The proposal seems to have its roots in the First Rate Regulator initiative announced by Nick Stace in November 2012. As part of the initiative, the College commissioned Sally Williams and Associates to conduct research amongst stakeholders and report back with recommendations for being a first rate regulator.
One of those recommendations was to move to the civil standard of proof (page 33/34 here). There is no stated rationale for this recommendation, other than: "The majority of other professional regulators have moved to the civil standard of proof".
Nevertheless, the recommendation then found its way into the RCVS 2017-2019 Strategic Plan.
The proposal was then mentioned in the published summary of the Legislation Working Party's meeting in December 2017:
"In considering reform to the disciplinary process, the Registrar noted that the RCVS is one of the only regulators (and the only healthcare-based regulator) still using the criminal standard of proof (‘beyond all reasonable doubt’) when determining the facts of a case. Most other regulators used the civil standard of proof (‘on the balance of probabilities’) when making their determinations. Consideration of moving to the civil standard has also been carried over from the College’s previous Strategic Plan and the Registrar agreed to review the last six months’ cases to assess what the likely outcome of those cases would have been under the civil standard, and the cost of change. The Working Party also decided to contact other regulators about their disciplinary processes, in order to gather information about their experiences of what does and does not work, both for long-standing issues and new reforms."
The proposal then resurfaced last week in the Veterinary Record, which reported that the College is in 'advanced discussions' about adopting the lower standard (Standard of Proof for disciplinaries could change).
The College has now issued a statement to VetSurgeon.org as follows:
"The Royal College of Veterinary Surgeons (RCVS) is currently very much in the minority of regulators still using the criminal standard of proof ('beyond all reasonable doubt') in its disciplinary proceedings, rather than the civil standard of proof ('on the balance of probabilities').
"By comparison, all nine of the healthcare regulators in the human field (as overseen by the Professional Standards Authority) have moved to the civil standard, as have other regulators such as the Bar Standards Board and the Solicitors Regulation Authority.
"In our last two strategic plans we have committed to considering whether or not the RCVS should change the standard of proof in line with other regulators and these discussions have been taking place as part of the ongoing deliberations around legislative reform.
"A change to the standard of proof would require an amendment of our 2004 Procedure and Evidence Rules via the Privy Council rather than new primary legislation, but we would consult with the profession before any such changes were made and, at present, this matter has not been put before RCVS Council for a decision."
COMMENT
So, as it stands now, no evidence has yet been presented to the profession which supports the need for - or benefits of - a change to the standard of proof required in disciplinaries. The idea that it should be done simply because 'that's what the other regulators are doing' does not hold water. The veterinary profession is unique. According to the College's own research, it enjoys a remarkably high level of trust amongst the public. But at the same time, it also suffers one of the highest suicide rates.
Clearly Council will need to reflect extremely carefully on whether the members of such a widely trusted profession should face an even greater threat of losing their career, particularly when they seem to be at such a risk of vexatious complaints, fear of a disciplinary is already so high, and the consequences of this change on mental health in the profession could be so profound.
It may even be true to say that lives could depend on this decision.
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I think your last sentence is no exaggeration - lives will be put in danger if this change is made. The lowering of the standard of proof by other regulators has proved very controversial and certainly in the medical profession is deeply regretted - at a time when the profession is (rightly) struggling with how to mitigate widespread mental health issues introducing a lower standard SPECIFICALLY to increase the number of vets facing disciplinary cases and specifically to increase the number of vets found guilty of misconduct is hard to comprehend. As a profession we are already at a ridiculously high risk of suicide and the activities of regulatory bodies are well known to cause increased anxiety in professions.The effect on the mental health of health care workers facing an investigation by a regulatory body can be devastating (Bourne et al, BMJ 2014 1) and are well documented. In the medical profession a General Medical Council (GMC) referral results in 26.3% of doctors suffering depression & 22.3% anxiety and many suffer actual physical illness too – gastrointestinal problems, headaches, and relationship breakdowns. More than a quarter end up being signed off from work for a month or more. There is no reason to believe that RCVS investigations have any less impact on veterinary surgeons – indeed given that we generally have less backup and support I would suspect the problem is greater. What is even more alarming is that being investigated alters the behaviour of the doctors concerned, making them more defensive, more likely to ‘hedge’ and avoid clinical decisions, order unnecessary tests and administer excessive treatments to the detriment of patient safety and well-being. Interestingly this behaviour spreads to the colleagues of doctors under investigation. An incisive and startling conclusion of the BMJ study (involving almost 8000 doctors) is that the damage done by GMC investigations to patient safety is so great that it outweighs the benefit of the GMC’s regulation. That is an astonishing – yet fact based – conclusion. Regulation is making patient safety worse! Given the serious negative impact both on the health of those working in health care and on patient safety, of being investigated or being subject to formal disciplinary hearings the focus of the RCVS should be on how to DECREASE the number of hearings not how to increase the number
This seems serious. Is it that when a client (or anyone else for that matter) complains against you, they have to provide less strong evidence to prove their allegation? Therefore, the college will be obliged to take more complaints into consideration.
Francisco Gomez I'm not a lawyer, but it strikes me that a lower standard of proof means a couple of things: first that PIC will be more likely to refer a case to a full DC (knowing they have a better chance of winning), and second that there would inevitably be a greater risk of a miscarriage of justice. And perhaps more to the point, my impression is that many in the profession live under a sort of permanent rumbling cloud of the threat of complaint / disciplinary. So in a profession characterised by high level of trust from the public, and a high suicide rate, what on earth is the rationale for a lower standard of proof. Does the College think there are vast numbers of shady vets getting off scot-free because the current level of proof required is too high? If so, where's the evidence?
It is more likely that they want the RCVS to be like the 'other' regulators. Very worrying.
I think I'm going to retrain as a lawyer - looks like a lucrative line of work.
I think I might retrain as a lawyer - looks like a lucrative line of work.
Estimates published last year put the total cost of outstanding compensation claims at £83bn.
NHS England's total budget in 2018-19 was £129bn.
Hahaha I do love a bit of gallows humour!
It's very simple. Is the veterinary surgeon guilty of what they are supposed to have done, or not? We have a principle that you are innocent until proven guilty. End of story. If someone in RCVS is sure that some guilty veterinary surgeons are getting off because RCVS couldn't prove the offence, perhaps they could now share this secret information that proves the guilt with the rest of us? If they are sure that the guilty are getting off because RCVS couldn't prove guilt, the answer is to improve RCVS investigations and procedures so that they can prove guilt – I believe the fashionable phrase is " they should up their game" .
Employment lawyer Belinda Lester stated in last week's Veterinary Record, "the public would welcome the change", and "if it happens, you are going to get more vets being found guilty of misconduct." Thanks Belinda. And thanks RCVS. I think it is becoming increasingly clear the RCVS is not there to represent the profession, or support the profession, but rather there to bully and control the profession, benefitting from the threat of disciplinary action to keep the profession in line. If the RCVS is really there to represent the animal owning public, and protect them from all us terrible vets and VNs, perhaps the public should be paying the registration fees.
Well said Arlo. Well said.