The RCVS has responded to the outcry sparked by the Disciplinary Committee striking off a veterinary surgeon that delayed an out-of-hours home visit to a dog that had been run over by its owner, a farmer.

The RCVS response addresses three main issues raised by the case:

• Many have expressed concern that this rule sets some sort of precedent through which any veterinary surgeon who doesn't attend a home visit within a certain time frame will automatically be struck off. The RCVS says that it has no legal framework for taking precedence into account.
• Some of the comments made in the case summary appeared to demonstrate a lack of veterinary knowledge on the part of the DC, leading to questions over whether lay members in particular have any training or experience of the issues facing veterinary surgeons in practice every day. In the College's response it highlights that DC members undergo one-day induction training, two-day annual training and any additional training as and when necessary. However this is legal training and lay members do not have to have any experience of veterinary practice.
• There has been some discussion concerning whether the ruling was in keeping with current advice in the Code of Professional Conduct, or whether it represented a new commitment for veterinary surgeons to attend home visits (where necessary) within the hour. The College confirmed that the current advice in the Code on 24-hour first aid and pain relief is consistent with the decision:
  • 1.4 Veterinary surgeons in practice must take steps to provide 24-hour emergency first aid and pain relief to animals according to their skills and the specific situation.
  • Supporting guidance can be found at www.rcvs.org.uk/247care, and includes the following: 3.14 Clients may request attendance on a sick or injured animal away from the practice premises and, in some circumstances, it may be desirable to do so. On rare occasions, it may be necessary on clinical or welfare grounds. The decision to attend away from the practice is for the veterinary surgeon, having carefully balanced the needs of the animal against the safety implications of making the visit; a veterinary surgeon is not expected to risk 'life or limb', or that of anyone else to provide the service.

However, the College has not yet responded to many of the other issues being debated, including:

• The case report says: "The Committee is satisfied that the delay caused Mitzi [the dog] unnecessary suffering, which was evidenced by her uncharacteristically biting Mr Matthews' [the owner] son." What evidence does the DC have to support this assertion that uncharacteristic biting is evidence of unnecessary suffering? 
• The case report says that the defendant: "...offered no advice to Mr Matthews as to how Mitzi's condition could be alleviated whilst waiting for the home visit." That beggars the question what advice would it have been possible to give under the circumstances (i.e. an animal that has been run over and not yet seen by the veterinary surgeon)?
• The case report says: "His [the vet's] advice that the dog should be moved on a blanket was completely wrong, as the dog may have had an injured back." What evidence base does the DC have to support this statement? How else would the RCVS recommend an animal is moved?
• The case report says: "The Committee listened carefully to the record of the four telephone conversations, which it considers showed an absence of compassion on his [the vet's] part." Was this merely a result of a cultural difference? If Mr Chikosi sounded not compassionate, but businesslike, would that not have been equally appropriate for an emergency situation? Should veterinary surgeons now fear that if their bedside manner is not up to scratch, they face removal from the register? Is it appropriate for the DC to comment on a veterinary surgeon's manner, or is it more appropriate to allow market forces to apply? 
• The severity of the sanction. Striking off is the ultimate penalty; the removal of a veterinary surgeon's ability to earn a livelihood in the UK. Mr Chikosi made one (arguably) poor decision which led to a delay in euthanasia of an hour. Should he have faced the ultimate sanction for this? In a poll on vetsurgeon.org, 53.7% of 123 participants felt Mr Chikosi had no case to answer in the first place, 40.7% said he acted unprofessionally, but the sanction was unduly harsh. Only 5.7% said the sanction was appropriate.
• Is it fair that the ultimate sanction can be applied in situations where the respondent has failed (for whatever reason) to respond to the charges and is not represented at the hearing? The case report says that documents were emailed and posted to Mr Chikosi in Zimbabwe, to where he had returned, but not whether receipt was acknowledged.
• Where in the ruling was there any recognition of the owner's responsibility to the animal and its welfare? Should a farmer and his son reasonably have been able to transport the animal to the practice?
• The case report says that: "Mr Matthews [the owner] told him [Mr Chikosi] that it would only take Mr Chikosi ten minutes to come out to the farm. Was this, in fact, more a turn of phrase than a fair reflection of the likely journey time? If not a turn of phrase, is it likely an underestimate (because the owner was trying to persuade Mr Chikosi to come), particularly if Mr Chikosi was unfamiliar with the address. Either way, many have commented that with the return journey, the likely time away from the practice would be at least an hour, which would further explain Mr Chikosi's reluctance to leave the practice and attend the house.  
• Exactly what responsibility does Mr Chikosi's employer bear for the fact that he was in a situation whereby he felt unable to do a home visit?  Varying reports suggest a difference in Mr Chikosi's employer's official written policy towards home visits, and an unwritten policy. Alternatively, he may simply have misunderstood the policy, written or otherwise. Was it explained clearly?
• Is it fair to enforce the harshest penalty on a veterinary surgeon who carries out orders which go against the GtPC when they might face the loss of their job if they do otherwise?  

For the full response, visit: http://www.rcvs.org.uk/news-and-events/news/response-to-feedback-on-recent-disciplinary-hearing/

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