Benjamin Disraeli wrote that “Change is inevitable. In a progressive country change is constant.” One wonders what manner of changes beset the UK in 1871 as he wrote these words and, of course, every generation believes that the changes it experiences are different from and more profound than others which preceded it.
Nevertheless, a quick glance at the news would show that the world in general is undergoing a period of profound and disruptive change on a social and political scale that would be hard to mirror at any earlier stage. The social and political upheaval in the Middle East will have major ramifications for the way in which politics and religion co-exist and have already contributed to a shift in economic influence as Russia steps in to fill the shortfall in OPEC supply of oil and becomes more cash rich than Croesus as a result, and the financial crises which have followed the excesses of capitalist greed threaten to challenge our way of life across several European states and in North America. Major changes in US domestic and foreign policy will have considerable effect on much of the rest of the world and, as if that were not enough, world population growth is set to outstrip our ability to meet the demands for food, water and fuel within a couple of decades.
The nature of change can, in a number of ways, be likened to neoplastic growth. Some changes are slow burning and can take decades to take effect while others are far hotter and cause major problems within an amazingly rapid course of time. But in the case of both societal change and neoplastic growths, ignoring the issue is rarely the best option. Often, it takes a momentous occurrence to orchestrate a change in public opinion or even a display of public opinion and, as an example, most of us would admit to having been surprised by the strength and magnitude of the public display of grief at the death of Diana, Princess of Wales despite numerous stories which made a soap opera out of the Royal Family at the time. In many cases, people show huge reluctance to really take change on board as can be seen by the nation’s embrace of the Help for Heroes charity despite a lack of political appetite to address the issues of our role in the combat arena of Afghanistan and elsewhere in the Middle East. Sometimes, change comes from unexpected directions and our collective recognition of the need to move away from the Palmerstonian era of sending in the gunboats at the drop of a hat might see a dramatic revaluation of our ability to act as one of the worlds policemen effectively brought about through financial cutbacks where other political methods have failed.
So, on the world stage, we see huge changes which filter down to have an effect on our own lives. Rising commodity prices such as fuel and food will play a major part in making families revaluate their budgeting and public sector unrest is unlikely to bring about much change in the scale of job losses and pay freezes as we go into the Autumn, despite threats or promises of a November to remember in terms of strike action. If people’s inability to pay will force them to reassess their ability to spend, particularly in a time of continuing pressure on credit, surely we should be making some provision for a plan B within veterinary practice. Farm vets have already had to face a complete shake up in their business model, more or less having to reinvent themselves in the way in which they conducted business and have done so very successfully. However, it is hard to see much evidence of any recognition among the growing number of veterinary surgeons seeing small animals that anything has to change. There is some degree of muttering about things getting more difficult but not much else.
Nevertheless, all the data points to problems ahead. We have had almost a decade between 2002-2011 where Fort Dodge Indices have repeatedly pointed to a real trend of reducing numbers of active patients and active clients and we’ve seen no growth in the absolute pet animal population over that period. Simple mathematics tells us that the old adage of having fewer people paying more may have kept income levels tolerably high but if people are coming in smaller numbers with their pets, this is simply unsustainable in the longer term. This column has repeatedly questioned the point when the ration of active patients and clients /FTE becomes unrealistic from a profit perspective and yet we go on expanding our numbers of trainee vets in waiting in the clear and certain knowledge that we are approaching the point when the current ratios no longer work.
In a time of plenty, we can afford for there to be a disconnect between the feedback from veterinary practice, the ambitions of those who train tomorrow’s vets and the organisations which guide, regulate and safeguard the profession’s future. We are, quite clearly, no longer in a time of plenty and few of us would bet money on anything happening to change that in the short to medium term.
Quite clearly, there needs to be a big plan. A war room chart where all the factors which affect the normal conduct of our collective business can be entered and where someone or some people make holistic decisions based on not just a realistic assessment of the present and the factors which led to this status quo but also on a pragmatic assessment of the needs, resources and scale required to meet the marketplace of 2020 rather than assuming that everything is fine and change will happen in a gentlemanly fashion. Looking around, I can see no sign of anyone taking such an overview and that is worrying. If we know the extent of the problems we face and we can see that things can only be improved by some form of intervention, are we being naive or negligent in refusing to tackle the issues in any cohesive sense?