Veterinary skills. Abstract. Introduction

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1 CHAPTER 18 Veterinary skills Andrew Paterson Abstract This chapter analyses the key features of demand for and supply of veterinary services in South Africa. It considers the challenges inherent in reforming not only the system of veterinary education but also features of veterinary service delivery in this country. Veterinary skills are sought after globally and international migration is strongly evident. In South Africa, state-supported veterinary activity historically focused on white commercial farming. Since 1994 the new government has expressed commitment to community animal health services, and to servicing the animal health needs of poor communities. However, as the data analysis in the chapter indicates, government veterinary services are suffering shortages of veterinary skills. The segmentation between private and public practice is reproducing low levels of access to veterinary services, especially among rural and low-income communities. The role of colonial and apartheid governments was critical in determining the distribution of access to veterinary services and to veterinary education, and those distribution patterns continue to prevail. Between 1994 and 2004, more than 90 per cent of Bachelor of Veterinary Science (BVSc) graduates were white. The most salient change was that after 2001, more females than males graduated with the BVSc. The chapter concludes that attention must be paid to the educational background of students presently unqualified to study for the BVSc, to the promotion of veterinary services as a source of career options, and to the veterinary science curriculum, if present skills shortages are to be adequately addressed. Introduction The field of veterinary practice has expanded since the establishment of the veterinary profession in South Africa, with its own nationally accredited qualifications and teaching and research institutions, in the first half of the 20th century. Veterinary professionals are now supported by a range of para-professionals such as technicians and veterinary nurses, whose roles have evolved through a process of occupational specialisation. This means that veterinary practice needs to be understood in terms of a broader framework of institutions, or in the context of value chains that bring together veterinary, animal health and other professionals in the creation of products or services. This elaboration of the occupational structure within the veterinary field is paralleled in the medical profession and in other occupational families which are evolving through the impact of technology, demands from the market, and service needs expressed by communities that governments are obliged to address. In South Africa, veterinary services treatment of endemic and epidemic diseases, parasites and other pests prevents significant losses to the economy as a whole, and more specifically 388

2 VETERINARY SKILLS secures profitability for thousands of enterprises and household sustainability for millions of households. In the new millennium, global movement of animals and humans has the potential to spread disease, especially virulent trans-boundary (animal-to-human) disease types such as avian bird flu (Hardy 2004: 3). Veterinary services are essential in creating the conditions for, and monitoring, the safe international exchange of animals and animal products that can boost economic growth and sustain public safety. In addition, global warming is inexorably producing climate change. Either of these global events, whether slow- or fast-moving, can impact on animal and human populations, and the management of both is likely to create new demand for veterinary skills. In terms of the Millennium Development Goals, developing countries across the globe are working towards the goals of social development which include improving the safety, health, livelihoods and productivity of rural people (UN 2000). The South African government as a developmental state has also committed itself to its own programmes, which have the twin goals of social development and economic growth. Veterinary and para-veterinary services informed by policy emanating from the Directorate of Animal Health in the Department of Agriculture (DoA) have the potential to play a major role in these efforts. What is unique about the South African veterinary profession and associated paraprofessionals is their genesis within the context of institutionalised racism, which had profound and recalcitrant negative consequences. The original driving force of veterinary science activity lay in the economics of the livestock industry which, in South Africa, was dominated by white farmers, while black (primarily African) farmers were in the main relegated to practising subsistence agriculture. Consequently, state-supported veterinary activity focused on white commercial farming, and the training of veterinarians was dominated by white males virtually until the new millennium. After 1994, the government was faced with the challenge of creating conditions within which livestock and animal health policy and implementation could be supportive of black farmers, in the context of the general thrust towards broadening black people s access to agriculture, aided by a land restitution programme and various forms of input support for emergent farmers (DoA 2001). The challenge is for the government to mobilise animal health support for all owners of livestock, in particular those who cannot afford private veterinary services. This array of demands on the stock of veterinary expertise, which are global and local in origin, places particular stress on veterinary capacity in government formations, yet the ongoing sustainability of such provision appears to be threatened by shortages of veterinary skills in public veterinary facilities. The veterinary skills challenge facing South Africa is not unique. In an international context, shortages of veterinary skills are experienced in many developing contexts and also in many developed countries such as Australia (Denney 2001; Park 2002), Canada (Anon 1976), the UK (House of Commons 2003), the USA and elsewhere (Pritt 2002; Pudsey 1990). Typically, these shortages are experienced in particular sub-sectors of the veterinary and animal health labour market, such as in rural areas (Cobbold 2002), in particular fields of veterinary specialisation such as large animal practice (Manning 2001), or in veterinary technician occupations (Hines 2001). 389

3 HUMAN RESOURCES DEVELOPMENT REVIEW 2008 This chapter addresses these issues through an analysis of the key features of demand and supply for veterinary services in South Africa. In this process, the discussion considers the complexities inherent in reforming not only the system of veterinary education, but also the features of veterinary service delivery in this country. The chapter first provides an account of the evolution of veterinary services in relation to the economic and political history of the country. Then the sources of demand for skilled veterinary and para-veterinary workers are identified (for example in government, higher education, research, veterinary products and private practice contexts) in order to establish a picture of the extent of demand. This is followed by a synoptic overview of the formation of veterinary and para-veterinary skills in South Africa through the higher education system. Following on from this foundation, the analysis explores critical factors affecting the delivery of services, including migration, the possible contribution of community animal healthcare workers (CAHWs), and strategy options for the DoA. In conclusion, some consideration is given to the need for institutional change in order to generate equity of access to veterinary careers in the long term. Historical background By the late 19th century, pastoral agriculture in South Africa was well advanced in the transition from subsistence and nomadic forms of livestock ownership to commercialisation. In the South African economy, agricultural products were second only to gold mining in the generation of export revenue, and wool was the primary pastoral commodity throughout the first half of the 20th century. After 1910, livestock presented the opportunity to supply cheap food for the growing population on the Witwatersrand, as well as to boost export revenues from primary products. The expansion of urban areas based on gold mining, followed by the evolution of the manufacturing sector from the 1930s onwards, generated a demand for meat and dairy products (Brown 2005: ). It is not surprising, therefore, that veterinary science played an important role in the evolution of the livestock economy in South Africa in the period, since veterinary skills were essential for ensuring the health and sustainability of animal populations. Support from the government was critical to the success of the agricultural economy; this was recognised in the creation of veterinary capability from the late 1800s. In the post-south African War period of reconstruction, Britain, as the imperial power, foresaw the value of promoting commercial agriculture as a means of making the empire pay for itself. Consequently, ways were sought to support local commercial farmers through provision of research and veterinary services. After 1910, research was recognised as essential to support agriculture, and the Union Department of Agriculture funded research into the development of dryland farming, cultivation of better varieties of seeds and grasses, and the elimination of injurious crop pests. This nascent research activity also extended into animal husbandry. The government increasingly assumed responsibility for carrying out research into livestock diseases that undermined the economy and providing veterinary services to ensure a healthy livestock population (Brown 2005: ; DoA n.d.). The key issue in South Africa was the generation of veterinary expertise, since western veterinary medicine had not hitherto been practised on a formal and institutionalised basis in the colonial territories. From their inception until well after Union, most veterinary 390

4 VETERINARY SKILLS services were carried out by metropolitan veterinary experts (Brown 2005: ). Practitioners such as Theiler, who worked on an ad hoc basis for Kruger s government in the 1890s, and whose ideas found favour with the British government after the South African War, lobbied strongly for the localisation of veterinary science and of veterinary education (Brown 2005: 524). The economic desirability of locally-based expertise, as well as pressure from practitioners in the country, led the Transvaal government to found Onderstepoort Veterinary Institute in 1908 as a research entity (Brown 2005: 513). In 1920 Africa s first veterinary faculty, affiliated to the University of Pretoria (formerly the Transvaal University College), was established with an emphasis on the livestock industry. From 1921, when the first group of students was enrolled, access to veterinary training conformed to racial and gender divisions of labour of the time the students at Onderstepoort were almost exclusively white and male. There is no evidence that efforts were made to train African veterinarians in the first two decades of the century. For most of the 20th century, white commercial farmers organised campaigns through which they were able to put pressure on the government to support veterinary research aimed at overcoming environmental barriers to improved production, such as disease (see for example Brown 2005; Jeeves & Crush 1997; Krikler 1993). In contrast, African communities were systematically excluded from access to land through the Natives Land Act (No. 27 of 1913), which imposed territorial segregation. These restrictions on Africans access to land, which severely limited their opportunities to engage in commercial farming, were further reinforced by the Native Trust and Land Act, later called the Development Trust and Land Act (No. 18 of 1936). Colonial and apartheid policies extended beyond land ownership to key inputs such as credit facilities, tax relief, infrastructural supply, R&D, technology, extension and veterinary services that were applied on a discriminatory basis to black and white farmers. The cumulative historical impact of this legislative and regulatory regime was the creation of a cohort of white commercial farmers and a livestock production sector which was dominated by white-owned companies, and a cohort of black subsistence farmers relegated to overcrowded communal land in the reserves and homeland territories. The view that white commercial farming was the key to economic progress in the agricultural sector (Brown 2005: 529) was supported by the apartheid characterisation of black farmers as traditional and subsistence farmers who did not require the same kinds of veterinary services as did white commercial farmers. The latter could afford and had access to an increasingly technologically sophisticated private veterinary services infrastructure, whereas black livestock owners, especially those in the rural areas, only had access to a stateprovided service. Demand for veterinary services The DoA careers guide describes veterinarians as professionals who provide services to farmers, pet owners, breeders, animal welfare organisations, game reserves, zoos, etc. At government level they are involved in regulatory services, i.e.: diagnostic services, control of diseases, prevention of disease introduction into the country and eradication of diseases. They are also concerned with small and large animal practice and the conducting of research (DoA 2004: 36). 391

5 HUMAN RESOURCES DEVELOPMENT REVIEW 2008 A definition of veterinarians and what they do is necessarily provisional, since the field of practice itself is changing in response to new demands from clients, and can change further in relation to the deployment of para-professionals who assume tasks that may in the past have been undertaken by veterinarians. This official definition supplied by the DoA covers the key sectors of demand, with the exception of higher education. Even though the higher education sector is the supplier of post-further education and training veterinary training opportunities, it is also a significant consumer of personnel with veterinary skills who work as academics and also as full-time researchers at higher education institutions (HEIs). The overall demand for veterinary workers is not precisely known. Nor is the demand for specific veterinary sub-occupations known with any accuracy. The current size of the veterinary workforce therefore serves as a proxy indicator of demand, assuming that the current cohort of workers needs to be replaced as they stop practising in the South African labour market. Data on numbers in the animal health professions that are affiliated to the South African Veterinary Council (SAVC) are held by the SAVC (Table 18.1). According to these data, there were approximately veterinarians registered in 2005, representing just under 62 per cent of all animal health professionals. The next-largest groups were animal health technicians 1 (22.7 per cent) and veterinary nurses (8.7 per cent). Clearly the majority of animal health professionals are veterinarians, but in the future this is likely to change, with a higher intensity of need emerging among para-professionals in the years to come. The introduction of larger numbers of para-professionals such as primary animal healthcare (PAHC) workers as discussed later could contribute to slowing the demand for veterinarians. However, the balance in demand between veterinarians and para-veterinary workers will depend on government policy and labour market forces. Table 18.1: Animal health professions, 2005 Occupations Registered Unregistered Total Percentage of animal (N) (N) (N) health professionals Veterinarians 2 712* Veterinary nurses Animal health technicians 594 ± Laboratory animal technologists Animal welfare assistants 267 unknown Total Source: SAVC personal communication in Paterson et al. 2005: 199 Note: * Of this total, 127 are pensioners and may or may not be active, while a further 50 are registered as living abroad. The SAVC updates its database on an annual basis with information provided by professionals when they submit their fees. The SAVC has indicated that it is aware that a number of South African veterinarians are practising abroad, but members are not obliged to indicate temporary or permanent changes in their work or residency status, so the size of this group is not precisely known. Consequently, the figures presented in Table 18.1 are probably an overestimation of the current availability of veterinary skills in the South African labour market. 392

6 VETERINARY SKILLS Government demand at national, provincial and laboratory level There appears to be a shortage of veterinary skills in government formations that has been evident for some time (see Hardy 2004). Data from a study conducted in April 2005, commissioned by the DoA, on the demand for veterinary qualifications within government revealed that there were large numbers of vacant posts at that time (Table 18.2). Of all government veterinary posts (at national, provincial and laboratory level) only 59 per cent were filled, while only 74 per cent of government posts for animal health technicians were filled. Of considerable concern was that only 148 out of 228 (65 per cent) of veterinary posts and 951 out of (76 per cent) of veterinary technicians posts were filled at the strategic provincial level. Across veterinary, administrative, technical and auxiliary animal health staff, out of positions there was a 23.9 per cent vacancy rate (564 posts). The fact that there was a vacancy rate of 18 per cent in administrative positions, which are presumably non-specialist, suggests that the high vacancy rates may be affected by weaknesses in the human resources management function of the DoA with regard to filling posts. The slow turnaround time between posts becoming vacant and being filled is a problem currently faced in several government departments. Table 18.2: Government needs for animal health personnel, 2005 Veterinary posts Administrative posts Technical posts Border & redline posts* Service Filled Vacant Total Filled Vacant Total Filled Vacant Total Filled Vacant Total National Provincial Laboratory Total N % Source: DoA personal communication in Paterson et al. 2005: Note: * This refers to posts in the DoA at international borders which involve controlling agricultural products that are in transit and where surveillance must be enforced to prevent spread of disease and to secure public safety. Assuming that unfilled veterinary posts are much more a labour market problem than an administrative shortcoming, it is important to gauge the size of the problem. According to the data in Table 18.2, the veterinarians employed in provincial and national governments and in state laboratories numbered 185 in 2005, which represented 6.8 per cent of the numbers registered with the SAVC in the same year. If all vacant posts were filled, the government-employed veterinarians could have risen to 11.3 per cent of all registered veterinarians. To put this in perspective, in the late 1980s 20 per cent of New Zealand veterinarians were in the employ of government (Boland & Morris 1988: 128). Even if all 314 government veterinary posts provided for within the post structure of South African government institutions were filled, would this number be sufficient to address the need for public veterinary services? The New Zealand example is cited to raise this critical service delivery issue. A forecasting exercise may suggest that the South African government needs to increase its veterinary skills base beyond the current 314 posts. Circumstantial evidence points to significant factors other than the purely administrative leading to government veterinary posts not being filled. The DoA itself 393

7 HUMAN RESOURCES DEVELOPMENT REVIEW 2008 has observed that there is a problem with poor salaries, lack of equipment, transport and incentives (DoA 2000: 4) which affects the motivation of staff and the capacity of government to retain people with these skills. This suggests that in the case of veterinarians, remuneration and institutional factors exact a sufficiently powerful influence on the decisions of persons with veterinary qualifications to lead them to elect not to enter the employ of the public sector. State veterinarians do seem to receive lower values in benefits than they might in private employ. This is not unique to the veterinary profession similar differentials between public and private sector remuneration are evident in a number of other professions. The contribution of lower salary and benefits to shortages in the public sector workforce needs to be interrogated through a comparative analysis of income between veterinarians in private and public practice. While there appears to be a shortage of state veterinarians, it may be possible to solve this problem at a price but we do not know what that price might be. On the other hand, it is well known that people in the professions do not only work for the financial bottom line, and that motivation derives from intrinsic rewards. There are signs that this source of satisfaction is under threat in some parts of the public veterinary system. Frustration over maintenance of state veterinary equipment and facilities seems to be a factor. This requires consideration of the commitment to investment in veterinary infrastructure, particularly at provincial level. Lastly, anecdotal evidence suggests that the shortages of state veterinarians are not even across rural and urban areas. The shortage in Gauteng, a predominantly urban province, is negligible compared to that in rural provinces. Local government veterinary services This discussion of sources of demand for veterinary skills must also take account of the needs of local authorities such as metropolitan and municipal governments, which are responsible for providing animal health services. There is some lack of clarity in the Constitution (Schedule 5 and Schedule 4 Part B) on the allocation of animal health and veterinary services competencies and responsibilities between provincial and local government; once clarified, this allocation could influence future skills needs. In many municipalities, the local pound is run by an animal welfare organisation such as the Society for the Prevention of Cruelty to Animals. Urban animal welfare assistants are examined and authorised by the SAVC to conduct particular practices under supervision. Recently, there have been moves under way to recognise animal welfare assistants as a paraveterinary professional group, with an accredited qualification available by These changes may increase local government demand for veterinary skills. In the meantime, it has been suggested that animal health technicians could be appointed to fulfil this function. The question is whether local government veterinary services, as they currently operate, are sufficient to meet the urban animal welfare needs of low-income communities for vaccination, sterilisation, control of parasites and advice given that they may not be able to bear the costs of private veterinary treatment (McCrindle, Cornelius & Schoeman 1997: ). 394

8 VETERINARY SKILLS Parastatal veterinary skills needs There is some demand for veterinary services in parastatals such as the Agricultural Research Council, Onderstepoort Biological Products (OBP) and the Perishable Products Export Control Board. OBP reports that it employs a number of people holding different agricultural qualifications but with an animal health speciality. The employment of people with these qualifications would, however, not be accepted if sufficient people with veterinary technician qualifications could be hired. This is contributing to substitution demand for agricultural qualifications in the labour market, which will last for as long as the first-choice skills are in short supply. HEIs and R&D needs HEIs experience difficulties with the acquisition and retention of suitably qualified staff in the field of agriculture. In a 2005 study, posts most difficult to fill for the subject Animal Health were universally indicated to be veterinarians (with these often bought in on a parttime basis) (Paterson et al. 2005: ). While the larger departments or schools of agriculture in urban areas did not seem to experience severe difficulties in obtaining staff, smaller and more rurally located departments observed that it was very difficult to get people to move permanently into their areas. The low salaries of academic positions, as against earning potential within the private sector, were noted as a factor that deterred people from pursuing an academic career in the veterinary field. Veterinary and related qualifications are also required to support the agricultural sector via corporate R&D inputs into a range of fields, including animal improvement and animal health product development (Paterson et al. 2005: ). More research is needed in order to attempt to quantify the extent of demand from this section of the agricultural labour market. Animal health skills needs in private enterprise sales and marketing Private enterprises which market and sell products related to animal health in South Africa are showing strong interest in veterinary and animal health skills. This is because product knowledge and knowledge of the application environment of products are becoming more important to improve sales and after-market service in the private animal health field. Business entities in this field formed the South African Animal Health Association (SAAHA), which has 15 member organisations, although a further 11 non-member companies are also competing in this sector and therefore have similar skills needs. Amongst these enterprises, the most sought-after qualifications for sales staff are veterinary science-related, although agricultural qualifications that include an animal health specialisation are part of a basket of qualifications accepted in candidates for sales positions by member enterprises. By shared agreement, all SAAHA members are required to have their sales agents complete and pass the Association of Veterinary and Crop Associations of South Africa animal health course that was developed in cooperation with, and is offered by, the Tshwane University of Technology (TUT) (Paterson et al. 2005: 198). A total of 320 people have received the certificate. TUT does not collect information on graduates previous qualifications and could not indicate the numbers of those enrolled who already held agricultural or veterinary qualifications (Paterson et al. 2005: 198). 395

9 HUMAN RESOURCES DEVELOPMENT REVIEW 2008 This example usefully demonstrates how demands for veterinary and animal health skills are broadening, driving the development of courseware and qualifications that may lead to accreditation by the South African Qualifications Authority (SAQA) or by industry associations. Private veterinary practice Both the state and the private sectors have demands for qualified veterinarians as well as for veterinary nurses, technicians and other para-professionals, but the vast majority work in the private sector. Tables 18.1 and 18.2 reveal that the approximate number of private veterinarians is registered on the SAVC list minus about 200 in the public sector. What we do know, on the basis of scrutinising graduation data over the past decades, is that the overwhelming majority of veterinarians are white, and are currently working in urban small-animal and large-animal practices. Nevertheless, an in-depth analysis, off the SAVC database, of the distribution of veterinarians within the various domains of private clinical practice (for example, work in industry/agri-business, large-animal and livestock production, game farming/conservation and small-animal practice) will greatly enhance our understanding of skills needs in this segment of the veterinary labour market. Such a task was not within the brief of this chapter. Notwithstanding this gap, some observations about the private veterinary labour market can be made without pronouncing on the extent of actual skills shortages. Firstly, an apparently growing market for veterinary services is providing opportunities for practice specialisations (for example in the domains of bird, equine, exotic animal and wildlife care) and also for clinical specialisations (for example in pathology and ophthalmology) that are based largely on referrals. This appetite in the market is not restricted only to high-end skills and services, but applies also to para-professionals (for example, veterinary nurses can subspecialise in providing water therapy for animals). The market for this diversity of services is found in high-density and relatively high-income urban populations which can be associated with high-density companion animal populations. In these environments, there are benefits that accrue to large-scale practices where a group of veterinary professionals work together. This confers advantages on the partners, who can share the costs of hightechnology equipment and can also then elect to specialise and by preference deal with particular animals or particular clinical fields by common agreement. There are a number of economic and sociological factors which contribute to this sustained demand for services; these would include increases in the propensity for human social groups to keep pets in their homes and to change their pet preferences (for example, if more people own dogs, the demand for veterinary services will increase because dog owners tend to spend more on their pets). Further research on this market would shed light on the apparent capacity of urban areas for absorbing veterinary services, including relatively high concentrations of single small-animal practices. This could help to explain why veterinary professionals appear to be in short supply in rural areas but not in urban areas. At the risk of oversimplifying the many kinds of rural labour market, the picture that emerges is of rural veterinarians who are not that comfortable in comparison with their urban counterparts. Few rural practices are purely small-animal based; they are more frequently mixed practices where practitioners do small-animal and production-animal 396

10 VETERINARY SKILLS work.this becomes a necessity where the local animal-owning population is not dense enough to sustain a small-animal practice. It is observed that things are tight in the rural areas with veterinarians looking for additional business to diversify their income streams. 2 Thus an apparent paradox emerges, in which under-serviced rural areas are facing the likelihood of experiencing even greater difficulty in obtaining veterinary help, because rural veterinary practices are not sufficiently profitable to attract enough veterinarians to these areas to stay. Consequently, the spatial distribution of these services seems to advantage urban and peri-urban populations and businesses which may require veterinary services. Supply of veterinary services The analysis that follows will first deal with the supply of graduates from South African HEIs in the specific field of veterinary science, starting with BVSc graduates, some of whom may continue into honours, master s and doctoral study. Thereafter, the analysis addresses qualifications in the veterinary science and animal health fields that may also be considered to contribute to the overall size of the population of persons qualified to work in occupations relevant to the veterinary and animal health needs of the country. The data tables constructed for the purpose of this analysis derive from three sources: data on BVSc graduates from , from the Higher Education Management Information System (HEMIS) database that is operated by the South African Department of Education (DoE); data on graduate output in various veterinary science qualifications from HEIs from , from SAQA; data on graduate output of various veterinary science and animal health qualifications from four HEIs for Each data set is generated by a different institution and covers a different time period. Together the three data sources make it possible to generate a reasonable overview of the shape of veterinary and animal health skills supply over the period of just over a decade, from 1992 to It is not possible to simply add up all the data to create a single overview, as each data set has its own slightly different assumptions and criteria for categorising and counting qualifications. For this reason, the data from SAQA form the core of this analysis since this is the most comprehensive data set produced by a single provider over a long period. More recent data referring to the period after 2003 have not been used, since the graduate outputs of 2004 and 2005 are subject to verification by the institutions and the DoE before they are made public. The BVSc The first set of tables shows the BVSc output on its own (Tables 18.3 and 18.4). From January 1998 the Veterinary Science faculties of the Medical University of South Africa (MEDUNSA) and the University of Pretoria were amalgamated to form a new Faculty of Veterinary Science at Onderstepoort within the University of Pretoria (Bengu 1997). This amalgamation was based on two investigations into veterinary science training in South Africa by the Land and Agriculture Policy Centre and the Advisory Council for Universities 397

11 HUMAN RESOURCES DEVELOPMENT REVIEW 2008 and Technikons, the findings of which were released in The amalgamation decision was influenced by the high cost of veterinary training and the financial difficulties of MEDUNSA, aggravated by the fact that the Veterinary Science Faculty at that institution operated at a loss (Bengu 1997). The degree of BVSc is now offered only at the University of Pretoria s Faculty of Veterinary Science. The number of people graduating with the BVSc degree did not exceed 100 in any year between 1994 and 2004, because the faculty does not have sufficient laboratory and other infrastructure to offer this programme to a larger group. Even given this trend, the annual number of veterinarians graduating has declined since A more comprehensive study than was possible within the scope of this chapter must be undertaken, in order to establish whether increased veterinary graduate production is necessary. Table 18.3: BVSc graduates (number), by race, African Coloured Indian White Total Total Percentage of total Source: DoE 2005 It is also quite clear that the group of students graduating with a BVSc degree is still overwhelmingly white, accounting for 96.4 per cent of graduates in the decade between 1994 and Evidence of slow change in the racial proportions of graduates emerged only after 1999, but African graduates numbered a mere handful between 2000 and There are also shifts in gender representation, with an evident decline in the proportion of white males graduating with a BVSc. Clearly, since 2001 white females are the dominant group graduating with this qualification (Paterson et al. 2005: ). The presence of increasing numbers of women in the veterinary field has stimulated international debate concerning the economic impact (Brown & Silverman 1999) and the impact on service delivery of this trend questions are raised as to the comfortability of female veterinarians in a physically demanding large-animal practice. Breier and Wildschut (2006: 52, 59) have observed similar discussions in South Africa s medical profession regarding female participation in specialisations such as orthopaedics, which seem to refer as much to conceptions of gender as to real differences between male and female professionals. 398

12 VETERINARY SKILLS Table 18.4: BVSc graduates, by gender, Female (N) Male (N) Female (%) Male (%) Source: DoE 2005 Production of all veterinary qualifications Although the BVSc qualification is the main building block of professional veterinary services, it is necessary to obtain a picture of the broader production of skills in the veterinary field by HEIs. This entails showing: the number of graduates with basic BVSc degrees from the universities; the number of Bachelor of Veterinary Technology (BVT) graduates from the technikons (which have now been renamed universities of technology, as part of a general restructuring of the higher education sector); the postgraduate degrees awarded to people with BVSc and BVT who study further; and the output of people holding diplomas from HEIs. From Table 18.5 it is clear that the production of university graduates in the BVSc field held to a range of roughly 100 per year from Over the decade, nearly two-thirds of the skills base in veterinary skills consisted of BVSc graduates. In the same period, universities dominated skills supply in the field, with 78.2 per cent of all graduates. The contribution of technikons to the production of veterinary skills came into its own from 1994 onwards. These institutions cumulatively added to graduate supply on a one-infive basis, providing 21.8 per cent of all higher education graduates in the veterinary field between 1992 and The production of veterinary technologists (the BTech degree) from 1998 onwards is important, since these skills can be applied across the animal health value chain. When the graduate output described above is disaggregated to assess the extent to which there is equitable participation in veterinary study fields and programmes on the basis of race and gender, it is clear that neither participation nor output is equitable. The racial composition of outputs of veterinary graduates in the universities was dominated throughout the period by white graduates, who constituted almost 88 per cent of graduates (Table 18.6). The proportion of African graduates increased from 1.7 per cent to 12.5 per cent between 1992 and 1998, but dropped off towards the end of the period covered. The number of Indian graduates increased steadily over the period to achieve a share of 6.5 per cent in In the technikons, the African share of graduates was higher, amounting to 399

13 HUMAN RESOURCES DEVELOPMENT REVIEW 2008 Table 18.5: Number of veterinary graduates at technikons and universities, Total % share Universities First degree Honours degree Master s degree Doctoral degree Universities total Technikons National diploma National higher diploma BTech degree Master s diploma/degree Technikons total Total of all graduates Source: SAQA 2004: Note: There were no postgraduate diploma graduates recorded by universities and no laureatus/doctoral degrees recorded by technikons. 20 per cent over the entire period from a zero base in the early 1990s. This suggests that the technikons provided new opportunities for the participation of Africans from the inception of their National Diploma and BTech qualifications in the mid- to late 1990s. Table 18.6: Veterinary graduates at universities and technikons (percentage), by race, University Technikon African Coloured Indian Unknown White African Coloured Indian White Average Source: SAQA 2004: In terms of gender, the presence of women graduates was higher over the decade in the universities (41.8 per cent) than in the technikons (36.1 per cent) (Table 18.7). Representation of women increased in the universities until in 2001, for the first time, female graduates were in the majority (56.5 per cent). In the same year a significant majority of graduates from technikons were women (65.5 per cent) although gender representation among graduates from these institutions was quite variable. The trends for veterinary graduates overall are not as clear in this regard as those for BVSc graduates. 400

14 VETERINARY SKILLS Table 18.7: Veterinary graduates at universities and technikons (percentage), by gender, University Technikon Female Male Female Male Average Source: SAQA 2004: Note: 1995 data for technikons were not included in the SAQA document. Postgraduate veterinary outputs It should be noted that the output of senior postgraduate students from the universities of technology is currently very small. A brief look at postgraduate production in the veterinary field, taking the University of Pretoria as an example, reveals that over a four-year period, the output of senior postgraduates is not particularly large (Table 18.8). At the master s degree level, only the MSc Vet (n=33) and the MMed Vet Ophthalmology (n=20) programmes produced more than six graduates between 1999 and White postgraduates constituted 73.3 per cent of the output of 116 graduates across all courses, from honours to PhD, in the four years. Continuing professional development Veterinarians are currently obliged to engage in continuing professional development (CPD). Rapid changes driven by technological developments across several veterinary subfields make CPD an increasingly important vehicle for upgrading the skills of veterinarians. The SAVC has developed a programme, based on a long-term pilot study, which utilises mobile telephone technologies for course completion. Graduate availability a view of supply and demand In Table 18.1, the numbers of veterinary and animal health practitioners registered with the SAVC in 2005 were given as veterinarians, 594 animal health technicians and 383 veterinary nurses. The sizes of these professional groups are a function of the output of veterinary training facilities over time, as described in Table The table shows the availability of people with veterinary qualifications in the labour market, who are not all necessarily practising. The actual numbers working in South Africa will be lower than the figures stated, for a number of reasons. These data show a general increase of 61.5 per cent in the numbers of graduates across all veterinary qualifications generated by HEIs between 1991 and

15 HUMAN RESOURCES DEVELOPMENT REVIEW 2008 Table 18.8: Number of graduates in postgraduate veterinary fields of study at University of Pretoria, by race and gender, African Coloured Indian White Total Qualification and field of study M F M F M F M F BVSc (Hon) MSc Vet PhD DVSc MMed Vet (Anaesthesiology) (Anaes) 1 1 MMed Vet Cattle Herd Health (Bov) MMed Vet Clinical Laboratory Diagnosis 1 1 MMed Vet LAS MMed Vet (Med) (Bov) 1 1 MMed Vet (Med) (Small Animals) MMed Vet Ophthalmology MMed Vet Pharmacology MMed Vet Poultry Diseases MMed Vet Reproduction (Gyn) MMed Vet Parasitology MMed Vet Surgery (Chir) (Small Animals) MMed Vet Veterinary Public Health MMed Vet Wildlife Diseases (Fer) 3 3 MMed Vet Diagnostic Imaging (Diag Im) 1 1 MMed Vet Pathology PhD Anatomy and Physiology 1 1 PhD Veterinary Tropical Diseases PhD Production Animal Studies (Veterinary Ethology) Total Source: DoA (personal communication) The two largest contributors to the animal health and veterinary workforce were those completing a first degree at the universities, increasing by 46.8 per cent in the period, and those completing their national diploma at the technikons, increasing by per cent in the period. These figures reinforce the argument that the mainstays of the fields of veterinary and animal health are in particular the BVSc and, more recently, graduates with national diplomas, particularly in animal health. While Table 18.9 demonstrates reasonable growth in availability, we are not in a good position to compare these numbers with demand. In the search for indicators of demand, the numbers of practitioners per population were considered. For example, the numbers of veterinarians per people are 21.3 in the UK, 21.8 in the USA, 25.0 in Canada and 33.0 in Australia (Heath 2002). Based on a South African population of approximately 48 million, and with a maximum number of currently registered veterinarians of 2 700, the national ratio per population is 5.6. The figure is considerably lower than that of other developed countries, thus raising the danger signal regarding losses through emigration of veterinarians. 402

16 VETERINARY SKILLS Table 18.9: Graduate availability, by highest level of qualification, (N) 1996 (N) 2001 (N) % increase Technikon qualifications Master s diploma/degree BTech degree 43 National higher diploma National diploma Total University qualifications Doctoral degree Master s degree Honours degree Postgraduate diploma First degree Total Total (technikon and university) Source: SAQA 2004 However, for the purposes of planning there are two problems with this overall average: first, basing veterinary needs on human population data has been shown to be inadequate (Thompson 1979) and second, real access to the practising South African veterinary population is highly skewed away from the large numbers of people who cannot afford to pay for these services. Further work on achieving a more accurate specification of the types of skills required, and the localities where these skills are required, is an important precursor to planning of veterinary and animal health rollout in this country. While it has been observed that the overall supply of professionals and para-veterinary workers in the veterinary field appears to be increasing, the same is not true for the supply of veterinarians qualifying with the basic BVSc, which has not shown an increase for over a decade because there is a constant number of student places available in veterinary medical teaching facilities. This cap on supply seems to be partially compensated for by increases in supply of para-veterinary professions. While a shortage is apparent in the public sector, we do not have empirical evidence as to the status of demand in the private sector. Perhaps the most critical question is whether private veterinary services are in short supply at all, or whether there is short supply only where the supply of veterinary services is unevenly distributed in space, leaving rural areas under-serviced. In order to shed some light on contributing factors that can influence a pattern of overall or localised short supply, international migration and PAHC will be discussed below. International migration of veterinary skills There is evidence of inward and outward migration of persons with veterinary skills. A number of South African veterinarians are reported to be working either temporarily or permanently in Australia, New Zealand, the UK, USA, Canada and elsewhere. There are 403

17 HUMAN RESOURCES DEVELOPMENT REVIEW 2008 claims that recent graduates go abroad for financial reasons, to earn currency that can help to cancel debts arising from seven years of study. The rising global movement among veterinary professionals in and out of the country reinforces the importance of sustaining international agreements regarding accreditation. Maintaining international agreements is important though a double-edged sword because it provides for the movement of veterinary professionals both out of and into the country. On the basis of regional labour market dynamics, increased numbers of applicants with foreign qualifications have applied to the SAVC to write the South African examinations leading to accreditation. For example, Botswana has recently begun sending veterinarians from the Democratic Republic of Congo to South Africa to take the SAVC examination, an indication of the importance attached to internationally credible benchmarks. In the recent past foreign applicants have been writing this examination at a rate of at least 10 per year, but the number has risen sharply from more than 20 in 2005 to 39 candidates in Even though not all candidates pass the examinations, it is clear that the stream of veterinary skills mostly from sub-saharan Africa represents a significant boost to the availability of veterinary skills in South Africa. The impact of migration on veterinary skills scarcity requires further investigation. Primary animal healthcare Veterinary service provision is driven by the government s principled commitments to community animal health services, food safety and public health. But the impact of these commitments on skills needs is revealed firstly in how the government interprets its responsibilities, and secondly in how it designs its implementation strategy and deploys veterinary services. How it chooses to interpret its responsibilities and implement strategy can involve an expansion of government employment of veterinarians and para-veterinary workers in various combinations. This may involve the substitution of veterinary labour by para-professionals such as nurses or technicians. In this instance the introduction of the PAHC worker may be considered as an important contribution to the overall veterinary service programme offered by the government. After 1994, the new South African government s DoA began a process of reviewing its animal health and livestock policies and service delivery priorities, with a view to countering the distorted support patterns of the past and creating a more equitable pattern of access to veterinary services. In the process, the department developed its draft document, Primary Animal Health Care Policy in South Africa, in The aims of the PAHC policy are to broaden access to veterinary services to rural communities in a cost-effective manner, ensure improvement in the health status and production of animals and safeguard public health while contributing generally to national development (DoA 2000: 5). These aims are acknowledged by the department to be a substantial challenge, given its own observation that government veterinary offices are mainly located in city centres, that the officials rendering services in some instances have a poor relationship with their farmer clients, and that there is poor coordination between service providers in rural areas (DoA 2000: 4). 404