What would YOU ask?

Re: What would YOU ask?

Ian Holloway — Mon, 24 Mar 2014 11:20:26 GMT

Many thanks to everyone who posted questions here for 'Quiz the candidates', and also for the ones we've received by email, twitter etc.

The candidates' recorded answers were published towards the end of last week on both the Webinar Vet and the election website.

The election website also has the full list of submitted questions, all candidates' contact details, biographies and manifestos, and links to the secure voting page (you will need the two security codes printed on your ballot paper).

Ballot papers were posted last week, second class, so if you haven't received yours by the end of this week, please email me at i.holloway@rcvs.org.uk and I will arrange for Electoral Reform Services to send you an official duplicate paper.

Thanks again, and please vote!

Ian

Re: What would YOU ask?

mariette asselbergs — Mon, 10 Mar 2014 20:51:09 GMT

That was a brilliant post Beat, whoever you are, please stand and I will vote for you! You know what you are talking about and I think you are dead right (for small animals).

We have to use crap oxycare (dog approved) in the shelter we serve, because ronaxan would strip them of their precious finances. If we could only use the 10 p doxycycline which we used for decades before the cascade!

Mariette

Re: What would YOU ask?

Ian Holloway — Sun, 09 Mar 2014 20:02:46 GMT

[quote user="Beats"]

Anthony - I think a new thread would be in order if you have further thoughts as we don't want to have a 2-way chat on the issue in the middle of everyone else's questions for the RCVS. I think it's healthy to discuss subjects and give them a good airing to distill our personal views, but presently I'd want to know if a prospective RCVS councillor would be of the same mindset that the "cascade" w.r.t. dogs and cats is not in the public interest and it is therefore necessary to grasp the nettle of the current supporting guidance offered by the RCVS and do something constructive with it such as preparing nettle soup.

[/quote]

Thanks - would appreciate that, but thanks for the question, which I'll certainly add to the list. Thanks to everyone else for their questions, too.

If anyone else has a question for the RCVS Council Election candidates, do please post them here, email them to vetvote14@rcvs.org.uk or tweet them using #vetvote14.

Ian

Re: What would YOU ask?

Beats — Sat, 08 Mar 2014 19:17:38 GMT

[quote user="Malcolm Ness"]Whatever you think of the cascade, it is not in the gift of RCVS to change it.[/quote]

I agree.

[quote user="Malcolm Ness"]Once it is written into law, then RCVS has no power to give any guidance or encouragement to its members to do anything other than comply with it.[/quote]

I disagree in part only.

I do not think it would be at all appropriate for the RCVS to insist that vets break with this regulation any more than it would be appropriate to break the working time directive or any other piece of legislation.

Equally, I do not see why the RCVS cannot stipulate that to break with this regulation in the interests of a dog/cat or its owner is not professional misconduct. i.e. it may be naughty in others' eyes, but is not conduct unbecoming of a vet in the eyes of their professional regulator.

Re: What would YOU ask?

Malcolm Ness — Sat, 08 Mar 2014 19:09:30 GMT

Whatever you think of the cascade, it is not in the gift of RCVS to change it. Once it is written into law, then RCVS has no power to give any guidance or encouragement to its members to do anything other than comply with it.

Re: What would YOU ask?

Beats — Sat, 08 Mar 2014 18:58:46 GMT

[quote user="Anthony Todd"]

So all you needed to ask the prospective candidate was "Are you in favour of the "cascade; will you seek to reform it?"

Nothing to do with owner choice; our hands are tied at the moment. [and the cascade is stupid and is a gift from the almighty to the drug manufacturers].

Of course I was too thick to realise that's what you meant, sorry, but giving owners choices gets me going.

I also thought it was actually against the law and the vet could be fined. Am I wrong?

[/quote]

I see your point.

I suspect we share a similar sentiment but were at cross-purposes.

Your question would may the information I would be looking for also; it may also give answers of "the RCVS does not have any jurisdiction over the cascade" etc from those who are opposed to it but believe this is not an issue that has any relevance to the RCVS.

I'm therefore interested in would you (our hypothetical candidate) seek to reform the supporting guidance issued by the RCVS in relation to the "cascade" w.r.t dogs and cats.

This is important on a number of fronts, but selecting just 6:

1) I may choose to break a law (e.g. rules on clinical waste by giving an owner the body of their dog home to bury) if I do so that is a matter for me and the law - a risk I may be happy to take on the basis that it would not be deemed in the public interest to prosecute me for an offence and I am happy to defend my actions in a public arena. I am not going to break any rules set by my professional regulator, however, so if they insist on a rule then I will follow it; the RCVS is independent and can issue its own supporting guidance to the profession and, while it cannot force the profession to break rules set by others, it can clarify that in its eyes to do so would not be professional misconduct on the part of the vet where the reason for breaking such rules is the protection of animal welfare served in the public interest. The current position is that the prescription of doxycycline capsules (to maintain the aforementioned example) would be professional misconduct, even if done out of compassion to a suffering dog whose owner cannot afford Ronaxan, after a lengthy and fully informed discussion. I take your point that a lengthy and fully-informed discussion is often not what a pet-owner is after, but given the predicament we are in and the restrictions of the current "Supporting Guidance", I think it would be by far preferable to have the option of inflicting a lenghty and fully-informed discussion on a dog-owner if the result was that they could accept a treatment that they could afford than the status quo.

2) Not all MRCVS's work under the jurisdiction of the VMD (and that's without Scottish independence!), yet the current supporting guidance from the RCVS applies to all MRCVS's (as I understand it). Therefore, for instance, an MRCVS working in a jurisdiction where no such crazy legal restrictions apply would be required to follow the "cascade".

3) The RCVS has previously issued a statement to the public that demonstartes their belief that it is really important that a drug has a veterinary-license and the "cascade"-rule w.r.t dogs and cats is vital; therefore they actually do appear to think this is vital regulation as a concept, independent of any other regulatory bodies, and changing the rules outside of the RCVS may not change their supporting guidance on this issue therefore. It also may mean that if they feel this is an important concept, it is only a matter of time before we are professionally-bound to follow the logical out-workings of the "cascade" by applying the same principles to other aspects of dog and cat work such as laboratory diagnostics, diagnostic equipment, surgical procedures, and of course diagnoses reached. It makes little sense to specify what form of spironolatone is permissible for the treamtent of congestive heart failure unless one specifies what tests must be preformed to reach such a diagnosis in the first place. If RCVS Knowledge assesses the evidence-base and concludes that there is a lack of evidence of safety of all bitch spay techniques other than a double ligation with a transfixing ligature, will we then be duty bound to perform this approved technique? Of course we'd have to use the dog-approved suture material and dog-approved chlorhexidine scrub as well in the same way you use the dog-approved oxygen and dog-approved water. You get the picture.

4) It is unlikely that any other regulatory body will take the issue seriously unless the RCVS's position on the "cascade" w.r.t. dogs and cats changes. The RCVS is tasked with regulating veterinary medicine in the public interest and therefore should be champing at the bit to offer fully informed choice to owners where they can decide if they want a cheaper, non-dog-licensed medicine; their current supporting guidance conflicts heavily with sections 1 & 2 of the current CODE which require informed choice and impartial advice from vets.

5) In former disciplinary hearings, the use of off-license drugs has formed part of cases against vets; this is a result of this supporting guidance issued by RCVS.

6) Many vets do not follow a strict interpretation of the "cascade" as detailed in the RCVS Supporting Guidance in all instances; there is little point having a rule on paper that is not being followed, or only being followed most of the time. Either have it or don't have it or amend it.

Re: What would YOU ask?

Anthony Todd — Sat, 08 Mar 2014 17:34:25 GMT

[quote user="Beats"]To be specific to your hypothetical question:[/quote]

So all you needed to ask the prospective candidate was "Are you in favour of the "cascade; will you seek to reform it?"

Nothing to do with owner choice; our hands are tied at the moment. [and the cascade is stupid and is a gift from the almighty to the drug manufacturers].

Of course I was too thick to realise that's what you meant, sorry, but giving owners choices gets me going.

I also thought it was actually against the law and the vet could be fined. Am I wrong?

Re: What would YOU ask?

Beats — Sat, 08 Mar 2014 17:30:05 GMT

[quote user="Anthony Todd"]

As far as I know the only licensed Vet POM is Robaxan anyway??

And, as far as I know, you'd be breaking the [stupid] law?

[/quote]

Correct.

I do not feel that offering a cheaper alternative in real life situations should be considered professional misconduct by the RCVS if in the interests of the pet or its owner.

The current supporting guidance reads that this would be professional misconduct.

I obey this, but think that is very sad and a poor reflection on the profession and certainly not regulation in the public interest.

Re: What would YOU ask?

Beats — Sat, 08 Mar 2014 17:26:22 GMT

[quote user="Anthony Todd"]

[quote user="Beats"]If addressed to my post, then my answer is because I would like to offer a dog-owner a choice of doxycycline capsules at 10p/tablet as well as ronaxan at £1/tablet (for example).[/quote]

And. I say again, all owners would say, "what do you recommend and, rarely, why?" They have come to you to fix their dog, they're not looking for the cheapest option.

Or "why are you offering me this choice, when one drug is ten times the price? Is Ronaxan 10 times better; won't the cheap one fix my dog?".

"In which case why offer something which is inferior?" "I just want my dog fixed"

What would your response in this [hypothetical] case be?

[/quote]

Well, at the minute they don't get the choice.

If I wish to prescribe doxycycline, they get the offer of Ronaxan at £1/tablet or nothing.

I guess that's simpler... unless you can't afford it and your dog's not getting any better.

To be specific to your hypothetical question:

"The Ronaxan tablets have been trialed on and marketed for dogs, might be more tasty to your dog and come in a pleasing package with a sheet of instructions that you probably won't read and a helpline that I can phone if they don't work, and are the preferred option if you have cash-to-splash; alternatively, you can have cheap human capsules containing exactly the same drug that are likely to have the same effect. I am required to recommend the Ronaxan tablets."

Re: What would YOU ask?

Anthony Todd — Sat, 08 Mar 2014 17:17:08 GMT

[quote user="Beats"]I think it would be polite to let the owner decide how they spend their money.[/quote]

As far as I know the only licensed Vet POM is Robaxan anyway??

And, as far as I know, you'd be breaking the [stupid] law?

Unless the example has, or I have, got it wrong?

Sorry Malcolm's "Why?" came right under your post.

Re: What would YOU ask?

Anthony Todd — Sat, 08 Mar 2014 17:05:29 GMT

And. I say again, all owners would say, "what do you recommend and, rarely, why?" They have come to you to fix their dog, they're not looking for the cheapest option.

Or "why are you offering me this choice, when one drug is ten times the price? Is Ronaxan 10 times better; won't the cheap one fix my dog?".

"In which case why offer something which is inferior?" "I just want my dog fixed"

What would your response in this [hypothetical] case be?

Re: What would YOU ask?

Malcolm Ness — Sat, 08 Mar 2014 16:13:27 GMT

[quote user="Anthony Todd"]As Malcolm says "Why?[/quote]

My question was intended as a general one to prospective candidates and not related to previous posts.

Over the years I have become increasingly puzzled about the motives of many who put themselves forward for election. Some are clear that they want to make a difference and genuinely believe that they have something to offer and are aware of the amount of hard work and frustration that will ensue. For them, I have the utmost admiration.

Of others, I am more suspicious. Some are single issue nuts who have little intention of doing other than sharing the sound of their own voice. Some seem to get re-elected repeatedly but never seem to achieve much at all other than waft around Belgravia House asuring critics that "things aren't as simple as they seem" and that "progress is being made, you just have to be patient" - the dreaded establishment conservatives - after 30 years of the same guff, my patience is wearing thin.

Then there are those who seem to be there to expand their CV - high office at RCVS seems to be a useful stepping stone to promotion and betterment in the day job.

So, my question for aspiring councillors is a simple, "Why?"

Re: What would YOU ask?

Beats — Sat, 08 Mar 2014 16:08:42 GMT

[quote user="Anthony Todd"]

[quote user="Beats"]Do you think that dog and cat owners should be given a fully informed choice with regard to available medicines that may be used to treat their pet, to include factors that may be of importance to them such as cost?[/quote]

As Malcolm says "Why?

The owner's inevitable reply is "What do you suggest" and so it should be!

Next time you go to your doctor just try it.

Owners want their pets fixed as cheaply, quickly and effectively as possible, they're not shopping for wine!!

[/quote]

I'd taken the "Why?" to be a legitimate and sensible question to ask a candidate regarding their motive for standing for election.

If addressed to my post, then my answer is because I would like to offer a dog-owner a choice of doxycycline capsules at 10p/tablet as well as ronaxan at £1/tablet (for example).

I think it would be polite to let the owner decide how they spend their money.

Re: What would YOU ask?

Utlendigur — Sat, 08 Mar 2014 13:13:00 GMT

What do you think you can do about the ever widening gulf, and increasing mutual distrust, between practising GP vets and an RCVS that doesn't seem to understand (or even be aware of) the problems and concerns of vets "at the coal face"?

Re: What would YOU ask?

Anthony Todd — Sat, 08 Mar 2014 11:03:37 GMT

As Malcolm says "Why?

The owner's inevitable reply is "What do you suggest" and so it should be!

Next time you go to your doctor just try it.

Owners want their pets fixed as cheaply, quickly and effectively as possible, they're not shopping for wine!!

Re: What would YOU ask?

Bob Russell — Sat, 08 Mar 2014 10:55:21 GMT

I would like to think the review of the PSS will make it more attractive to non-PSS practices in the future. It should be self-financing rather than subsidised by our fees (going on a previous post on another thread).

What steps are being taken to ensure all disciplinary processes are completed within more reasonable timeframes? Perhaps a target to get to to the DC stage by 6 months unless the delays are created by the 'defendant'. Delays by the complainant should not be allowed!

A full and open review process (similar to the 24/7 consultation) of the disciplinary process perhaps?

Re: What would YOU ask?

Michael Woodhouse — Fri, 07 Mar 2014 21:28:48 GMT

In an era of evidence based veterinary medicine should veterinary surgeons practising homoeopathy be struck off the register?

(*ie accepting money for something proven time and time again not to have any clinical efficacy)

Re: What would YOU ask?

Malcolm Ness — Fri, 07 Mar 2014 21:14:03 GMT

Why?

Re: What would YOU ask?

Beats — Fri, 07 Mar 2014 19:53:20 GMT

Do you think that dog and cat owners should be given a fully informed choice with regard to available medicines that may be used to treat their pet, to include factors that may be of importance to them such as cost?

Do you think that the RCVS should update its "Supporting Guidance" to allow for this and stipulate that such professional behaviour in the interests of a pet's welfare or its owner's resources is not professional misconduct?

Re: What would YOU ask?

bob lehner — Fri, 07 Mar 2014 19:31:15 GMT

Would you actively support and promote the PSS as it continues to evolve ?

Would you encourage those practices that have not yet joined up to do so, in order to demonstrate their commitment to striving to improve their clinical performance and also giving assurance to their staff that they are providing a working environment where all pertinent legal and health and safety issues have been addressed ?

Re: What would YOU ask?

Evelyn Barbour-Hill — Fri, 07 Mar 2014 16:33:49 GMT

Would you campaign for the RCVS to divest itself of the Practice Standards Scheme (sell it off, give it away, remove the RCVS from its name, cease to subsidise it) ?