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Surveillance under scrutiny

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OVER the past few weeks, concern about the future of veterinary surveillance in the UK has mainly focused on England and Wales, and changes to the Animal Health and Veterinary Laboratories Agency's (AHVLA's) network of regional laboratories (VR, November 5, 2011, vol 169, pp 485–486). That could be about to change. The Scottish Government published the results of a review of veterinary surveillance in Scotland last week (see p 539 of this issue). If fully implemented, the recommendations could fundamentally change the way surveillance in Scotland is organised.

The review was commissioned in February last year. Undertaken by a panel chaired by John Kinnaird, a former president of NFU Scotland, it was asked to examine the current arrangements for animal disease surveillance in Scotland, how well they meet the needs of the government and other stakeholders, and how capability could be maintained and improved. It was also asked to make recommendations on the size and location of Scotland's disease surveillance centres (DSCs), and on obtaining best value from the resources available.

A key recommendation of the review, and one that has already been agreed by the government, is that a strategic management board should be established to set and implement strategy for veterinary surveillance in Scotland. The present system, the review panel suggests, has simply evolved rather than being developed to any set plan, and it believes that the board should be able to foster improvements in both active and passive surveillance by agreeing and setting surveillance goals.

It also recommends that laboratory services should be centralised either within or close to one of the three main centres of veterinary research in Scotland (that is, Edinburgh university, Glasgow university or the Moredun Research Institute), arguing that the case for centralising laboratory facilities and expertise is ‘compelling’. In parallel with this, it suggests that the number of local DSCs in Scotland should be reduced; interestingly, however, it does not indicate which centres might be closed, or how many, stating that it was ‘not in a position to come to a definitive solution about the number of DSCs, their size, location or level and range of services’. Instead, it suggests that this should be a matter for the strategic management board and sets out a number of factors that should be taken into account before any structural changes are made.

For those expecting a clear outcome from the review, this approach may seem surprising, but is perhaps understandable given the many complex factors involved. Not least among these is the difficulty in disentangling the diagnostic service and disease surveillance functions of the local centres (activities which some might argue are inextricably linked) and how they should be paid for. There are also the practical issues associated with delivery of samples and the transport of carcases to distant laboratories, as well as ensuring that contact between veterinary investigation officers and local practitioners is maintained. While concluding that there is scope for rationalising services, the review group argues that this must be done gradually, without jeopardising the delivery of surveillance and in a way that is sensitive to local conditions and needs.

While a cautious, step-by-step approach to rationalisation sounds sensible, it does mean that, for those working in and dependent on the current eight DSCs, uncertainty about the future remains. Meanwhile, as the BVA President remarked last week, any decisions must be made on the basis of good surveillance and diagnostic outcomes, not just on the grounds of cost.

The review seems to recognise the importance of maintaining a good throughput of samples for surveillance and it is vital that, if services are centralised, this throughput is maintained. It also seems to recognise the value placed on the services provided by the DSCs by practitioners and farmers, and it seems important that, whatever arrangements emerge in the future, the benefits of these working relationships are not lost.

Such arguments, of course, do not just apply to Scotland; they also apply to England and Wales, where the changes being made to the regional laboratory service remain of concern. In the meantime, it is worth remembering that Great Britain represents a single epidemiological unit, and that surveillance is important at a local, national and international level. Diseases are less sensitive to borders and budgets than governments and their agencies and efforts must be coordinated across Great Britain as a whole.

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