No expense spared: a dachshund gets ear acupuncture at a Japanese vet's: Photo: Getty
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Should you shell out for a dog’s MRI scan when there are queues at the local food bank?

Money determines which procedures and treatments are carried out. I tend to discourage clients from spending ridiculous sums on their animals.

“I don’t care how much it costs!” The refrain is heard every day in veterinary practice. I have no idea who has some money, who has none, who has less than none, who has won the Lottery. The fluent and well spoken often have nothing to spend on their animals; the incoherent and almost incomprehensible sometimes have thousands in their back pocket.

Money determines which procedures and treatments are carried out. I tend to discourage clients from spending ridiculous sums on their animals. The increasing availability of MRI scans, for example, has certainly enlightened many conditions in the dark backward and abysm of the brain; but it seems that many in the profession are falling back on such diagnostics in cases where it is obvious that something is untreatable. The cost of an MRI scan for a dog? Over £1,000. The cost of the apparatus? Over £1m.

I do care what it costs. The food banks here in the north-east are thriving. When clients tell me that they “don’t care how much it costs”, it is a cause for anxiety.

There was recently a letter in the Veterinary Times by a clinician still traumatised by the abuse from a client who insisted that his puppy should have a CT scan – but would not pay for it. Vets do receive abuse and threats: I reckon on about one tirade every six months. It’s a professional millstone that we cannot respond in kind. Worse, we then receive a letter of complaint through the Royal College. More paperwork. More diplomacy. Surely it’s easier in the Foreign Office.

Some people have their animals insured. Great. Early in my career, I was called out to see a lame horse. On examining it, I found it needed a more extensive work-up than I had the equipment and the experience for. The owner, tab smouldering in the corner of her mouth, agreed that referral was appropriate, especially given the excellence of the insurance policy she had. I suggested an equine practice that might help her. She recoiled, drew hard on her cigarette, shook her head and told me she’d had to sue it for the death of her last horse. So I referred her to a different practice. Her horse went along and was treated appropriately. She left an insurance claim at the practice – for a cat belonging to someone else. There’s bravado for you.

Sometimes, “I don’t care how much it costs!” means, “How dare you mention money! That’s all you vets think about! None of you care!” I think we do care but in a way they’re right – each consultation, I go through all the treatment options and their expenses in detail. Some people are embarrassed that they do not have enough money for the treatment. I praise them wholeheartedly – out of relief that they can spend their money more appropriately. I was once appalled to hear that a client had needed to move house, having spent £5,000 on futile colic surgery for her horse. It is a weakness that must not be exploited by vets.

Besides, there are usually cheaper ways of doing things. Try another practice, for example, as the prices are arbitrary and differ vastly. I have removed a cat’s thyroid (thyroidectomy) in three different practices for £200, £500 and £800. Same surgeon, same procedure, same equipment. I find it extraordinary that clients rarely compare prices on surgery.

Is it a rich man’s world? Most vets who have been qualified for more than ten years earn between £35,000 and £50,000 a year. The farm vets get paid the least, then the equine; the small animal vets are the richest of us all. Where I live, that is often considerably richer than most of our clients.

Then again, compared to the other middle-class professions (accountants, lawyers, medics), we are a poor relation. However, I’d rather squeeze the purulent anal glands of a basset hound than inspect the haemorrhoids of an obese Yorkshireman or advise a crook under which floorboards to hide his or her money. “I don’t care how much it costs . . .”

This article first appeared in the 28 May 2014 issue of the New Statesman, The elites vs the people

European People's Party via Creative Commons
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Ansbach puts Europe's bravest politician under pressure

Angela Merkel must respond to a series of tragedies and criticisms of her refugee policy. 

Angela Merkel, the Chancellor of Germany, is supposed to be on holiday. Two separate attacks have put an end to that. The first, a mass shooting in Munich, was at first widely believed to be a terrorist attack, but later turned out to be the actions of a loner obsessed with US high school shootings. The second, where a man blew himself up in the town of Ansbach, caused less physical damage - three were seriously injured, but none killed. Nevertheless, this event may prove to affect even more people's lives. Because that man had come to Germany claiming to be a Syrian refugee. 

The attack came hours after a Syrian refugee murdered a pregnant Polish woman, a co-woker in a snack bar, in Reutlingen. All eyes will now be on Merkel who, more than any other European politician, is held responsible for Syrian refugees in Europe.

In 2015, when other European states were erecting barriers to keep out the million migrants and refugees marching north, Merkel kept Germany's borders open. The country has resettled 41,899 Syrians since 2013, according to the UNHCR, of which 20,067 came on humanitarian grounds and 21,832 through private sponsorship. That is twice as much as the UK has pledged to resettle by 2020. The actual number of Syrians in Germany is far higher - 90 per cent of the 102,400 Syrians applying for EU asylum in the first quarter of 2016 were registered there. 

Merkel is the bravest of Europe's politicians. Contrary to some assertions on the right, she did not invent the refugee crisis. Five years of brutal war in Syria did that. Merkel was simply the first of the continent's most prominent leaders to stop ignoring it. If Germany had not absorbed so many refugees, they would still be in central Europe and the Balkans, and we would be seeing even more pictures of starved children in informal camps than we do today. 

Equally, the problems facing Merkel now are not hers alone. These are the problems facing all of Europe's major states, whether or not they recognise them. 

Take the failed Syrian asylum seeker of Ansbach (his application was rejected but he could not be deported back to a warzone). In Germany, his application could at least be considered, and rejected. Europe as a whole has not invested in the processing centres required to determine who is a Syrian civilian, who might be a Syrian combatant and who is simply taking advantage of the black market in Syrian passports to masquerade as a refugee. 

Secondly, there is the subject of trauma. The Munich shooter appears to have had no links to Islamic State or Syria, but his act underlines the fact you do not need a grand political narrative to inflict hurt on others. Syrians who have experienced unspeakable violence either in their homeland or en route to Europe are left psychologically damaged. That is not to suggest they will turn to violence. But it is still safer to offer such people therapy than leave them to drift around Europe, unmonitored and unsupported, as other countries seem willing to do. 

Third, there is the question of lawlessness. Syrians have been blamed for everything from the Cologne attacks in January to creeping Islamist radicalisation. But apart from the fact that these reports can turn out to be overblown (two of the 58 men arrested over Cologne were Syrians), it is unclear what the alternative would be. Policies that force Syrians underground have already greatly empowered Europe's network of human traffickers and thugs.

So far, Merkel seems to be standing her ground. Her home affairs spokesman, Stephan Mayer, told the BBC that Germany had room to improve on its asylum policy, but stressed each attack was different. 

He said: "Horrible things take place in Syria. And it is the biggest humanitarian catastrophe, so it is completely wrong to blame Angela Merkel, or her refugee policies, for these incidents." Many will do, all the same.