For the past two years, United Kingdom veterinarians have been under an uncomfortable spotlight that many vets on the other side of the Atlantic — and indeed, worldwide — may find familiar. What started as media concern about rising veterinary costs and “rip-off fees” escalated into a full investigation by the U.K.’s Competition and Markets Authority, with tens of thousands of responses from pet owners and veterinary professionals alike. Now, the findings — and legally binding changes — have finally been published. Here’s the insider look.
The Backstory
After the media amplified growing concerns from pet owners about veterinary pricing, the CMA — the U.K.’s competition watchdog — opened a “review of the sector” in September 2023. It received 56,000 responses from the U.K. pet-owning public, veterinary professionals, and service providers, after which the CMA opened a formal investigation. This triggered a two-year process — a grueling time for veterinarians, with recurring media backlash at every minor milestone of the investigation.
At long last, the results are in. The CMA ruled that there are competition concerns and produced a package of remedies. Now, U.K. veterinary practices have a few months to get up to speed with the “new normal” before the remedies become law.
What the CMA Ruled
Despite widespread media attention of the “price caps” designed to “crack down on veterinary fees,” the focus of the changes is not pricing. The CMA is more concerned with whether owners can meaningfully compare options and make informed choices, especially with the impacts of sector consolidation. With almost 60% of U.K. veterinary practices owned by just six groups — which often retain the original practice branding — it isn’t always clear who owns what. Coupled with a lack of visible pricing and corporate ownership of suppliers like crematoriums and referral practices, it became difficult for pet owners to shop around for veterinary services. That’s what the CMA aims to fix.
The major changes U.K. veterinary practices will face over the next 18 months include:
- Corporate ownership should be made clear on the website, on any signage, and at the practice.
- Every practice must publish price lists for 36 common services and procedures on its website and in the clinic. These will also be collated on the Royal College of Veterinary Surgeons’ “Find a Vet” website and shared with third-party comparison sites.
- Veterinarians must provide a written estimate for procedures over £500 ($670), and a new estimate should be prepared if it changes significantly.
- Businesses must provide itemized bills.
- Written prescriptions must be offered verbally and in writing, and they must be prepared in a reasonable time frame.
- A maximum of £21 ($28) can be charged for the first item on a prescription, and £12.50 ($17) for each additional item.
- Clinics must provide clear complaint systems that encourage mediation.
- Out-of-hours service providers must change their contracts, allowing practices to more easily get out of contracts, shop around, and make new ones.
While not under the CMA’s power to change, the watchdog also recommended that the U.K. government reform the 60-year-old Veterinary Surgeons Act to allow greater delegation to veterinary nurses and greater control over non-veterinary-owned practices. Consultation on this is now underway.
What the Changes Mean for UK Veterinary Practices
Many veterinarians are glad the investigation is finally over, and some have called the rulings “anticlimactic.” Many — if not most — vets were already doing these things. The written estimates, itemized bills, complaint systems, and information about written prescriptions are all covered in the RCVS’ Code of Conduct, to which all U.K. vets are obliged to adhere.
The difference? The Code of Conduct and the RCVS’ control only apply to individual veterinarians; businesses owned by non-vets didn’t have to comply, and therefore, corporate-owned businesses were slipping through the cracks. The CMA’s ruling levels the playing field somewhat, but it doesn’t impact the majority of veterinarians.
Even the much-reported prescription fee price cap is more noise than substance. A Society of Practicing Veterinary Surgeons survey found the average prescription fee is £16.
The major change to how veterinarians work is, of course, the price lists. Currently, 60% of practices don’t publish pricing information online, and those that do share a small list of initial consult fees, vaccination fees, and — maybe — neutering fees. Some of the 36 items that must now be reported in price lists include:
- Vaccinations
- Microchipping
- Consultations
- Routine procedures
- Ear swabs
- Echocardiograms
- CT scans
The prices for a range of dog and cat sizes must be listed, and practices must keep the information up to date. In addition, the CMA has recommended the RCVS charge a levy to practices to keep the price lists — an additional £450 ($600) per year is likely.
Likely Impacts for Pet Owners
Despite the media attention, there’s little in the ruling that will reduce fees, and some suggest that it may even increase them — the additional bureaucracy costs and the RCVS levy will likely be passed on to pet owners. Published price lists could also lead to “loss-leader” pricing — fixing easily compared costs lower to attract customers, and recouping the costs further down the line on things that are more difficult to compare. For pet owners, it’s a great example of “be careful what you wish for.”
Implications for Other Countries
Are other countries likely to see similar investigations or changes? In many countries, corporatization of veterinary clinics is following a similar trajectory to that of the U.K. In the United States, estimates suggest around 30% of general practices are now corporate-owned, rising to 75% of speciality and emergency practices. In Canada, it’s 20%. As with the U.K., it’s estimated that fewer than 15% of corporate consolidators in the U.S. put the corporate brand on their practices, hindering the consumer’s right to choose, and the Federal Trade Commission has already prevented one private equity firm from buying additional clinics without prior approval. It seems that the U.S. might be a couple of years behind the U.K., but it’s heading in the same direction.
So, what can practice owners and veterinarians take away from the U.K.’s example?
- Try to protect the consumer’s right to choose with fair signage, clear communication, and written estimates wherever possible.
- Veterinary prices likely aren’t a primary concern. The media frenzy over veterinary pricing is remarkably consistent regardless of where you live and work. In the U.K., however, independent investigations have not found widespread evidence of inappropriate pricing.