The Swedish Agency for Public Management

An improvement of supervision within veterinary healthcare (2016:29)

The Swedish Agency for Public Management (Statskontoret) has been commissioned by the Swedish Government to analyse whether the supervision of veterinary healthcare personnel, that is currently conducted by the county administrative boards, should also be complemented by the introduction of organisational supervision within veterinary healthcare.

The aim of the supervision of veterinary healthcare personnel is to ensure that veterinary healthcare complies with the legislative objectives of good, safe care for animals and good animal health. The supervision also has to ensure that the care complies with the legislative requirements concerning animal protection, infectious diseases control and safe foodstuffs. Statskontoret believes it is possible to better fulfil these objectives by changing the individual supervision that is currently in place, for example by introducing prescriber codes for veterinarians so that the county administrative boards can monitor the prescribing of medicinal products by each individual. Fulfilment of objectives will likely also increase if the county administrative boards were able to devote additional resources to individual supervision and if the Swedish Board of Agriculture improves the support it provides to the county administrative boards. However, fundamental problems relating to the design of the supervision will remain which cannot be rectified within the scope of individual supervision.

Individual supervision should be complemented with organisational supervision

Statskontoret’s assessment is that organisational supervision should be introduced within veterinary healthcare. Combined individual and organisational supervision has the benefits of being more flexible, more adaptable to the situation and more resource-efficient.

The current supervisory regime is not adapted to the conditions within contemporary veterinary healthcare as the supervision is only directed at individuals. The supervision does not check how feasible it is for personnel to comply with legal requirements, which means that the supervision has a limited impact. The current supervisory regime does not allow the county administrative boards to inspect shortcomings at the organisational level.

Another problem with the current supervisory regime is that not all personnel are encompassed by the inspections; only those with registration or qualifications (known as veterinary healthcare personnel). Our investigation shows that the division of responsibility between qualified and other personnel is perceived to be unclear, which makes inspections at the individual level more difficult.

Statskontoret believes that individual supervision, combined with organisational supervision has the potential to improve the fulfilment of objectives. Our assessment is that the value of supervision increases if the county administrative boards are able to review, for example, the organisations’ procedures, premises and the division of responsibility between occupational groups at the clinic. This means that the county administrative boards may demand accountability on two levels. Organisational supervision makes the entire organisation, and thus all employees, subject to supervision.

Our assessment is that supervision will become more resource-efficient if organisational supervision is introduced. By directing supervision at a person with responsibility for the organisation, the impact can be even greater, as this person has a mandate to implement improvements in the organisation. A combination of individual and organisational supervision may also be more true of aim and lead to more shortcomings being identified. Furthermore, it is reasonable to assume that the need for individual inspections will decrease in the long term.

The introduction of organisational supervision involves certain costs

Statskontoret estimates the cost of introducing organisational supervision to be approximately SEK 2.3 million. This includes both the county administrative boards’ and the Board of Agriculture’s initiatives such as support, information and educational initiatives.

We also estimate that the annual cost to the county administrative boards will increase if organisational supervision is introduced. This increase will be between SEK 0.6 and 1.4 million, depending on how often organisations are inspected. Over the past five years, the cost of individual supervision has been SEK 3 million per year. The cost of combined supervision will thus be between SEK 3.6 and 4.4 million per year if the costs of individual supervision remain at the same level as over the past five years.

The long-term costs are difficult to assess as these are affected by factors that are hard to predict. However, we assess that it is unreasonable to expect the costs to decrease. This is because the current resources allocated by the county administrative boards to the supervision of veterinary healthcare are minor and also do not equate to the county administrative boards’ resource requirements.

It may be possible to finance the supervision using direct charges

The Government’s communication concerning supervision indicates that it may be appropriate for supervision to be financed through taxation in cases where the costs of administering direct charging is judged to be high in relation to the charges collected. Our assessment is that this is just such a case, as the running costs of operational supervision are expected to be relatively low.

The Government’s basic premise is however that supervision should normally be financed through a fee. If a fee that cover all costs are introduced, the cost of supervision to central government will decrease by SEK 3 million per year. Consequently, the Government should investigate the possibility of designing a fee structure that includes the costs of both individual and organisational supervision and in which the cost of a supervisory visit can accrue to an organisation. We are of the opinion that financing through a fee should be introduced.