operating model is going to work and how will it impact veterinary capacity moving forward? Are there any recommendations that we as a Committee could hopefully make to Government to make it future-proof?
Dr Middlemiss: Once the full model is ruled out and implemented I think it will be a good and effective regime because it is more focused on products and countries of higher risk. There is a risk basis to it. More attention will be focused there and less on, for example, things we call composite products, which are highly processed. There will be less attention on those because they are much less likely to bring disease.
We have our controls for the rest of the world. We continue with what was the EU regime for those. We have implemented this new structure coming online for products coming from the EU, we now have export health certificates in place, and we will be moving to having the border control post controls for things coming from the EU. Then we will change the rest of the world regime to align to this risk basis. It needs to be a flexible regime and it will respond as risk changes around the world, which is another thing that I like about it.
Key for is me having the resource. You need to understand people who are compliant, who bring product in with their export health certificates and things, but we need to have a strong focus where there is non-compliance. That is particularly a Border Force role for me, picking up people who are completely trying to avoid all of the import rules. We know very small amounts of meat can carry African swine fever or foot and mouth disease with them, and we need to have a strong system across all agencies at the border to pick these up.
Q64 Chair: You hit on that point of non-compliance and the unscrupulous people who are going to be trying to get around and avoid checks and use loopholes. As a Committee, we have been very concerned. We went to Dover and there is the inland port in Sevington, 22 miles away, that people will be directed to. We have been very keen to say, “Look, can we still have some random checks at the port?” We are cognisant that they do not want to disrupt the flow through the port but there may be unscrupulous people trying to smuggle in suitcases or boxes full of pig meat that might potentially have African swine fever.
My colleague and friend Selaine is this week taking the puppy-smuggling Bill through Parliament. If bad people trying to smuggle heavily pregnant dogs or puppies are told to drive 22 miles up the road, what is to stop them potentially offloading their puppies before they get there? These are some of the concerns we have biosecurity-wise but also animal welfare-wise. What can we do to tighten up and close the loopholes?
Dr Middlemiss: I am not so worried about the 22 miles because it does not make a difference whether it is 22 miles or the five miles to Bastion Point. For me, it is about the co-operation of the organisations involved from coming into port all the way through to being released into the UK market, particularly around intelligence sharing among organisations, not working in their silos. Border Force tells us that you often find somebody who might be bringing in meat is also non-compliant in other areas. They want to bring in other things that would be illegal. Having that intelligence is critical.
Q65 Chair: Can we still have some random checks at the port, not 22 miles away? That is what we—
Emily Miles: Yes, absolutely.
Q66 Chair: That will be intelligence-led, so that these people will know that it could be on weekends, it could be on bank holidays, it could be in the middle of the night and that they still will be checked? We want people to know that the UK is trying to protect its borders from diseases and adverse animal welfare situations coming in.
Dr Middlemiss: We have noted Dover but of course we have a number of other ports and routes into the UK. We need to be able to have a similar focus on all of them and not be strong in one place and have back doors.
Q67 Chair: Malcolm, something that your membership has been pushing for as well is pre-import checks of animals. We have touched on Brucella canis. Can you tell us the impact of the stresses and strains on practitioners in small animal practice, who are very concerned if they have a heavily pregnant dog that may have been imported from the continent of Europe, from Romania or Macedonia, that potentially could be whelping and exposing “team vet” to Brucella canis, which is a not nice disease in people and a grim disease in dogs? You have been calling for that. What is the impact and what does it mean for the veterinary sector to do those checks?
Malcolm Morley: Absolutely. If we wind back some time, when we had robust rabies controls they served to as a control measure for a lot of other exotic diseases. We are seeing several exotic diseases of dogs particularly coming into the UK, as well as exotic parasites and ticks that can transmit zoonotic disease. As you have alluded to, of those Brucella canis is the one that our members are most concerned about, not just for themselves but for the owners. That is where we have seen people getting infected, owners of bitches who whelp who are infected with Brucella canis. It is much better to deal with these things before they come into the country than deal with them afterwards.
Q68 Chair: You have mentioned tick treatments. I think in 2014 the EU changed that mandatory requirement to have a tick treatment coming in. Is that something, Christine, that the UK could strengthen? There were the cases in Harlow in Essex where a dog picked up Babesia from a field in Harlow, but the dog had never been out of the country. A tick obviously has been deposited in that area from a dog that had been out. Is that something that we could do? We can strengthen our borders by bringing in some of these checks, but also some of these preventive health treatments.
Dr Middlemiss: Yes, we have the ability, based on the risks that we are seeing, to define our own import controls.
Q69 Chair: Thank you. Before I get on to the final question on animal welfare, I just wanted to touch again on official veterinarians. We have touched on recruitment and retention. Are there any points or take-home messages on what we can do to improve that side of things?
To Emily, the temporary registration system has been to try to help the shortage of official veterinarians in abattoirs. In the FSA’s next procurement exercise, could you expand that to allow more usage of the private sector and vets out in practice to be part of that, rather than a central pool? Is that something that you are directly looking at? Is that something that we could do?
Emily Miles: Yes, so we need to let the contract by April 2025. That is when the existing contract runs out, so we are in the middle of engagement with the sector. We will be going out to tender in the next couple of months and then we will take responses to that. We have been very clear in the design of the contract this time that first and foremost we protect consumer health and consumer safety, and we can provide a service to the meat industry that we need to do, but also we want to ensure that the supplier base is supported. If possible we do not want to be in a monopoly situation.
There are of course knock-on costs to that. One of the financial risks that I am handling at the moment is the financial risk we have already described around the meat hygiene inspector migrant salary cost, but also the potential risk of an increased cost to official controls because once you have more than one supplier there is less economy of scale. Nevertheless, it is very important that we have sufficiently diverse provision, and we are trying to encourage as best we can a diverse set of applicants for that tender so that we can have a more diverse supply.
Q70 Chair: If I can go over to you, Christine. I think in your submission to us you mentioned our reliance, when we have an emergency of the people on the frontline, on private practitioners, who stepped up in 2001 in the foot and mouth crisis. Is that something that the Government would be supportive of to see if we can mobilise that army in a peacetime situation, albeit you have said that we have significant threats, but heaven forbid we get a catastrophic disease outbreak. Is that engagement with private vets for more of them to become official veterinarians so that a farm vet could follow that herd into the abattoir and see the health status on the supply chain something the Government would get behind?
Dr Middlemiss: We use private vets through our veterinary delivery partnership. We have used them hugely in the outbreaks that we have had in the last few years, so over 3,000 days a year for the avian influenza outbreak. I do not see them as a separate workforce; they are a critical part of the workforce that we have, but we are all pulling on the same people often. As I said at the beginning, that is in addition to the day job where outbreaks—as Malcolm Morley has said—have almost become routinely part of that. The call is really further stretching resource, but absolutely we need to work together through the system from farm through to fork, I believe.
Chair: Before I get on to the final questions on animal welfare, does anyone else want to say anything more about biosecurity or public health? Okay, over to Barry Gardiner now.
Q71 Barry Gardiner: The first question is a very easy one. Is it not great when we have a vet in the Chair of the Committee? I want to focus on animal welfare. Where is our next Lincolnshire? You will recall that a couple of years ago in Lincolnshire I think there were only eight vets operating in the county on farms and there was a question, in fact I think the BBC did an exposé, showing that there was a real risk to animal welfare because farmers had to do things that vets should be there doing. Where are we exposed now? Where are the hotspots that are of concern or should be of concern?
Dr Middlemiss: I note my Scottish colleague, Sheila Voas, and the Highlands and Islands Veterinary Services Scheme where the Scottish Government have close involvement with practitioners there because there is not the level of business and animal population to support having a lot of vets in the area, but the service is required for animal health and welfare.
Q72 Barry Gardiner: Given that that is a devolved Administration, and we are focused here on England, where are the hotspots in England? Where is the shortage. Ms Miles, I think you said when you were talking with the Chair about the situation in the abattoirs, when there is a shortage of veterinary professionals, animal welfare issues get quite serious quite quickly. I think those were your words.
Emily Miles: I was talking about backing up on farms for the animal welfare issues. In terms of vets and abattoirs, vets on behalf of DEFRA—
Q73 Barry Gardiner: I did not want to focus simply on abattoirs but, please, go on.
Emily Miles: What we find in terms of recruitment is that it is easier to recruit overseas vets to cities than it is to rural areas. Rural areas struggle more.
Malcolm Morley: I think we need not so much to be asking the question now as to looking over the horizon, scanning over the next five or 10 years. Increasingly if you are a new graduate vet you can work in small animal practice and you do not have to cover any out-of-hours, because that is becoming centrally resourced. You are likely to be able to work more flexibly. I think it is any area of remote and rural veterinary practice where we would have concerns.
Many of these measures that we have talked about, supporting vets with veterinary technicians are important, but as soon as we do that, and we start replacing vets with other people we also reduce the number of people that can be on duty at night. If you have a practice of four vets that is more resilient to trying to provide that out-of-hours, 24/7 cover, and I think we may have to have some challenging conversations about that requirement to provide 24/7, out-of-hours cover if we are going to be able to provide veterinary cover at all in some areas.
Q74 Barry Gardiner: It is interesting that you and Ms Miles have taken the question back to the issue of adequate cover and the human side of it. I am trying to focus on the animal welfare side of it. You say, “Well, let’s look prospectively, let’s look to the future and see what we can do about it”, and obviously we know what we can do about it. We can get more vets trained up, we can get more vets into the country, and we can pay them better, put simply, but that does not tell us what the problems are now.
You are being very diplomatic in not wanting to point the finger, I imagine, but I want to know what the impact is currently on the shortage of veterinary professionals, not just in rural areas, not just in the pet and domestic animals, but in farm animals, in the whole package. Where is the system creaking under the strain currently?
Malcolm Morley: It is creaking under the strain, but vets are delivering it. I am not aware of anywhere where animal welfare is starting to suffer but it is the veterinary profession that is creaking under the strain of delivering that, and that is a concern. In answer to your question, I do not have another Lincolnshire to look at, because vets—
Q75 Barry Gardiner: Vets there were doing 70 hours a week.
Malcolm Morley: Yes, vets are amazingly good at stepping up when it is needed, but that is unsustainable.
Professor Reid: I am still struggling a little bit with your question because I would argue that it is creaking right across the industry. We run a tertiary level referral hospital and there are some services where you cannot get an appointment for months. Whatever you might think of it, an emergency is an emergency, and they are seen on that basis, but animal welfare is challenged in the same way as human wellbeing is challenged by not being able to get appointments in a timely fashion. That will not be ubiquitous and that is at the tertiary level of referral, but it is symptomatic.
Q76 Barry Gardiner: To be clear, you believe that animal welfare is suffering across the board because of the lack of veterinary capacity.
Professor Reid: Potentially, I said, but not ubiquitously.
Q77 Barry Gardiner: We now have the responsibility placed on vets to neuter bully XLs. Let’s start at the other end. What is the carrying capacity of most of the average veterinary surgeons to overnight a dog after they have been neutered? How many places would they have available to do that on average?
Malcolm Morley: I don’t think I can give you a figure, but I don’t think there is an issue with the capacity to do that. There is an issue with perhaps the capacity to do that in a specific practice, so a lot of out-of-hours care is outsourced to somewhere else, and so there is the capacity to do it. Many veterinary practices themselves will not do that themselves.
Q78 Barry Gardiner: Do we have any idea of how many bully XLs need to be neutered? Chief Veterinary Officer?
Dr Middlemiss: I think our current estimate is about 70% of those that have been registered so far will require to be neutered.
Q79 Barry Gardiner: In numbers what would that be?
Dr Middlemiss: The latest figure I had for registrations—I will put it a different way. We think there is an extra 0.13 additional dogs per practice per week to be neutered.
Q80 Chair: What are the latest figures for registered XL bullies?
Dr Middlemiss: I do not have them off the top of my head. It is changing all the time.
Q81 Chair: Yes, so maybe write to us afterwards.
Dr Middlemiss: The estimate is an additional 0.13 animals per practice per week. Of course we recognise that it does not work like that because there will be more in some places and less in others, but that is the estimate.
Q82 Chair: Surely we have a snapshot of the number of registrations because the deadline has passed.
Dr Middlemiss: Yes, we had an update on Friday.
Malcolm Morley: We absolutely cannot just take the number of XL bullies and divide that by the number of practices and the number of weeks until the deadline, because these animals are not equally distributed, and vets are actively encouraging people to leave it until the last minute for the health and welfare of those dogs.
Q83 Barry Gardiner: I was coming on to that, but please keep going. Twelve, 18 months. What do you want?
Malcolm Morley: The profession is encouraging people to look ahead, plan ahead and book appointments.
Q84 Barry Gardiner: Dr Middlemiss is listening, but I think the Department has a different view, hasn’t it?
Malcolm Morley: There is so much evidence about the negative health and welfare implications of neutering large breeds of dog too early so owners of young dogs are being encouraged by vets to wait until closer to the deadline, so we have less weeks. Many veterinary practices do not have a lot of XL bullies. Some have a significant number. Where that is particularly unequally distributed is charity practice. What we are going to do is put a heavy burden on charity practices in a short space of time. We would particularly like to see an extension to the neutering deadline to allow dogs to be 18 months old before they are neutered. That would both benefit animal welfare and veterinary capacity.
Q85 Barry Gardiner: I think my colleague Ian Byrne and I, as urban Members of Parliament in our constituencies, would feel that very acutely. Dr Middlemiss, give us a solution from government.
Dr Middlemiss: We have had the advice from BVA and yourselves around looking at the age of neutering and now we have the figures of the number that are registered and their age it is being reviewed.
Chair: That is something that as a Committee we have called for and asked for. So it is under review.
Q86 Barry Gardiner: When is it likely that you will reach a decision?
Dr Middlemiss: I do not have that information today.
Q87 Chair: I want to come quickly before we wrap up to talk about veterinary capacity around the country and in more rurally isolated areas. Stuart, you talked about your partnership between the Royal Veterinary College and Aberystwyth now, so hopefully part of that model will help supply in rural Wales as well.
Professor Reid: One would hope so. It remains to be seen.
Q88 Chair: That is something that was very much when you set that up. You mentioned also SRUC in Aberdeen. That will hopefully have some help in capacity for Highlands and Islands as well.
Professor Reid: Again one would assume so. I pay tribute to Elizabeth Treasure who was the VC at Aberystwyth who had a real commitment to the local community and meaningful professions and jobs being created in that area. She had a nursing programme, and she introduced the veterinary collaboration with us.
Q89 Chair: A final quick question covering an issue in terms of how veterinarians can operate across the United Kingdom. One of the issues—and I know the BVA is working very hard on this as well, and I have asked questions on this too—is about the supply of veterinary medicines in Northern Ireland. We have had a temporary dispensation so that they will be available until the end of 2025 but there was the situation before that extension that potentially 50% of veterinary medicines may not be available in Northern Ireland.
That would include things such as salmonella and leptospirosis vaccines as well, so it is not only for the health of animals and flocks but there is also a public health aspect. Can I ask for your thoughts on that in terms of what pressures we can make in terms of Europe and UK dialogue to get that over the line? It is a common sense thing that will help the entire United Kingdom.
Dr Middlemiss: The conversations continue. We have given an extension of three years, as you have said, and conversations continue with the EU Commission. What is helpful now is getting additional data from the pharmaceutical companies on which particular products will be at risk, because we can then translate that on to the impact on the ground and that is very important, rather than just a percentage figure of veterinary medicines will not be available, because we know we have generics and different things. Getting that data is extremely helpful and conversations continue.
Q90 Chair: Thank you. Malcolm, did you want to say anything on behalf of the BVA and the sister organisation in Northern Ireland as to what you would like to see?
Malcolm Morley: We need conversations across the board. I know Christine has spent a great deal of time looking at this as well. The solutions will be found within Europe as well as the UK. I think there are wider implications than just the supply of medicines into Northern Ireland. The United Kingdom is a relatively small market for some of these manufacturers. Again, if we put friction in the way we will see less drugs coming into the UK, and we will see less innovation. It is important to see Northern Ireland as a big part of that jigsaw.
Q91 Chair: We have talked about the UK and Christine Middlemiss has talked about the Chief Veterinary Officer for Scotland, Sheila Voas, and you work very closely across the entire UK and with your counterparts in Europe. Is there some scope for a veterinary arrangement between the UK and the EU to help with the combined protection of biosecurity on the continent of Europe and across the UK? Is that something that you can have dialogue with your counterparts in Europe about?
Dr Middlemiss: I have ongoing conversations with chief veterinary officers, particularly at the moment with the Netherlands, for example, about bluetongue, understanding what they have been through. Absolutely that sharing of intelligence continues and is critical, particularly with the island of Ireland as well, and the CVO in the Republic.
Q92 Chair: We are going to come to an end now. I want to have a quickfire final question to everyone, just a very quick wish list. We will not be writing a formal report, but we will be potentially writing to the Department and writing letters and so on, so just two or three bullet points that you feel that as a Committee we could raise on your behalf as to what issues you feel that we have talked about today, or things that you would like to see with the pressures that are facing the veterinary profession. I started from left to right last time, so I will start with Malcolm this time.
Malcolm Morley: The first one is probably pretty clear: reform of the Veterinary Surgeons Act, and then my other two bullet points are a statutory instrument for modernising of the statutory membership exam for overseas vets and an exemption order for vet techs, which has already been proposed to DEFRA by the British Cattle Veterinary Association.
Q93 Chair: It is a bit like a round of “Countdown” now. I see everyone writing down their three words. Okay, so Emily?
Emily Miles: I want to say a massive thank you to the Committee for doing this hearing. In the “Our Food 2022” report that we published in November last year we said we were concerned about vets and vet supply, and it is helpful to have this opportunity to talk about it, so a massive thank you. Official vets are the backbone of work on animal health, animal welfare and public health for us.
My wish list has four things on it. The first is financial investment in the system, which is about increased remuneration, support to universities, support to students. The second is RCVS getting support to do that accreditation for overseas veterinary qualifications. The third is the VSA reform piece that we have been talking about and the fourth is an exemption to meat hygiene inspectors for the salary cap.
Q94 Chair: Thank you. Christine, you are allowed four now.
Dr Middlemiss: I was going to add one; I could have five. I agree on the Veterinary Surgeons Act. We need to update it and make it contemporary for now but also the future. Unsurprisingly, for me continued investment in Weybridge is absolutely critical because a big exotic disease outbreak undermines everything that we are doing across the profession.
I would like to see recognition of professional pay within government, within the structures that we have in the civil service. We are bound by the Department and wider structures as civil servants, and less recognition of professional pay. Absolutely the definition, which probably falls on vets, of what is a vet I think we need to look at, and then that leads into how we are educating the people who are going to be vets.
Professor Reid: No surprises: the new Act and with as much as possible being put into secondary legislation because we cannot afford to go another 60 or 70 years before we modernise the next one. I had the soapbox for two minutes on unit resource of veterinary education. I cannot get away from that one because I don’t think it is sustainable in its current form. Maybe a 10-year horizon, but unless that gets sorted we will have fewer veterinary surgeons in this country, not more. The final thing, and it is a missed opportunity on my part, is to see the term One Health appear in the official transcript. I think I have just achieved that.
Chair: Thank you. On that point, which is a great way to end the concept of One Health, the role that “team vet” does to protect and uphold animal health and welfare but also human health and welfare. Thank you to all our four expert witnesses today. It has been a wide ranging and thorough session exploring lots of issues. It is very helpful to us as a Committee that we will be able to feed this into the Department and to our parliamentary colleagues as well so that we can protect the sector moving forward. Thank you very much.