Discussion

Under the Veterinary Surgeons Act 1966 (VSA) only veterinary surgeons can carry out acts of veterinary surgery. Exceptions to this rule include exemptions for specific tasks outlined in Schedule 3 of the act (e.g. farmers or their employees carrying out minor procedures such as disbudding, or minor surgery for veterinary nurses) or where an Exemption Order (EO) is in place for a specific task.
Many paraprofessionals (e.g. AI technicians, bovine ultrasound scanner operators, physiotherapists) work under the cover of EOs. Exemption Orders do not and cannot provide a framework for regulation of conduct, most do not require the layperson to be part of a veterinary-led team, and there are inconsistencies (e.g. a lay person can carry out tuberculin testing when employed by AHVLA but not when employed by a private veterinary practice).
A number of associations have been set up with voluntary regulation requirements, for example, the British Association of Equine Dental Technicians. These service providers are seen to want to work closely with the veterinary profession and ensure accredited standards of training and competency; but although in favour of developing a better working relationship with veterinarians, it seems many paraprofessionals do not wish to be direct employees of a veterinary practice. The use of paraprofessionals with suitable training, and supervision or direction within a veterinary led team, could provide potential new business opportunities for veterinary practices and benefits to clients too; for example cost savings for food animal producers, leaving resources available for a vet to concentrate on higher level issues such as herd health planning.
The regulation of paraprofessionals was one of the controversial issues in the original proposals made by RCVS on the creation of a new VSA, and was withdrawn due to issues surrounding the expense to and governance of small groups, and the status that regulation may give to providers of therapies which are not evidence-based. Defra (which is responsible for managing EOs) is currently consulting BVA and RCVS, as well as BEVA, BCVA etc., with the aim of conducting a review of the existing EOs and making recommendations for any legal or operational adjustments which could be made in a straightforward manner.