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There is also the question of the proper recognition of the coroner service. I was grateful for the note that I received from the coroner for Essex and Thurrock, Caroline Beasley-Murray, who stressed the importance of the service while emphasising the need for training
and a career structure. She hoped that that aspect would be dealt with through regulations, even though the Bill is silent on the issue. Perhaps the Minister will be prepared to reflect on that aspect of the service as the Bill goes into Committee.
I want to come back to clause 11 and the certification that would do away with a jury and enable an investigation to be held in private. I do not want to repeat the important points that have been made by other hon. Members, except to comment on the Secretary of State’s point about the availability of judicial review. He said that there would be a right to challenge a decision on whether certification could take place. I have one fundamental question on that. If such a decision had been made on the basis of information that, by its very nature, had to be kept secret, how could someone challenge it on an ex parte basis and argue before a judge that there had been a procedural irregularity or that the decision had been unreasonable or irrational? A high hurdle would have to be overcome in order to gain protection in such circumstances, particularly in the context in which that right is intended to be framed.
I also want to talk about the thorny issues of data protection and data sharing. The last time I had the opportunity to debate these issues was during our consideration of the Serious Crime Act 2007, when we actively considered the use of data sharing and data matching to combat serious crime and fraud. The rules that were put in place by that Act were carefully crafted, and recognised as being there for a specific purpose. However, this Bill effectively drives a coach and horses through certain provisions, and does not properly take account of the fact that there are rights of ownership involved when we give personal information to other agencies, or that that information is given for a specific purpose. It is all very well to say that codes of conduct will buttress the provisions in some way, but the proposals are very wide-ranging and overarching. Once they are in place, there will be no real ability to change them.
Anne Main: Will my hon. Friend give way?
James Brokenshire: I will not give way, unfortunately.
The Bill seeks to justify some of the big databases that the Government propose to create. To my mind, this underlines a new concept for the Government in the creation of large databases and the storing of information at potential risk. They seem to be saying that in order to deliver services, they need to know almost everything. That is what is driving the creation of these databases. However, if that information is already at risk, because of the honeypot effect that makes it vulnerable to attack by cybercriminals and those who want to use it to perpetrate cybercrime—one of the fastest-growing kinds of crime in the country—we need robust measures to ensure that those data are properly protected.
If we then factor in the idea that the data will be shared with other agencies for those specified purposes, the chain is only as good as its weakest link. Information may have been provided to a particular agency in the knowledge that data protections would be in place in that area, but if it is then shared with other agencies, the standard of vigilance and the standard of data protection may not be as high. That alone shows how data sharing may create a further risk of cybercrime. Equally, there is the issue of insider risk in terms of the integrity of the
information, where it resides, and the role of individuals who may take the information and sell it on for their own personal gain to those who may wish to misuse it.
Because we are going down this route, those activities may make us all less safe as individuals, which shows why this whole approach needs to be considered very carefully. It also shows why it is so important that the definition of what information is used for, and to whom it is provided, is framed in primary legislation. As currently framed, it seems as if this law will enable the Government to drive a coach and horses through fundamental legislation, including the Data Protection Act itself, and the protections encompassed within it. To my mind, that simply cannot be right. If those provisions remain as they are, it is difficult to see how they can possibly be acceptable.
My reading of the Bill is that it seems not only to allow the transmission of information between Government Departments, but to envisage that the information could, if it were serving a certain purpose, be transferred outside the UK—even though normal protections in the Data Protection Act would ring-fence it within the EU.
With the Government asking for that information and those rights, it almost comes down to a question of trust: do we trust the Government to use them appropriately? Sadly, the Government’s record in holding our data, securing them and making sure that they are not misused is not good. The trust that we have put in the Government to do that has been misplaced. Until we can have confidence in how our data are stored, how they are used and how standards are maintained—and, as I believe they should be, raised—many people will ask, “Why should we trust the Government to receive those wide-ranging powers if at this stage we cannot even trust them to keep our information secure?” Until the Government can answer that question, they need to go away and think again.
9.22 pm
Mr. Marsha Singh (Bradford, West) (Lab): I would like to speak about a very narrow area of this legislation—the Bill makes the tiniest of references to it—as it might have an even greater impact than the other proposals on many people. I am talking about non-invasive surgery.
My attention was drawn to the issue of non-invasive post-mortems following the information that such surgical practices were happening in the Manchester area. I was approached by members of my local Muslim community to find out what was happening there, and whether it was possible for it to happen in Bradford. To that end, I established a steering group of local people, involving Ghulam Rasool of the Bradford council for mosques, Councillor Imran Hussain and Maulana Fazal Dad of the council for mosques, Idris Bashir, Aurangzeb Khan, a community activist, and Michael Levy, a solicitor from Manchester and legal adviser to the group.
The group considered a range of issues, which I will try to summarise. First, it considered technological advances such as the MRI scanner, which made non-invasive post-mortems possible. Secondly, it noted that for certain religious groups, such as Muslims and Jews, the integrity of the body was paramount. Thirdly, it found that Muslims and Jews, in particular, must bury the body as soon as possible, and that in some cases the
MRI scanner could make that possible. Fourthly, the group also felt that people of other faiths, and no faith, would in some cases also prefer to have non-invasive post-mortems.
Before I continue, I want to thank the Under-Secretary of State for Justice, my hon. Friend the Member for Lewisham, East (Bridget Prentice), for meeting me privately to discuss the issue and for agreeing to meet a delegation from the Bradford steering group. We hope that Jennifer Leeming, Her Majesty’s coroner for the west Manchester district, will also attend that meeting. Her contribution has been invaluable, and I applaud her and her staff for the pioneering and groundbreaking work that they have done in the Manchester area. I hope that she will see the fruit of her labour enshrined in legislation. If any hon. Member thinks that this is an awful idea, they know who to blame.
MRI scans of deceased persons are done out of hours, usually in the evening or early morning. They do not therefore prejudice or delay any access by live patients to the scanner, nor do live patients come into contact with the deceased or their attendants. In the Manchester jurisdiction, the option of non-invasive post-mortem by MRI scan is discussed with all who object to invasive post-mortems for whatever reason. If a request for non-invasive post-mortem by MRI scan is then made, it is discussed by Her Majesty’s coroner or her staff with the consultant radiologist, who carries out the procedure to ascertain whether the medical and other history of the deceased person is such that an MRI scan is likely to reveal the cause of death.
If a scan is undertaken but is unsuccessful in revealing a cause of death, Her Majesty’s coroner will consider proceeding to an invasive post-mortem. The bereaved are advised that that is the case before the scan is agreed. Some cases are entirely unsuitable for scan. For example, a scan is not suitable if a police investigation that necessitates an invasive forensic post-mortem is taking place.
The cost of a scan is borne by the family or other party requesting it. That is understood by the Bradford steering group, and would probably apply across the country. When the scan is concluded, a disc recording the result is retained. Thus a scan has, to that extent, an advantage over the invasive post-mortem, of which there is no permanent record.
I shall now move on from scans to the out-of-hours service. If we want to speed up post-mortems and burials, which is especially important for the Jewish and Muslim communities, we need an improved out-of-hours service. I understand that the Greater Manchester West jurisdiction is the only jurisdiction in England and Wales offering a service that includes non-invasive post-mortems and invasive post-mortems out of hours. I press the Minister to look into out-of-hours service and, with regard to scans, to consider specifying radiologists as people who could be officers responsible within the legislation.
I have already received many representations about clause 152, on information sharing. One constituent wrote:
“I object in principle to personal information being given out without my express permission. Leaving aside the fact that the only people who seem to hang on like grim death to various bits of information about me are the biggest generators of junk mail,
I would still like to be able to decide who needs to know all about me. This Bill changes my position in a way that suggests that I was somehow a person in need of monitoring”.
In similar vein, another constituent wrote:
“I do not consent to such an abuse of my personal information...Our personal details should remain fully protected by the Data Protection Act.”
I ask the Minister to look again at the proposal.
Finally, I thank the Minister for introducing in legislation the non-invasive option. That is important to my Muslim and Jewish constituents, but equally to those of other faiths and no faith.
9.28 pm
Dr. Richard Taylor (Wyre Forest) (Ind): I thank the last few speakers for being so commendably brief. I am sure that I am the only person here who has ever signed a death certificate or cremation forms—both the first and second parts—so I am desperately keen to get in to speak. I think I have eight minutes, so I will cram as much as I can into them.
To prepare for the debate, I looked at the current death certificate, which is headed “Births and Deaths Registration Act 1953”. I do not think that that has been changed since 1953, and it is certainly the same as the last death certificate that I signed, which was at least 13 years ago. I looked back also at Dame Janet Smith’s brilliant and comprehensive third report following the Shipman inquiry. I shall remind the House of one or two things that she said.
First, the current system depends on the honesty of the doctor. Dame Janet said:
“Many of Shipman's patients died suddenly in circumstances in which no honest doctor could have claimed to know the cause of death. Yet Shipman, who had killed them, was able to certify the cause of death, avoid a report to the coroner and thus also avoid any official enquiry into the death.”
She went on to stress the importance of training, observing:
“A further problem with the current system is that the quality of certification is poor. Doctors receive little training in death certification.”
Certainly the training that I received was not really about the accuracy of the death certificate. It was about the terms that were acceptable to the registrar examining the certificate, who would be entirely unqualified.
The death certificate still contains some helpful notes. In very small writing at the bottom is the following advice on completing the certificate by giving the cause of death:
“This does not mean the mode of dying, such as heart failure, asphyxia, asthenia, etc: it means the disease, injury, or complication which caused death”.
I do not think that anyone nowadays would use the terms “asphyxia” and “asthenia”. Shipman, however, used the term “natural causes” in two of his death certificates. Dame Janet Smith draws attention to the fact that, amazingly, the registrars in Tameside did not know that “natural causes” was not acceptable as a cause of death. They had to get in touch with their superiors, who felt that it was acceptable, so Shipman got away with “natural causes”.
Another unacceptable term—some of us are probably already beginning to suffer from it—is “senile decay”. Even Shipman did not try to use that one. We were told
that an acceptable term was “bronchopneumonia”, and that as long as that condition was put first on the death certificate of any elderly person, whether he or she had had it or not, the registrar would accept it. It is clear from those examples that death certification is very inaccurate.
The form still asks whether the person certifying has arranged a post-mortem. Since Alder Hey, the rate of hospital non-coroner post-mortems has dropped remarkably. That has a tremendous downside. The first recommendation in the Health Committee’s 2005 report on venous thromboembolism states:
“We are concerned that the number of post-mortems being performed has decreased since Alder Hey. As a result the true cause of death is not being determined in many cases.”
I believe that it is very important to allow a number of hospital post-mortems to continue. If a senior clinician who has been looking after the patient approaches people for consent, that will not be too unacceptable. There are many good points on the certificate at present, but I want to know whether the Bill picks up Dame Janet’s recommendations.
At least cremation forms have been changed. One that I saw recently was drawn up in 2008. Cremation form 4 is now the first to be filled in by the first doctor. There is much more space for details of the cause of death and the examination carried out. Form 5, the old second form filled in by the confirming doctor, contains the same questions, but places a little more emphasis on asking the referee doctor to talk to the relatives or others involved. Question 6 reads:
“Please state the date and time that you saw the body of the deceased and the examination that you made of the body.”
Dame Janet Smith makes some play of that, feeling that examination at that stage is essential.
One must be realistic, and at present, all one can do at that stage is go into the mortuary and ask the mortuary attendant where the body is. If it is already wrapped up and in the fridge, all one can do is identify that it is, let us say, a white male or female with the right label on it. What examination can one conduct to help establish the cause of death? It is crucial that there is a system for the medical examiner who is to be appointed to conduct a proper examination at this stage, if no post-mortem has taken place.
Dame Janet Smith concludes with the recommendation that there should be one system of death certification applicable to all deaths, regardless of whether the death is to be followed by burial or cremation. There should be a requirement that the fact that a death has occurred be confirmed and certified. I welcome the parts of the Bill that go a good way towards fulfilling her requirements. However, along with many others, I do not welcome the parts that imply secrecy, or those that ride rather roughshod over data protection measures. And there I must finish, having used my allocated few minutes.
9.36 pm
Mr. Henry Bellingham (North-West Norfolk) (Con): First, I should declare an interest: I am a former barrister.
We have had a well informed and constructive debate, and we have covered a lot of subjects. That is unsurprising, however, as this Bill has clearly been cobbled together and covers many different subjects under one heading. As the hon. Member for Cambridge (David Howarth)
pointed out, it covers 28 different topics. I fear that the Bill will lack direction and focus, and I think it would have been much better if the Government had come up with four or five separate Bills.
On coroners, it is bad enough for our constituents to lose a loved one in a violent incident or accident, but all too often the resulting inquest is a thoroughly traumatic and bewildering experience. Reform is, therefore, long overdue. I noted that the Coroners’ Society said:
“If the coroner service is neglected, then society also neglects the bereaved.”
I think it was Edmund Burke who said:
“The true way to mourn the dead is to take care of the living who belong to them.”
I am indebted to Victims’ Voice for that quote, which is highly pertinent to the Hillsborough families, whom the right hon. Member for Knowsley, North and Sefton, East (Mr. Howarth) referred to so movingly.
As I have said, the coroner service is long overdue for reform. The Shipman inquiry under Dame Janet Smith and the excellent Luce review both took place almost five years ago. They were followed by the Government’s draft proposals in 2004. Reform is better late than never, however.
A great deal in part 1 of the Bill is to be welcomed. I agree with the comments of the hon. Member for Blackpool, North and Fleetwood (Mrs. Humble), who made a well-researched speech, and I congratulate her on the work she has done on behalf of bereaved service families. I welcome the creation of the posts of chief coroner and deputy chief coroner. We welcome the new appeals system, too, and the powers to transfer investigations of deaths to another coroner. That is highly relevant to military inquests, and I was very impressed by what the right hon. Member for Berwick-upon-Tweed (Sir Alan Beith) had to say on that subject. I have always found it strange that inquests involving the deaths of fallen servicemen and women could not be transferred to the district of the bereaved families, although I take on board the point made by my hon. Friend the Member for North Wiltshire (Mr. Gray) that it is important to recognise the expertise that exists in certain areas—he referred to Brize Norton in Oxfordshire and RAF Lyneham in Wiltshire. There needs to be more flexibility, however, and the Bill allows for that.
We welcome the new charter for the bereaved, but I agree with my hon. Friend the Member for Hornchurch (James Brokenshire) and the hon. Member for Stafford (Mr. Kidney), who both said that, in future, it is important for there to be far better co-ordination between the different agencies. The people putting together that charter should look carefully at the suggestions made by the hon. Member for Bradford, West (Mr. Singh) and at the points that he made about the use of MRI scans.
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