Veterinary Surgery (Testing for Tuberculosis in Bovines) Order 2005

– in the House of Lords at 2:42 pm on 18 November 2005.

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Photo of Baroness Byford Baroness Byford Spokespersons In the Lords, Environment, Food & Rural Affairs 2:42, 18 November 2005

rose to move, That an humble Address be presented to Her Majesty praying that the order, laid before the House on 25 July, be annulled (S.I. 2005/2015) [8th Report from the Merits Committee].

Photo of Baroness Byford Baroness Byford Spokespersons In the Lords, Environment, Food & Rural Affairs

My Lords, I am sorry that the measure was not included in the Minute. The reason for bringing this measure before the House is underlined by the fact that the Merits of Statutory Instruments Committee has drawn this and the following measure on the Order Paper to the attention of the House. The committee states:

"We question whether the pilot programme, which will deploy only non-veterinarians drawn from the State Veterinary Service, will offer an adequate basis for assessing the wider use of 'lay testers'".

I have several questions for the noble Baroness, Lady Farrington. The Explanatory Notes clearly acknowledge the fact that the use of non-veterinarians for testing purposes is a very sensitive issue for the profession. However, the NFU supports the measure as its members are as well aware as anyone, including vets, that it is undesirable to have a backlog of tests.

I understand that about three years ago, after the foot and mouth epidemic, the statistics in regard to the late running of lay testing were challenged and that British cattle vets undertook a survey. The survey showed that 3,000 tests were waiting to be done. However, the results also showed that some of the parties surveyed did not exist or had given up farming, or that the TB test had been completed but had not been signed off by the SVS office because of staff shortages. So before we talk about the details, will the Minister confirm how many tests are outstanding and say whether she is confident that the situation of three years ago is no longer true and the figures apply? It is an enormously important point.

The noble Baroness will also be well aware, because she has been spokesman on this topic for some time, of the Government's desire to see greater working in the farming community and improved animal healthcare. The most important way of achieving that is by the proper use of veterinary surgeons. At this stage I should perhaps declare an interest, as I am sure others will shortly, as an associate member of the BVA. It does an amazing job. Vets may well be called to a farm to respond to a specific problem that may be nothing to do with lay testing, but while on the farm notice that other matters are not quite as they should be. Their expertise is greatly valued. One of the BVA's big worries is that lay testing will jeopardise that close link. The Government should consider that very seriously.

On the financial side, the vets will be paid for lay testing. However, if it is done by non-qualified people, that income will not go to practices which otherwise would have received it. As I am sure the noble Baroness will realise, there is still a question mark over the viability of large animal practices. The small practices are not the worry; it is the large ones. Every time one of those practices disappears or loses a partner or a vet, the response time and the mileage covered is increased and the service is closer to being jeopardised. If there are fewer such practices and they have to cover a wider area, it is likely that their fees also will increase. It presents a no-win situation. The Government are pushing on the one hand to try to improve animal health and welfare, but on the other, really through default, they may be jeopardising the very objective they are trying to achieve.

The order deals with setting up the test programme, which we are told will last 12 months and involve about 1,100 tests. Will that number be broken down into a certain number of farms in certain areas? How do the Government propose to define their "test area"? That information would be helpful to the House. Will the information gained in doing the tests and from any observations made on the farm on a given day be passed back to the local vet who normally provides veterinarian services to the farm, or will that vital information be lost? That issue has not been addressed at all.

Finally, I turn to paragraph 34 of the Merits of Statutory Instruments Committee report, which states:

"We note that in 2003 DEFRA's initial proposals for lay testing was met with extensive disagreement on the part of the profession (46 out of 88 responses).

It then goes on to say that it recognises that Defra has responded by deciding to conduct the pilot programme before deploying lay testers more widely. However, we are not clear that the pilot programme as planned will necessarily produce the sort of evidence needed to meet some of the concerns expressed, and I would be glad for clarification on that point. This statutory instrument raises important issues about the way the department views the value of vets per se and how it will establish and maintain that vital link in keeping the health and welfare of animals on the farm in its main criteria for future welfare. I beg to move.

Moved, That an humble Address be presented to Her Majesty praying that the Order, laid before the House on 25 July, be annulled (S.I. 2005/2015). [8th Report from the Merits Committee]—(Baroness Byford.)

Photo of Lord Addington Lord Addington Spokesperson in the Lords (Sport), Culture, Media & Sport, Spokesperson in the Lords (Disability), Work & Pensions, Deputy Chief Whip, People With Disabilities, Non-Departmental & Cross Departmental Responsibilities

My Lords, coming as I am rather new and nervously to the field, the arguments that have been put forward by the noble Baroness have a certain degree of weight. If you are going to allow some highly-specialised people onto farms to do one particular function, the general power to observe the well-being of the animal is almost bound to decrease and things will be missed.

Also, as the noble Baroness pointed out, we have an area where we are short of vets. We are effectively taking away a revenue stream from them, and the laws of supply and demand may mean that it cuts down the number of vets further by cutting down the revenue streams, which means that those vets that remain can charge more. That also means that people will delay longer in calling in a vet and will let certain situations go on longer. That may cause more infectious disease, more distress to the animal and higher degrees of infection.

The fact of the matter is that it is something of an emergency, stop-gap measure. An indication from the Government of exactly how much of an emergency measure it is would be helpful. Also, are they planning to expand the numbers of state vets? I am informed that the numbers have fallen in recent years. If the Government can give us some assurances that they do not look on this as a long-term solution and they are merely doing it to make up the lost time and the backlog, there might be a grudging acceptance from us. If, however, it is seen to be a general fix of getting people in to do one specific task that might be opened up to the entire veterinary profession, then we would have much more of a problem with it. I look forward to the Minister's reassuring answer.

Photo of Lord Soulsby of Swaffham Prior Lord Soulsby of Swaffham Prior Conservative

My Lords, I welcome the prayer to annul the Motion put forward by my noble friend Lady Byford. I declare an interest in that I am a veterinary surgeon and I was president of the Royal College of Veterinary Surgeons a few years ago. It is also likely that I am the only person in this House who has even performed a tuberculin test on an animal.

As a young veterinary surgeon, I, along with many of my colleagues, performed innumerable tests on dairy cattle in all weathers; a boring and at times dangerous task, especially with cattle loose in yards. We did it to rid the country of the scourge of tuberculosis and to remove the source of human infection, especially for children; although pasteurisation helped in that too. We were very nearly successful. With the exception of a small focus of infection in the south-west, the country was rid of that awful disease. Farmers welcomed it because they could become TT-tested dairy herds and thereby gain a premium on their milk, or they could become attested, which allowed them to sell their cattle in special markets, also with a premium.

In 1941, TB was found in badgers, but I shall not go into the subsequent problems associated with that.

There is an urgent need for the widespread testing of cattle now, as there was many years ago, and this order provides for lay personnel, after training, to undertake the procedure. As the noble Baroness said, there is great concern that this important diagnostic procedure is to be undertaken by lay personnel. The argument put forward is that it is not difficult to train a person to inject a small quantity of tuberculin intradermally and to measure the reaction that occurs 72 hours later.

But there is more to it than that. While conducting a herd test, a veterinary surgeon cannot but observe the general health status of the herd and often he gives advice on the situation—all at no cost to the animal owner. Many veterinary surgeons know the phenomenon of farmers saying, "By the way, while you're here, would you like to have a look at this or can I ask your advice on that?". No lay tester can respond to questions such as that. It is all done free and gratis and is regarded by a veterinary surgeon undertaking a herd tuberculin test as part of the expected procedure. Lay personnel cannot be expected to respond in such a way.

Whatever the measures that need to be taken to curb the spread of TB in cattle, the use of lay testers for what is regarded by the profession as an act of veterinary surgery is not the way ahead. Veterinary surgeons must take a pivotal role in the surveillance, diagnosis, control and eradication of bovine tuberculosis. Their advice to farmers and stock owners is important and, in the long run, their presence on farms is essential to improve the health status of the national herd.

Photo of Lord Kimball Lord Kimball Conservative

My Lords, I declare an interest. I am an honorary member of the Royal College of Veterinary Surgeons after serving for nine years as a Privy Council Representative at the Royal College as a Member of another place. For 10 years, I was chairman of the University of Cambridge Veterinary School Trust when my noble friend Lord Soulsby was dean of that school, and we raised sufficient money to keep the trust in being. I also happened to live near Melton Mowbray and the Remount Depot, where many of the graduates from Cambridge end up in the Royal Army Veterinary Corps. In fact, today, Cambridge University trains so many successful vets that they are lecturing in all the other colleges throughout the United Kingdom.

When you are visiting a farm, the dogs at Melton Mowbray or the horse lines, you need a trained veterinarian who knows the subject in its complete environment. That is very important. It is not just a question of reading the thickness of the skin in one single TB test; one wants to know how the animal is kept and the extent of the farmer's interest in the proper control of disease.

Today, we have a special problem with large animal practices. Vets are called in in the case of cows, bullocks and horses and, sometimes, when the problem is serious, they are called in to look at a very valuable ram. But you cannot afford to call in a vet to look at a ewe, although you might if an illness is affecting the whole flock. Today, we face a real danger from the fact that vets are not getting on to farms. When we had an outbreak of foot and mouth, vets became a precious commodity and we had to call in many from abroad to help us.

We cannot allow large animal practices to become any smaller, and this experiment—I know it is only a very limited experiment—will withdraw vets from farm practices, which is a serious matter. As my noble friend Lord Soulsby said, that would never have happened if the Government had faced up to the fact that we should have had a proper cull of badgers. In the summer, one only has to drive down a country road early in the morning to find a large number of dead badgers. Thank goodness they are dead; we want more of them dead. There is an explosion in the badger population and when they become overpopulated they succumb to disease—TB—which spreads to cattle. This order is an experiment—an unnecessary experiment—and I hope the Government will not go ahead with it. It distances vets from farms and it means that the Government are not facing up to where tuberculosis comes from and are not dealing with the badgers.

Photo of Baroness Farrington of Ribbleton Baroness Farrington of Ribbleton Government Whip 3:01, 18 November 2005

My Lords, I thank the noble Baroness, Lady Byford, for giving us the opportunity to air this issue in your Lordships' House. As the noble Baroness recognised, the possible introduction of lay TB testing is not new. It has been discussed, off and on, for at least the past 30 years. The issue provides a number of concerns for the veterinary profession, as the noble Lord, Lord Soulsby, is aware. The order represents a very cautious first step towards finding a resolution that meets many of the concerns expressed by noble Lords. We are all aware of the serious impact that bovine TB is having on our cattle industry. It is one of the biggest animal health threats that we face in the country, and as the noble Lord, Lord Kimball, said, it is a very important issue.

Since the foot and mouth outbreak, we have gradually reduced the significant backlog of outstanding tests. The noble Baroness asks for the exact number outstanding. On 30 September, the number was 2,049. However, one of the key lessons learned from the foot and mouth outbreak was the need to be prepared and to plan ahead. We can be certain that the demand for TB tests will increase in response to the continuing spread of the disease and in anticipation of the introduction of compulsory pre-movement testing, which is likely to mean several hundred thousand additional tests being required.

The profession tells us that rural practices are struggling to provide veterinary services in many parts of the country and yet, at the same time, they seem confident that vets will be able to meet the increasing demand in TB testing. We are not convinced that we can wait and see. We note that that concern, as was recognised by the noble Baroness, Lady Byford, is one shared, expressed and voiced in consultations with the NFU.

In July 2003, we published a consultation document which invited comments on proposals to permit properly trained and competent non-veterinarians to perform TB skin testing of cattle. Having successfully completed an approved course, lay testers would work alongside and under the direct and continuous supervision of a veterinary surgeon until such time as the vet was satisfied that the trainee had reached proficiency in the technical aspects of TB testing. A veterinary surgeon would also check the test results and interpret them.

We reassured the veterinary profession that there would be no compulsion on veterinary practices to employ lay testers. If individual practices decide not to employ lay testers, that is a matter for them. However, other practices may well see that as an opportunity, rather than a threat, and seek to involve well trained technicians under the direction of a veterinary surgeon. Smaller practices, in particular, may find this option attractive.

Having listened to the concerns raised on behalf of the profession, we sought to establish a better evidence base to clarify whether well trained lay testers could indeed carry out the test. We decided on a carefully controlled pilot, using experienced field staff within the State Veterinary Service. We worked closely with the Royal College of Veterinary Surgeons and the British Veterinary Association to explain the aims of the pilot and to show them how the State Veterinary Service is proposing to train and supervise their staff. Both organisations sent observers to the training courses and were complimentary about what they saw. Both organisations have also been invited to monitor the pilot, and to help analyse the results. The value of using State Veterinary Service staff for the pilot is that when and if lay testing is rolled out to the private sector, it is likely that the State Veterinary Service will have a key role in training lay testers. Through the pilot, it will have the opportunity to assess the suitability of its current training programme from the view of the trainer and of the trainee.

Part of the culture change that the veterinary profession needs to embrace is a preparedness to build closer relationships with other farm service providers. There must be benefits in greater co-operation between vets and para-professionals. We recognise that the profession is going through significant changes and faces some difficult challenges. We formed a working group with the RCVS and BVA specifically to address these issues together on a partnership basis. I am sure that the noble Baroness and the noble Lord, Lord Soulsby, will welcome that. There may be some limited interventions that we can make to help rural veterinary practice meet the challenges that it faces.

In response to another concern, we do not expect the introduction of lay testers to have a detrimental impact on veterinary surveillance. I recognise the reference made by the noble Lord to, "While you're on the farm, could you just have a look at . . . ". It is true that the need to carry out a TB test provides the veterinary surgeon with an opportunity for a farm visit that may not otherwise take place. However, it is unusual for significant findings to be brought to our attention as a result of a routine TB test. Veterinary surgeons themselves have developed the art of not spending the whole of their day doing work as a follow up to, "While you're here, could you just . . . ". If there is a need for veterinary attention or advice, it is ultimately up to the owner to arrange for it. It would be dangerous to rely on infrequent visits for TB testing for the detection of most important animal health or welfare issues.

Were this order to be annulled, it would mean that the pilot could not continue. That would represent a lost opportunity, and undermine our attempts to ensure that farmers are able to have their animals tested for TB without delay. On previous occasions in your Lordships' House, there have been references to a need to tackle the backlog. No decisions on the possible extension of lay testing will be taken until the results of the pilot are known. If we decide to proceed with lay TB testing, the current order would need to be amended and there would be further consultation with interested parties.

There are issues that we can revisit after the pilot has been completed. However, we hope that representatives of the veterinary profession will recognise that ensuring the viability of rural veterinary practice may require it to adopt new ways of working and to enter into new partnerships. To reassure the noble Lord, Lord Soulsby, we hope that lay testing will free vets to do work that uses their higher skills and their ability to charge at a rate to allow rural practices to survive.

The noble Baroness, Lady Byford, asked about the test area and test information being passed back to local practice. We are looking at 10 of the main areas of the country where TB is most prevalent. In State Veterinary Service offices results will be shared with local practices, and the local vet will be fully involved in looking at the results of the lay test and information being passed back to the local practices. I think that will cover some of the concerns raised by the noble Lords, Lord Kimball and Lord Soulsby.

The option to employ lay testers is a matter to be left to individual practices. I say to the noble Lord, Lord Addington, that it is not a short-term fix; it is about releasing vets to use the skills that I referred to.

The noble Baroness raised the issue of the merits committee's report. The State Veterinary Service will be involved in training lay testers if the principle is extended. The TB test involves the interpretation of results. The injecting, reading and recording of results is a technical matter. They do not require professional judgment. The professional judgment and diagnostic expertise of a fully trained veterinarian could be delivered by a trained para-professional. The experience of the pilot project is important, and we are very grateful to those professions from all sides that will be involved in the evaluation of the pilot scheme.

It is extremely important that we work very closely with the profession in seeking to resolve some of these issues. The Animal Health and Welfare Strategy, which we published last year, issued some clear challenges to everyone with an interest in raising the standards of animal health and welfare. One of the key outcomes the strategy seeks to bring about is the understanding and acceptance of roles and responsibilities. It called for a culture change in the way vets operate and a move towards services that customers need and have to pay for.

The strategy recognised that vets are uniquely placed to help animal owners adapt to their changing responsibilities. We would welcome ideas from the profession on how vets can use their skills to help achieve the aims of the strategy and bring about a culture change, which is needed to ensure that farm veterinary practice has a sustainable future.

I hope that I have covered all the points raised. I shall of course carefully read Hansard, and I will write to noble Lords covering any outstanding points.

Photo of Baroness Byford Baroness Byford Spokespersons In the Lords, Environment, Food & Rural Affairs

I am grateful to the Minister for her response, to which I shall return, and also to the noble Lord, Lord Addington, who, like me, is fielding very heavily on behalf of his party. Perhaps this is not his natural home ground, but we are grateful to him for his support. I am grateful to both my noble friends. My noble friend Lord Kimball has had a long association with the royal college and the long and highly recognised work of my noble friend Lord Soulsby within the veterinary profession is greatly valued.

I deliberately did not go down the line of talking about bovine TB and controls of TB apropos badgers. I thought I was very calm this morning, but since the noble Baroness has opened the door—

Noble Lords:

Oh!

Photo of Baroness Byford Baroness Byford Spokespersons In the Lords, Environment, Food & Rural Affairs

No, no, my Lords, the noble Baroness did. I cannot possibly resist the temptation to come back on that. If only the Government could get their act together on the whole question of how we control the spread of bovine TB in our wildlife population as well as within the cattle population, we would not need so many testers long term. That is as much as I will say today, but I must put that on record. I know that the Government have spent a long time considering ways to control bovine TB in wildlife and what is the connection, but the longer that they delay, the worse the situation gets. I cannot not stress that at this moment.

The noble Baroness talked about para-professionals—another word to add to my veterinary vocabulary. I will be interested to know what the response to that is. If we are to have some super para-professionals who will be moved to do certain things in different ways, where will that stop? But that is for another day.

I thank the noble Lords who have taken part in the debate. As I said, it is important that we get to grips with the disease and stop it from spreading, whether in wildlife or cattle to cattle. I hope that the Minister will reflect on what I said earlier about my fear that the order will make things more difficult for some in large veterinary practices. I beg leave to withdraw the Motion.

Motion, by leave, withdrawn.