Why the CMA Got It Wrong: The Real Reason Veterinary Care Feels Broken

When 26-year-old Nicole Hawley took her dog Ernie out for a walk, she didn’t expect to end the week £12,000 poorer.
Ernie, a young spaniel, inhaled a grass seed. It sounds trivial until it isn’t. Within days he was fighting for his life. The emergency vet gave Nicole two options: put him down or pay for surgery that would save him. She’d just switched pet insurers, so her policy hadn’t yet begun. In the end she and her fiancé took out a loan and raided their wedding fund.

This case was reported in an article that followed a BBC File on Four investigation into rising veterinary bills. Stories like these make good headlines, and “vet-bashing” has become an easy sport.

It’s an awful story, and it deserves sympathy. But it also deserves context. The CMA now says pet owners are being blindsided by rising veterinary costs, with average prices up sixty-three per cent since 2016. Their proposed cure is mandatory price lists, prescription caps and a rewrite of the 1966 Veterinary Surgeons Act. The impulse is right. The diagnosis is wrong.

The Illusion of Fair Pricing

A bitch spay is a bitch spay. That’s how the market sees it. The price for a spay in one practice looks very much like the price down the road, regardless of who’s holding the scalpel or what lies behind the theatre door. In my old hospital we had highly qualified nurses with degrees and surgical certificates, full anaesthetic monitoring, sterile theatres and a team who could switch to emergency protocol in seconds. A few miles away someone was doing the same procedure in a semi-converted garage for almost the same fee.

The problem is that our profession cannot ethically say “we’re better”. We don’t name and shame. We don’t boast about infection rates or accreditation. So all spays are priced the same, and the public assumes equivalence where none exists. I heard more than once, “a vet is a vet”. True, but not entirely.

Different flavours of practice should be encouraged — that’s the CMA’s own principle of choice — but the cost of delivering gold-standard care should be recognised and valued too. The RCVS’s voluntary accreditation scheme could do far more to help owners understand the difference. There should be a cheap option, but that cheaper option may carry more clinical risk, and we ought to be able to say so openly. Transparency alone won’t fix that. A spreadsheet of numbers tells you nothing about skill, safety or care.

The Economics of Care

Providing good veterinary medicine is breathtakingly expensive, even at the most modest level. Modern standards demand specialist staff, equipment that rivals a small hospital and compliance with endless regulation. For decades the way practices coped was by spreading the cost. Routine surgery and consultations often ran at a loss, balanced by modest margins on medicines.

The CMA sees high drug prices as profiteering. In truth those margins were the glue holding general practice together. Remove them and the economics collapse. A cap on prescription fees or a forced shift to online dispensing sounds consumer-friendly until you try paying your nurses and your rent without them.

Meanwhile the profession itself has modernised. Younger vets expect a fair wage and a reasonable life, and who can blame them. The four-day week is becoming the norm, continuity is harder to maintain and the James Herriot era of twenty-four-hour service has rightly passed into folklore. Costs rise because the people delivering the care finally expect to live like professionals, not martyrs.

Expectation Inflation

Human medicine has set the benchmark. Every year brings new possibilities, and veterinary medicine follows fast behind. We can now offer MRI scans, keyhole surgery and chemotherapy for pets. Owners are told that their animals are family, and they quite rightly believe it. The result is moral whiplash.

Take Ernie’s case. That £12,000 bill represents perhaps a tenth of what the same procedure would cost in a human hospital. Yet the vet offering it is treated with suspicion. Decline to offer it and you risk being accused of callousness, perhaps even negligence. Offer it and you are accused of greed. Somewhere in between sits a profession trying to reconcile compassion with arithmetic.

What Real Reform Looks Like

The CMA wants more price lists and ownership disclosures. Fine. But those things won’t rebuild trust on their own. What will help is honest education about what veterinary care actually costs to deliver. We should regulate practices as well as people, recognising quality rather than flattening it. We should use technology to make costs clearer without reducing medicine to a menu. And we need a new understanding between vets and the public, one that accepts compassion and cost as part of the same duty.

The CMA says the market isn’t working. I’d say the market has been doing a heroic job of holding itself together. What’s breaking isn’t competition. It’s the relationship between care, cost and common sense.

Mike Jackson is a veterinary surgeon and founder of Good Day, Inc., a consultancy helping practices modernise with purpose.

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