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I did indeed read the article to which the noble Baroness refers and, while I understand that it is an emotive issue, we have, at least in this House, the ability to understand the underlying fundamental facts of what is happening.

Lord Kingsland: My Lords, when the legislation went through Parliament about seven years ago, I do not recall the Government addressing the issue of a party who went into liquidation buying back the assets at a lower price. That is the core problem to which my noble friend Lady Gardner of Parkes has addressed her mind. Will the Government undertake to look at that legislation again in the light of the increasing amount of evidence that there is a real chance that there is inappropriate behaviour?

Baroness Vadera: My Lords, we will look, and indeed are looking, at the evidence from the administration’s pre-packs, in particular, and the returns that we are going to receive. We will see if there is evidence of any abuse or misuse both by company directors and insolvency practitioners. That is the place at which to root out any abuse that occurs. However, we must not forget the benefit of pre-packs: more jobs and companies are saved and there is a better economic outcome than by

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other sorts of administration in certain circumstances. It would be extremely unfortunate to lose that benefit because we are not able to understand the underlying facts.



3 pm

Asked By Lord Wallace of Saltaire

Lord Brett: My Lords, we deeply regret Russia’s decision to veto the extension of the United Nations Observer Mission in Georgia. We worked hard on a draft resolution that was acceptable to all, but Russia rejected the draft in an attempt to change the Security Council’s agreed position on Georgia’s territorial integrity.

We also regret that Russia blocked consensus on Greece’s proposals to continue the OSCE mission to Georgia. Russia’s counterproposals were unacceptable to the other participating states in the OSCE.

Lord Wallace of Saltaire: My Lords, I thank the Minister for that Answer and mark that the future of the OSCE must now be in doubt if Russia is going to use its veto to prevent that organisation doing anything useful. How closely are the Government now working with other members of the EU and other allies within NATO to make a common policy towards Russia that states that Russia’s policy towards Abkhazia and South Ossetia is not acceptable and that we do not accept the imposition of new boundaries in international law on a truncated Georgia?

Lord Brett: My Lords, the UN mission has no mandate to continue and must cease its patrols. That means that other elements of international monitoring, particularly the EU monitoring mission and the Geneva talks coming up on 1 July, are very important. It is important in that context, in the light of the demise of the UN and OSCE missions, that we support continuing work with partners to ensure that they can adapt their activities if necessary to ensure that we continue to have a presence in Georgia. We will continue to press Russia to live up to its international obligations in Georgia and we remain committed to our support for the territorial integrity of Georgia. There are number of meeting coming up in the next few days that provide the opportunity for a dialogue with both Russia and Georgia.

Lord Howell of Guildford: My Lords, having spoken with Russian officials only this morning, my understanding is that, although they are obviously being very difficult about Abkhazia and South Ossetia and are determined to regard them as separate countries, they have not in fact closed the door on a possible dialogue about a renewed UN or UNOMIG presence. Therefore, in the discussions that the noble Lord has mentioned are coming up in the next few days, will he bear in mind that, despite the apparent difficulties in principle, there

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are possibilities for getting some kind of mission going again to reinforce the EU mission, which is important, and maybe even for keeping the door open for a continued OSCE mission as well?

Lord Brett: My Lords, I thank the noble Lord for his question and, indeed, for his information in respect of speaking with Russian diplomats as recently as today. As I said earlier, the opportunities exist for dialogue. Today the Minister for Europe, Glenys Kinnock, departs for Georgia for a three-day visit. We have the G8 meeting in Trieste on 24 and 25 June, an OSCE informal ministerial meeting in Corfu on 27 and 28 June, a NATO-Russia Council meeting, which will take place on the margins of the Corfu meeting, also on 27 and 28 of June and the very important UN-EU OSCE meeting in Geneva. Those opportunities shall be used and will be a part of dialogue. I hope that the comments of the noble Lord are indeed borne out by those events.

Baroness Nicholson of Winterbourne: My Lords, will the Government consider, during these dialogue meetings that the Minister has told us are upcoming, the plight of the Abkhazian and Ossetian farmers who have been internally displaced inside Georgia through the Russian movement? Will the Government also consider some bilateral aid from the United Kingdom to Georgia, given that we, of all the EU member states, have perhaps the lowest gas imports from Russia, while countries such as Germany—our fellow member states—have as much as between 47 and 52 per cent of their imports coming from Russia and are therefore in a somewhat more difficult position?

Lord Brett: My Lords, I am sure that the noble Baroness has raised an important point and I am equally sure that that is part of the dialogue we wish to see. Humanitarian aid and, of course, the assistance of those who are suffering in Georgia and the disputed territories—that is, disputed by Russia—will be the subject of keen discussion. I will ensure that the points made by the noble Baroness will be passed on to the Foreign Office.

Lord Wallace of Saltaire: My Lords, my experience is that the Russians prefer blunt rather than delicate speaking. Could we not point out to them very clearly the entire contradiction between their current behaviour in the south Caucasus and in the north Caucasus where their suppression of minorities in Ingushetia and in Chechnya is causing increasing disorder every week, with assassinations and local conflict? Could we not ask for a dialogue with the Russians about the future of the Caucasian region as a whole as a means of moving forward?

Lord Brett: My Lords, the noble Lord has raised the issue of contradiction. Of course, there is a total contradiction in the position taken in respect of the Georgian territorial entity. As recently as February, Russia supported resolutions, which it now denies have effect. Therefore, I can do no more than say that the UK attitude should be, and is, best summed up in the words of your Lordships’ EU Committee report, which said that our policy should be:

“Hard-headed and pragmatic engagement and not isolation”.

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I am sure that that is the guiding message of the Ministers attending the various meetings and that all the points raised by the noble Lord are equally in the minds of Foreign Office officials when briefing those Ministers.

Arrangement of Business


3.06 pm

The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Davies of Oldham): My Lords, with the leave of the House my noble friend Lady Royall of Blaisdon will repeat the Statement on the European Council at a convenient point after 3.30 pm.

Business of the House

Motion on Standing Orders

3.06 pm

Moved By Baroness Royall of Blaisdon

Motion agreed.

Financial Services and Markets Act 2000 (Regulated Activities) (Amendment) (No. 2) Order 2009

Data Protection (Processing of Sensitive Personal Data) Order 2009

Transfer of Functions of the Consumer Credit Appeals Tribunal Order 2009

Transfer of Functions (Estate Agents Appeals and Additional Scheduled Tribunal) Order 2009

Transfer of Functions (Transport Tribunal and Appeal Panel) Order 2009

Transfer of Functions of the Charity Tribunal Order 2009

Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) (England and Wales) Order 2009

Criminal Defence Service (Provisional Representation Orders) Regulations 2009

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Banking Act 2009 (Restriction of Partial Property Transfers) (Amendment) Order 2009

Motions to Refer to Grand Committee

3.07 pm

Moved By Baroness Royall of Blaisdon

Motions agreed.

Coroners and Justice Bill

Bill Main Page
Copy of the Bill
Explanatory Notes
7th Report from the Delegated Powers Committee
8th Report from the Joint Committee on Human Rights
16th Report from the Joint Committee on Human Rights

Committee (3rd Day)

3.07 pm

Clause 16 : Post-mortem examinations

Amendment 41

Moved by Baroness Finlay of Llandaff

41: Clause 16, page 9, line 42, after “may” insert “after consultation with the appointed medical examiner”

Baroness Finlay of Llandaff: This group of amendments concerns the way that post-mortems are conducted, who conducts them and who authorises what can be done during a post-mortem, and attempts to rectify an anomaly relating to retained tissues that has arisen from the Human Tissue Act. First, I thank the Minister for pointing out an error in my drafting of Amendment 42. The amendment refers to page 10, line 3. After the words, “at the end insert” only the second proposed new paragraph should be inserted because the phrase,

is already in the Bill and should not appear twice. I apologise to the Committee for not having had that corrected before the Marshalled List went into print.

I shall address how a coroner may decide who will undertake a post-mortem. Clause 16(2) states:

“A request under subsection (1) may specify the kind of examination to be made”.

I have a concern, which I have discussed with pathologists from the Royal College of Pathologists, because the coroner is not medically trained. Hence, the requirement to insert the words “after consultation”. The reason is that there has been a change in the way that post-mortems are conducted. The post-mortem in which the body is, essentially, cut up, the organs looked at microscopically and then tissues taken and examined under the microscope is now being supplemented by other investigations using scanning such as CT and MRI. However, I emphasise that these are supplementary examinations, not substitute examinations. The information that you get from them is different and complementary to that from a conventional post-mortem. There have been problems, too, for families, who have the expectation that a scan will somehow be quicker and less invasive than an ordinary, what you might term, old-fashioned post-mortem. These scanning examinations are conducted by a radiologist.

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However, there are complexities over the governance of the system because if these examinations are part of an investigation of death, the clinical governance for them should fall under a pathologist, although, of course, because of radioactivity, the examination and the control of the machinery falls to a radiologist, as does the interpretation of the images. That is why it is important that there should be a discussion over the investigation of each case. In an ideal world, the pathologist would supervise everything, but we do not have an infinite number of staff. What matters is that it is not left to a legally qualified coroner and a radiologist on their own but that it involves a pathologist who, ultimately, has the experience and expertise in the governance of the investigation of deaths. In forensic work you can get important additional information from, particularly, CT scanning.

However, there are two aspects to a coroner’s work: first, to ascertain whether the death was unnatural and whether there was foul play of any kind and a case to be pursued; and, secondly, to establish the cause of death where it is a natural death. There needs to be a balanced assessment, on a case-by-case basis, of how each case is best investigated, not only for the most cost-effective way but the most appropriate way to obtain the information needed. The problem is that imaging and microscopic investigation can delay the process.

On Amendment 43, there is currently a grey area in training and post-mortems are essential for the training of the next generation of pathologists. However, it is not currently clear how a coroner can authorise a coroner’s post-mortem to be used for training purposes—certainly not when it goes beyond the training of pathologists and into the training of nurses, mortuary technicians and other people who may be involved, or when it involves the presence of medical students to observe what is happening. Very few post-mortems now occur apart from coroners’ post-mortems and therefore the emphasis on training in these post-mortems has become greater, not less, since the passage of the Human Tissue Act.

Of course, using a coroner’s post-mortem for training goes beyond its current statutory remit. Ideally, you should have full consent from the relatives for everyone who is present at the post-mortem, but the consent process takes time and personnel. It can be very burdensome and there is no real benefit when people are in training and coming along to observe the post-mortem. The process of obtaining consent can be a burden on the relatives and certainly the coroners’ officers are not happy to do this.

There is a need for consistency across the country. At the moment, under different coroners’ jurisdictions, different practices occur and training is happening much more in some than in others. It would seem very sensible that the Chief Coroner should be able to authorise what happens but my amendment makes an assumption that the post-mortem examination is authorised for training purposes unless it is specifically prohibited by the coroner. It would make it much easier and practical to have an assumption that, just as in any teaching hospital, teaching goes on and there are students around, similarly at a post-mortem there would be the ability to train unless of course there was

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a problem over national security, public health or if somehow the conduct of an inquiry would be jeopardised. It would then seem that the Chief Coroner could produce guidance as to how those who would be in attendance at a post-mortem should be vetted. They might even be required to sign a form to verify that they had no connection whatever with the deceased or with the case involved, but there may be times of course when a clinician who has been involved in looking after a patient should, quite rightly, be present at the post-mortem, because the post-mortem can be the most revealing and important time for them to learn.

Amendment 45 has been tabled because of a number of concerns about the present regulation of the retention of tissue samples from those who have died. The existing legislative framework for the retention of tissue samples fails to serve the interests of families with inherited conditions, especially those who suffer the trauma of a sudden adult death. That is because two legislative systems apply to the retention of post-mortem samples—the Human Tissue Act and the Coroners Act—and they do not currently operate in a joined-up way. This Bill gives us the opportunity to rectify that.

There have been tragic consequences for families where tissue from one family member who died unexpectedly could have been used to identify other family members who are themselves at risk of sudden death. I should declare here that I am grateful to the Foundation for Genomics and Population Health for its help in providing background to the amendment and indeed to the Royal College of Pathologists as well. Noble Lords will be aware that I raised this concern during the passage of the Human Tissue Act and nothing that has happened since that time has allayed the concerns I expressed then. I am most grateful to the Minister for meeting me recently to discuss this matter.

The Human Tissue Act of course was prompted by concerns that health services were failing to respect the interests of families when they retained tissue from dead family members. The Act attempts to right the wrongs that had occurred towards families when tissues had been retained, and regulates retention storage and use of tissue held for DNA analysis for a number of prescribed purposes by introducing a statutory obligation for those wishing to use or store tissue to seek consent from qualifying family members. These purposes include determining the cause of death and obtaining scientific or medical information about a living or deceased person which may be relevant to other persons in the future.

The difficulty is that once the coroner is satisfied with the cause of death that is attributed to the deceased, the coroner’s authority lapses, and the continued retention of any samples after that time will be lawful only if consent has been obtained from qualifying family members as prescribed by the Human Tissue Act. The codes of practice published with that by the Human Tissue Authority prescribe that, in the absence of the necessary consents, tissue should be destroyed up to 10 weeks after any deadline imposed by the coroner has expired. That is the nub of the problem. The coroners and their officers have a statutory responsibility for obtaining consent for continued retention of tissue

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for which they may be and often are inadequately trained and resourced. Although it is best practice for local protocols to be set up between genetics departments and coroners’ offices, these are rare in practice.

So what happens? The coroner undertakes a post-mortem of an unknown cause of death. On taking the heart out and examining other tissues, he realises that this is a sudden cardiac death. Having taken the heart out, he then has to put it back again, because he cannot retain it. He then asks the relatives about permission to retain the heart and other tissues and then he has to take it out again. It is manifestly important and in the interests of the family that if a young person has had a sudden cardiac death, it is understood as there may be others in the family who are genetically related and are at risk, and whose death can be prevented by appropriate interventions.

Another situation arose recently where, again, the retention of tissues was making progress in the common good difficult. The Department of Health had been supportive of a project trying to understand the incidence of new variant CJD, and it was thought that very small samples from the spleen taken at the coroner’s post-mortems would allow a broad epidemiological study to occur. The problem was that, even though tiny tissue samples were to be taken, consent had to be obtained, and consent was not viewed as a coroner’s task. The coroners’ officers did not want to be part of that process and there was no funding for a whole additional layer to go in to obtain consent, so the project has fallen through. It would have been for the benefit of society, not for the benefit of the individual families, which is why the amendment is worded as it is.

I had also felt it important that the whole supervision of autopsies was done under a trained pathologist and not put out to technicians or others. The reason is that diagnosing the cause of death is incredibly complicated. It is easier to do so when there has been a crime such as a knife crime or a shooting, but unexpected deaths and deaths in hospital can be very complex to diagnose. Someone who has training in pathology but also has full diagnostic skills training is needed in order to integrate all the information that comes together.

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