Petitions Committee

Item 2 on the agenda, the first evidence session for petition P-06-1291, 'Hold an enquiry into the corporate takeover of the veterinary profession in Wales'. This is a petition submitted by Linda Joyce-Jones, which the committee took interest in. Part of the consideration of this petition was that we held an event, which I sponsored as Chair of this committee—it was the first of its kind in the Senedd—to learn more about the veterinary profession in Wales. We also spoke to the Economy, Trade and Rural Affairs Committee, who did have an interest in this area, albeit their forward work programme was a little bit too jam-packed to take it on, so we decided as a committee that we would hold a short inquiry and today's our first session of that.

With us we have Dr Julia Mewes and Dr Susan Paterson. Please could I ask you to introduce yourselves for the record before taking questions from Members? Dr Mewes.

Hello. Yes, and thank you very much for inviting me to be part of this process. I'm, as you say, Dr Julia Mewes. I run The Mewes Vets, which I set up from scratch as an independent practice 28 years ago. In the last 18 months, I've opened two new branches in areas where I recognised that—. Sorry, did—. Can you hear me all right?

Yes, fine, yes.

So, I specialise in being, hopefully, a very good first-opinion veterinary surgeon, and I encourage all my colleagues to do the same. We are like GPs for pets.

Thank you, Dr Mewes. Dr Paterson.

Good afternoon, everybody. My name is Dr Sue Paterson. I'm currently the president of the Royal College of Veterinary Surgeons. I am a veterinary surgeon. I'm also an RCVS specialist in dermatology, previous owner of a large independent practice group with referral hospital and primary care hospitals, and, for complete transparency, I'm also a veterinary trustee of Battersea Dogs and Cats Home. And it's lovely to be with you.

Thank you. We're grateful for your being with us. I should also say: we've had extensive briefing from the Dogs Trust this afternoon, who couldn't be with us in either this session or the next session we've got, but Members will take that into consideration during our inquiry. Can I hand over to Peredur Owen Griffiths to start questions to the panel?

Thank you, Jack, and thank you very much for attending today.

It's good to see you on screen, having once wanted to be a vet, but I didn't quite get into vet school, so my path eventually led me here, so it's quite interesting to see how that happens.

But, looking back over the last 25 years, what's changed, in your opinion, in the veterinary world, and the veterinary profession, since 1999—obviously, from your perspectives? I've got Dr Paterson on the big screen, so shall we go there first, and then Dr Mewes after that?

Yes, of course. Happy to answer that one. I think, realistically, there are four big things that we've seen change since 1999. The first of those, of course, is practice structure, which I know we're going to talk about in a lot of detail today. We've also seen a real change in the facilities that veterinary practices have available to them and the capabilities of our veterinary practice. We've also seen a very big change in our workforce and we've also seen changes in veterinary education. I don't know whether you want me to expand on those now, or let Julia have a word before I talk some more.

Maybe, yes, from—. If we go to Julia, then, just as, 'Do you concur?' And then, obviously, we can unpack some of that afterwards.

Yes, no problem.

Yes, absolutely; I would concur with that. From a general practitioner point of view, this has meant an enormous change since I first joined the profession nearly 35 years ago, from really simple things like it being very unusual to place an intravenous cannula into our patients to doing that absolutely routinely every hour. The practice standards scheme, of course, is relatively new in that same era. The registration of veterinary nurses has really been a big change, and what veterinary nurses are capable of and competent to do. I hope that that's been a huge change. I think there's been a big shift from farm animal work more to GP work [Correction: 'more to small animal/pet care GP work'] and referral work within the profession as a whole. And, of course, when I joined the profession, it was very rare for women to be in the profession. I think we were the first ever year that had 50:50 male and female, and now it's a very female-dominated profession. I think, Sue, you'd agree with that. Of course, we're experiencing terrific issues with mental health issues right now, and that's a very sad problem. It is very much impinging on our workforce capabilities, I'd say.

Thank you. So, if we go back to Sue and look at the four areas, and maybe—. Do you want to have a look at that and say what the pace of change is? Is it increasing, is it slowing down? Is it finding a happy medium now, in your opinion? So, if you go through those four points.

Let me give you a few facts and figures. As far as corporatisation is concerned, we know that 50 per cent of practices across the UK are actually corporatised now. I would suggest that's probably levelled out. Wales is slightly behind that; Wales has about 41 per cent of their practices corporatised, in that there are 351 practices in Wales, of which 151 of those are owned by one of the big seven corporate entities. So, corporatisation is very definitely affecting Wales, but not to the same degree as it is across the rest of the UK. As I say, my feeling is that's probably levelling out.

As far as facilities are concerned and capabilities are concerned, I could not imagine in 1999 the access that I would have to the drugs I have today. We've got incredible new drugs that have been developed that are state of the art. We've had some of the first monoclonal antibodies available to us as veterinary surgeons, and they have taken an enormous amount of development, and, therefore, they've come with a pricetag associated with them. So, the treatments have become more expensive. Diagnostics have also become more expensive. We've now got CT and MRI, which we didn't have back in 1999. And, of course, we can do all sorts of surgical interventions that we could not before; something like cataract surgery has now become completely routine. So, there's a wider range of services available through primary care. As Julia's already said, we've seen this increased specialisation, but I think the other thing that's very much brought that to the front is the fact that the public are much more aware of specialisation through things like social media, through things like television and through things like celebrity endorsement.

We've seen more insurance with animals, and, as we've already heard, we have our practice standards scheme, which was launched by the college in 2005. That, though, is a voluntary scheme. The Royal College of Veterinary Surgeons cannot regulate currently veterinary practices. We can only regulate veterinary professionals, and that is a huge hole in the regulatory process and something we'd very much like to put right.

We've also heard our profession is becoming feminised. We're seeing—. Things like out of-hours provision are now available, which it never used to be, which has helped vets enormously around quality of life. We've seen, again, more small animal work. Our production animal vets, their work's changed very definitely in that we're seeing much more preventative treatment—herd health schemes, for example, that production vets now do—rather than the sort of fire brigade work they were doing before. We've seen a growth in part-time working, and then, again, as we've already heard, we're seeing a lot more in the way of allied professionals. Our veterinary nurses back in 1999 were cleaning kennels, and now these are highly qualified, professional, driven people who are regulated by the royal college.

Great. You talked about the difference between England and Wales there, do you have any insight into the difference between urban and rural, as well, in that context? Are the corporates more involved in an urban setting, rather than a rural, mid Wales or elsewhere? Is that something that you could comment on?

I don't have data on that. I'm not sure whether we do have that data, but, certainly, if that's data that you would like, I can certainly go away and see if I can find that for you, but I don't have that off the top of my head.

Yes. It's just an interest: is there a difference between—?

Inevitably, I would suggest that there are going to be much larger conurbations in England than there are in Wales, and so you will inevitably tend to get clustering of specialist hospitals where there are large conurbations. So, for example, the biggest referral hospitals in England will be in Manchester, will be, for example, in Birmingham, will be in London, and then the biggest referral hospitals in Scotland will be in Glasgow and Edinburgh. I wouldn't expect there to be any specialist referral hospitals in the highlands and islands and I wouldn't expect there to be any big referral hospitals down in the south-west. So, I think you can expect to see the big hospitals where the populations are.

Okay. Thank you. Going over to Julia, you're an independent practice and your practice is independent. So, the practices around you, then, in your neck of the woods, are you seeing more corporate entities coming in and becoming part of that, or—? Can you comment a bit on, on the ground, what you're seeing?

Absolutely. So, when I first set up my original practice in Haywards Heath, which is just south of Gatwick airport—halfway between London and Brighton if that helps you, geographically, to get it on your map—I knew all the local practice owners; we were all independent, of course. Now, we actually are something of an anachronism, I think, in the locality, because we still have another independent in the town. A third practice opened up as an independent, but is now corporate. And in our neighbouring town, which is Burgess Hill, just counting them up, they're all corporates in Burgess Hill. So, in terms of competition, if you wish, from a client pet owner's point of view, they'd have to travel to Haywards Heath. Is there still one—? No, I beg your pardon, there is still one independent in Burgess Hill and two in Haywards Heath.

Down on the coast, on the other hand—. I've opened a practice very close to Brighton, but in a little village just outside, and the only independent left in Brighton is a cat-only clinic and there is an independent if you count a mobile feline-only unit, I think. The other practice I've opened is in Peacehaven. All the other vets, three of them, recently, the last one fell to the corporate system—that's a bit wrong language, isn't it—and I think a new independent has opened up in Newhaven; I think there are now two independents in Newhaven. So, we're lucky, in some ways—if a client owner is very keen to see a vet at an independently owned practice, then they exist—but, compared with the total number of practices in Brighton, we're in a distinct minority at the moment.

Okay. One of the things that Dr Paterson said was that you can regulate vets but not veterinary practices. As an independent practice, what does that entail? You and your vets will be regulated, but the work that your practice does is not regulated—is that how it works? Maybe you could expand a little bit on that, and then we can ask the royal college to see their perspective on it.

So, you're referring to the practice standards scheme—and, gosh, Sue, I hope I'm not going to speak out of turn—and it's a tricky question for an independent to decide to be in the practice standards scheme, and one of the reasons we do is because we believe that it would help us to attract the right type of employee; they might wish to know why we weren't doing the practice standards scheme. The disadvantage from the point of the view of the practice standards scheme—and I apologise, Sue, if this is a special area of interest for you—is that it regulates all kinds of things from whether we've had our boiler serviced to the last time the machinery was portable appliance testing tested. But it isn't able—and I think the royal college never tried to make it—to represent how we care for patients, how competent we are, how caring we are and how much we look after the welfare of the patients under our care. It's not what it's set out to do.

It's also, from a marketing point of view, if I may be so bold, something that we feel that the clients are probably completely unaware of and, however much we try to market it as a positive, it is a hugely costly exercise, from just the sheer amount of time we invest into ensuring we are completely in line with it. We choose to do it, at this time, but it is a huge burden on our emotional well-being, actually, to find every single piece of paper that the royal college demands, when we'd rather be looking after sick animals, honestly.

And is that something that you've voluntarily done, or is it something for your registration with the college that you have to do?

All veterinary surgeons have to be registered. So, you see the initials after my name, MRCVS; I am not allowed to practice unless I am registered with the royal college, and therefore a member, hence the 'M'. But, for the practice, it's voluntary for us to join the practice standards scheme, and we choose to because there was an argument 15 years ago that we would attract staff better if we were.

Okay. Sue, having listened to that—and, maybe, your reflection on that—for us to understand how the systems work, is the regulation of veterinary surgeons and being members of the royal college through an Act of Parliament, or is that through—? If you could talk us through that, and then what the standards scheme for practices is supposed to do, and what it's designed to do, and maybe what would need to happen to make that compulsory, if you like, across the board.

I would love to. Thank you. Yes. So, first of all, we are unique, as a royal college, in that we are both a regulator and we're actually a royal college. Our regulatory activity is the same as the General Medical Council, so we regulate educational standards, we hold the register for our registrants, which are our members—so, our veterinary surgeons—and we also regulate professional conduct, and that applies purely to veterinary surgeons. And veterinary surgeons work under a code of professional conduct with associated guidance in the same way that doctors do. So, that is done under the Veterinary Surgeons Act, which is a horrible outdated piece of legislation that goes back to 1966. We have been working really hard to try and get a new veterinary surgeons Act and, so far, our pleas have fallen on deaf ears. We're hoping to try and get some leverage over the next 12 to 18 months, but we need that. We need to modernise our whole regulatory system, because, at the moment—. Back in 1966, practices were owned by vets and, therefore, by regulating vets, we regulated practices. With the change in the legislation back in 1999, veterinary surgeries could be owned by non vets, and therefore we have progressively lost control of our ability to regulate practices because they're not owned by vets anymore.

Under our royal charter, which is from 2015, if I remember rightly, we actually have royal college activities, and our practice standards scheme is run under our royal college activity. So, it's a voluntary scheme that we run, and that, as the name suggests, is purely up to the practices as to whether they want to join or not. That regulates standards in the practices, and essentially it's about facilities within the practices. As you've already heard, it's perhaps not just, 'Have you had your boiler serviced?'; it's about the levels of clinical care that that practice actually provides, which is really, really important.

All vets have to work at our core standards so we maintain standards through our core, which is through the code that we actually regulate vets under. But the practice standards scheme is far from perfect, because there's no clinical reporting, there's no benchmarking, and there's a desperate need for us to have mandatory practice standards. We would love to have that, but we need a new veterinary surgeons Act. We're hopeful we may get that, and we actually have a mandatory practice standards group working at the moment, looking at putting together what that would look like as and when we get a new veterinary surgeons Act. But, at the moment, that hasn't actually happened. It's just something we're hoping that we'll be able to push forward over the next 12 to 18 months. Hopefully that explains it.

Thank you.

Thank you, Peredur. Just before you carry on with questioning, can I just ask Dr Paterson, then, with regard to the 41 per cent of corporate veterinary practices in Wales, how many of them are signed up to the voluntary practice standards scheme?

I don't have the exact figures, but I would suggest that quite a lot of them are, and I would suggest probably 70 per cent of them, because most of the corporate practices have structures in place to be able to facilitate that, because they have administrative structures in place that many of the independent practices don't have access to. As you've heard from Julia, Julia is being a vet and running the practice at the same time, I suspect, whereas, within the corporate structures, they often have additional administrative staff to do that. So, a very high percentage of the corporates are members of our practice standards scheme, I would suggest. Again, I don't have exact figures, but I can find those out for you.

That would be really useful. I wonder—the same question—of that 59 per cent who are not the corporates, how many have signed up to the scheme as well. And then, perhaps, to ask Dr Mewes, if there was an update to the Veterinary Surgeons Act and this became mandatory, would you fear that corporates would then have more of a chance of taking over because of the administrative work that may place a burden on independent contractors such as you?

It's a terribly difficult question to answer. Obviously, the thing about independents is that we're all run by businesswomen like me with no training in business, who are trying to do, as Sue has pointed out, two tasks under one head—run the business and be the veterinary surgeon, and be the mentor and trainer for the whole team. It's quite onerous, and I think, when you decide you're going to set up an independent practice, you really have no idea of the level of work that's going to be involved. So, we are seeing quite a lot of new independent practices starting to open up.

I think perhaps what you're asking is do I think that those—. Certainly, we will continue. We'll have to—if it becomes compulsory, of course we'll have to. But for those who've never done it before, if they're presented with a compulsory practice standards scheme that's incredibly onerous and takes weeks and weeks of preparation, they may be forced to decide they can't and close their businesses, and that could be quite a big deal for someone who's never done it before.

I would say any change of law of that nature would need to go for extensive consultation with the profession to try and iron out some of those issues. I appreciate it was a difficult question, but thank you for the honest answer. Would you agree—and perhaps this is slightly easier—without going into detail, that there does need to be a change in the Veterinary Surgeons Act 1966, an update to the Act, albeit that you don't know the full nature of what that may entail, but that, certainly, an update would be welcome?

Wholeheartedly.

Thank you. I'll pass back to Peredur Owen Griffiths.

Just a couple of questions, really, to finish my section before I pass on to my colleagues. Since 1999 and the changes that have happened, could you give us a flavour of what the impact has been on vets as individuals and as practices? That's one part. And then, on owners, domestic and farmers, and then, obviously, the wider community—. So, basically, what have you seen initially? Maybe I'd go to Julia. What's been the change for you as a practising vet, and then for your business, and then, putting it from the other way around, looking at your clients and your patients, what's been the impact for them?

Well, I think most of it's been extremely positive, actually. I've come into the profession as a scientist with a special interest in caring for animals, so whenever an advance in science occurs, I'm very excited and enthusiastic—I want to learn about it, embrace it. And so, with all these modalities that Sue has previously mentioned, like access to digital radiography or ultrasound—when I trained as a vet, ultrasound was very experimental, and now it's absolutely routine; you wouldn't dream of running a veterinary practice without having ultrasound on site—endoscopy and even more advanced equipment like magnetic resonance imaging and computed tomography scanners, it's been hugely fun to constantly challenge myself to keep that up to date and to work on whether I need to provide that for my GP patients, or if that's something that's going to happen for them at a referral centre. And I think mostly, well, exclusively, all of these advances in science have been very much for the benefit and welfare of our patients, which is my sole interest. So, it's all been a good thing.

Obviously, we as GPs have to charge for everything we do, and our clients are not used to that—they're used to the NHS where everything happens miraculously for nothing. So, we do have to be very careful about the budget, and we have to learn to deal with all sorts of different kinds of clients. So, you've got some clients who want, literally, the very best available, even the most cutting edge. I've got a client I'm managing right now who is doing her own research and looking up quite advanced things, and bringing them to me and saying, 'Could we talk through these eight different types of painkiller for my dog and decide together which one would be best for him?' And I've got other clients who want to have a much more pragmatic approach and they don't want to spend the earth on their patient.

I think I've gone a little off the question. Am I helping? So, what has been the benefit over the last 25 years of all this change? In terms of facilities and capabilities, it's been hugely positive. In terms of practice structure, dare I say, I think it might be negative. I'll come back to that one. For the workforce, I have mentioned we've got some really big problems with workforce, and Sue's probably better placed to talk to you about that. The royal college has been doing lots and lots of stuff to try and turn that around, and I'm not involved with education at all.

So, talking about what effect on clients, patients and the general community corporatisation has had, I've never worked for a corporate, so, anything I say now, please accept that it'll be slightly second hand. But I did just take a moment this morning to speak to three colleagues that I currently work with who have all worked recently in a corporate environment, and I think, hopefully, their comments that they're happy for me to pass on to you are helpful in this context.

Thank you very much for that. We understand where you're coming from when you're reporting other people's comments. Maybe if we turn to Dr Paterson and some of the counterargument—if you wanted to comment on anything you've just heard or maybe a view from the royal college as well.

Thank you. I don't have any evidence to back up any claims of any sort of commission or anything like that. That is very definitely against our guidance; it's against our code. Veterinary surgeons and, indeed, veterinary nurses should be caring for animals, and their primary concern should be for animal health and welfare. It states very clearly in our guidance that commissions and incentives are something that should not be part of their day-to-day work. If that's happening, the college has not been made aware of that. Certainly, if the college was made aware of that, the college would move to do something about it. So, I can assure you, if that is happening, then we would very much like to know. That's not something that vets should be doing on a day-to-day basis. I can't comment beyond the fact that I know that's not within our guidance to do that. They should not be influenced, in any shape or form, by anything other than the animal's health and welfare.

I'm not going to disagree with Julia; I absolutely agree with her that veterinary practice has improved in that we've got better facilities, we've got access to better drugs. I don't think there's any question about that. She's absolutely right that we have a workforce shortage. We have veterinary surgeons who are under more stress and strain than they ever have been before. We have problems with significant mental health issues within our profession. We have a high suicide rate, we have stress, we have burnout, we have compassion fatigue. The college is working really hard to put as much support in place as we can for our veterinary professionals and for the whole of our vet-led team. It's not just vets; it's the nurses, it's the receptionists—absolutely everybody. And we have our Mind Matters initiative, which helps them care for themselves, because we feel very strongly that unless veterinary professionals look after themselves, they cannot possibly look after the animals entrusted to them. So, we're working really hard on that, and that, of course, has that knock-on effect that is a result of the fact that people recognise it's an incredibly rewarding but stressful profession. We have problems with recruitment and we have problems with retention, but again, those are areas that we're working on.

I think the other thing that we perhaps ought to just touch on is that, because clients have got so much choice now—you know, we can offer them so many different drugs, so many diagnostic tests, so many different treatment options—owners are pretty much spoilt for choice, and it can be really difficult for owners to decide what they want to do. That in its turn puts pressure on veterinary professionals to actually offer the sort of advice that owners perhaps want without it becoming emotional blackmail. That's why I think the new move towards contextualised care is so powerful, because I think it's going to empower owners to have conversations with vets about what's right for them, what is the best treatment for their animal, which may be a lower cost option, still maintaining animal health and welfare, and it also will empower vets to have those conversations with owners where we move away from what we used to refer to as the gold standard, where the most expensive treatment was the best treatment. I think we now know that is not the case. There's lots and lots of different treatments, and it very much depends on the needs of the owner, the resources and capabilities of the owner, as to what we would actually choose for that animal. So, I think that's been a really big shift in the way that we manage cases.

Thank you, Dr Paterson. I thank Peredur Owen Griffiths as well. We have roughly nine minutes or so left. Perhaps we can just extend a little bit beyond that to let Peter Fox have an opportunity to ask his questions.

Thank you. Good afternoon. It's really good to speak to you. I've had a lot of association with veterinary practices; I'm an ex-dairy farmer and still farm livestock now, so I've seen veterinary practices evolve over at least my 30 years in farming. Can I absolutely say that what is on offer, the quality of the drugs, the quality of the service, has generally improved? I absolutely see that; things have advanced an awful lot. To pick up on some of the specific points, which were very interesting, I don't want to explore it too much—I think you've described the mental health issue—but I'd be interested in what the key drivers are for that. Is it workload? What is the nature of the pressures? I can see from large animal practices perhaps TB and issues like that would be a real pressure. But what are these real pressures that are driving people to suicide, so that we can understand what the context is on that?

Do you want me to take that, Peter? I think it's multifactorial. You're absolutely right, workload is a large part of it, and of course, the problem is the more work that vets get, the bigger stress they're under, the more vets leave, then the worse that problem actually becomes. I think part of it is the hours that they work, and I think some of it is the fact that owners now want a lot from their vets, they want the best possible care they can from their vet for their animals. Sadly, as well, I think we live in a litigious society, which perhaps we didn't back in 1999, where perhaps mistakes are not tolerated in the same way that they were before. So, I think vets are under pressure to be perfect and to deliver 100 per cent of the time, and we're not dealing with cars here, we're dealing with living, breathing animals, and of course sometimes things go wrong.

It would seem to me, certainly, looking at the number of concerns that come through to the royal college from members of the public, that owners can sometimes be a little bit intolerant of that, and that can put an enormous amount of stress and strain on veterinary surgeons who are constantly, perhaps, concerned that if they do make a mistake, they may be punished for it. The college does not punish veterinary surgeons or veterinary nurses who make mistakes; we only punish them for gross professional misconduct. Vets are allowed to make mistakes, but owners sometimes are very intolerant of the fact that it can actually happen. So, I think it's work and it's stress, it's compassion fatigue, and I think it's also the fact that owner demands are perhaps far more excessive than they used to be back in 1999.

Thank you. I'm assuming, Dr Mewes, that you would concur with that. I'm just conscious of the time I've got to get through a few questions.

Absolutely.

Great. Thanks. One of the things is that, obviously, pet insurance—Petplan and things like that—has come on board a lot more. To what degree do you think that has pushed up the cost to the client? Because there is an assumption that most people will have it and that insurance companies will pay. And, of course, that leaves, perhaps, some clients really quite vulnerable if they haven't got pet insurance. Do you think that the fact that pet insurance has come on has increased the cost of service?

I would totally disagree with that assertion. We charge absolutely the same whether the pet is insured or not insured. Certainly, we make no differential between an insured client and an uninsured client. I think it is a very important factor for a pet owner to consider, whether to insure or not, but from the veterinary surgeon's point of view, it hadn't been an issue, until very recently. We're getting some demands from the insurance companies about where we may refer to and which specialist centre we can send to on cost grounds, and that is an interference that we're finding very annoying. I would prefer, as the medical carer for the animal, that I choose which referral centre I send it to and am not forced to do it based on the pet's insurance company's decisions.

That's really helpful. I'm playing devil's advocate here, so I'm putting questions that people are genuinely anxious about, especially if you put into context the third party messages that came to you about corporatised practices and the pressure to generate money, and things like that. I can see there might be pressure on vets in that situation to perhaps advise for the more expensive course of treatment than what might really be necessary. How do you safeguard the client in that situation—probably that's more of a question for Dr Paterson, actually—so that people can have confidence that they're not being ripped off, if you like, by certain corporatised veterinary surgeons who might be chasing the money, if you like?

Obviously, as a royal college we have absolutely no jurisdiction over the prices the practices charge, and of course practices will charge differently depending on where they are, what their overheads are, et cetera, so prices can never be the same across the country. But again, our guidance is very strict in this, and it says that veterinary surgeons must not have a different pricing structure for clients who are insured versus clients who are not insured. And obviously, if it came to our attention that that was happening, then we would be able to do something to act against that veterinary surgeon. But as I say, unless we know, there's nothing we can do about it. Our guidance is very clear that that differential should never be in place.

Just two seconds, Peter; can I just ask if Dr Paterson and Dr Mewes would be willing to go to 14:50 and extend this meeting?

Yes, of course I can.

I've got a client who's arrived with a cat that's bleeding—

Dr Mewes, if you have to go and do that, perhaps we can extend with Dr Paterson.

I'll tell you what; leave me on the meeting. I'll just go and check how badly it's bleeding and I might jump back in.

Yes, absolutely. That's fine. Peter Fox.

Thank you. I totally understand. I'll just move on to my main substantive question. Whilst I acknowledge that the type of care, the medication, the equipment and everything is now far more advanced and better, in your view, Dr Paterson, is a sick pet today treated faster, more efficiently, perhaps less compassionately, than one a decade ago, and has the care become more expensive? And all of these advancements that we talked about and celebrated—they have to be paid for, I think you said yourself. Are those costs being fairly distributed to the clients?

First of all, let me address the point around compassionate care and say, 'Absolutely, definitely not.' Veterinary surgeons today provide the same level of care as they've always done, because that's part of our whole ethos. We care passionately about animal health and welfare. So, veterinary surgeons and veterinary nurses still treat animals compassionately. As far as costs are concerned, costs have increased. Of course they've increased. The price of a house has increased since 1999, so I'd expect veterinary care to increase during that period of time. I think advances in veterinary medicine and the cost of drugs and the cost of equipment have increased and, therefore, prices have to reflect that cost. Beyond that, I don't think I'm qualified to comment specifically on costs, because that's not something, as I say, that I have any knowledge of. Does that answer your question?

Yes. Thank you very much. Perhaps, Dr Mewes, you didn't hear my question. I was just just really summing up and just wanting to know your views on whether a sick animal today or a sick pet today is treated faster and more efficiently, hopefully not less compassionately, than one treated a decade ago. Obviously, costs have gone up, but I was also reflecting on the cost of all of the new equipment, machinery, new drugs and things like that. Would the cost, proportionately, have been fairly passed on to the client to cover all of that?

[Inaudible.]

You may be muted, Dr Mewes. I'll ask the team to unmute. You're unmuted now.

I really believe that—. Now I've lost my thread. Let's deal with cost. I work very hard at working out our pricing structure, and it is a really difficult thing for a person with no business training at all to do, and I do keep a very close eye on what my local competitors, if you wish, colleagues, are charging to make sure that I stay in line. But, what I will comment on is that it is incredibly hard to make a living as an independent veterinary surgeon, in my opinion. I drive a Toyota Yaris, I live in a two-up, two-down mid-terraced property; I am not printing money, despite what most of my clients and many friends, even family, seem to think. But, I just love what I do. I love that I can and am able to care for sick animals, and I ask for a reasonable return for my level of skills, expertise and compassion.

Recently, I lost a colleague, a registered veterinary nurse, because, as a single person, she simply could not buy a home locally to Sussex on the salary that I could afford to pay her. And I really do feel that the vast majority of my team are underpaid for their level of skill, and I would very much like to be paying them significantly more. I don't know if any of you have done this, but you go to the vet and you are told that the initial consultation is £54.50 and the total bill today is £120, and the first thing the client does is to gasp, 'How much?'. And it's like, 'I am so worth this. The care that I am giving you is so worth it.' But, the perception from the customer is something quite different, and this is a very real issue for the whole profession, and possibly contributory to that mental health thing, because the employed vets are getting that slight gasping sound every 15 minutes.

Thank you so much. I'll pass back to the Chair.

Thank you, Peter. We are coming up to the extended time of 14:50. I did have some questions around the work of the Competition and Markets Authority action, and also around, perhaps, any recommendations that you think may be worth while that this committee may wish to make, but I'm going to suggest that, perhaps, I write to you after this and if you could think about responding in a written format, that would be great. We'd be very grateful as a committee for that.

Just in terms of what you said at the end, Dr Mewes, I should place on record the committee's thanks to the veterinary profession, particularly those who do—and many of them do—care compassionately for animal welfare. And I reflect on a recent time when my dog was attacked by two dogs, and the veterinary team locally here saved her life. So, we're very grateful to everyone who works to do that.

Just to say about what the process is next, we will write to you with the letter I've suggested and also a transcript of today's proceedings. If you could check that for factual accuracy and correct anything that may need correcting, and if there's further evidence that you wish to submit to the committee that we haven't got around to today, then please do so in written form. But, just to say thank you to Dr Paterson and Dr Mewes for taking time out of their busy schedules today to join us. It has been a welcome evidence session. We will now move to item 3 on today's agenda, before pausing before our next evidence session. We're very grateful to you both. Diolch.

I move to item 3, new petitions, on today's agenda. Item No. 3.1, P-06-1411, 'I oppose the Welsh Government "Senedd Reform Bill", published 18 September 2023, becoming law'. There is additional information available to members of the committee. This was submitted by Rees James, with a total of 21,037 signatures. I look to committee members to discuss this petition and any actions they may wish to take. Peredur Owen Griffiths.

Diolch, Cadeirydd. I'd like to thank the petitioner for bringing this, and his interest in this particular subject. Obviously, we've been through a lot of scrutiny around this Bill. We've been through all four stages of the Bill, and it's now awaiting Royal Assent, as it was passed very recently. I know that colleagues have been through the finances—I know that Peter and I sit on the Finance Committee and have been through the finances of this Bill and reported upon it, and lots of views have been made. The Bill has now passed, as I said, and is awaiting Royal Assent, so I don't think there's much we can do as a committee with this petition now. It's worth noting, I think, that the clerking team here have had quite a few duplicate petitions about this since the Stage 4 vote but that those have been rejected, obviously, because now it's in the process of becoming an Act. So, I think we should be closing this petition, because, as I say, the scrutiny of this Bill has happened and has been passed by a two-thirds majority in the Senedd.

Diolch, Peredur Owen Griffiths. As you say, the Bill itself has had extensive scrutiny and the final vote at the Senedd was 43 in favour and 16 against at Stage 4. Any further comments to make? Peter Fox.

As Peredur said, it's now moved past anything that anybody can do about this now, and I often wonder if the wider public understand the stages of where it comes from, because it's a shame we couldn't have debated this petition before we got to Stages 3 and 4. While the petitioner probably does feel slightly frustrated, I personally voted against this. However, it is done; democracy has taken place, we lost the vote, and now it goes forward as the Senedd requires it to. So, I don't think there is any more we can do, but there might be in future, to help future petitioners to understand the actual stages they go through—and, I'm sorry, that may already have been done there; I'm a new member of the committee—to help people understand that timing is quite important, when they close their petitions, and all of that, to fit in with the Bill progress and its time frame.

I thank Peter Fox for that and note his comments. We are soon due to discuss our annual report, which may reflect on some of the comments that you made there.

Item 3.2, P-06-1426, 'Install traffic lights at the McDonald’s Pontypool roundabout'.

'There have already been a number of accidents at this roundabout (A472/A4042). With the increase of traffic using the new Aldi store it can only be a matter of time before there will be fatalities.'

This was submitted by Jenny Williams, with 256 signatures in total. I'll invite committee members in to discuss this petition and any actions they may wish to take. Peter Fox.

Thank you, Chair. I know this junction and this roundabout extremely well, and I'm quite surprised there are so few signatories to this, because I daresay virtually everybody who uses it every day realises how hair-raising it is to get through it and around it. It is surprising that there aren't lights there, because it sometimes feels as busy as the Coldra roundabout, which has got traffic lights on it entering the motorway. So, I've got great sympathy for what Jenny Williams, as the petitioner, has put forward, and I can see the concerns, especially with the additional access now into Aldi, as it does create a bit more confusion as people do tend to whip around when people are coming east from Newport, they want to go straight up to Pontypool, but if there's something pulling up to turn into Aldi, it causes some problems, I can see that. Also, people coming out of the service area to join the roundabout, again, is extremely difficult because of the speed of vehicles coming around that roundabout. So, I absolutely see where we are.

The Minister notes that there have already been some safety measures put in place. I think the Minister suggested that

'The Welsh Government takes road safely very seriously. Consent for the Aldi store at this location was provided by the local planning authority. As part of this development, a visibility screen was introduced on the northbound A4042 approach to Pontypool Roundabout to restrict excessive visibility which is linked to high roundabout entry speeds'.

One of the big issues is the entry speed into the roundabout often there.

'There is a longer term plan',

I understand,

'to improve safety on...the A4042'

especially from the Pontypool roundabout through to the M4. I hope it might pick up some more around that actual roundabout itself. There is no clear timescale for the project, and also it doesn't seem that funding has been identified yet. I suppose, Chair, a possible action could be for us to write to Gwent Police asking for an update on annual data regarding incidents at the roundabout in question. This would allow us to judge whether the safety measures already introduced are proving effective. So, I believe there is a genuine concern that people have, not just the petitioners. I would say that the majority of people silently feel there is an issue here.

I thank Peter Fox for that. Are Members content?

Content.

Yes. Okay. Thank you, Peter. We'll write to Gwent Police with those thoughts.

Item 3.3, P-06-1437, 'Increase, don’t cut, funding for the National Library, Amgueddfa Cymru and the Royal Commission'. There is further information available to members of the committee and members of the public. This was submitted by Susan Jane Jones Davies, with a total of 12,075 signatures, and I'm aware of the request to close this petition earlier than initially submitted for. I'll bring committee members in to discuss this petition and any actions they may wish to take. Peredur Owen Griffiths.

I'd like to put on the record a 'diolch yn fawr' to the petitioner on this, a very timely and apt petition, and it possibly speaks to what you were saying earlier about timings and understanding that, for us to be able to debate this, we would need to close the petition down earlier than the six months. So, that's something that we might be able to pick up on in our annual report.

But turning to the petition itself, it's such a very important topic. It's an important aspect of our culture, and I think there's quite a lot of information being sent through from the petitioner around this, and it's very much for the Finance Committee and other committees to be looking at supplementary budgets when they're coming through in the next few weeks and months. So, I think the important thing is for us, hopefully, to be able to have an urgent debate in the Chamber. It's had over 12,000 signatures. I think there are some very valid points there that need to be discussed. I think there is also very much public attention—I know that Michael Sheen, over the weekend, was commenting on this. So, it's in the discourse in public life, as well. I think there's a good strong case for us to debate it as early as possible and ask the Business Committee for a date for that—hopefully before the summer.

I think we should also make the culture committee aware that we've had this petition and of the volume of people who are interested and willing to sign that petition. And as Chair of the Finance Committee—and Peter is here as a member of the committee, and Rhianon Passmore is also a member of that Finance Committee—we will take an extra view, maybe, when we come to scrutinise the supplementary budget. But, formally, if this committee could write to the Finance Committee to make us aware of it, so that we can make sure that those questions are raised in the scrutiny of the supplementary budget.

I'm grateful to Peredur Owen Griffiths for the suggestion to write to the culture committee and the Finance Committee and also to request time for a debate from the Senedd's Business Committee. Are Members content? Are there any further comments?

Yes, I concur.

Thank you.

I will continue with item 4, updates to previous petitions, whilst we're waiting for witnesses to join for our next session. So, if we go through these petitions now.

Item 4.1, P-06-1326, 'The Senedd should scrutinise the prepayment meter scandal in Wales'. This was submitted by Sam Ward of Climate Cymru, with a total of 294 signatures. Members will be aware of the inquiry we held with energy suppliers and Ofgem, the petitioners and campaigners on the prepayment meter scandal. We then produced a report and debated that report on 1 May. I think the Welsh Government's response was a very positive response to the report, but as Climate Cymru say, the issues around this are certainly not closed; they continue to be of prevalence in people's lives and I think the point around standing charges and energy costs at the moment is certainly something that Members of the Senedd will want to take seriously, and the Welsh Government. But in terms of the petitions process, do Members agree that the process is at the end of the line and it will be for individual Members to continue the work and to support campaigners, like Climate Cymru and others, and therefore we'll close this petition? Peredur Owen Griffiths.

Yes. I concur with you, Jack, and thank you very much for all the work that you've done personally to highlight this. I know, individually, we'll all be wanting to keep an eye on this, going forward. I do concur that we close this petition, but thank the petitioner for bringing it forward.

Thank you. Item 4.2, P-06-1392, 'Reform of the additional learning needs Code of Wales 2021'. This was submitted by Victoria Anne Lightbown, with a total of 15,160 signatures. Again, Members will be aware of the debate that took place on 8 May, with an extended time period. Because of the number of petitions we've had on this topic, the request was agreed by the Business Committee for a longer period on the Senedd floor. I note that, usually, this is the end of the road for petitions when they have been debated. However, we have received an extensive detailed response from ALN Reform Wales, which highlights the work of the wider team here, the clerking team and the Senedd, and we thank them for all their support throughout this process. But they do raise valid points to the Minister's positive response that we should respond to. Therefore, can I suggest a letter to the Minister with the questions raised in the response to us from ALN Reform Wales and request how the Minister intends to work with campaigners such as ALN Reform Wales? And in the meantime, we'll keep this petition open and look to bring it to a future session where we can discuss the topic of ALN and all the petitions and the actions we may wish to take collectively as one. Are Members content? They are. Thank you.

And then, item 4.3, P-06-1395, 'Halt significant new development on the Gwent Levels SSSIs'. This was submitted by Deborah Joanne Munton, with a total of 5,713 signatures. I'll invite Members to discuss this petition and any action they may wish to take. I believe supporters of this petition may be with us in the gallery, so welcome to them. I'll look to Peredur Owen Griffiths to discuss this.

The supporters of this petition are waving at me—it's nice to see you in the gallery and taking an interest, as always, in the Gwent levels. I'd like to thank them for their response to the Minister's detailed response as well. I've had conversations with the petitioners and others around this since then as well.

There were three main points that came back from the petitioners on this. If the Minister is unwilling to issue stand-alone clarification on how the new chapter 6 of 'Planning Policy Wales' should be interpreted with regard to development and SSSIs, then either the forthcoming guidance on net benefit for biodiversity should be broadened to include chapter 6 SSSI policy, or the Cabinet Secretary could issue a 'Dear chief planning officer' letter. They've gone into quite a lot of detail in their response. I think there's merit in us writing to the Cabinet Secretary to ask that she considers doing that, because, I think, with planning policy, and planning in Wales, it's set up based on precedent, and if we allow a precedent, then it creates things down the line. So, I think there's an element there that needs clarification, and being able to clarify her own policy is important.

They've also asked for us to undertake a short inquiry—the Petitions Committee, or another suitable committee. We could write to the planning committee—I think it's the Local Government and Housing Committee. I'll check which committee is responsible for that, but we could ask them. I don't think it's something that we could do as our committee, but we could write to the relevant committee for that, and maybe also ask, if we're writing to the Cabinet Secretary, about a potential light-touch rapid preview of 'Future Wales'. I don't know how far that would get, but we could ask in that letter. Because we're asking for the other aspect, we could do that. And especially as it's the Cabinet Secretary's own policy that we're asking for clarity on, I would want her to be as forthright as she can be, to make sure that that information is passed on to any developers.

Diolch yn fawr, Peredur Owen Griffiths. Are there any further comments? Peter.

I agree with what Peredur said.

Thank you, both, for that. We will write to the Cabinet Secretary with the points you've raised, Peredur, and agreed with by Peter, and also we will just take stock of what committee in the Senedd has the responsibility for planning in Wales, and make them aware of the request from the petitioners.

Before we move to item 5, we'll take a short technical break whilst we let witnesses into the meeting.

I'll move to item 5 on today's agenda. This is our second evidence session for petition P-06-1291, 'Hold an enquiry into the corporate takeover of the veterinary profession in Wales'. With us we have Caroline Allen, the chief veterinary officer at RSPCA Cymru, and we also have Carlie Power from CatsMatter. Perhaps I could ask you to just introduce yourselves for the record. Carlie's on my screen first, so I'll go to you, Carlie, first.

I'm Carlie Power, and I am representing a charity called CatsMatter. I think that's all you need to know, isn't it?

That's perfect. Thanks, Carlie, and thanks for being with us. Caroline.

Hi everyone, I'm Caroline Allen. I was a practising vet for 20 years before I joined the RSPCA and I have worked for small corporate as well as independent vet practices. I've been the RSPCA's chief veterinary officer for five years. Just to note as well, I have got a relatively new rescue dog who's on her best behaviour at the moment, but we're still working through some of her behaviour, so if I mute and disappear, I may just be giving her an enrichment toy.

That's no problem at all. Can I just check? We're slightly running behind schedule. Would it be okay if we need to extend till 4 o'clock? Is that okay with both of you?

That's fine with me.

Okay. We'll try and get through beforehand, but if we do need to extend, we've got until 4 o'clock. We'll jump straight into questions from Peter Fox.

Good afternoon, both. It's great to see you. This is a really important topic and I look forward to hearing your views on the subject. I suppose, perhaps, if I could get a feeling from you of how you believe the veterinary sector has changed since 1999. Do you believe that change journey, if you like, is likely to continue over the medium to long term? Perhaps I could bring Caroline in first.

I actually qualified in 1998, so I've very much seen this change first-hand. I think it has been a significant change, and it has been quite a rapid change. When I qualified, practices were owned by vets, they were generally small businesses, really quite embedded in the community. That's not to say I look back on it with a sort of nostalgia lens of, 'Oh, wasn't it better back in the day?' because there were certainly bad practices—not having contracts, work conditions were not always great. But yes, the practices did tend to be owned in the community. Subsequently, we have seen lots of those practices bought up by the corporates, if you like, which probably started, in some cases, through those practice groups growing. We do now have much bigger involvement of big business and multinationals. I think that the regulatory environment has not kept up with that, and that has created quite a lot of the challenges that we have now. So, there are pros and cons, but there are definite real challenges and tensions at the moment. I'm sure we'll come on to talk about those. I think that there is still a real drive for these corporates to be buying more practices, but at the same time, I do think that some vets are seeing opportunities with actually being identified as being independent, and so there does seem to be a little bit of a resurgence of independent practices, but I think that's still early days.

Caroline, how would you see the comparison between England and Wales? How are things advancing here in Wales? Are things very different here? Have you got any perspectives on the split of rural against urban, especially from an interest perspective of corporates?

I think that very much at the beginning the corporates were focusing on the south-east of England, London—yes, definitely south-east, more urban areas, where it was easier to perhaps have a central practice and branches around, and it was very companion animal focused, but I actually think that in the last probably five to 10 years there has been real corporatisation across Wales. I know that is something personally that I have experienced, trying to seek veterinary care for our Newport centre. So, in south Wales, it did appear that a lot of practices were owned by the same corporate group. That was quite some years ago, and also now we are seeing much more prevalence of the corporates within the livestock side of things as well. I personally don't have as much experience of that. My background is as a companion animal vet, but I do know that that is the case. So, I think it is quite generalised, but the more rural areas have lagged behind.

Corporates are starting to move into the big animal veterinary practices, as well as the more obvious urban ones.

I don't know if I would say 'started'; I think that's been happening for a while.

Thanks for that. Carlie, from your perspective, or from CatsMatter's perspective, how have you seen the veterinary sector change over the last 20-odd years?

Oh gosh, I'm really sorry—I'm so rubbish at this. I'm a bit nervous now. So, I've not really seen it. I've seen it on a personal level as a person who has animals. I've got five cats; I'm a crazy cat lady. So, from a personal view, the increase in price has just got ridiculous. This continuous, greedy rise in profits, it's just getting—. I know from a personal level, from my last two cats that I've got—. So, I've got Dolly and Nix. Now, when Dolly was neutered seven years ago, I had a voucher from Cats Protection that was worth £40, and I paid £11.99 and she was neutered. Seven years later, when I got Nix and I took Nix, I had a £70 voucher from Cats Protection. I paid £89 on top of that, plus she had an ulcer behind her eye, and that was an extra £62 for three days' worth of eye drops. That's the difference. It's just—. It's crazy. That's in seven years. It's just—. But the thing is, the second, like—. They were both done at the same vet, but when the second, Nix, was done, it was changed from a normal vet to a not-for-profit, an animal trust not-for-profit, which is supposed to help people like me on a low income, but it cost me more money.

Yes. So—

It seems crazy to me.

Yes. So, it creates quite a lot of anxiety then, the things that have moved on, you know—that's a big worry, because everybody loves their pets, don't they, and you want the very best for them, but now it's becoming almost unaffordable to give the best care to your own pets. That puts a lot of pressure on you.

Yes. One of the biggest problems that a lot of the shelters deal with is they don't have enough space for kittens, but then if we can't afford—or not just kittens, puppies—but if we can't afford to get our pets neutered, the responsible ones, then that's going to put even more pressure on the shelters, because people have got animals that they can't afford then.

That's a really pertinent, good point. So, back to you, Caroline: what impact do you think the changes have had—you know, more corporatised veterinary practices coming on board? What effect has that had on the individual practices and perhaps on the animal owners and the animals themselves? Are you seeing, through the RSPCA, better quality of care or worse standards of care, or people just not being able to afford care and you having to step in? What's your take on things?

Yes. I mean, I think it is—. There is a nuanced picture here, which is, obviously, that other things have happened during this 25 years, which is how long we're talking about. Actually, veterinary medicine—I've seen it myself—has advanced incredibly in terms of what is available, what can be done, the tests that can be done, the medication that's available, the pain relief that we would give around a procedure such as a neuter. So, in many ways, standards have improved. So, I don't think you can put everything on to the corporates; there are certainly independent practices where the fees have risen. So, in some ways, care has become better, but I think that the risk is that it becomes, then, this very, very high level of care, very driven by protocols that the corporates may have, and that is available as a very high level of care to those who can afford it. But, obviously, for those who can't afford it, who can't afford those higher fees, it is more challenging. Because the vets out there feel that they want to always offer the best, that this is what they're expected to do within their practice, this is what the practice protocols are saying. So, I think there are quite a lot of factors that are driving the increase in cost, but it is a real concern. There's also, obviously, the cost-of-living crisis—so, vet practices also have increased bills and these kinds of things. So, there are a lot of factors. Obviously, when there are shareholders and other imperatives, that's bound to be a factor, but it's certainly not the only one.

We actually have some figures around the cost of pet care from our RSPCA animal kindness index: 78 per cent of pet owners in Wales, in 2024, said the cost of looking after their pet had become more expensive in the last year, and 52 per cent of Welsh pet owners were worried about being able to afford vet bills. So, I think this is a very real issue for people. Ninety per cent of pet owners were worried about feeding their pets. So, this is part of a broader pet cost-of-living situation. And similar figures in 2023, actually: 81 per cent then said it had become more expensive. So, it is building. And I think Carlie makes a really, really good point that, if people can't afford to do those preventative measures or they're not seeking treatment early, because they're worried about cost, things escalate and then that falls on the animal charities, and it is a very, very challenging time for the animal rescue sector at the moment. It is very challenging.

Yes, thank you for that. I don't wish to demonise corporate entities at all and things; we're trying to understand if there's any difference in care as well, I suppose, and I suppose that was leading to the question of how things have changed since 1999. So, do you think there has been an impact on the wider community as a result of the change, a sort of shift away from or the lessening of independent veterinary practices over the last few years? Is that having an—? Apart from the financial side—or perhaps it is the financial side; perhaps that's the main issue, I don't know. Any further views on that? And I'll come to you as well, Carlie, in a second.

This is anecdotal, obviously, but it does feel as though there is an impact from breaking, a little bit, that bond with the community. I think where you are a veterinary practice that is owned in the community, as was the case when I started work, there was something much more about being in the community, belonging there. I think that when you have got a kind of—. So, some of the corporate ownership structures—and there are lots of different ways that they do this, by the way, so they're not all the same—. But, alongside the real challenges of recruitment and retention in the profession, I think there is something that creates challenges for the vets and vet nurses as well around feeling part of that community, getting to know your clients and your patients in maybe quite the same way as you did before. I think that it's also a wider issue that we're seeing in a lot of services, public facing, that there is actually also more challenge, and also we know there is more abuse from the public as well. So, I think that has been very challenging for people on both sides and you can't purely put it down to the rise of the corporates, but I do think there is something there about that kind of ownership and being embedded in your community. That would be my personal experience.

Thank you, Caroline. Carlie, similar question—same question—to you, really, and from yourself personally and perhaps from the charity, how have you felt that the community has been affected by, perhaps, changes in the way that veterinary practices are being delivered now, or over the last decade or more?

It's the same with nurses: people who go into being vets or vet nurses, or working with animals, they go in because they care about animals and to be able to help. When I dropped—. Even though the animals—[Inaudible.]—you can tell that they absolutely adored my cat Nix. They absolutely were like, 'Can we keep her?', I was like, 'No, she's mine.' So, you know they go into that job because that's what they wanted to do, because they love animals, but it must feel to them like they can't do that as much anymore, it's just paperwork now. Do you know what I mean? And I do feel like it's not great for them on that side. And then, in the community, well, obviously, people like myself who are on a low income, we can't always afford to go, so what do we do? It's complicated all round. It's not just black and white; there are grey areas, there are coloured areas. It's complicated for everybody on all sides, I think.

Thank you, Carlie, that was really helpful. Thank you for being so candid and open about your points. Chair, I think I'm okay with that.

Thank you, Peter, for that. Before I bring Peredur Owen Griffiths in, can I perhaps just ask a question to Caroline first? The Veterinary Surgeons Act 1966 is the law that all of this is governed by. The change in 1999 was to allow those persons who are not vets to legally own veterinary practices, hence corporates and some others. We heard earlier that that Act, the 1966 Act, is outdated. Would you agree with that, and would you think there should be work to be looking into a refreshed veterinary surgeons Act?

Yes, absolutely. The Act is very, very outdated now if we think about the changes that have happened in the last 25 years, never mind since the 1960s. The real challenge is that, under the Veterinary Surgeons Act, it is only the vets who can be held to account. That was fine when you were a vet who was in charge of your own domain, through your own practice, but now the vets will be held responsible for things that they may be being asked to do by the corporate entity and there's no kind of responsibility on that entity, so I think that the vets end up with the worst of both worlds, really, and that leads to situations of moral injury and we know—obviously, it's well known about—the issues around mental health within the veterinary profession, and I think that's going to be made worse if the vet is wanting to do the right thing by the patient on one hand from their professional obligation, and then they've got these industry, corporate demands that are challenging that, and I think you find yourself in a really difficult situation. I'm still in touch with a lot of vets who are working in practice, and that is a very real challenge for them, so I think any kind of influence or pressure to bear on a new veterinary surgeons Act is definitely something we need. It would also allow for veterinary nurses to be able to do much more, and I think there's so much potential there as well. There's a lot that needs fixing.

Okay. Thank you for that. And then, Carlie, would you support—? We're doing this piece of work. I know the Competition and Markets Authority are also looking at the market in general, but, in terms of the UK Government looking at a new Act, would you support the need for a new Act, given the experiences that you've had with your two different, or two of your five cats, I think you said?

Yes, definitely. Yes, definitely, it does need to change. The charities have been great. I could tell you another story about the RSPCA helping my oldest cat. It cost me less to go through the RSPCA than it was from the normal vet, and this was—. Gosh, he's 11. He was about nine years old at the time and he got attacked by two Staffies. They tried to rip him in half and he spent a week in the RSPCA hospital. The normal vet wanted £200 for an x-ray, and I took him to the RSPCA hospital, he spent a week in there, with several lots of antibiotics to get his temperature down, and it cost me £118. That's for everything—that's stitching up, medication. Why is it so much less for the charity, the RSPCA charity, than it is for the normal vets, for the exact same things? It's just crazy to me. It really is.

Thanks for that, Carlie. I'm sorry to hear of that experience.

He's fine now. He was in here before, actually—he's disappeared.

We could see one of your cats behind your shoulder. I said this in the earlier session—Members will forgive me—but I experienced a very similar situation where my dog was attacked by two off-the-lead Staffordshire terriers, so I'm well aware of the challenges that you had to go through there. Caroline, I saw that you had your hand up. And then I will bring Peredur Owen Griffiths in.

It was just to say, I mean, I'm very glad that the RSPCA was able to help. Obviously, that was a subsidised service that we would have been providing, but, unfortunately, we have had to withdraw from the direct provision of services to the public, and we've done that through partnership with PDSA to minimise the impact, but the reality is that we are having to use our own veterinary provision to focus on the RSPCA's core role, which is the care of animals suffering neglect and cruelty. Part of that is because we have really struggled to get private vets to assist us with that work. That's not, I think, because they don't want to or they don't want to support, but there is a shortage of vets. They're very busy elsewhere, and also, obviously, we were finding the costs increasing considerably. So, when we look at it, it makes more sense for us to have our own vets focused on that core work. So, it's disappointing that we've had to do that, but that was a decision that we had to make.

Sorry, Peredur—I will bring you in next.

That's fine.

Just on the costs, though, because that's got my—. The costs going up considerably—is that within reason of where we are, with the cost of living, procurement of new machines, new drugs all increasing, or is there also perhaps an element of excessive profiteering from corporates in the veterinary profession? You may not have the evidence to answer that, but it might be a suspicion. I'll come to Carlie afterwards.

I—. Sorry, did you—

Caroline, if you want to respond to that, and I can come to Carlie afterwards.

I think that that is a big sort of step to—. Certainly, I am not seeing vet colleagues charging and thinking about massive profits. And I think that it's very much a combination of the improvements that have been made but also a different way of approaching cases and a feeling that, unless you're doing the blood test and the drip and everything, you're somehow failing. And I think that that has come about a little bit through corporatisation and the idea that there will be a way of doing things and you should follow this protocol. But, there are also elements, I think, around education as well, and I know you've got Aberystwyth now getting involved in veterinary education, and I think that there is something here around how we create the vets of the future who are able to be pragmatic and able to work with people's different contexts, because I think that what we're tending to see is—. There are always going to be examples, and I could give you examples, but I think it's very much that what we're getting estimates for is, 'We want to do this and we want to do it this way, and this is the only way', and that tends to be belt and braces, throwing everything at the animal, which you can sometimes justify, but I think not always. And I think it's difficult to have that kind of conversation in the space about, actually, what is good enough, how we are going to approach situations where people don't have a lot of money, and I think the real danger is that the veterinary profession, in the way that it has gone, has become a profession for the more well-off people. I think that's the challenge.

Okay. Thank you for that. I will bring Peredur Owen Griffiths in now. Peredur.

Thank you. Hi, both. Thank you very much for coming in this afternoon. I just wanted to reflect a little bit on something that Carlie said earlier, if I may. Maybe, Carlie, could you do a comparison for me, keeping the money out of it? So, we've talked a lot about the money, but when you compare Dolly, was it, and Nix—

Yes.

—when they went in for treatment, was there a difference? As in, was it faster, was it more efficient, was it less complicated? Were there any tangible differences between the treatment or the care that Dolly had seven years ago, compared to Nix recently?

No. Both surgeries were standard neutering, both were female cats, so—[Inaudible.] Maybe Nix was a little bit smaller—[Inaudible.] Then, with Nix, there was the thing with her eye. She likes to have her nose rubbed. This is how she gets to sleep: you rub her nose. And I think she must have rubbed her nose on the cage—you know, they put them in the cage, and she rubbed her nose or something and caught her eye and ended up with an ulcer behind her eye, which they found just before I picked her up. And that was what the extra £62 was for, for three days' worth of eye drops.

So, from your experience, then, with the other cats, the level of care, the efficiency, the speed or anything like that, nothing much has changed from that point of view. Obviously, we heard from Caroline that some of the treatments have got more advanced, I suppose, in different ways, in being able to do things and putting a belt and braces on things—and I'll bring Caroline in on this in just a second—but were you, I suppose, with Nix as opposed to Dolly, were you offered more things, like wormers or other treatments on top, or anything like that?

No.

No. Okay. It's just to try to understand where things have changed over the time.

It's crazy, isn't it?

Yes. Maybe, Caroline, from your point of view, then, as you talked about treatments being possibly more advanced, so comparing what it was like for you, maybe 10 years ago, as a practising vet, compared to now, have things changed? Carlie's experience there of a standard neuter was the same seven years ago as it is today, but maybe you could talk through what might have changed or if there has been any impact in the industry in that time.

Yes, there has, behind the scenes definitely. So, if we just think about, maybe, a cat neutered when I was in my first job, it's probably likely that the anaesthetic would have been monitored by someone who wasn't actually qualified to do that, and now that would be more likely to be a registered veterinary nurse, which I think is a definite improvement. In terms of the monitoring, it might have been a stethoscope back in the day, and you know, sort of, 'Hope you don't get any complications.' I think now there would be a piece of equipment as a minimum, called a pulse oximeter, which is measuring blood oxygenation, heart rate, and it might even be measuring blood pressure. I think there would be advancements in the anaesthetics that would be used, with less risk of complication, faster recovery, better pain relief, and probably sent home with pain relief. So, there have been improvements, undoubtedly, but they do bring cost, and I think it comes back to, 'What is good enough?', because I think some of these advancements are then available for, maybe, a smaller proportion of the public and their pets, and I think, perhaps, that that's a debate that we haven't so much had in the profession, although I am really pleased to see that the topic of contextual care is starting to be more discussed in the profession, I think. We followed our medical colleagues very much for a while, and it was almost like, 'More tech and more drugs, and it's all better, better, better', and actually, maybe, having a look at the context that we're working in and the realities of the pet-owning public, we might be able to have a little bit more of a better debate about it. But, yes, things have changed for the best, and it probably results in the animals being a little bit more comfortable, a few less complications, but most animals do do very well after their neuters anyway.

So, from a compassionate point of view, then it's probably advanced a little bit, because of the level of care and the level of things that you've got that you're able to monitor—oxygen, and all the rest of it—during an operation. So, does that mean that the level of compassion would be the same, or would it be more so now because of the advances in technology? The human compassion there towards the animal is probably the same, I'd imagine. Or is it the fact that, as you talked about, processes and things from the corporates make it more of a tick-box exercise and, therefore, it pushes a little bit of that compassion out to the side?

From my perspective, and as Carlie said, right at the very beginning, vets and nurses don't go into this for the money. They're bright people; they could have all sorts of ways of making money and they really do go into this for the animals, so I think that compassion has always been there.

I think, obviously, when you do see advances that become available, you always want to be doing the best for the animals in your care. So, maybe if you know that the practice down the road has this equipment and you don't now, you might feel uncomfortable and ask are you doing the best for your pets. But, I think the debate really is about accessibility of veterinary care to as broad a population of animal owners as possible without an over-reliance on charity, because the charity sector absolutely cannot fill this gap that has grown, I would say, in terms of people being able to access private vet care.

I suppose, on a personal point—you talked about your dog and you talked about your farm animals—over 10 years ago now, a long time ago, I had Gin and Tonic, two cats, and they were neutered then, and Treacle and Marmalade now have just gone through the same process, and both sets were treated with compassion, and luckily with vets of ultimate professionalism. I'll just put that on the record as well, seeing as everybody else is talking about their pets as well, so there we are.

I don't know if you saw the cat go past before.

Yes.

That was actually Dolly.

Oh, was it? [Laughter.] Excellent.

We did see her. I must say, Peredur, you have a way with words and names. [Laughter.] Okay, thank you. Moving forward to some final questions from me or final reflections from you both, in terms of the committee, we will review the evidence we've heard from yourselves today, the evidence we had in the earlier session and that's come in written format, and we'll be looking to make a set of recommendations to the Welsh Government about where we feel they can make improvements in this area. I'm conscious that the issue of veterinary provision is non-devolved, but I think I've had a strong feeling around the veterinary 1966 legislation, both in this session and the earlier one, and it will be something for the committee to think about. Are there any other areas in which you think this committee could perhaps make a recommendation to improve veterinary services and provision of veterinary services in Wales? I'm not sure who wants to perhaps answer that first. If I've put you on the spot there, we're happy to take those—[Interruption.]—thoughts at a later date in written format. Carlie, I think I interrupted you.

No, I was just thinking, actually, there has been—. I don't know if you may have seen an article in the Daily Mirror recently. They are now offering in Turkey a combination package of human and animal—[Inaudible.] And it's a heck of a lot cheaper than the UK. For removal of cat teeth in the UK, it's £2,000 per tooth. In Turkey, they're offering £1,000 for everything: that's x-ray, surgery, aftercare, a hotel for the pet and the owner for 10 days, transfers, city tours. It was on 8 April it was in the Daily Mirror, the Manchester Evening News and the Metro newspapers. It's getting now where even Turkey, I know, are offering that you can go and have a nose job, and your pet can have a nose job for £1,000.

Thank you, Carlie. I've scribbled that down, and I can see Mared and Gareth have also scribbled that down. We will certainly be taking a look at that, because that does pose further questions for us. Caroline, perhaps comments or thoughts from you.

I suppose I would always say be careful what you read in the tabloid newspapers; I don't know anyone who's charging £2,000 to remove a tooth. But I think that it is a valid concern around the whole sector. I guess one of the areas that is devolved is around the licensing and the regulations. I think we've also got to look at the broader picture of the very serious health and welfare problems that do exist because of the extreme confirmation, so the breeding, of the brachycephalic-type dogs or any of those dogs that don't look like dogs any more, and cats. Equally, we're seeing it with cats, very sadly: the overlong backs, the short legs, the squashed-up faces. They are fundamentally unhealthy animals and are suffering as a result. So, let's not create more health problems that people have to deal with. I think with the dog breeding, these awful fertility clinics, where there is that opportunity to cut that suffering off at source, that is the bigger picture. But I think it's really valuable, and I know that we do work well with Wales on a number of issues and cases. So, that's definitely something to look at, that bigger picture. But if we've got people overseas picking up on these problems and trying to create a market, I can just see all sorts of really hideous welfare problems associated with that, and follow-up and transporting of animals. So, I really hope that doesn't develop; that just sounds hideous.

But I think the point that I referred to earlier around veterinary education is something—if we are looking to the next generation of the vets coming through, it is around being able to—and this is not a criticism of the current students, because they're brilliant. But it's just making sure that the course, I think, is very much enabling them to work across the spectrum of animal owners, not necessarily being really focused on being a specialist, or trying to follow our medical colleagues. It is different. I know that some other schools are looking at access programmes and how we get students in from different demographics and I think that's really positive and something to be encouraged, because we're not the medical profession; there isn't an NHS and we need to be working in a different way. So, I think those would be key areas for me.

Thank you, Caroline, for that. Can I thank you both for being with us, spending time with us, and your knowledge, as a committee? The petitioner, in the petition wording, actually says that

'Cymru has led the way before on animals and their welfare, so we ask our Senedd to do so again.'

So, we, I think, as a committee, will be keen to try and add value to that and this session will certainly help with that.

We will send through a transcript of today's session for you to check for accuracy, and if there are things that need to be corrected, then please do let us know. Equally, if there are things that you haven't said that you've thought may be useful at a later date, then please do let us know by writing in. But, in the meantime, I'll end this session now, which, again, has been useful, and I'll just thank again Carlie Power from CatsMatter—

Nice to meet you all.

—and Caroline Allen from RSPCA Cymru. Thanks, and all the best to your five cats, as well, Carlie.

Thank you. Thanks for having us.

Diolch.

Take care.

Thank you. Bye bye.

Okay. Before I move on to the next item and close the public session this afternoon, I do just want to go back to item 4.3, P-06-1395, where we agreed to write to the Minister with the comments that Peredur Owen Griffiths made. We also agreed to write to the Senedd committee responsible for planning, and, just for clarity, that is the Climate Change, Environment and Infrastructure Committee and I believe the Chair is Llyr Gruffydd. We'll seek to write that letter to that committee.

Okay. That does bring today's public business to a close. Can I propose, in accordance with Standing Order 17.42(ix) that the committee resolves to meet in private for the remainder of the meeting? Are Members content? I can see that they are. Can I thank all members of the committee today and our witnesses who have been with us? The committee will meet again on Monday, 10 June 2024. We'll now go into private to have a discussion on the evidence we've heard. Great. Diolch yn fawr.