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Session 2008 - 09 Publications on the internet Public Bill Committee Debates Coroners and Justice Bill |
Coroners and Justice Bill |
The Committee consisted of the following Members:Alan Sandall, Committee
Clerk † attended the
Committee Public Bill CommitteeTuesday 24 February 2009(Afternoon)[Mr. Roger Gale in the Chair]Coroners and Justice BillClause 15Post-mortem
examinations 4
pm Dr.
Brian Iddon (Bolton, South-East) (Lab): I beg to move
amendment 188, in clause 15, page 8,
line 22, after ‘practitioner’, insert
‘including a
radiologist’.
The
Chairman: With this it will be convenient to discuss the
following: amendment 363, in clause 15, page 8,
line 25, at end insert
‘, so long as he or she is supervised by a
qualified
pathologist.’. Amendment
190, in
clause 23, page 13, line 31, after
‘staff’, insert
‘including staff available outside normal
office
hours,’. Amendment
189, in
clause 37, page 22, line 37, at
end insert ‘“post mortem
examination” includes both invasive and non-invasive
examination;’.
Dr.
Iddon: I am sure that you will be pleased to hear
that I have no correspondence to shuffle today, Mr. Gale,
just as I did not have any correspondence to shuffle in our last
sitting week, despite the fantasies of journalist Henry Porter in
The Observer the Sunday before last.
The
amendments are interrelated. About 10 years ago, Her Majesty’s
coroner for the Manchester Central jurisdiction, Len Gorodkin, proposed
that post-mortems should be possible by non-intrusive examination of
bodies by magnetic resonance imaging. He had the sizeable Jewish
communities in Greater Manchester in mind when he made the proposal. In
the past few years, working mainly with the Bolton Council of Mosques,
Her Majesty’s Manchester West coroner, Jennifer Leeming, has
developed the technique into an acceptable way of carrying out
post-mortems, and the so-called Bolton protocol has spread to other
Greater Manchester boroughs and towns and cities throughout the
country. The
Manchester West jurisdiction covers Salford, where there is a sizeable
Jewish community, Bolton, where there is a sizeable Muslim community,
Wigan and Leigh, but I should stress that MRI post-mortems are
available for the whole community, not just the Jewish and Muslim
communities. Some families have asked for MRI post-mortems because they
need the procedure to be carried out in a hurry—for example, if
they are visiting a loved one in this country who dies, and they need
to return quickly to their own country because of their
occupation.
The
Manchester West jurisdiction is one of the 10 busiest in the country,
with more than 4,000 deaths reported each year, costing the council tax
payers in the four local authority areas £1,434,000 each year.
Council tax payers in the jurisdiction therefore bear a higher cost
than council tax payers in other
jurisdictions.
Mr.
Tim Boswell (Daventry) (Con): Does the hon. Gentleman
agree—he might have said this—that there is often a quite
important religious and ethnic minority interest in swift burial or
disposal? If formalities have to be undergone, they could extend the
process and the degree of concern in those
communities.
Dr.
Iddon: The hon. Gentleman is correct—that is the
main reason why the procedure has been developed in the Manchester West
jurisdiction. The
average cost of an MRI post-mortem is £885 and 50 to 60 are
carried out each year. They are usually carried out overnight, when the
MRI scanners are not required to scan living people, for obvious
reasons. Costs are usually met by the family, but the Jewish Burial
Board in Greater Manchester meets the cost of a scan for its
members. Consultant
radiologists play an important role in determining whether an MRI
post-mortem will reveal the cause of death, which is the reason for
amendment 188. Radiologists feel strongly about their inclusion in the
Bill.
Of the 50 to
60 examinations carried out in this way, perhaps one will have to be
referred to a pathologist in the end because the MRI post-mortem did
not reveal the actual cause of death. That is explained to the families
who choose to undertake the
procedure. One
advantage of an MRI post-mortem over a pathological examination is that
the results can be kept on a disc for future examination, if necessary.
Also, it is usually quicker than a pathological examination, especially
when histology samples must be sent away for analysis, which can take
several days or sometimes even weeks.
The
Manchester West coroners’ jurisdiction provides a full
out-of-hours service for the issue of documentation for the release of
deceased persons for burial, cremation or even removal from the UK,
which is common in Muslim communities. In Manchester West, not only Her
Majesty’s coroner but the administrative assistant who issues
such documents is available out of
hours. I
am pleased that the Bill’s explanatory notes refer to such
post-mortems, on page 26. The procedure is at least now recognised by
this Government. The power to request a post-mortem examination by MRI
scan is underpinned by clause 16, which we shall consider in a moment.
The clause gives the coroner the power to move a body between
jurisdictions.
Obviously, an
MRI scanner might not be available in the coroner’s own
jurisdiction. Non-invasive MRI post-mortems are not yet available for
children in Greater Manchester, as no participating paediatric
radiologist is available. In such cases, it would be necessary to move
the body from Greater Manchester to Sheffield, where the nearest
consultant paediatric radiologist is located. Here in the south, Great
Ormond Street children’s hospital also has a specialist
radiologist. To
summarise, radiologists feel strongly that MRI post-mortems are a
developing technique that will spread rapidly across Britain,
particularly in the communities that I have mentioned, and that will
involve a considerable number of our citizens. They feel that now is
the appropriate time, as an opportunity such as the Bill comes only
rarely, to put radiologists on the face of legislation. That is the
substance of amendment 188.
Amendment 189
is consequential. It defines a post-mortem as either invasive or
non-invasive. Again, the coroners to whom I have spoken, such as
Jennifer Leeming in the Manchester West jurisdiction, and radiologists
feel that there should be a definition in the clause along the lines of
my amendment.
Clause 23
relates to providing accommodation overnight and at weekends. I remind
right hon. and hon. Members that coroners, by the nature of their
employment, must make themselves available 24/7, so that is not a
problem. Jennifer Leeming, in my jurisdiction, is always available if
needed. Furthermore, administrative assistants are provided in the
Greater Manchester West jurisdiction as well. The cost of the provision
is not excessive and would be met in most cases by the charge for the
MRI scan in the first place. I have pleasure in urging the Committee to
accept the two amendments, particularly amendment
188. Mr.
Henry Bellingham (North-West Norfolk) (Con): I welcome you
to this afternoon’s sitting of the Committee, Mr.
Gale. The
suggestion of the hon. Member for Bolton, South-East that we put the
term “radiologist” on the face of the Bill makes a great
deal of sense. I rise to speak to our amendment 363, which would ensure
that if a suitable practitioner is not a registered medical
practitioner, he or she is supervised by a qualified
pathologist.
There may
well be cases when such scans are carried out by relatively junior
technicians. As the hon. Gentleman suggested, the use of such highly
sophisticated medical equipment will probably take place out of hours.
He also alluded to the fact that in two of the great religions in this
country, Judaism and Islam, there is an imperative that bodies be
released for burial the following day, if at all possible. I am
concerned that short cuts should not be taken and that, where fairly
junior technicians are in charge, they should always be supervised by a
qualified pathologist.
Our
amendment speaks for itself. I hope that the Minister understands why
we are keen to put that extra safeguard in place. I agree with what the
hon. Member for Bolton, South-East said in speaking to his amendments.
That aside, it is a good clause, and it should command the support of
the entire Committee.
Jenny
Willott (Cardiff, Central) (LD): This is clearly an
important matter for religious reasons, and it is important for those
who are suffering a bereavement in the family, for whom it is clearly a
difficult time. Having to reconcile one’s religious feelings and
beliefs with the British justice system can be difficult. It is
appropriate that we be as sympathetic as possible.
I support the
amendments tabled by the hon. Member for Bolton, South-East. The
proposal seems to be a sensible way forward, particularly as it works
in the jurisdiction where his constituents live. However, it has been
suggested to various members of the Committee that coroners should have
a duty to make families aware of the option for the non-invasive
post-mortem as well as the surgical post-mortem.
In areas such
as Manchester, the technique is well known; it is supported and
promoted and people are aware of it. In other parts of the country,
however, religious communities may be much smaller and less well
represented. They may not have the support of the surrounding
community, and they may not be aware of the options if they feel
strongly that a post-mortem should not be carried out. Will the
Minister say whether it would be possible to require information on
what is possible and what is available to be spread more
widely?
The
Parliamentary Under-Secretary of State for Justice (Bridget
Prentice): Welcome, Mr. Gale, to this
afternoon’s discussions.
I entirely
understand why my hon. Friend the Member for Bolton, South-East (Dr.
Iddon) tabled the amendments, but I believe they are unnecessary for
two simple reasons. First, all practising radiologists should also be
registered medical practitioners; they would therefore fall within the
definition of a “registered medical practitioner” under
clause 15(3)(a). I suspect that we would all be a little uneasy if
someone who was not a registered medical practitioner were able to
carry out the post-mortem procedure—invasive or
otherwise—without having been designated as suitable by the
chief coroner.
Secondly, we
want only those who are properly trained and qualified to carry out
such procedures. In clause 15(3)(b), we provide the necessary assurance
that only those who are registered medical practitioners or who are
otherwise recognised by the chief coroner as possessing the relevant
skills can carry out such procedures. For example, that would apply to
some toxicologists, forensic scientists and forensic archaeologists as
much as to radiologists.
Amendment
363, tabled by the hon. Member for North-West Norfolk, goes too far in
the opposite direction. Saying that we would need a qualified
pathologist to oversee people who, by definition, are already qualified
medical practitioners—they would have to be so for the coroner
to have allowed them to carry out the post-mortem—is over-egging
the pudding. If the chief coroner had any doubt about the suitability
of certain individuals, either he would not appoint them or he would
take advice from the national medical
adviser.
Mr.
Boswell: I am conscious that the General Medical Council
is putting in place requirements for quinquennial recertification and
demonstration of fitness to practise for general medical practitioners.
Can we have an assurance that the chief coroner will at least look at a
system that shadows that for persons whom he approves, so that such
approval will not be lifetime approval, but will be subject to regular
review?
4.15
pm
Bridget
Prentice: That is a very positive and constructive
suggestion, and I will certainly take it forward. That is exactly the
way to ensure that we raise standards right across the coronial
system.
If the
medical adviser is able to advise the chief coroner that a person is
suitably qualified, another qualified pathologist should not be
required to be present to oversee their work and to ensure that they
carry out the post-mortem in a proper fashion.
On the points
raised by the hon. Member for Cardiff, Central on the availability of
MRI scans, we certainly want to encourage coroners to use non-invasive
post-mortems as well as invasive ones. In future, coroners should make
people aware of the opportunity to use that form of post-mortem,
although it is slightly more expensive. The problem at the moment is
that not every area can benefit from the work of people such as
Jennifer Leeming or from facilities such as those in Greater
Manchester. Over time, however, I would like such facilities to become
available across the country, so that non-invasive post-mortems might
become more common. I say that not only because of the religious
reasons that have been mentioned, but because families might have other
reasons for feeling that such a post-mortem is appropriate.
On amendment
189, it is not necessary to set out in the Bill that post-mortems
include invasive and non-invasive post-mortem examinations, because the
drafting of the Bill outlines that. To be clear, however, let me say
that the provisions that refer to post-mortems do indeed apply to both
invasive and non-invasive
post-mortems. Finally,
my hon. Friend the Member for Bolton, South-East talked about coronial
staff being available 24 hours a day. Clause 23 makes it clear that
staff have to be available to ensure that the coroner can carry out
their functions properly. In effect, that means that someone has to be
available 24 hours a day to ensure that a post-mortem could, for
example, be carried out urgently in the middle of the night. It is
implicit in clause 23 that staff will be available outside normal
office hours.
On that
basis, I hope that my hon. Friend will withdraw his amendment. For the
reasons that I have outlined, I also ask the hon. Member for North-West
Norfolk not to press his amendment.
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