Veterinary Services in Trinidad and Tobago by xdi18574

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									Second FAO E-Conference on Veterinary Services               002_eng


Veterinary Services in Trinidad and
Tobago

Abstract from the paper titled, ‘Profile of the Veterinary Services
in Trinidad and Tobago’ by Dr. Vincent Moe, 1997.


Foreword
The profile has been summarized under 14 headings. The
headings relate to the activities and performance of the public and
private sector in the delivery of veterinary services. Abstracts for
papers on Argentina, Mexico and Jamaica have been prepared in
similar fashion to facilitate comparison between different
approaches to service delivery. At the end of the abstract, the
editors raise a number of questions to stimulate debate and further
discussion.
Texts in square brackets are comments raised by the editors. All
figures are quoted in US dollars.
This abstract was produced by Paul McCosker and reviewed by
the Veterinary Services Group, AGAH in FAO.


Introduction
In 1997 a total of ninety-one (91) veterinarians were enrolled
[registered] to practice within the Veterinary Surgeons
Registration Board and this number was increasing at an average
of eight to ten (8-10) graduates per annum as graduates from the
School of Veterinary Medicine in Trinidad entered the job market.
Over seventy percent (70%) [64] of these Veterinarians were

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engaged in Private Practice. A further 13 graduate veterinarians
were employed by government [12 by the Ministry of Agriculture,
Livestock and Marine Resources (MALMR) and 1 in the Ministry
of Health (MoH)], 4 by the School of Veterinary Medicine and the
remaining 10 in other occupations.
The livestock population (1982) includes cattle (37,000), sheep
(12,000), goats (30,700), pigs (79,400), horses [includes donkeys
and mules] (1,150) and poultry (9.16 m). Average herd/flock sizes
are small. The country is now self sufficient in the production of
poultry meat and eggs, and produces 33 percent of approximately
17 m litres of milk consumed annually. However, it still imports
over 57 percent of its domestic meat requirements in the form of
beef, veal, pork, lamb and mutton. Of major concern is the heavy
dependence on imported grains to provide the raw material for
livestock feeds.

Trinidad and Tobago is implementing a structural adjustment
program that aims at the reduction of public sector expenditure
through the contraction of those public goods and services that
could be better performed by the private sector. In the context of
this program, the Veterinary Services of MALMR have already
introduced cost recovery for laboratory diagnostic services, that
had been available free of charge to both private practitioners and
government veterinary officers. However, the recommendations
for the privatization of the government clinical veterinary service
[also subsidized to livestock producers] have not been
implemented yet. There has also been a revision of fees charged
for certain genetic breeding stock available on government
livestock stations. The responsibility for extension and advisory
services has been devolved to the MALMR North and South
Regional Administrations. The government's policy of subsidizing
the clinical veterinary service is primarily to support and stimulate
livestock production and to keep the high costs of veterinary
pharmaceuticals down.
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Government Veterinary Services
1 Government Tasks And Responsibilities
Government veterinary services, which are accessible to all
livestock producers and are available nationwide, are provided by
the MALMR through its Animal Health Subdivision, divided into
field and laboratory services, and through the Veterinary Public
Health Unit of the Ministry of Health.
Table 1 summarizes the respective roles of the public and private
sectors in the delivery of different types of veterinary services.

2 Experience To Date By Government In Performing These
Tasks
An assessment, covering the period 1993-1996, of government
performance using key indicators for each of three important
activities demonstrated that two services provided by government
(vaccination of cattle against bat-transmitted rabies and
tuberculosis testing) are operating at sub-optimal levels and need
to be drastically improved. The Veterinary Services Division is
appraising these programs with a view to provide greater
institutional support and monitoring. A high level of performance
and a strong demand for the third service, artificial insemination,
was indicated by the assessment.
3 Consumer Satisfaction With The Government Sector Services
In its attempt to provide greater customer satisfaction and a
quality veterinary service, the government has established County
Agricultural Consultative Committees and Customer Complaints
Desks in four locations throughout the country to provide advice
and feedback on the quality of services provided by the Ministry,
inclusive of veterinary services. Consumer satisfaction with
services generally has been good because they are becoming more
widely available and costs are subsidized.
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Table 1 Role of the public and private sector in the
delivery of veterinary services
Type of Service                                  Institution responsible
                                               Public     Shared Private
 Public Sector Justification
 Disease surveillance                            Yes
 Compliance monitoring                           Yes
 Quarantine                                        -
 Quality control of remedies and vaccines          -
 Export inspection & certification                 -
 Accreditation of personnel                      Yes
 Planning for emergencies                        Yes
 Creation of enabling environment for private    Yes
 sector
 Shared Responsibilities
 Disease diagnosis and reporting               Yes (1,5)
 Compulsory testing                              Yes
 Vaccination and other prophylactic actions      Yes                  Yes
 Diagnostic support                             Yes (4)
 Animal welfare                                    -
 Notifiable disease control (TB)                 Yes
 Disease emergency response                        -
 Zoonoses control                               Yes (3)
 Research                                        Yes
 Advice and Extension                            Yes
 Private Justification
 Clinical diagnosis and treatment               Yes (2)               Yes
 Drug and vaccine production/distribution          -
 Artificial insemination                         Yes
 Marketing livestock and products                  -
 Embryo transfer                                   -
Notes
(1) Full cost recovery.
(2) Partial cost recovery for farm animals includes the costs for drugs +10
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Second FAO E-Conference on Veterinary Services                          002_eng
    percent and standard fee depending on mileage and type of case attended.
(3) Major control/eradication programs aimed at tuberculosis, leptospirosis,
    yellow fever, paralytic rabies (involving both vaccination and vampire bat
    control) and equine encephalomyelitis are implemented with the
    collaboration of the Veterinary Public Health Unit of the Ministry of Health.
    There is no cost recovery.
(4) In collaboration with the Veterinary School.
(5) ??



However, there still remains some level of dissatisfaction in the
farming community over the availability of veterinary services on
weekends and public holidays. With the increasing number of
veterinary graduates and competitiveness in the market among
veterinarians, it is expected that the quality of service will
improve significantly.
Many livestock producers are now prepared to pay for a quality
service, once it is accessible and readily available.

4 Problems Arising And Future Changes Contemplated

Government veterinarians are allowed to perform private practice
after government working hours on non-food producing animals.
[government working hours are 0800 to 1615, Monday through
Friday.] This practice is common and abuses that occur involve
the performance of private practice during government working
hours and the use of government supplies when performing
private practice. The latter is kept to an inescapable minimum by
close monitoring.
Government's policy over the next five years will be to:

(a) Privatize the clinical veterinary service while maintaining this
    service to rural communities that are not able to attract private
    practitioners for as long as is necessary.

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(b) Strengthen its statutory and regulatory role to meet the
   challenges of trade liberalization in accordance with the
   sanitary and phytosanitary measures of the WTO.
(c) Restructure veterinary service's management and oversight
    with the view to improve the performance of the bovine rabies
    control and tuberculosis eradication programs. Such
    restructuring could include contracting private practitioners
    with payments on a fee per animal vaccinated/tested and
    include measures to ensure validation of work done.

(d) Maintain Government's obligations for public safety through
    multi-sectoral, inter-ministerial coordinated programs for food
    protection, zoonoses and environmental control that cannot be
    undertaken by the private sector because of their animal and
    public health importance within the context of national
    development.
The above will allow for a free market driven competitive
veterinary service that will be available to the farming community
on a contestable basis. Moreover, institutional strengthening of the
Ministry's Veterinary Services Division will then be guided by
this major policy shift from public goods and services to private
goods and services.

5 Changes In Reportable Disease Situation, Livestock
Productivity And Export Potentials
Disease situation: Trinidad and Tobago are free of the serious
epizootic diseases like foot-and-mouth disease, hog cholera,
African swine fever, equine encephalomyelitis, anthrax and
velogenic viscerotropic Newcastle disease that are known to exist
in many countries of the world. These diseases have been kept out
of Trinidad and Tobago despite the pressures of trade
liberalization due to the efficient enforcement of regulations under
the Animals (Diseases and Importation) Act.
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Livestock productivity/export potentials: Trinidad and Tobago are
a net importers of animal products. No clear indication of the
impact of government policy on either productivity or export
potentials is possible from the figures presented. The annual
percentage changes in the amounts of animal products supplied,
produced locally or imported between 1992 and 1996 are
presented in Table 2.

Table 2 Annual percentage changes in the amounts of
animal products supplied, produced or imported
(1992 to 1996)
Product                               Supply     Produced   Imported
Total meat excluding poultry           -30.7      -32.1      -29.6
Beef and veal                          -29.8      -12.2      -34.4
Pork                                   -23.5      -38.3      231.0
Mutton                                 -49.5      -25.5      -50.4
Broilers (to 1995)                     28.2        28.2       0.0
Eggs (to 1995)                            7.9      7.9        0.0
Milk (to 1995)                            3.0     -15.7       21.6



Total meat supply, excluding poultry meat, decreased from 9.74 in
1992 to 6.75 million kg in 1996 [a decline of 31 percent]. Broiler
production increased between 1992 and 1995 (last year with
complete figures) from 12.1 to 15.5 million birds [an increase of
28.2 percent]. The supply of beef and veal, pork and mutton fell
by 29.8, 23.5 and 49.5 percent, respectively, while the supply of
broilers, eggs, and milk increased by 28.2, 7.9 and 3.0 percent,
respectively, between 1992 and 1995. These figures indicate a
substantial change in the type of meat consumed in favour of
poultry meat and suggest that the total level of meat consumption
has changed little. Importation of pig meat and milk increased by
231 and 21.6 percent, respectively, from 1992 to 1995/96.
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6 Effects Of Changes Made In The Delivery Or Privatization On
The Private Sector (Large And Small Holders) And On Equity
Of Service Availability
The policy of the government of hiring out practices has led to
some human resource deficiencies in the delivery of a quality
veterinary service to the community at large. In addition, cost
containment has affected negatively on veterinary supplies and
equipment available to government veterinarians for the
performance of their duties. The increasing number of veterinary
graduates who have now entered the job market has brought some
relief to the high demand for a quality service and users are
extremely appreciative of the ready availability of the contestable
services in a competitive environment that can only improve with
time.
Government's policy to reduce public sector expenditure in the
mid- and late-1980s has had a negative effect on the employment
of veterinary graduates in the public service. This has been
compounded by the increasing number of young graduates from
the Veterinary School who would prefer employment in the
Government service before moving into private practice.
Opportunities for employment in the Government veterinary
service remain limited. These measures have resulted in a shift of
employment to the private sector. However, very remote rural
areas have not been able to attract private veterinarians because of
the low levels of activity and income.

7 Strategy For And Results Of Changes Upon Under Served
Areas Of The Country
Both rural and urban end users have adequate access to
government-provided veterinary services. The major complaint
relates to the lack of service on weekends and public holidays.
The cost of the service has not been a cause for complaint because
of the subsidized rates.
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8 Statistical Indicators/ Comparators (Figures For 1997)
The absolute and relative allocation of public financial resources
in the animal health sector is shown in Table 3.

Table 3 Allocation of public financial resources in the
animal health sector
                                 Total (US$)                Percentage
National Budget                   1,983.85m
Budget MALMR                          59.54m            3.0 (of national)
Vet. Serv.* budget                     2.86m          4.8 (of MALMR)
Recurrent costs**                                   83.3 (of Vet. Serv.)
Operations costs                                    14.9 (of Vet. Serv.)
AH training budget                                   NA (of Vet. Serv.)
Notes:
* Veterinary/Livestock services. Government veterinary services are financed
  entirely from the Treasury. All user fees collected are paid into consolidated
  revenue and do not return to the Division.
** Recurrent costs include personal emoluments and material and supplies.
  NA Information is not available.


The percentage annual changes (derived from budget figures in
the original), year on year, for the Veterinary /Livestock services,
MALMR and National budgets together with annual inflation
rates (%) are presented in Table 4.

It is interesting to note that while all three budgets increased over
the period 1993 to 1997, the National budget increased annually.
The Veterinary/Livestock services budget increased only
marginally while the budget of MALMR and the National budgets
increased substantially in absolute terms, while in real terms
MALRM budget has slightly declined. The budgets of the
Veterinary/Livestock services and the MALMR experienced
reductions in three and two of the four years, respectively.
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Table 4 Percentage annual changes in government
budgets
                                                            Tot. % Change
Budget            1993      1994     1995    1996   1997      1993-1997
Vet. Serv.           -      -5.8     -12.2   34.3   -5.2         5.2
MALMR                -      -7.6      27.9   66.6   -38.3       21.4
National             -      11.1      0.5    6.0    10.7        31.1
Inflation          8.8      10.8      5.3    3.3     3.6        24.9



PRIVATE SECTOR SERVICE
All private veterinary practices are situated in the urban and peri-
urban areas of the country. There are three types of practice viz.,
companion animals (pets), horses and mixed animal practice. [No
data are presented on veterinarians dedicated exclusively to cattle,
pigs, small ruminants, poultry or industry].

9 Activities
Mixed animal practitioners work primarily with pet (companion)
animals, and to a lesser extent with farm (food producing) animals
including, beef and dairy cattle, pigs, sheep and goats and in some
cases a small percentage of equine activity. These practices may
comprise all or a combination of these species. The major income
earner is pet animal practice and this usually represents
approximately seventy to eighty percent (70%-80%) of the mixed
practice activities and income. The highest gross and net incomes
are derived from: vaccinations (including clinical examination)
and parasite control; treatment of clinical cases; and elective? and
therapeutic surgery. Farm practice comprises mainly consultancy
and advisory services, treatments and reproductive activities. Herd
health programs are a major activity on dairy farms encompassing
mastitis, endo- and ecto-parasite control and infertility problems.
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Second FAO E-Conference on Veterinary Services               002_eng

Companion animal practices cater mainly for canine patients,
which account for 85 percent of the practice activities, and their
highest net income is derived from: vaccinations (including
clinical examination) and parasite control; out patient treatment;
and surgery.
Equine practitioners spend approximately sixty percent (60%) of
their time on reproductive/stud farm practice and the remaining
forty percent (40%) on racetrack activities. Their highest gross
and net incomes are derived from: clinical examinations/
vaccinations and treatment, reproduction/infertility problems and
pregnancy diagnosis, dispensing and sale of medication and
surgery (what else is there left?). As a rule, private equine
practitioners engage fully in veterinary activities and do not
engage in non-veterinary occupations.
There are no significant seasonal variations in veterinary
activities.

10 Key Financial Indicators By Type Of Practice
Key financial indicators derived from interviews with 22
veterinarians [representing approximately 38 percent of all private
practitioners] working in different types of private practice (pets,
horses, and mixed animal practice) are presented in Table 5. All
values are in US$ (Trinidad and Tobago $6.5 = US$1) and are
median values for veterinarians with three or more years of
practice.

11 Primary Sources Of Finance For Starting A Private Practice
There is no financial assistance or other form of inducement
offered by the Government to private veterinarians whether they
are in pet, equine or mixed animal practice. However, the
government provides subsidies to livestock producers in the form
of subsidized remedies and services provided by government-

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employed veterinarians. This indirectly affects veterinarians in
mixed animal practice.
[The profile gives no indication of other sources of finance. It is
assumed that this is available from normal commercial sources.]



Table 5 Income and expenses by type of practice
                                                        Type of practice
                                               Pets         Horses         Mixed
No. Interviewed                                 8              6             8
Median no. of vets per private practice:
-full time                                      3              1             1
-part time                                      1              0             0
-number of men(women)                          2 (1)         1 (0)          1 (0)
Hours worked/week(women)                      60 (30)       43 (na)        65 (na)
Gross income/practice                        136,000        36,800         57,180
% of gross income from:
-services                                       67            60             75
-sale of drugs                                  33            35             25
-others                                         0              5             0
Median Practice expenses                      64,000        22,240         21,124
-as % of gross income                           47            60             37
Median Net income/practice                    72,000        14,400         38,440
Median Non-practice income                     8,000        1,920          14,940
Practice start up cost*                      35-50,000    30-40,000    40-45,000
Notes:
* Ranges estimated by the original author.
na Not available



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Second FAO E-Conference on Veterinary Services                002_eng

12 Main Obstacles To Successful Private Practice
The common obstacle to successful private veterinary practice,
whether engaged in pet, equine or mixed animal practice, is direct
competition with government-employed veterinarians who are
still required to provide a clinical service to farmers’ livestock on
request as part of their official duties. Additionally, since 1976
government employed veterinarians have been allowed to provide
private veterinary service to non-farm animals, such as pets and
racehorses, outside of normal government working hours under
specific conditions. Some veterinary auxiliaries [government
employees] also illegally practice veterinary medicine in rural
areas, and are a source of illegal competition to all veterinarians.
The absence of adequate specialist diagnostic and referral services
is also a hindrance to successful practice, although the School of
Veterinary Medicine now provides a referral service for all classes
of animals. Veterinarians in North Trinidad, where the school is
located, increasingly use these services.

13 Consumer/Client Satisfaction With Services Offered
Clients are generally satisfied with the quality of services rendered
by veterinarians in mixed practice. These veterinarians provide
services seven days of the week and in some cases may be
contacted for emergencies through an answering service.
However, some clients complain about the poor availability of
services on weekends and public holidays.
Clients would like to see services which will provide coverage for
24 hours per day for seven days per week, cheaper and more
affordable services, especially in the case of livestock owners, and
a proper referral system.
One does not expect to see a major change in the government's
policy towards the livestock sub-sector in the near future and,
therefore, the government will continue to provide the farming
community with a clinical veterinary service at a subsidized rate
for some time.
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Points for Discussion Raised by The Editors
1. Provision Of Clinical Services
There appears to be a need for change in the government policy in
respect to provision of clinical service for farm animals and after
hour’s work of government veterinarians competing with private
practitioners. Possibly some of the mixed animal practitioners will
be well placed to thrive and fill the gap provided by the release of
government vets from the responsibility of providing clinical
support for farm livestock.

2 Government Policy Of Implementing Public Health Programs
It is noted that there is dissatisfaction concerning the
implementation of at least two of these programs, i.e. vaccination
against bat-transmitted rabies and the bovine tuberculosis
eradication program. Such implementation would appear to be a
government function that could be shared with the private sector.
Recourse could be made to a system of contracts with private
veterinarians for the field aspects of the programs while the
government maintained its regulatory role. Such an approach
would further encourage private practice and allow a greater
geographic coverage for remote areas. This option will apparently
be considered in the near future.




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