Michael Fitzmaurice: Will vet nurse changes cost rural vets?

First of all, thanks for coming in. Can you explain there the line, the average salary of a visionary assistant visionary practitioner employed in Ireland is just £50,000 vs 38,000. Is that a young bit or what? Explain that. Thank you Deputy. That figure was taken from our benchmark survey of the profession in 2020. Explain both. I know what a veterinary nurse is but at the other end. No, no, I'll explain it. It's the average salary for a veterinary assistant who's an employee in a veterinary practice basically. The average salary in the same survey for principals or partners in practice was €96,000 and if we take that... So just let me get my head around this. Yeah. You say an assistant, is that the person that sort of runs the place if you want to go in and they'll take the cards from you or they get them signed for you or whatever is done? Is that what you're on about? No, they're essentially fully qualified practicing vets within the practice but they're employees of the practice as young vets. So they're not the principals or partners. They're the new vets that lend in. Yes. What's the availability of them? Is it pretty good at the moment? It's pretty good. I suppose if we were, historically if we were dependent on the number of spaces in UCD we would have had a huge shortage but we've had a huge supply of vets from other countries, Irish vets studying abroad. So for example since 2019 the number of vets on the register has gone from 2,933 to 3,813. Are you saying to me, going by looking at that figure, it's like I do hire work and if I get a trained machine driver, as again someone that cannot drive a machine that I have to learn, are you saying to me that at 50 grand and probably prudently enough that person can go out then and they can pull a calf or pull lambs or they can do whatever you want. Are you saying to me that when you get them at 50,000 then it's not as attractive to take on a veterinary nurse at 38 because they cannot do those things. Is that what you're saying? No, thank you Deputy. I'm working a small practice with myself as a principal. I have two qualified vets working with me and I employ two veterinary nurses. My practice is very mixed. The assistant on 50,000 that starts off fresh from college, he's qualified to do anything that I am qualified to do. To go out, pull a calf, examine a cow, examine a dog, examine a cat, make a clinical decision. Veterinary nursing, our veterinary nurses are somewhat different. They work more in-house. They're much more aligned with our small animal business. What can they do? You have them now. So tell us because the last day we were, they were explaining the last day they were in here to us that basically they couldn't administrate I think injections or they couldn't operate or they couldn't do, basically just nearly hold the dog while they've done the work. No, no, no. They're not vets so they're not qualified to operate on an animal. However, they are qualified to do things like take bloods. They're qualified to x-ray animals. They're not qualified to interpret x-rays. They're qualified to put things like IV cannulas, which is the same in human medicine. They're basically qualified to do everything to an animal that a human nurse is qualified. If that makes sense. Give them injections? They are qualified to inject under the direction and prescription of a veterinary surgeon. Right. Because that was a, in your opinion, are my reading, should it get a sort of an overall relook at what a veterinary nurse is, and to both parties I'd like to know this. Should it get an overall relook at, should a veterinary nurse be trained to test cattle for TB, yes or no? Probably not. Why not? TB testing is an interpretive test. The test is interpreted by the vet doing the vet. Now, on a practical... You can't train anyone to do it, can you? I don't know, maybe we'll ask the veterinary council that. I heard this question the last day, and I thought quite a bit about it. And I said, what would happen in my practice if I had a trained veterinary nurse to do my TB testing? We have three vets. We're a mixed practice. We provide large animals, small animals, equine cover. If I had a veterinary nurse or a registered technician doing that sort of work, I would probably lose one of those two vets that I'm employing. So I would have one less vet in the practice. So I have to have a vet on call 24-7, 365 days in the year. So the vet that's left working with me, he or she is going to go from a one and three rota to a one and two rota. That guy is going to come to me and he's going to say, listen, Alan, when I started here, it was one and three. Now it's one and two. I don't really want to do that. I'm afraid I'm going to have to leave. So I'm going to find it very difficult to get somebody in this day and age to work every second weekend for me 24-7. Following on from that, I would have to look at maybe my large animal practice and see, you know, is it financially feasible to do that amount of work myself? Would it be better to say I'll just do small animal work and maybe, you know, run my own call with another small animal practice 40 miles away? My farm animal clients will suffer. I won't be there for them. My small animal clients will suffer because the weekend I'm off, they're going to have to drive 40 miles to get their animal attended to. So, you know, taking veterinary work away from the qualified vets might sound like a good idea, but could end up in a situation where you will have less vets on the ground in rural Ireland to attend to sick animals, be they large, small or equine. It wasn't taking, you know, the cushion thrust of veterinary work away. I specifically talked the last day about TB testing. Yeah, I know you did, yeah. The reality of farm animal practice... It could take pressure off vets, that's what I was... It might in the short term. In my practice, I am extremely busy for a couple of months of the year. The rest of the year in farm animal work, I'm not that busy, hence why I run a mixed practice. I'm trying to even out the peaks and troughs, okay? Farm animal vets are extremely busy, as you well know, during maybe the spring for a number of weeks or a number of months. Not so busy this time of the year, not so busy in the autumn and the winter. We need probably work to smooth out those peaks and troughs. Is it... If you look at the... You mentioned the nursing profession, and then you looked at the veterinary nurses. What's the comparable salaries that way, you know? I'm not too sure. Do you mean in human medicine? Yeah, if it's a person... Nurses are trained in human medicine. They start off on salaries of around 48... They're on 10 grand more than the veterinary nurses. 46,000 to 56,000, but they can go up as high as 130,000 for management grades. It's similar between the difference between the veterinary salaries. The average veterinary salary for all vets with over 11 years' experience in Ireland came out at 82,000 during a recent survey. What I'm trying to establish here... Vets are busy certain times of year, as you've alluded to. There could be a week in that never get to bed, if they're on call or whatever. Do you know what I mean? I understand all that. But if there's a problem that we have with a lot of veterinary nurses leaving the whole thing and going away from it... In your opinion, and I'd like to hear your opinion... There's a need for veterinary nurses, if you agree with me or not. How do we make it... Do we need to revamp it to make it... That they could do more things to help the vet? And that it could be... Basically, you're after alluding to it there, that some people... If you're a vet and you're working for the bossman of a veterinary practice, you'll go up a ladder and you'll go up fairly quickly. Or if you're in the HSE, you'll go up the ladder as well. Whereas the veterinary nurses don't seem to be on that scale as per se. And why have we an exodus from it? Or what's the solution to not having an exodus from it? That's the question I have for you. Thank you, Douglas. I think it's important to understand the huge variation in practices across the country. There's a huge difference between a small animal hospital, for argument's sake, in Dublin versus a mixed practice in Mayo. And I think it's very important as well that each individual practice has the autonomy to use the resources at hand to provide the best service to clients. That's why we're all there, to ensure the best standards of animal welfare are upheld on a daily basis. As I said, in terms of hiring, maybe for argument's sake, in a small animal hospital, there might be a lot more use for veterinary nurses. As Alan said, they mainly remain in-house rather than attending farm calls and stuff like that. And the other thing that's important to remember as well is if we are to have a situation where maybe I bring a veterinary nurse with me in the middle of the night to a caesarean or whatever it is to a farm call, the costs have to increase, unfortunately. And I don't think anyone is in favour of that. I think it's already considered expensive enough to get a vet out to maybe a cow calving or something like that. Too expensive for class. I didn't hear anything at all from the hierarchy of the veterinary institutes of Ireland. You don't seem to have a view on anything I talked about. What's the reason? In relation to TB testing, the veterinary council is a regulatory body, so we look at TB testing as an act of veterinary medicine. Therefore, it involves both diagnosis and certification. Therefore, as far as we're concerned, veterinary nurses is now within the scope of what veterinary nurses can perform. I know it's not within the scope, but have you looked at working with the vets around the country to see what new things could be brought in to make it more attractive to keep people in it? To give them probably a fairly good wage and to get more youngsters involved in it? Because certain times of the year, as you know well, vets are out the door under pressure. I can comment on that one. Currently, we've already produced a document called the role and scope of the veterinary nurse in practice. We're expanding on this at the moment, looking at how we can better integrate nurses into exactly that farm and equine practices. We acknowledge that their penetration into these types of practices has not been the same as their uptake in companion animal practices. We're looking at having them do things such as taking bloods. They would assist during a caesarean section to look after the calf, for example. Hold on one second now. If you listen to a farmer, what you have to say in there now, if you're looking at that, if it generally does the caesarean, you don't need an army doing the caesarean. Or if you have the army at it, you're going to cost an awful lot more. So if it was within the practice of getting pups with a dog or that you're brought to the vet or whatever, you have to watch that side of it as well. But go on as if they're saying. Would you agree? I would agree, but again, the Veterinary Council doesn't have a role in terms of setting the prices. Our role is to promote and utilise nurses to the veterinary community. Our role is to promote and utilise nurses to the best of their ability.