You may, or may not, have heard about the recent CMA investigation into the veterinary profession. Broadly speaking, this investigation is into how the veterinary profession operates as a business. It is not investigating the vets or nurses themselves, or the care that we provide, but the costs around what we do.  As you can expect, it has been met with differing opinions and feelings. This article aims to outline what the investigation entails, why it came about in the first place and what it means for our profession.

Table of contents

Firstly, who are the CMA?

The CMA, or the Competition and Markets Authority, is a non-ministerial governmental department in the United Kingdom. The department was founded upon the Enterprise and Regulatory Reform Act of 2013. They have several goals; one being the protection of the consumer from exploitation such as from inflated pricing. They are responsible for ensuring business markets operate in favour of consumers. They are also responsible for promoting the competition between businesses in their respective markets, ensuring all UK businesses are conducted fairly and legally to the highest standard and the enforcement of legislation.

What is the CMA investigation into the veterinary profession?

1. Initial review

In September 2023, the CMA launched an initial review into the UK’s veterinary service sector. A Call for Information (CFI) was issued which led to 45,000 responses from the general public and 11,000 responses from those working in the vet industry, including around a fifth of UK vets and veterinary nurses. This CFI, although not statistically representative of the UK’s pet owners or those working within the veterinary industry, showed that 56,000 people felt strongly enough about our sector to provide feedback on it. 

The CMA’s collated the evidence they had collected and formulated five key concerns to investigate further:

  1. Consumers may not be given enough information to enable them to choose the best veterinary practice or the right treatment for their needs.
  2. Concentrated local markets, in part driven by sector consolidation, may be leading to weak competition in some areas.
  3. Large corporate groups may have incentives to act in ways which reduce choice and weaken competition.
  4. Pet owners might be overpaying for medicines or prescriptions.
  5. The regulatory framework is outdated and may no longer be fit for purpose.

2. Consultation

Based on the CMA’s findings above, they launched a four week consultation to further gather opinions from the veterinary sector on their proposal to launch a full market investigation. This opened on the 12 March and closed on the 11th April 2024. Based on the responses, they made the decision to launch the market investigation to investigate their concerns further.

3. Market Investigation

On 23 May 2024, the CMA launched their full market investigation into supply of veterinary services for household pets in the United Kingdom. This is the stage where we are currently up to.

Response from the BVA

The BVA, that is the British Veterinary Association who represent more than 19,000 vets across the country, submitted a response to the CMA’s 5 key concerns they propose to investigate further. This response was jointly submitted by the BVA, British Small Animal Veterinary Association (BSAVA), the Society of Practising Veterinary Surgeons (SPVS) and the Veterinary Management Group (VMG). They raised concerns around potential unintended consequences of some of the CMA’s ideas including reduced client choice and competition; compromised animal welfare; damage to the vet-client-patient relationship; and in some circumstances increased costs for clients.

This is what they said…

“This data is rarely available from clinical practice and where it is, it is unlikely to be statistically significant enough to be meaningful. This could result in misleading comparisons and potentially misinform and confuse pet owners rather than helping them make informed decisions.”

Annual ‘wake-up’ letters from vet practices to pet owners prompting them to reconsider their choice of first opinion practice. 

“This has the potential to seriously undermine the vet-client-patient relationship (VCPR) which is key to achieving good long-term animal welfare. Encouraging clients to frequently reconsider and possibly switch their veterinary practice could lead to fragmented care, miscommunication, and a lack of comprehensive medical records, which risks compromising animal welfare.”

Prescription lengths

“Mandating longer prescription periods without allowing vets to use their clinical judgement could seriously threaten animal welfare. Vets choose prescription durations based on the animal’s specific medical needs. Extended periods could lead to antimicrobial resistance, unmonitored side effects, or worsening conditions without timely check-ups.”

Use of generic medicines

“Veterinary surgeons must abide by the Veterinary Medicines Regulations and prescribe medication according to the Cascade. This is a framework that ensures vets prescribe the most appropriate medications for animals, prioritising licensed veterinary products that have been tested and evaluated to maintain high standards of medicines safety which is essential for animal health and welfare. It would be irresponsible to suggest that unlicensed generic medication is equivalent, especially where that unlicensed product may not have the same absorption rate or efficacy.”

Of course, there were other concerns with the report, but these have been highlighted by the BVA in a recent statement.

Positives?

The positive aspect of this investigation is that it (hopefully) tackles the issues of pricing within our profession. Generally speaking, the vet or veterinary nurse you speak to when taking your pet to the vets is not responsible for the costs of your visit. A significant amount of practices now are owned by corporates, therefore the price of your visit is set by someone not in the building, and in many cases not even in our profession. 

Negatives?

There are two main issues with this investigation; the first being that it has inadvertently increased abusive behaviour towards our profession. There has been a worrying rise in abuse directed towards vets and nurses, mainly regarding the costs of care. As stated above, it is likely that the vet or nurse, or receptionist, that is being faced with harassment or abuse is not responsible for the cost incurred to owners. But that unfortunately does not stop us from being the subject of such abuse by a minority of pet owners.

The second issue is the threat to animal welfare the CMA’s concerns may bring. As discussed above, vets prioritise patient care above the costs of such care. We recommend diagnostics and treatments based on the patient in front of us. We use our clinical judgement and years of training to make decisions regarding your pet. So, to enforce longer prescription lengths or specific medicines would go against our ethos. It needs to be remembered that, at the end of the day, although the veterinary profession is a business, we are not like other businesses in that we have living creatures to care for. Our profession doesn’t behave like a ‘normal’ business.

Conclusion 

The takeaway from the CMA’s investigation is that those within the veterinary profession are calling for change as much as pet owners are. We do not support the inflation of prices, nor do we support any kind of consumer exploitation and we hope this investigation will lead to positive change. But most importantly, we hope the outcome of this investigation does not threaten animal welfare in the pursuit of positive change.

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