public confidence
in veterinary medicine
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2B. Fees and related matters
1. The RCVS has no specific jurisdiction under the Veterinary Surgeons Act 1966 over the level of fees charged by veterinary practices unless they are so extreme as to constitute disgraceful conduct. There are no statutory charges and fees are essentially a matter for negotiation between veterinary surgeon and client.
2. There are a number of fee related issues which raise ethical concerns, on which the following guidance is offered:
Re-direction to charities
Discussion of fees
Invoices
Securing payment for veterinary services
Pet insurance
Unpaid bills
Holding an animal against unpaid fees
Re-direction to charities
3. All charities have a duty to apply their funds so as to make the best possible use of their resources and animal owners or keepers seeking assistance will have to satisfy the almoning rules of the charity concerned. They should first contact the charity to confirm that they are eligible for assistance, and the veterinary surgeon must ensure that the animal's condition is stabilised so that it is fit to travel to the charity, arrange a suitable appointment and provide a referral letter with full details of the animal's condition and any treatment already given.
4. If the client does not fall within the almoning rules of local charities, and no other form of financial assistance can be found, euthanasia may have to be considered on economic grounds.
Discussion of fees
5. Discussion should take place with the client, covering a range of reasonable treatment options and prognoses, and the likely charges (including ancillary or associated charges, such as those for medicines/anaesthetics and likely post operative care) in each case so as to ensure that the client is in a position to give informed consent. It is wise for any estimate to be put in writing and to cover the approximate overall charge for any procedure or treatment including VAT, pre and post operative checks, any diagnostic tests, etc. The owner should be warned that additional charges may arise if complications occur.
6. If the animal is covered by pet insurance, it is in the interests of both veterinary surgeon and client to confirm the extent of the cover under the policy, including any limitations on cost or any exclusions which would apply to the treatment proposed.
7. If a quotation as distinct from an estimate is given it may be binding in law.
8. If during the course of treatment it becomes evident that an estimate or a limit set by the client is likely to be exceeded, the client should be contacted and informed so that consent to the increase may be obtained. This applies equally to treatment in referral centres.
Invoices
9. All invoices should be itemised showing the amounts relating to goods and services provided by the practice. Fees for outside services and any charge for additional administration or other costs to the practice in arranging such services should also be shown separately. See Part 1, D, paragraph 7 for the invoicing of relevant veterinary medicinal products.
Securing payment for veterinary services
10. A client is the person who requests veterinary attention for an animal, for example when a veterinary surgeon is called to the scene of a road traffic accident by the police or by the RSPCA, the organisation in question will be liable to pay for any emergency treatment and for the call out even if the animal owner is subsequently identified (because the owner had no opportunity to consent to treatment). This applies equally to any member of the general public taking in a stray or injured animal whose owner is unknown.
11. When dealing directly with the owner, or the owner's agent whose consent to treatment must be given, it is important to obtain that consent in writing on a properly drafted form which should include any estimated charge (see annex, Consent forms specimens)
Pet insurance
12. Many animal owners take out insurance to cover veterinary fees. Since this is offered by a number of specialist and other companies, it is prudent for a practice to display a range of promotional literature so as to avoid any implication of bias, financial advice, or brokering. If commission may be paid to the veterinary surgeon or support staff if a particular policy is taken out, this should be disclosed.
13. Pet insurance schemes rely on the integrity of the veterinary surgeon who has a responsibility to both the client and the insurance company and any material fact which might cause the company to increase the premium or to decline a claim must be disclosed.
14. When treating an animal covered by pet insurance the fees charged must be at the normal practice rate and any additional or administrative charges shown separately. In cases where the bill is sent direct to the insurance company, a copy should be sent to the client.
Unpaid bills
15. A veterinary surgeon is entitled to charge a fee for the provision of services, and where the fee remains unpaid, to place the matter in the hands of a debt collection agency or to institute civil proceedings.
16. In the case of persistently slow payers and bad debtors it is acceptable to give them notice in writing (by recorded delivery A.R.) that veterinary services will no longer be provided.
Holding an animal against unpaid fees
17. Although veterinary surgeons do have a right in law to hold an animal until outstanding fees are paid, the RCVS believes that it is not in the interests of the animal so to do, and can lead to the practice incurring additional costs which may not be recoverable. This right should therefore only be exercised in extreme cases and after discussion with the RCVS.
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