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8 Mar 2007 : Column 549WH—continued

From that point of view, this modest Bill looks like a great leap forward.

We have listened very carefully to what coroners have said. We have listened to the voluntary organisations, such as Inquest. We have listened to, among others, the very important organisations that are analogous to the Victim Support witness service. The people in those organisations are volunteers who meet people and help to explain the system, and I pay tribute to them. We have listened carefully to the views of bereavement organisations, which are mostly self-help groups comprising those who have been bereaved in particular circumstances. I will take the points made by hon. Members as part of the consultation as we develop the Bill’s substance.

When we get to the substance, we want national standards, delivered locally. We want the system to be prompt, sensitive and contestable. That is where complaints and appeals are so important. With a system that is neither inspected nor has any proper
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appeal system, it is not possible to ensure the right quality of decision making. That would be dealt with in the Bill. We want the system to be professional. When I talk about whole-time coroners, it is so that we do not have a situation in which the local coroner, who is part of a solicitors’ practice and is also the coroner investigating deaths, feels pulled and pushed between his responsibilities to his firm and his responsibilities to his public office. That is not acceptable.

I am not saying that there cannot be part-time coroners, but they must be whole-time coroners—I am sorry to be confusing about this. They must not be doing another job as a solicitor. There could be part-time coroners, but they could not be part-time coroners and part-time people in a solicitors’ firm. One problem with that is that conflicts of interest arise. Somebody might be sitting as a coroner in relation to a hotly disputed inquest at which one branch of the family has been represented by the coroner’s solicitors’ firm. If somebody from a local firm of solicitors is the local coroner, conflicts of interest can arise.

Dr. Whitehead: There is an enormous amount of warmth for the thrust of the measures that my right hon. and learned Friend proposes, and a wish to get on with them. Perhaps the issue about local government funding is that a number of local authorities have now discovered that they are funding coroners’ courts and therefore the genie will not go back in the bottle in terms of the rather hazy arrangements that there were before. The question of national standards with local delivery will perhaps be considered in terms of local authorities saying, “We now have even less control over what we are providing, because of that national framework,” and questioning how that system works. At the very least, an understanding of how it operates—an understanding of, for example, what real money is being spent, including money that is below the counter, as it were, as well as above the counter—could inform that debate in the future.

Ms Harman: I very much appreciate what my hon. Friend says. What he describes might well be the next step, but the Bill sets out the important first steps. That is the best I can say at this point.

We want the system to be prompt, sensitive, contestable and professional. We want its proposals and findings to be acted on. That is all in the Bill. We have listened to what people have said about deaths abroad. We will not restrict coroners’ inquests in relation to deaths abroad in the way that was in the draft Bill. We are changing our mind on that. We are making a U-turn, because of what people have said. We are making a U-turn on juries for deaths at work as well. We have put proposals in the draft Bill. People came forward with views, such as the one about the case of the young man, Christopher Rochester, who died on Rhodes. We thought about whether our Bill would be all right in those circumstances. It did not look as though it would be. Therefore, we have changed our position.

Resources were mentioned. I have to say to the hon. Member for North-West Norfolk that the new service would not be cost-neutral; it would cost an additional £6 million a year and implementation or start-up costs would be £15 million.

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Death certification is mostly the area of my colleagues in the Department of Health, but hon. Members have complained about where we differ from what has been proposed by Dame Janet Smith and Tom Luce, and they have asked about death certification. We have been working across the Government to identify ways in which the system can be improved.

In responding on behalf of the Government to the Shipman report, my right hon. Friend the Secretary of State for Health said in the House on 21 February that her Department would produce proposals to improve the death certification system. That is likely to involve an independent check on all certificates, carried out by a medical professional employed in a clinical governance capacity and attached to a hospital or primary care trust. There is no blueprint for that medical capacity, but there is a determination that it should be available. The individual would scrutinise the first doctor’s death certificate and investigate as necessary—for example, by looking at the medical history and interviewing the certifying doctor or the family. If there were concerns, the death would be referred to the coroner in the usual way.

Our Bill would provide an opportunity for families to make a referral to the coroner. One of the problems is that if families are suspicious, they do not necessarily have the ability to make a referral directly to the coroner. The Bill would make that possible.

Mr. Beith: That is where cross-Government work is not working. The Minister relied heavily on her brief from the Department of Health to address that point, although I do not criticise her for that. The system could lead to a three-stage medical examination, because the coroner’s medical adviser will have to check, on behalf of relatives, what the medical examiner who was employed by the trust has done. Will the Minister look into that on the public’s behalf to ensure that the medical examiner of death certificates is sited in the coroner’s office? That is logical and would fit naturally into her Bill. Her Department has to start asserting itself.

Ms Harman: I hope that we combine the right degree of assertiveness and co-operation when working with colleagues in other Departments. Primary care trusts have to be concerned about ensuring that patterns of malpractice in general practice are identified and about spotting the early warning signs of bad practice or criminality. I am working closely with my colleagues in the Department of Health to ensure that we propose the right solution.

I pay tribute to the work of my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble), who is the chair of the all-party group on Army deaths, which does important work. I hope that she, the Secretary of State for Defence and I will meet to take matters forward.

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I also pay tribute to the all-party group on funerals and bereavement, which deals with the burial industry and graveyards, which my hon. Friend the Member for Nuneaton (Mr. Olner) chairs. Such matters are not glamorous, but they are incredibly important to our constituents. As my hon. Friend the Member for Llanelli said, these issues will not hit the front pages of newspapers day in, day out, and nobody particularly thanks Members of Parliament who take up the cases of constituents who have a problem with an inquest.

Nobody particularly fights to have ministerial responsibility for graveyards and coroners, but, as my hon. Friend made absolutely clear, that is incredibly important, and not just in terms of learning lessons and making changes. The system should treat people who have had terrible bereavements properly; it should help to answer their questions and not make matters worse. That is what we are trying to do with the Bill.

5.2 pm

Mr. Beith: I thank my colleagues on the Committee and other hon. Members for their contributions, including the hon. Members for Southampton, Test (Dr. Whitehead), for Llanelli (Nia Griffith) and for North Durham (Mr. Jones), my hon. Friend the Member for North Southwark and Bermondsey (Simon Hughes), and the hon. Member for North-West Norfolk (Mr. Bellingham). They all made valuable contributions.

I also thank the Minister for her response. I hope that she will write to me about one or two of the points that she was unable to cover, such as post-mortems and religious objections to them, which I believe the Government are still considering. We all want to help her to get the Bill on the statute book, because we are conscious of how urgent the need for legislation is, but we cannot ignore the fundamental problems that we have identified. There can be few present who do not still feel uncertainty as to whether the chief coroner and the national structure can deliver very much if the complex resource and power problems that will remain in the system are not sorted out.

Several of us who looked into this matter remain very dissatisfied with the idea of medical examiners being sited in the employing trust of the institution at which criticism may be directed at the inquest or in subsequent negligence proceedings. The right place for those medical examiners is in the coroner’s office. I genuinely believe that the Department of Health needs to sit down with the Department for Constitutional Affairs and work through this issue. The proposals are very good in many ways and will fill the gap that we were worried about, but they retain a fundamental weakness. I do not intend to leave the Minister alone on this; I shall continue to pester her, because I know that that will make her continue to pester her officials and Department of Health officials. We have to get this right and we have to get it right soon.

Question put and agreed to.

Adjourned accordingly at four minutes past Five o’clock.

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