RSPCA reneges on memorandum of understanding

Re: RSPCA reneges on memorandum of understanding

Rob Loxley — Thu, 12 Jan 2012 23:02:19 GMT

[quote user="alex gough"]

[quote user="David Mills"]whether some replies, Ms Mostyn, have to be quite so abrasive is another matter.[/quote]

I wonder if you have a pot and a kettle David, and what colour they are.

[/quote]

This brings to my mind nails and heads, Alex

Re: RSPCA reneges on memorandum of understanding

Alex Gough — Thu, 12 Jan 2012 17:20:40 GMT

[quote user="David Mills"]whether some replies, Ms Mostyn, have to be quite so abrasive is another matter.[/quote]

I wonder if you have a pot and a kettle David, and what colour they are.

;)

Re: RSPCA reneges on memorandum of understanding

David Mills — Thu, 12 Jan 2012 15:31:48 GMT

[quote user="Gillian Mostyn"]

As to your other comments - I agree completely with the comments above. You seem to be under the illusion that practice profits are vastly higher than they actually are. Thus, as you are obviously not in full possession of the facts of running a private practice, it is impossible to have a reasoned argument about it really.

[/quote]

Assumption. I've worked in various places, and been offered partnerships - I've seen accounts and had them looked over so I have an impression of how variable practice economics - and relaince on different income streams - can be. My impression from some courses is that a good practice, well run, should turn 10% profit, but the majority of UK practices run at 5% or less.

My ideas are obviously not for everyone. Just like a lot of practices don't run PetAid (where one receives only £6/month per animal). That's fine, I respect your choice. I just happen to think differently is all. If that were to impact on my practice profits, if I owned one, then that's that. My musing was merely to take the gauge of opinion - whether some replies, Ms Mostyn, have to be quite so abrasive is another matter.

Re: RSPCA reneges on memorandum of understanding

Mark Holmes — Thu, 12 Jan 2012 14:26:29 GMT

How are you defining "cost price"? What are your feeling on contributions?

If the choice is between doing a piece of work, say an RSPCA contract (or other) and not doing the work then the only costs to consider are variable costs. The work has no bearing on your fixed costs at all which all need to be paid regardless of whether the proposed contract goes ahead. Unless the contract involves increased staffing levels, heating etc then any revenue over the variable costs is a contribution towrds fixed costs and profits. I guess its a personal business decision to decide at what level this contribution is worth having.

Accountants prefer to account for all costs in a proceedure, which is necessary in the long term but contributions are used in economics

Re: RSPCA reneges on memorandum of understanding

Gillian Mostyn — Thu, 12 Jan 2012 13:46:22 GMT

[quote user="David Mills"]However when I have been on call at various places weekends and evenings, I have spent a long time either in the surgery not doing anything directly financially beneficial for the practice because it's been quiet. Would it not be beneficial in these cases to have RSPCA stray cases come in? My question is how big a problem is this? How many per month are people seeing? I saw about 2-3 max per month[/quote]

How are you defining 'stray'?

How would you prove this status?

You are correct - we currently see a couple of strays a week. If we did cut price drop-in surgeries for stray animals.......

Re: RSPCA reneges on memorandum of understanding

Judith Joyce — Thu, 12 Jan 2012 12:59:16 GMT

[quote user="David Mills"]'cost price' (and my contention still is that cost price is the break even price for a procedure, which is night on impossible to calculate very accurately in GP[/quote]

John Sheridan remarked recently that an average vet practice in UK operates at around 10% profit (after owners' pay). Many do less well. So a reasonably accurate starting point for "cost price" calculation would be 90% of the normal fee.

[quote user="David Mills"] I would happily pay, say, £100 a month to treat some strays[/quote]

So would I - it would be a massive reduction on the amount of free/subsidised/not paid for work that we currently do each month.

Malcolm N

Re: RSPCA reneges on memorandum of understanding

J G Wray — Thu, 12 Jan 2012 07:37:59 GMT

[quote user="David Mills"]I think the tendering idea has legs whereby RSCPA have preferred practices with whom they have fee arrangements, and it may relieve a lot of tension all round as well as providing a 'wipe your face' income for the practice concerned. Imagine it would also be a great PR asset for the practice. The PDSA have a very successful though slightly different arrangement through PetAid.[/quote]

We havebeen effectively excluded from RSPCA work for a number of years. We endured some sniping from the local branch members for some time, but that faded and our shoulders are broad. The local hospital practice gets the cases now, for all the reasons you can imagine. I have no intention of seeking out the work again and RSPCA central numbers don't seem to direct cases to us anymore.

We scrupulously keep track of work on strays, charging all to an account

We scrupuloulsy keep track of discounted work, directing most toward our controlled version of discounting, our healthy pet club

We have used a number of costing models over the years. Our accountants based one of cost of use of different areas of the practice allotting costs to consulting areas vs theatre areas etc. This was cumbersome. We have also used consultants with benchmarking for cost areas and adjusted fees accordingly. John Sheridan used to have a nifty spreadsheet model for the most basic stuff he'll let you have for a nominal amount. It all becomes part of management accounts and budget setting after a time.

As for seeking out RSPCA work for "wipe your face" income, you've got to be kidding. If you can't make your business work with what you do day in and day out, you've got big problems.

RSPCA rely on subsidisation from vets in practice . It would be a PR asset to tell the paying public what we do, not that we are an undevralued resource for a political charity.

JGW

Re: RSPCA reneges on memorandum of understanding

David Mills — Thu, 12 Jan 2012 00:20:29 GMT

My idea was a musing more than anything else - and I can see it is almost universally unpopular - and that's fine. It's true I don't own a practice, and have never owned one, but I do realise it would be a financial 'hit' to treat stray cases for the RSPCA at 'cost price' (and my contention still is that cost price is the break even price for a procedure, which is night on impossible to calculate very accurately in GP). I have also had suboptimal dealings with the RSPCA in my time and don't think the MoU is fir for purpose, and think the NCC arrangement is disgraceful.

However when I have been on call at various places weekends and evenings, I have spent a long time either in the surgery not doing anything directly financially beneficial for the practice because it's been quiet. Would it not be beneficial in these cases to have RSPCA stray cases come in? My question is how big a problem is this? How many per month are people seeing? I saw about 2-3 max per month, mostly during surgery hours - we saw far more wildlife cases that we treated for free (would we do this if it wasn't in the GPC?) - and I suppose my question is how big a dent would it make? As it goes, I would happily pay, say, £100 a month to treat some strays, but I wouldn't dream of enforcing that on others.

I think the tendering idea has legs whereby RSCPA have preferred practices with whom they have fee arrangements, and it may relieve a lot of tension all round as well as providing a 'wipe your face' income for the practice concerned. Imagine it would also be a great PR asset for the practice. The PDSA have a very successful though slightly different arrangement through PetAid.

Just ideas, after all.

Re: RSPCA reneges on memorandum of understanding

Gillian Mostyn — Wed, 11 Jan 2012 21:16:10 GMT

OK David, let's look at it a different way seeing as we disagree on what 'cost price' means.

If I agreed to charge your idea of 'cost price' to all the charity cases I see (that includes all charities, not just RSPCA) I would take a drop in my income. Don't call it 'practice turnover' or 'profit margins' , as that insinuates others are also taking the hit, but rather the money I take home every week.

Would you pay for a stray animal's treatment out of your own pocket, every day of the week? Because, believe me, if we did charge such low fees we would be overrun with 'stray' cases.

Re: RSPCA reneges on memorandum of understanding

Judith Joyce — Wed, 11 Jan 2012 13:14:44 GMT

[quote user="patrick murphy"]£12 would be very fair if someone gave me a free machine.[/quote]

I suspect it wouldn't be enough EVEN if they gave you a free machine.

Assume life of machine is 5 years and assume that you are going to do the exam lasting approx 30 mins indoors (=cost) with an assistant who expects to be paid, like you, at minimum wage. Already, we are into negative numbers. But even if we have, say £1=00 left over to pay for this "free" machine or pay for its replacement (say £5,000=00) we see that you need to scan 1000 patients a year just to stand still. That is at least 4 every working day and it ignores power, servicing costs and other consumables. It also ignores the fact that any vet or VN who is prepared to work for minimum wage or less, needs their head read.

The vets that RSPCA and PDSA employ directly are paid properly, there is absolutely no justification that those of us in private practice should be bullied or pressured into accepting anything less.

Malcolm N

Re: RSPCA reneges on memorandum of understanding

patrick murphy — Wed, 11 Jan 2012 13:00:59 GMT

£12 would be very fair if someone gave me a free machine.

Re: RSPCA reneges on memorandum of understanding

Hannah Wynne Richards — Wed, 11 Jan 2012 10:57:28 GMT

David Malcolm and Gillian both own and run practices They KNOW how small a % of turnover they actually have as profit You obviously don't or you would never even begin to think £12 fair for an ultrasound-if ultrasound was available when I was in school,it might have been a fair price-but you could buy a decent house for £5k then

Wynne

Re: RSPCA reneges on memorandum of understanding

Hannah Wynne Richards — Wed, 11 Jan 2012 10:50:55 GMT

David You're wrong in saying the RSPCA spend 70% on legal fees The Inspectorate which funds all the cost of prosecutions only accounts for 3/8ths total RSPCA spending The Inspectorate (prosecutions ) are the most worthwhile of RSPCA activities-especially as the police who have a statutory duty to investigate ALL crime reported to them , including animalcrime will direct members of the public to the RSPCA (a charity ) who have less than 350 Inspectors to cover the whole of England and Wales Much as I hate paying tax,funding investigation and prosecution of animal crime is one of the very very few things I would be happy to pay taxes for -Grrrr!!!!!!!!!!

What I resent is the cost of headquarters expenses-based at Horsham-Surrey stockbroker belt

Wynne

Re: RSPCA reneges on memorandum of understanding

Mark Rowland — Wed, 11 Jan 2012 09:55:51 GMT

Seized bird or reptile, Initial consult and meloxicam/baytril at first practice, advised "we dont do exotics really, you need to go here as your animal probably needs bloods/hospitilisation/treatment", Pitch here, no money left for even the most basic of work ups. Asked by RSPCA "Is this neglect" Answer " I dont know without a workup of some sort".

Some local practices also divert all their "Free wild animals" to us as "they dont do exotics"

Re: RSPCA reneges on memorandum of understanding

Lorna McHardy — Wed, 11 Jan 2012 09:46:44 GMT

[quote user="Mark Rowland"]

My problem is that I have other practices seeing these cases at the start, charging normally for the consult fee and drugs hence using up the £50 then referring them to me because we do exotics. Am I therefore expected to treat them at a loss?

[/quote]

I'm a little bemused by the notion of referring an RSPCA case... they certainly won't pay for it, and if the owner could pay for it, it wouldn't be an RSPCA case. What am I missing?

Re: RSPCA reneges on memorandum of understanding

Rob Davis — Wed, 11 Jan 2012 09:15:35 GMT

[quote user="David Mills"]some things are priced higher than others - a bitch spay for instance is higher per minute time than most other surgeries in GP.[/quote]

I assume you mean lower as generally bitch spays cost considerably less than other surgical procedures taking a similar amount of time.

Re: RSPCA reneges on memorandum of understanding

Mark Rowland — Wed, 11 Jan 2012 09:07:16 GMT

Re: RSPCA reneges on memorandum of understanding

Michael Woodhouse — Wed, 11 Jan 2012 01:07:26 GMT

[quote user="David Mills"]I don't think cost prices are calculated by thinking of a number and doubling it, and never suggested such. But you cannot seriously suggest that there is a tool available that can assess all the variants on what goes into deciding the final cost - and with the human element it is nigh on impossible. Add into that consumer factors and...well, I'd be seriously impressed if there was.[/quote]

No but you can do a reasonable job. Something like an ultrasound machine easier to cost than a lot of things because your PMS should be able to tell you how much you use it. SPVS have a booklet on it.

By working out how many chargeable hours you work on average and how much things cost before you do anything allow for the capital cost know the number of times it has been used and then see what the book value is. I reckon with an ultrasound machine you could be rather accurate what it costs you.

Re: RSPCA reneges on memorandum of understanding

David Mills — Wed, 11 Jan 2012 00:33:16 GMT

[quote user="Gillian Mostyn"]

No it isn't. We have to work out the true cost of everything we do - how else would we compile a price list. Or are you under the impression that we think of a number and double it?

[/quote]

Do enlighten. Given the changing cost of consumables on a weekly basis, you need a bloody sensitive algorithm to predict that procedure or product x costs y on that day, everything that goes towards that procedure, the busyness of the day/month/year, the cost of vet/nurse/receptionist/phone line/heating/syringe/one or two needles/takes 2.5 minutes rather than 2.6 minutes/how many autoclaves had to do that day. The very best you can hope for is an estimate, and rough at that, and some things are priced higher than others - a bitch spay for instance is higher per minute time than most other surgeries in GP.

[quote user="David Mills"]costing procedures according to their average time taken by GP vets - hence a 10 minute ultrasound at £12 (no VAT) is likely fair. [/quote]

[quote user="Gillian Mostyn"]

So the machine was free then? Because if you'd paid £10K (or much more) for it, you wouldn't think charging £12 to use it, including staff wages for at least one vet and one nurse and disposables, was in any way fair! I really can't understand your maths.

[/quote]

It links to above. The £12 is an estimate. Some will cost more, some less, some will take longer. £12 is about average. There are other - dull - reasons why we can afford a 23k US machine - savings in exlaps, referrals from other charities, that sort of thing.

I don't think cost prices are calculated by thinking of a number and doubling it, and never suggested such. But you cannot seriously suggest that there is a tool available that can assess all the variants on what goes into deciding the final cost - and with the human element it is nigh on impossible. Add into that consumer factors and...well, I'd be seriously impressed if there was.

[quote user="Gillian Mostyn"]

And bigger salaries than any of us are ever likely to see. Funny how the people who are 'being asked' to sacrifice part of their income for the good of animal welfare - ie private practice owners - aren't the ones actually being seen to work for charities.

[/quote]

Hmmmm, capitalism's a funny thing, I agree. But hey ho, we are vets aren't we?

Re: RSPCA reneges on memorandum of understanding

Gillian Mostyn — Wed, 11 Jan 2012 00:08:08 GMT

[quote user="David Mills"]Yes, I think this is the problem. It is hard to ascertain cost price.[/quote]

No it isn't. We have to work out the true cost of everything we do - how else would we compile a price list. Or are you under the impression that we think of a number and double it?

[quote user="David Mills"]costing procedures according to their average time taken by GP vets - hence a 10 minute ultrasound at £12 (no VAT) is likely fair. [/quote]

[quote user="David Mills"]In most cases they are large investors, run by ex-City execs, and have immense resources at their disposal.[/quote]

Re: RSPCA reneges on memorandum of understanding

David Mills — Tue, 10 Jan 2012 23:46:40 GMT

[quote user="Judith Joyce"]

[quote user="David Mills"]cost price[/quote]

What do you mean by cost price??? - if I was a charity with loads of dead people and philanthropists giving me a shed-load of cash, my "cost price" would be what I paid the wholesaler (less discount). In the real world, I can only buy from a wholesaler because I have premises that have to be paid for out of fee income and the "cost-price" drugs have to be dispensed by people whose wages have to be paid for out of fee income. Without others paying fees, there is no "cost price" and I don't think we should effectively surcharge our good clients to subsidise this already wealthy and politically powerful charity.

[/quote]

Yes, I think this is the problem. It is hard to ascertain cost price. Likewise, I take your point Ms Mostyn, it is difficult to ascertain the full cost of providing out of hour services, staff time etc. I suppose my view is slightly different in that working for a large charity (not RSCPA) we have to 'cost' things up, and this involves wholesaler prices, and costing procedures according to their average time taken by GP vets - hence a 10 minute ultrasound at £12 (no VAT) is likely fair. Compare this to private practice where I have worked variously, especially OOH, and I think it's often difficult to marry the two systems especially in some places with the pricing structures e.g. Injection fees at £7 etc are things I've never really understood and you can imagine charities querying these.

On another note, expecting large multi-million pound charities to be run different to businesses is naive I think. They are not part time enterprises run by well-meaning concerned individuals in their spare time. In most cases they are large investors, run by ex-City execs, and have immense resources at their disposal. Perhaps the question isn't whether they should be run how they are run, which is the most efficient way, but rather what their focus should be. The RSPCA, for example, spend around 70% on legal fees, and are essentially a prosecuting body used by the CPS/police - whether this is right is another question, but it cannot be denied that they do occupy a unique area.

Re: RSPCA reneges on memorandum of understanding

Gillian Mostyn — Tue, 10 Jan 2012 22:55:48 GMT

[quote user="David Mills"]Would it really be so much of a stretch for vets to charge the RSPCA cost price as opposed to price + profit adjustment for emergency treatment[/quote]

Are you talking the true cost, including staff time and overheads, or simply the cost of the drugs? Because the true cost wouldn't drop the bill by that much would it?

[quote user="David Mills"]the RSPCA may naturally compare the costs of vets' treatment to that in their hospitals where most things are priced at cost - or even below cost - price e.g. ultrasound exam £12, biochem/haematology £5, drugs at cost price - etc as for large animal charities it is essential that costs are controlled. [/quote]

Hmm....you seem to be missing the point somewhat. The RSPCA subsidise the cost of treatment. It isn't about charging cost price at all. Afterall, do you really think an ultrasound scan only costs £12??

I am not happy to be EXPECTED, and indeed forced, to give my time FOC. Afterall, the managers and vets at the RSPCA who are charging 'cost price' for their treatments aren't working for free.

Re: RSPCA reneges on memorandum of understanding

Judith Joyce — Tue, 10 Jan 2012 22:43:50 GMT

[quote user="David Mills"]cost price[/quote]

Malcolm N

Re: RSPCA reneges on memorandum of understanding

Judith Joyce — Tue, 10 Jan 2012 22:36:23 GMT

[quote user="Mark Rowland"]

We rehomed the snake, Not sure but think the bill went unpaid.

Le sigh

[/quote]

In another world this would be "le crime" - gaining goods or services by deception.

I have previously done a lot of work for RSPCA, including appearing as expert witness in a fairly high profile case, but recently their attitude and conduct has deteriorated significantly.There seem to be some unpleasant and badly misguided people setting the agenda in that organisation.

Malcolm N

Re: RSPCA reneges on memorandum of understanding

David Mills — Tue, 10 Jan 2012 21:22:08 GMT

This may be a dissenting voice, and I've no idea if this is true, but the RSPCA may naturally compare the costs of vets' treatment to that in their hospitals where most things are priced at cost - or even below cost - price e.g. ultrasound exam £12, biochem/haematology £5, drugs at cost price - etc as for large animal charities it is essential that costs are controlled. I imagine vets' fees can be quite variable. Equally, I imagine some vets charge the full £60 amount regardless of treatment, and whether it cost x y or z.

Would it really be so much of a stretch for vets to charge the RSPCA cost price as opposed to price + profit adjustment for emergency treatment then come to some arrangement with a branch for cheaper treatment? Great PR. Great CSR. And let's not forget the animals.

I don't think the RSPCA have behaved very well over the MoU. Equally, however, I think we sometimes don't do ourselves many favours when we go on about cost. How many RSPCA cases are people seeing, after all?

There could even be a tendering process for local branches and vets' surgeries for ongoing treatment. What a great range of cases that would present.