Veterinary Surgery (Testing for Tuberculosis in Bovines) Order 2005

Part of the debate – in the House of Lords at 3:01 pm on 18 November 2005.

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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.