We need a veterinary ombudsman – Part 2

By David Anderson

I have great respect for people like David Anderson, because he has done the research and the work, and put himself out on behalf of others, and so I’m delighted to carry his article in our newsletter.

In 2014, David Anderson says that Vets Now, an out-of-hours veterinary franchise, overcharged him and over-treated and overdosed his dog. All complaints to the Royal College of Veterinary Surgeons (RCVS) and enquiries over fees were rejected. As a result he started the Facebook group Vetsnow complaints.

David says, “The page elicited many stories and comments from pet owners who felt they had suffered much more than I at the hands of Vets Now. All of us had followed the British Veterinary Association (BVA) and the Royal College of Veterinary Surgeons (RCVS) advice to raise issues with the company, and not one had received anything other than stock excuses and platitudes.

“All of us subsequently complained to the RCVS, as they tell us we should, and not one complaint received any redress whatsoever.”

In July 2017 the RCVS held its annual day, an impressive affair with various members wearing pretty gowns and hats. It was a day of smug self-congratulation. They gave themselves hundreds of awards; they spoke of the success of the scheme to allow vets, who are not doctors, to call themselves doctors because Australian vets can.

They spoke of how much they wanted to avoid external regulation and the importance of change. Few organisations need these things more. However they made absolutely no mention of the hundreds of complaints that are dismissed with no further action every year.

Since 1966, an important date, the RCVS have received, by their own admission, about a thousand complaints from clients each year. In fairness I make it less, on average about 800 , but as the RCVS rejects nearly all of them anyway, 200 loved pets make little difference.

Until very recently on the RCVS website you would find a page that proudly proclaimed that, “despite the annual number of complaints, because of our robust investigation procedures, only 1% ever reaches a disciplinary stage.” This means that the remaining 99% are dismissed with no further meaningful action.

The RCVS has removed the page and now says that around 80% of complaints have not progressed beyond Stage One of the concerns process. They also say that there are two more stages which increase this percentage further…. to 99% , which is what I said.

When challenged on this they insist that through Health and Safety regulations and the Code of Practice, a number of vets are given ‘advice’. These are not my quote marks; advice is simply that, and vets can take it or leave it. The RCVS admit that advice “offers no practical solutions or avenues for redress for consumers who may consider that something has ‘gone wrong’.”

It’s almost impossible to find out how many vets take any notice of this ‘advice’ and it appears that the RCVS doesn’t know either as, “the way our computer system works, we cannot search for cases that were closed with ‘advice’.”

So the governing body of veterinary surgeons, the much revered Royal College that loudly proclaims how it strives to set standards for the benefit of the profession and its clients, has steadfastly dismissed for the past, now 51 years, in the region of 45,000 complaints. These complaints are about standards of care, extortionate fees, and more.

How can it be that the interests of pet owners are treated with such uncaring contempt? Well, the RCVS blames the jurisdiction of the Veterinary Surgeons Act of 1966, which they conveniently insist constrains their actions. This Act stipulates that a vet can only be disciplined if they are guilty of serious professional misconduct for which they can be struck off. There is no other avenue of complaint.

Not surprisingly this very high level of malpractice is very rarely reached, especially as only vets can judge a vet and the RCVS themselves undertake the investigations. The RCVS knows full well that there are literally thousands of genuine complaints from clients who only want some justice for poor care and/or excessive fees, but they have simply chosen to bemoan and bewail that this ‘antiquated’ Act has, for 50 years, completely tied their hands.

Within this group (of 800 complaints per year) there are potential cases of negligence as well as consumer and service disputes, neither of which the RCVS has power to resolve as they don’t cross the high threshold of misconduct – so says the Registrar of the RCVS.
Put very simply they are perfectly happy with things as they are as their role in life is to protect their overblown Royal status and above all the reputation of their paying members. Frankly the interests of unhappy clients are of no importance.

Although the RCVS perpetuates the nonsense that the only sanction that a vet can receive is to be struck off (a vanishingly small likelihood as even those few who are disciplined are rarely deregistered), not many aggrieved clients actually want a vet to lose their livelihood and the Act does not, and never has, prevented the introduction of a much simpler and quicker second tier complaint process to allow the hundreds of unhappy clients a degree of justice. The fact is that the RCVS has never made any effort to set up such a process or to introduce an amendment to the Veterinary Surgeon’s Act.

As a classic example of how little the RCVS cares about the interests of clients, it’s worth noting their refusal to implement their own regulation about fees. In the Guardian online article (April 2016: Are Vets´ Bills Making You As Sick As a Dog?) reporters were told by the RCVS that they do not regulate fees , but were told that there exists a regulation that says that if a vet charges excessive fees this is considered to be serious professional misconduct worthy of disciplinary action.

The reporters were not told, however, that this regulation had only ever been applied once in 50 years (and that the offender was acquitted). The Disciplinary Panel considered that mark-ups on medication of 200% to 300% were disgraceful. Take a quick look at a bill from a large infamous out of hours company and Google the prices of medications and blood kits etc. Disgraceful is not in it. The RCVS refuses to apply this regulation to this company’s CEO, who is famously on record as saying, “I am not in this business to make money”.

The refusal of the RCVS to do anything about their hiding behind the 1966 Act was raised by (I quote from the RCVS Council Report Sept 2017) the Environment, Food and Rural Affairs Committee of the House of Commons (back) in 2008. The report said that, “Allowing such a large number of complaints each year to be dismissed in this way inevitably harms the reputation of the veterinary profession.”

This Government Committee required the RCVS to work with Defra to change this and to provide a White Paper to amend the 1966 Act. The RCVS and Defra combined did absolutely nothing until 2013 and 4000 complaints later, when an LRO was implemented which did nothing more than tinker with the Committee membership in order to modernise and speed up , but not change, the Disciplinary process that rejects 99% of cases.

According to the RCVS figures, nothing whatever has changed. No speed-up nor reduction in complaints, nor any increased number being disciplined, nor any sensible second-tier complaint process. So in 2015, and 1600 more complaints later, the pressure on them was such that they had to do something – and that something was two ludicrous trial Alternative Dispute Resolution Schemes.

The first of these came into play when the RCVS had rejected, as they do, the client’s complaint and the matter was then referred to the scheme. This scheme was entirely voluntary, with no sanction nor criticism if the vet chose not to participate. So 88% did exactly that: they didn’t participate.

Thankfully this Scheme was cancelled, but only after it had been extended for six months and more vets simply refused to participate. This Scheme then gave way to another that is even worse.

The RCVS now ‘signposts’ complaints straight to the newly formed Veterinary Client Mediation Service (the VCMS) – a mediation service outside the RCVS. As a consequence these complaints no longer appear in the RCVS statistics. This scheme is also voluntary and a goodly percentage of vets simply refuse to face their complainants.

If a complaint is made directly to the RCVS it will be (their word) ‘triaged’, but most likely the RCVS will try to hive it off to the VCMS. However, the very most an aggrieved client might expect by way of redress would be an apology or a contribution to a charity, but only as long as the traumatised or grieving pet owner stops posting nasty things on Facebook.

At long last, as a consequence of the ongoing pressure from many consumers and action groups, the RCVS has come to the realisation that they are losing public trust and say they intend to do something about it by setting up a working party to consider whether new legislation to regulate the profession may be appropriate.

It is as plain as the nose on your face that after 50 years and 45,000 unanswered complaints it most certainly is appropriate and desperately needed, but nonetheless this working party made up entirely of RCVS personnel is only going to consider the matter. They have apparently only just realised that “Clearly using 50-year-old legislation has its limitations, ………the fact is that this somewhat antiquated legislation is the basis for all we do.”

It is my guess that they will change as little as they can and take a long time doing it. We can safely assume that one member of the panel will be reluctant to change anything. This person is a senior manager in the RCVS and also a senior manager of the out of hours practice that benefits so much from the fact that the RCVS allows them to operate monopolies in large geographical areas (a matter in the CMA’s “pipeline”) and to charge as much as they please.

Any suggestion of a special relationship between the RCVS and this company will be vehemently denied. It is not easy to place much faith in an organisation that does not understand that declaring an interest does not actually remove it.

Mr May, who chairs the working party, observes that “The UK leaving the EU will necessitate some changes to the Veterinary Surgeons Act as it currently exists so this feels like an opportune moment to carry out a wholesale review of the legislative basis for regulation of the veterinary profession in the UK”.

Clearly nowhere on the 50 year journey to 45,000 complaints was any other time considered opportune.

The RCVS are always polite and appear helpful but they are past masters at presenting vested interest as moral principle and I have no confidence that much will change especially noting their already declared open-ended timescale.

“The Legislation Working Party is to meet at least four times and will report to RCVS Council in due course.”

So they will meet twice a year, with nice lunches, another year to report to the Council, another year to refine and implement … and this equals 3,200 more unanswered complaints.

The RCVS is not fit for its purpose. It fails to regulate the profession; it appears to allow vested interest to influence the continued use of contested medicine and it seeks to ban the use of alternative treatments. We hope to be a part of changing this.