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Maintaining surveillance

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GIVEN the furore prompted by the proposal, it is not altogether surprising that opposition to the idea of closing the disease surveillance centre (DSC) at Inverness should feature so prominently in responses to Scotland's Rural College's (SRUC's) consultation on changing the structure for veterinary surveillance in Scotland (VR, June 6, 2015, vol 176, p 583; July 18, 2015, vol 177, p 56). Summarising the responses to the consultation in a report published last week1 (see also p 161 of this issue), SRUC notes that most of the responses it received related specifically to Inverness: there was, it reports, ‘strong opposition’ to proposals to close the centre and, furthermore, private veterinary surgeons in the area were ‘united in their opposition to their providing postmortem services to their clients’, which had been suggested as an alternative option if the Inverness centre were closed. This is not to say that the proposed closure of the Inverness centre is the only aspect of SRUC's proposals that seems to be causing concern, and a glance through the various responses to the consultation that have been posted on SRUC's website shows that concerns have also been raised about the possibility of relocating the Ayr DSC, as well as about plans for a new centralised diagnostic facility on the Royal (Dick) School of Veterinary Studies' campus near Edinburgh.

Discussing ‘common themes’ in the responses, SRUC notes that principal among these was the value veterinary surgeons and farmers place on easy access to diagnostic postmortem facilities, with veterinary practitioners also valuing access to independent local advice. Regarding the centre at Inverness, there was, it reports, ‘a widespread belief’ that loss of the services it provides would have a damaging impact on the viability of livestock farming in the region. This is certainly borne out by the responses that have been posted on SRUC's website, which were received from a wide range of organisations and individuals and, interestingly, are not just concerned about the impact on farming, but on other activities, too. These range from marine mammal rescue to deer farming and wild deer management, and from gamebird management to bird and wildlife conservation. As well as vets and farmers, respondents included local MSPs and councils, conservation organisations, the British Deer Farms and Parks Association and the RSPB. A response from NHS Highland draws attention to the possible impact of the proposed closure on its response to future outbreaks of Escherichia coli O157 in people and on projects relating to Lyme disease, highlighting the importance of joint working and of veterinary surveillance to public health.

Regarding the Ayr DSC, where options outlined in the consultation document included maintaining the existing centre at Auchincruive, moving to a new site in Ayrshire or relocating to the University of Glasgow veterinary school, SRUC's summary report notes that the overwhelming consensus among respondents was for retaining the existing centre in Auchincruive, in order to provide a flexible, accessible postmortem service for local farmers. In Ayr, as in Inverness, local vets were unwilling to provide postmortem services themselves. As far as plans for a new centralised facility at the Royal (Dick) School of Veterinary Studies in Edinburgh are concerned, a response from the nearby Moredun Research Institute notes that postmortem, carcase disposal and specialised diagnostic facilities are already available on its own site, which also houses APHA Lasswade, and argues that it would make more sense to situate the new facility there. More generally, it argues that there is a need to take a more holistic view of how to develop an optimal surveillance system service for Scotland, and that ‘no changes should be made until the entirety of the surveillance objectives and associated operational issues for future delivery have been addressed’.

According to SRUC's summary, the APHA recommended a ‘radically different’ approach to addressing the particular challenges facing the veterinary surveillance network in Scotland. This would involve just three DSCs and depend on a network of private practitioners who would provide an initial screening network. Unfortunately, the APHA's response is not among those available in full on SRUC's website, but it would be interesting to see its proposals explained more fully. They would seem to be based on the model already adopted in England and Wales where, last year, despite opposition, more than half of the APHA centres carrying out postmortem examinations for disease surveillance purposes were closed within the space of a few months (VR, June 7, 2014, vol 174, p 564). The Scottish Government would be ill-advised to implement such an approach, partly because local practitioners in Scotland have already made clear that they would be unlikely to cooperate, but also because the system adopted south of the border has still to show its worth. As John Kinnaird argued in his review of the surveillance structure in Scotland in 2011 (VR, November 19, 2011, vol 169, pp 538, 539-540), and as the BVA pointed out more recently in its response to SRUC's consultation, existing structures need to be maintained until any alternative arrangements have been proven to be effective.

All in all, the responses to SRUC's consultation seem unlikely to make it any easier for the Scottish Government to decide on any changes to the disease surveillance structure in Scotland. It must be hoped that, despite the challenge of maintaining effective surveillance at a time when the threat of disease is increasing and budgets are tight, and as promised at the start of the exercise, a ‘uniquely Scottish solution’ might still be found.

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