Veterinarians and Public Health: Food Control in the Professionalization of Veterinarians

On the veterinary profession

The veterinary practice has its roots in tending to the health of army horses. The first academic college for veterinarians opened in Lyon, France, in 1762. Carr-Saunders and Wilson (1933) see the veterinary profession as one of the classic professions, and they point to differences between veterinary education in Britain and that on the continent. In Britain, the roots of veterinary education were more practical, with a weak academic basis. Veterinary education on the continent was academic, and the position of veterinarians was different with respect to positions of prestige in practice, government, and science. A Danish veterinary college opened in Copenhagen in 1773, inspired by the Lyon College, while Norway’s veterinary college did not open until 1935.

In her study of the sociology of professions in Sweden, Hellberg (1978) discusses veterinarians as an example of the role of shifting groups of clients in the professionalization process. She argues that the increased strength of the European veterinary profession during the latter decades of the 19th century has to be related to their role in the process of the modernization of agriculture. Hellberg identified three periods of professionalization: the first, the “horse doctor” period, continued into latter decades of the 1800s. The army—and therefore the state—was the most important employer of veterinarians. During the “animal doctor” period, contributions to agriculture and the treating of animal diseases were predominant. Hellberg frames the final stage, which continues to the present day, as the “pet doctor” period.

A recent volume on the history of Norwegian professions includes veterinarians as one of 34 professions (Asdal & Druglitrø, 2014). The authors explore the process of gaining jurisdiction for the profession, inspired by Andrew Abbot’s work (1988), and they include institutional factors in their history. The authors emphasize efforts by the veterinary organization (established in 1888) to gain jurisdiction over the health of animals, to fight quackery and to promote animal welfare, all around the turn of the 19th century. A monopoly over the provision of health care for animals was formalised in 1935. The influence of animal health issues on import restrictions is seen as part of a nation-building strategy and of the tensions between Sweden and Norway in the years before the dissolution of the union in 1905. Aspects of the role played by the relations between the two countries are also explored in works on the history of the veterinary administration (Asdal, 2005, 2006). However, the studies by Hellberg and Asdal do not explore the role played by food and meat control or public health, and the present article aims to contribute to the literature by doing so.

In the European context, Hardy’s (2003) study of veterinarians and public health is of interest. Hardy discusses the practice of British veterinarians in public health and the veterinarians’ struggle to build a state veterinary agency, starting in the 1860s. When the state introduced a veterinary administration in the Ministry of Agriculture in 1939, veterinary public health activities disappeared from the field of public health at the local, city level. With reference to Schwabe (1969), Hardy underlines that the veterinarians in Europe had achieved a stronger position in public health during the late 1800s and early 1900s than had veterinarians in the UK and US. Koolmees (2000) addresses the same issue in relation to the Netherlands, where veterinarians entered the food control units in the cities from the late 1800s.

The veterinarian and medical professions are often seen as separate, “by virtue of their easily segregated functions and their capacity to practice as entrepreneurs to maintain themselves separately” (Freidson, 1970/1988, p. 52). In the professionalization literature, the number of studies of the professionalization of physicians is high. By contrast, research on the veterinary profession in general, as well as comparative studies between countries and professions, are few. In a review of 207 comparative studies of professional groups, Bourgeault, Benoit, and Hirschkorn (2009) find only a very few that include veterinarians, the majority concerning physicians and jurists.

Theoretical framework

The present study is inspired by a number of contributions to profession literature. Historical-sociological perspectives have inspired studies of the relationship between professionalization and state-building processes (Burrage, Jarausch, & Siegrist, 1990). Relations with the state and the roles and tasks of a profession in the state apparatus may vary over time and between situations. This calls for exploring the specific services in specific contexts that particular professions offer to the authorities, which for veterinarians were the various practices that they performed within the field—or ecology (Abbott, 2005)—of medicine. Professionalization studies often refer to the very different roles of the state in Europe and the US. State-oriented professions tend to be typical of the continent, and perhaps to an even stronger degree in the Nordic countries. In a comparative study of the health professions in Norway and Sweden, Vibeke Erichsen (1995) finds the concept of “the profession state” to be useful. This concept refers to the importance of actor groups within a profession, acting within or in alliance with the central health administration. Their contributions to institution building may, in turn, contribute to the profession’s authority and legitimacy. Erichsen underlines that Scandinavian professions connected to the health sector have largely developed through the state (Erichsen, 1993, p. 395).

The decision to study professions as entities composed of different segments has been inspired by Bucher and Strauss (1961), who emphasise that professions are usually composed of segments that together form an amalgam—the profession—and discuss the possibly different roles of these segments, asserting that some segments may have common features with social movements. The authority and trust achieved by one segment may also be important to other segments.

Freidson (2001, p. 144) argues that the concept of segments does not necessarily refer to specialization into new professions, but it may underline that segments can be characterized by different fields of practice or use of knowledge or different reference groups, while nonetheless having a common community within the profession. In this context, the relationship with the authorities, whether at local or state level, can be said to represent a reference group clearly different from groups related to different specialities within medicine, or veterinary medicine, such as groups of patients or farmers. However, state or local authorities as reference groups may be very wide and complex.

The analysis of professions as an amalgam of groups of actors may originate in Brante’s (1988) call for studies of different professional groups of actors, such as for physicians; practitioners, university teachers or civil servants. However, different segments of a profession may have divergent positions and roles with respect to the state and research communities, and their practices may address different fields of knowledge and relations to the authorities. In line with this, a profession may be understood and analysed as being composed of different actor groups, based on different activities and with different connections of knowledge, clients and organizations. A study of physicians by Phillip Elliott (1972) has motivated investigation into the kinds of knowledge and skills that different segments of a profession offer to the authorities—or to different groups of clients.

Many studies of professionalization refer to the concept of “jurisdiction” and the work of Andrew Abbott on professions (1988). His analytical concept of “profession formation” is connected to the division of labour between professions. Different fields of practice can have different jurisdictions—with different dynamics in relation to the state. DiMaggio (1989) points to another concept used by Abbott: “the niche.” DiMaggio finds a profession’s ability—or good fortune—to find, develop or inhabit a niche to be a very important analytical tool in the study of professionalism. A profession can find new niches of work and practice, with new opportunities to gain jurisdiction and influence. Activities on the fringes of a profession’s core activity may reveal a niche practice with new responsibilities, roles, and jurisdiction. Furthermore, professional entrepreneurs may play important roles within a niche. Whether a niche is seen as the core or at the fringe of a professional field is likely to change over time. Jurisdiction may be connected to a fringe or a core activity, possibly with different results.

A recent study explores the role of hygiene and psychiatry in the professionalizing of medicine in Norway in the 1800s and early 1900s (Elvbakken & Ludvigsen, 2016). Hygiene and psychiatry were disciplines addressing issues of social order. With their specific knowledge and expertise they contributed to the standing of physicians generally. The concept of hygiene, or public health, was synonymous with state medicine or politica medica and the practice of hygiene had close ties to the state. This argument is in line with Larson (1977), who notes that physicians, in general, earn respect from the efforts of physicians in public health.

The main question in this study is related to veterinary engagement in public health, which is discussed as a niche aspect of the veterinary profession and from a historical perspective. What was the contribution of public health activity to the veterinary profession? The discussion is based on an examination first of local public health activity involving veterinarians, and second of what happened at the governmental level in connection to these issues. In each section, the characteristics of legitimacy and value from this niche activity are explored. Since the assumption is that segments outside the core professional activity can bring value and legitimacy to the profession as such, important aspects of legitimacy will be discussed. This includes legitimacy from practice, knowledge and scientific activity, as well as the importance connected to that activity. It is assumed that the values from this field of practice are important for the legitimacy of veterinarians more generally.

Material and study design

The author’s 1997 study of the institutionalization of food control in Norway up to the 1990s included an analysis of the role of veterinarians (Elvbakken, 1997). That project provided a collection of material that is re-examined in the present study. This material includes documents from ministries and directorates, such as proposals and preparatory work for legislation, but also journals and publications from key actors. This material has been supplemented by new material, such as reports from the Norwegian Veterinary College, official veterinary statistics and other official documents. In addition, historical contributions on the formation of the veterinarian profession, such as Horne (1925) and Frøslie and Ødegaard (1991), are used as sources and as guides to other documents.

In the following, veterinarians’ involvement in public health and food control at a local level is explored first. Then, the central veterinary administration is investigated. These sections outline the central characteristics of veterinary public health activity and the legitimacy of this activity. The discussion that follows focuses on what this activity meant for the professionalization of veterinarians in Norway and, more generally, the role of niches within professions.

Public health and food control

Public health legislation in Norway was first implemented with the Public Health Act of 1860, which required local authorities to organize boards of health. These local boards were headed by the city physician, a chief medical officer, employed by and answerable to the state. Although Norwegian cities were rather small, some saw enormous growth in the second half of the 19th century and experienced public health problems similar to those of other European cities (Rosen, 1958/1993).

The cholera epidemics of the 1830s and 1850s, when temporary city health commissions were set up to combat them, provided an important background for Norwegian public health legislation (Benum, 1979). This legislation was inspired by an international awareness of public health problems but especially by the British Public Health Act of 1848 and what followed (Berg, 1986). Problems with housing, poverty, alcoholism, food supply, food adulteration and the flow of infectious diseases were considered to be of vital importance. The hygiene situation in the cities during industrialization was of serious concern in across Europe (Porter, 1994). Illnesses and unrest threatened order, as well as life and health. Such problems were also addressed in Norway, where the boards of health and many city physicians played an active role following the introduction of numerous public health initiatives, such as supplying water, opening public baths and regulating sewage.

Veterinary administration

Norwegian public administration dates back to 1814 when Norway was separated from Denmark and forced into a union with Sweden that lasted until 1905. However, during the union with Sweden, Norway was allowed to keep the main provisions of its 1814 constitution and its parliament, the Stortinget, which required the building of a state apparatus. However, the state bureaucracy was small, and resources were few (Svalestuen, 1988).

Within the field of health administration, beginning in 1858, accounts of veterinary matters were included in the government’s Annual Health Report. In 1865, the government allocated money to the fight against imported or endemic contagious livestock diseases (Horne, 1925), and in 1867, a military veterinarian was engaged to serve as a consultant to the administration responsible for health. The first Director of Health was employed in 1875, and the administration of health was moved from the Ministry of Interior to the Ministry of Justice in 1878; veterinary issues were included in health administration. The number of veterinarians was low, however, and according to Horne, recruiting veterinarians was difficult due to poor working conditions and a lack of interest in sending students abroad. From 1886, veterinary reports were published separately under their own titles (Norwegian Official Statistics), but the responsibility for them remained with the administration of health.

From the 1870s, ministries started to employ specialists in order to serve and support the development of important fields. For example, an agricultural expert was hired as a consultant and later became a Director of Agriculture. Government counselling agencies were established from the 1870s to promote new technologies in agriculture. This was a dual strategy: reforming agriculture was important in itself but also for the Norwegian nation-building process (Jacobsen, 1964). In the field of health, as well as that of agriculture, expertise was included in the central administration, even if the resources were few.

Until 1890, the veterinary and human health administrations were placed under the purview of the Ministry of Justice, where the Director of Health licensed veterinarians and compiled veterinary statistics (Svalestuen, 1988). Licensing depended on education from an approved institution and citizenship. The state only licensed veterinarians educated abroad, most often from Copenhagen, but also from Stockholm. On October 1, 1890, the Ministry of the Interior took over veterinary issues from the Ministry of Justice (Horne, 1925). Later, from 1900, veterinary issues moved to the new Ministry of Agriculture.

Health administration was also undergoing changes in the years around 1890. These changes are interesting and must be understood as elements of larger, more comprehensive changes in Norway’s state and nation building, in relation to policy and administration. Such changes will not be discussed further in this article, however.

Discussion

The field of food control in the Norwegian context was open to the veterinarians, in collaboration with physicians, in public health activity in the cities. Milk and meat inspection were fields that veterinarians had the competence to cover. Their knowledge of animals and their laboratory skills in a time of growing interest in bacteriology and microbiology was useful.

In the interplay of food control, administration, and research, the Norwegian veterinary profession was formed. The profession’s entrepreneurs leaned towards food control, especially meat inspection. Meat control was an essential part of food control in the cities, and veterinarians gained a monopoly in this field. It is reasonable to claim that veterinarians acquired legitimacy from their work in public health in the cities and that this strengthened their overall position. Using meat inspection as the lever, the veterinary administration was separated from the health administration at the central level. This allowed veterinarians to obtain positions in the ministry with a Veterinary Director equal (rather than subordinate) to the Director of Agriculture.

Co-operation with physicians was important. Even though food inspection was not considered to be important by representatives of veterinary medicine, city veterinarians were included in local public health partnerships. Veterinarians concerned with hygiene may be seen as belonging on the fringe of the profession, but veterinarians served in local health administrations and had public positions. Some cities also had partnerships in research.

The legitimacy that city veterinarians and meat inspectors acquired seems to have strengthened the position of veterinarians in general. Norwegian physicians transferred responsibility for food control to veterinarians; food control was available to veterinarians, and physicians were willing to allow them to manage this area. We see a segment of the profession with a monopoly on the overseeing of slaughterhouses, a practice important to public health. Veterinarians thus earned a specific role in the new Norwegian state, even if the numbers were small; a majority of the licensed veterinarians were employed by the state or city, in 1895 (58%) and 1920 (63%) (NOS, 1895, 1920). This was a state-financed and state-built profession, and the veterinary profession can be seen as a statist profession, educated abroad, often on public scholarships.

From the beginning, there were strong connections between veterinary public practice, veterinary administration and veterinary science in the cities. Veterinary education had a scientific orientation as early as the 1820s, and in Malm’s time, nearly a century later, this principle was maintained; the norm of science seems to be strong. When the Norwegian Veterinary College opened in 1935, it offered a veterinary medical education. Its first rector, Halvdan Holth (1880–1959), combined his position as rector with that of director of the Veterinary Laboratory (Frøslie & Ødegaard, 1991). Veterinary research was performed in a dual institutional context, in the Veterinary Laboratory from its opening in 1891, but also within the Boards of Health in cities such as Oslo and Bergen.

Public health activity may be a field that, in general, contributed to legitimacy. Magali Sarfatti Larson (1977, p. 39) underlines that physicians, in general, benefited from the respect that physicians earned in public health during the years of epidemics in the 1850s—respect that gave physicians “capital” that could be used in other situations and contexts. This is in line with the view that public health or hygiene activity and psychiatry contributed legitimacy to the medical profession, as both activities concerned order and were linked to basic functions of the authorities (Elvbakken & Ludvigsen, 2016). Similarly, for veterinarians, city public health activities generated valuable respect for the authorities responsible for securing health and order. Malm took possession of the field handed over by the director of health. One may ask why. Many reasons can be found. For one thing, this may be understood as the result of a situation in which the field of hygiene was wide, and where other forms of expertise were needed. For another, Norwegian public administration was in its formative years and was relatively open to efforts made by entrepreneurs. If the Director of Health Holmboe was less interested in food and meat control than the former director—who had proposed the meat control legislation—perhaps this helps to explain how the field was ceded.

In addition to public health activity, the veterinary administration was important in the prevention of animal disease. As Asdal and Druglitrø (2014) underline, the veterinary authorities banned the importation of live cattle from Sweden in a period of threatening infectious cattle disease, which was important for the nation-state as it was seen to be connected to Norwegian efforts to gain independence from Sweden in the years up to 1905. The fact that veterinarians were working to prevent animal diseases by hygienic efforts would have supported the economic interests in the agenda of the agricultural Directorate, to use the concepts discussed by Asdal (2006).

This professionalization process demonstrates the close relationship between the vets and the city authorities, as well as the significance of the combination of scientific work with hygiene inspections in promoting the profession. This finding supports the view that we should examine not only the core practices of professions but also what might be regarded as fringe practices that may have been viewed differently in other situations. Different practices can provide access to groups of clients (such as city authorities) and reference groups (such as scientific networks) that are important to the strength of a profession. Insights from Bucher and Strauss (1961) have motivated the present discussion of the role of veterinarians in public health. In line with Abbott (1988), this is studied as a possible niche activity. I argue that practices at the fringes of veterinary jurisdiction contribute to the profession as a whole and that niches may be as important as core areas.

Conclusion

Food control veterinarians provided valuable knowledge to the state. They cooperated with the physicians of the cities and central government. This case may provide a nuanced picture of the professionalization of veterinary medicine. Microbiological and bacteriological research in veterinary medicine provided useful knowledge for food inspection, and the Boards of Health were partners in hygiene research. The interplay between research and administration illuminates the formation of the Norwegian veterinary profession in a significant way. Veterinarians earned respect and authority through their practices in the field of public health.

In Norway, with a new and rather small state administration, an independent veterinary administration came early. In the laboratory, veterinary entrepreneurs combined research and administration. The contributions of veterinarians to public health, research and the directorate paved the way for the professionalization of veterinarians.

This case study may illustrate the importance of studying professions not as united entities but as groups of professionals or segments with some common characteristics and varying practices, knowledge bases and orientations. The important features of one field of practice may promote the process of professionalization. Scholars represented in the contemporary profession literature call for studies with comparative perspectives, across countries and professions over time (Brante, 2011). I argue that the case of the Norwegian veterinary profession can contribute to a more general discussion about the understanding of professions and professionalization, focusing on the roles that one segment—veterinarians in public health and their field of practice—had in the process of professionalization. Public health engagement offered co-operation with the vital interests of the city and nation in the late 1800s when industrialization and urbanization were connected to a rise in epidemics and threats to the good order of cities. Public health dealt with important societal problems, which in turn gave public health and veterinarians’ status and authority in the cities. This cooperation contributed to a scientific legitimacy that, in turn, was important to providing a scientific basis for education, even if it came very late.