Today the Competition and Markets Authority (CMA) has published its findings following its review of veterinary services. At VetHelpDirect, we have been working with UK vets over the last six months to help them make their pricing easier for pet owners to find – lack of transparency has been one of the key findings of the CMA so far. So what’s happening, and what comes next? And how will vet practices respond?

The CMA investigation was opened in September 2023, as a result of concerns around the increase in veterinary fees above inflation over some years. The initial consultation received 56,000 responses from the public and the vet industry. After sifting through the data they have today published their report.

The CMA found five areas of concern:

  • Transparency of information – ownership of practices, and above all fees charged
  • How competition is working given the increase in consolidation with a single corporate in some cases owning most of the veterinary practices in an area
  • Larger corporates may have incentives to act in ways that might reduce competition, for example, using their own referral centres, crematoria, and even directing pet owners to their own online dispensaries.
  • The costs of medicines and prescriptions from practices
  • The regulatory framework is not fit for purpose

Sarah Cardell, Chief Executive of the CMA says “50% of people did not receive up front pricing out of hours, 80% of vet websites don’t contain any price information. 25% of pet owners did not know that they can take a prescription from a vet and get medicines more cheaply” – for example, from an online dispensary or pharmacy. 

The CMA has also expressed concern about business models used in the sector

10 years ago, 10% of veterinary practices were owned by corporates (usually backed with venture capital or private equity funding) – now a majority are. It’s not always apparent who owns a local practice (a number of the pet owner respondents incorrectly thought that their vets was independent, when actually it was corporate-owned). Another concern they raised was that the corporates have been investing in and focusing on sophisticated treatment options, and the CMA are concerned that clients are no longer always offered cheaper options, that might be better suited to their needs.

There are also reports that in a minority of cases, pet owners are not always being given estimates of costs before treatment – allegedly, 10% of surgical procedures do not involve an estimate.

What happens next?

The CMA is recommending a formal Market Investigation and is now consulting on this proposal. If this happens the CMA will be able to compel those under investigation to provide information; it will also give the CMA access to a range of legally enforceable actions, such as mandating the provision of certain information to consumers, imposing maximum prescription fees and ordering the sale or disposal of a business or assets.

So what about fees?

Well, the CMA reports that most pet owners believe that vet prices are the same everywhere – in fact, that’s a view we’ve often heard in the comments here. The truth is different – every practice, including in some cases different branches of the same corporate, has a different pricing structure. This will reflect the area they’re in, but also the focus of that practice. In some cases, for example, expensive medicines sales may be used to cross-subsidise professional fees; in others, the opposite may occur.

This is why VetHelpDirect started publishing prices for vet practices this January – to help pet owners better understand what the fees at their local practices are, and to help vet practices be more transparent. Since the consultation went out, we have published prices to about 2,000 practices and have plans to enhance this transparency even more over the next six months.

Check vet prices near you

The other important point to mention is that in most cases, the vet you see won’t be the one who sets the prices – they are an employee who does the best they can within the pricing structure set by their practice. They’re rarely seeing any commission or performance related pay, and are torn between their obligation to put your pet’s welfare first and foremost, and the need for their employer to make enough money to function.

Can you directly compare fees between vets?

Well, yes and no.

Certainly, there are some “fixed price” items, such as the cost of a prescription for a single medicine, or the initial consultation charge (the “initial barrier” to accessing vet care).

However, taken more broadly, comparing prices for veterinary services can be challenging due to various factors. 

Firstly, the pricing structure for different services varies between practices

For instance, some practices may include additional items such as food, a buster collar, and post-operative checks in their castration package, while others may charge for these separately. This lack of uniformity makes direct comparisons more complex than it may initially appear.

Secondly, the level of service offered by veterinary practices can vary significantly

Some practices boast advanced facilities like in-house CT scans, specialised teams, and sophisticated laboratory equipment. This type of care is often on a par with human health and has meant that some of the best veterinary care in the world is available to pet owners in the UK. Others have more of a focus on affordable care. Understanding where a particular practice stands on this spectrum can be unclear for consumers.

Vets themselves may have different approaches to care

Some may opt for extensive investigations to cover all possible conditions – ensuring that a firm and accurate diagnosis can be made more quickly, allowing for definitive treatment to commence sooner. Others, though, may take a more empirical, symptom-based approach based on clinical experience which may be curative, but may result in a delay in determining the underlying problem and starting the optimum treatment. In reality, of course, all vets can and will do both, but we are all naturally predisposed towards one approach or the other, even before practice policy is factored in. These differences in philosophy can impact both the care received and the associated costs – as does “defensive medicine”, where vets are afraid of being sued or having to face complaints to the regulator because they missed a diagnosis. 

Lastly it is often impractical for consumers to compare prices for veterinary treatment

The problem with estimates for treatment, as opposed to routine care, is that no-one (including the vet!) knows what will be required until the vet has done some initial investigations, by this time it is often too late to shop around.

We’ve been working on providing transparency in these areas and have ambitious plans to enhance this transparency even further over the next six months.

Are there “affordable care” practices?

It is interesting that, whilst practices vary substantially, there is little overt segmentation in the industry. Very few practices market themselves as ‘affordable’, with the exception of vaccination clinics (who generally only provide routine care). The vast majority of vet practices focus on presenting themselves as providing the best quality care possible. Whilst animal welfare must always be foremost in any veterinary service, it is also acceptable to provide this with less sophisticated equipment and facilities, teams with no extra post-graduate qualifications, and a focus on trying symptomatic treatment before moving into diagnostic tests. 

Barriers to different models

One of the issues with this is that there is a severe shortage of veterinary staff in the UK, and relatively few vets want to work in practices where they do not have all the best facilities and set up. Treating diseases symptomatically is often more stressful for the vet, too: they lack certainty over what is wrong with the patient and therefore may miss something – and there is still the concern about legal or regulatory action if they do. Despite being able to make sure the pet is not in pain, the vet might not be able to give them the best possible chance of recovery without further testing – and thus further expense. Add to this a bias over the last few years towards what is called “gold standard care” – i.e. the care one would expect from a top level hospital – and you can see why some vets themselves may be reluctant to offer a “lower” standard, even if it is occasionally more appropriate (and more affordable!).

This is the basis of contextual care – the idea that the best treatment is the one that’s most suitable for that pet, and that owner, in that context. It doesn’t mean throwing the textbook at the case, but working with the owner to choose the most suitable option. This is the care that most vets aspire to provide, but it is actually very difficult to do and therefore it doesn’t always happen perfectly.

We’d like to see more segmentation as well as more prices being published

Prices are certainly only one metric when it comes to choosing a veterinary practice but they are a metric that pet owners want to take into consideration. While many simply want to access the best and most sophisticated care for their pet, others may become priced out of pet ownership if this is the only option. We want to help pet owners to understand all these differences so they can choose the best practice for them and their pet.

We do need to bear in mind vets are a caring profession and want to do what best for the animals in their care, so these conversations need to be constructive. In your discussion – and in comments! – please keep in mind the distinction between veterinary businesses and the dedicated staff working in them: we don’t tolerate vitriol or any sort of abuse against vets.

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