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Post-mortems are certainly not tasks that we would envisage being carried out by someone fresh out of medical school, although it is of course possible that some routine functions of assistance to the pathologist could be carried out by someone recently qualified, particularly as part of further training. Noble Lords may point to subsection (3)(b) of Clause 16 as a way of enabling persons other than pathologists to carry out post-mortem examinations. However, this provision is not designed to enable the Chief Coroner to designate registered medical practitioners to carry out particular kinds of examination; it is certainly not intended to use the provision to enable a range of persons with no suitable qualifications or relevant skills to carry out examinations or tests on the body of a deceased person. The provision is there to enable the Chief Coroner to designate practitioners from outside the medical profession who may be called upon to provide expert advice, such as toxicological scientists or forensic archaeologists. I want to reassure the House that post-mortem examinations will be carried out only by someone who has the necessary medical qualifications or has been approved by the Chief Coroner.
I turn to Amendment 43. We can see value in making provision in the underpinning regulations or the guidance mentioned earlier about training provisions for trainee pathologists, perhaps based around their attendance at and participation in post-mortem examinations. I agree that this should be considered further in the context of that work.
On Amendment 45, about which the noble Lord, Lord Walton, also addressed the Committee, I am of course aware of the noble Baroness’s very long interest and expertise in the subject of tissue retention, and I acknowledge her reference to the different approach that is taken in Scotland. However, we do not believe that this is the time or the legislative vehicle in which to bring about the changes that she may wish to see, all of which were debated in this House some five years ago when the Human Tissue Bill was before us. As noble Lords may be aware, the Human Tissue Authority is currently preparing new codes of practice dealing with the handling and retention of human tissue, including the handling and retention of samples taken during coronial post-mortems conducted by pathologists. Officials from the Ministry of Justice have contributed to the review of the codes and we would prefer to see how the revised codes of practice bed down before we take any action.
I refer noble Lords to paragraph 37 of our published draft charter for bereaved people:
“Sometimes, organs or tissues are retained for additional examination. In this instance, the coroner should reach advance agreement with the appropriate next of kin as to what should happen when they are no longer required for coroners’ purposes. The coroner should convey the wishes of the next of kin to the relevant pathologist”.
We believe that such a statement is Human Tissue Act compliant and that it provides scope for families to agree to organs or tissues being retained indefinitely.
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I move on to the amendments tabled by the noble Lord, Lord Kingsland, and I hope I can put his mind at rest that they are already catered for in the Bill. His Amendment 41A seeks to add radiologists to the list of persons who are automatically allowed to conduct post-mortem examinations under Clause 16(3)(a). My understanding is that all practising radiologists should be registered medical practitioners and therefore I reassure him that they are already covered by that clause.
Moving on to the noble Lord’s second amendment, we do not believe it necessary to state in the legislation that a post-mortem examination includes both invasive and non-invasive procedures. This is permissible under the Bill as drafted. However, for the record, the provisions that refer to post-mortems do indeed apply to both invasive and non-invasive procedures.
More generally, as noble Lords will be aware, the Government are committed to pursuing the increased use of non-invasive MRI scans as a method of carrying out post-mortem examinations. This measure has been particularly welcomed by members of the Jewish and Muslim faiths, both of which require the body not to be tampered with after death and for burial to take place, wherever possible, within 24 hours of death. At present, scanning facilities for those who have died are available in only small pockets of the country, and under the current system coroners are prevented from moving the body outside their jurisdiction or an adjoining jurisdiction. Clause 17 allows bodies to be moved anywhere to enable the appropriate examination to take place. I am pleased to say that in the current system coroners in the Manchester area have led the way, in conjunction with local health providers, in making non-invasive post-mortems available to the communities they serve. We await the outcome of Department of Health research into the full effectiveness of such procedures, especially in the detection of particular causes of death, but we are already encouraging coroners in other parts of the country to engage with their local health services to establish whether there is a possibility of making use of local scanning facilities.
I hope that I have been able to give some reassurance to noble Lords whose amendments we have debated this afternoon and I look forward to hearing from them now.
4 pm
Baroness Finlay of Llandaff: I am grateful to the Minister for his full reply. I must begin by saying that I am not totally reassured, and I believe that this is something that we need to continue to discuss and came back to on Report. I am also grateful to all noble Lords who have contributed to this debate. There are a few points I would like to make, just to underline my reservations. I assure the House that I will be as brief as I can on these.
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It is true that there are groups in society that do not want delays and who are worried about the body being tampered with after death. However, I think we should not be under any illusion that the non-invasive MRI is a substitute for a full post-mortem. It is not: the trials that have been done demonstrate that one gets different bits of information. I am concerned that the public may be feeling misled. It is also quite expensive to undertake these investigations, so there is therefore a problem of cost. Moreover, the machines in use for post-mortems either must be dedicated machines, or—if they are also patient machines—they may be taking up patient investigation time.
My main concerns relate to the post-mortem process being supervised by an appropriately trained pathologist. As the noble Lord, Lord Alderdice, already said, there are many people who are members of the Royal College of Pathologists. Some of them are chemists, some are haematologists, but very few of them would be able to undertake a post-mortem. I am a registered medical practitioner of many years standing, but I would not be able to do a post-mortem with any degree of competence. It would be completely fallacious to pretend that I could.
To do a post-mortem properly, one needs to be highly skilled with a great deal of training. My amendment does not state that the post-mortem itself has to be done start to finish by somebody with that level of training, but it says that it must be supervised by somebody with that level of training. Indeed, part of the initial preparation of the body and the closing-up afterwards does not have to be done by somebody with a very high degree of training at all. Certainly, however, somebody has to be available to come in and out to make sure that the standard of post-mortem is high. If the standard is not high, it is dangerously misleading and can create a false sense of reassurance. I have a concern that, when we may be faced with, for example, convictions of corporate manslaughter that could relate to deaths, it would be very important that a high quality of post-mortem is undertaken to provide the evidence to underpin, uphold or refute such a conviction.
Will the Minister say whether there is a need for primary legislation to amend the Human Tissue Act, and to allow the Human Tissue Authority to change the codes of practice to extend the length of time and the amount of tissue that can be retained while consent is being sought? My understanding—but I may be wrong here—is that it would require primary legislation for a step in that process.
I would also like to return later on to training—but I will not push the Minister on this now. If we do not train pathologists adequately, and we do not have a training environment created around post-mortems that are happening, we will indeed have an extending shortage of pathologists, and those we have will be inadequately trained. An inadequately trained pathologist would probably be more dangerous than not having enough pathologists around altogether, because there may be undue weight put on an opinion which is not appropriately or fully informed. That is another point to which I would like to refer after this debate.
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My last point relates to the retention of tissues and justice for families. It may be that there is a conviction over the death of a child that is inappropriate, because it was not the parents who were the cause of death, and the child had died naturally. We have already seen that happen.
In the future, the opposite may occur, too; that there is a child’s death and the family is acquitted. The family is asked whether it consents to tissues being retained, but of course it says no and wants the tissues to be cremated. If there is a subsequent death in that family and the tissues have gone completely, there will be no way of linking across. We have an increasing range of chemicals that can be used in poisoning, and increasing access to all kinds of substances that are toxic and can be used. Not only gross external blows may be the cause of death, and I worry that, by not retaining even the blocks and slides, we may not do justice to the dead child or may commit a gross injustice through the wrongful conviction of parents who, acutely bereaved, are not in a position to argue their case. I would like to discuss with the Minister outside the confines of this debate some of the issues arising from the Human Tissue Act and whether primary legislation is required. In the mean time, I beg leave to withdraw the amendment.
Amendments 41A to 45 not moved.
Clause 17 : Power to remove body
European Council
Statement
4.07 pm
The Chancellor of the Duchy of Lancaster (Baroness Royall of Blaisdon): My Lords, with the leave of the House, I will repeat a Statement made by my right honourable friend the Prime Minister in another place, entitled “European Council”.
“With permission, Mr Speaker, I would like to make a Statement on the European Council held in Brussels last Thursday and Friday, which I attended with my right honourable friend the Foreign Secretary and which focused on the intensive economic co-operation needed within Europe and across the world as we follow through the agreements made at the London G20 summit and ensure the co-operation needed in economic and environmental policies.
The Council expressed its determination to continue playing a leading role at the global level, and called on its international partners to implement fully the commitments made at the London G20 summit: in particular, by providing additional resources to international financial institutions and accelerating the reform of the financial and regulatory framework. Member states have already stated their readiness to
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For many months, the UK Government have rightly been at the forefront of proposals to strengthen international regulation. That is why we have taken forward Lord Turner’s report. Radical proposals for the reform of regulation were a key outcome of our G20 summit in London in April. With so much of Britain’s financial sector’s activities linked to Europe and the rest of the world, and with cross-border investments between the UK and the rest of Europe alone amounting to more than €250 billion every year, Britain needs greater European as well as wider international cross-border supervision.
So in line with the recommendations of the reports from Lord Turner and de Larosière, the Council agreed the principles on which a new international framework for the regulation and supervision of financial services in Europe would be delivered: first, the better early warning of financial sector risks through the creation of a new European Systemic Risk Board to complement the work of the IMF and the Financial Stability Board and to help to identify problems early and thus prevent future crises from developing; secondly, and as proposed by the review from Lord Turner—which was itself welcomed by most people in this House—agreement to develop a strengthened and more detailed set of European rules for the single market in financial services, measures to raise the quality and consistency of supervision across Europe, to ensure that common rules are enforced, and to improve co-ordination between national supervisors, and measures for mediation between the supervisors of institutions with operations in more than one member state; and, thirdly, a clear commitment from the Council, which,
- “stresses that decisions taken by the European Supervisory Authorities should not impinge in any way on the fiscal responsibilities of Member States”.
The principles agreed at the Council provide the foundation for a new financial supervisory architecture, with the aim of protecting our financial systems from future risks and helping to ensure that the international regulatory failures of the past will not be repeated.
The G20 decided that countries should take similar action on economic policies in what is recognised by the leader of the Opposition as a Europe-wide recession. While the Council acknowledged that the co-ordinated measures taken so far in support of the banking sector and the wider real economy,
- “have been successful in preventing financial meltdown and in beginning to restore the prospects for real growth”,
the Council also emphasised the,
- “imperative for the EU to continue to develop and implement the measures required to respond to the crisis”.
While it is absolutely right that we maintain our commitment to medium-term fiscal sustainability, it is equally vital, as the Council reiterated, that we remain determined,
Recognising the worldwide nature of the financial crisis and that around 1 billion people face poverty, malnutrition and hunger, the European Council also
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On climate change, the Council agreed:
“The time has now come for the international community to make the commitments needed to limit global warming to under 2°C”,
and that a coherent response to the challenges posed by both climate change and the economic and financial crisis would, by enabling the move to a low-carbon economy, offer new opportunities for jobs and growth. The Council repeated its call for all parties to co-operate in reaching an ambitious and comprehensive agreement in Copenhagen later this year and to accelerate the pace of negotiations at forthcoming high level international meetings, including the G8 and the Major Economies Forum next month.
The Council agreed that both developed and developing countries should contribute finance in the fight against climate change and that such global burden sharing should be strictly on the basis of two principles: the ability to pay and the scale of emissions.
When the Council met in December, we agreed that we would seek to provide the legal assurances that Ireland needed to move forward on the Lisbon treaty—on taxation, defence, the right to life, education and the family. However, we were equally clear that, in doing so, there could be no change or amendment to the treaty, only clarification of what it will and will not do. That is exactly the purpose of the guarantees that the Council has agreed for Ireland. To be absolutely clear, the Heads of State or Government have declared:
- “the Protocol will in no way alter the relationship between the EU and its Member States. The sole purpose of the Protocol will be to give full Treaty status to the clarifications set out in the Decision to meet the concerns of the Irish people. The Protocol will clarify but not change either the content or the application of the Treaty of Lisbon”.
Its content is fully compatible with the treaty of Lisbon and will not necessitate any re-ratification of that treaty. Those guarantees will be set out in a protocol only at the time of the next accession treaty. This will be specific to Irish concerns. Its status will be no different from our own protocols and will be subject to ratification in this House.
On Burma, the Council marked the 64th birthday of Aung San Suu Kyi by expressing its deep concern at her continued imprisonment, as the Burmese regime still pursues its absurd and contemptible sham trial. The Council called for her “immediate and unconditional release” and agreed that if this does not happen, Europe,
against the Burmese regime. It is absolutely right that we stand ready to step up sanctions. We will also work with Asia to further increase international pressure and I hope that the Secretary-General Ban Ki-Moon will be able to visit Burma soon.
- “stressed that the outcome of the Iranian elections should reflect the aspirations and choices of the people of Iran”.
The onus is on Iran to show the Iranian people that recent elections have been credible and that the repression and curtailment of democratic rights that we have
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It is therefore with regret that I should inform the House that Iran yesterday took the unjustified step of expelling two British diplomats over allegations which are absolutely without foundation. In response to this action, we informed the Iranian ambassador earlier today that we would expel two Iranian diplomats from their embassy in London. I am disappointed that Iran placed us in this position, but we will continue to seek good relations with Iran and to call for the regime to respect the human rights and democratic freedoms of the Iranian people.
The Council unanimously agreed that it intends to nominate José Manuel Barroso to lead the next European Commission and, as we look forward to the next five years, this Council has put in place the building blocks for the Europe of the future. It is by co-operating on the basis of our interdependence that we achieve more. By engaging and working in partnership with Europe, and globally, we take forwards our commitments from the G20 in April. By putting Britain at the heart of Europe—not on the sidelines, with Europe's single market worth over £10 trillion—we in Britain can responsibly deliver security, new jobs, prosperity and a strong future for all our people. I commend this Statement to the House”.
My Lords, that concludes the Statement.
4.15 pm
Lord Strathclyde: My Lords, I thank the noble Baroness for repeating the Statement. I shall begin by exploring some of the foreign policy issues discussed. Were there discussions in Brussels about the strategic aims of action in Afghanistan? The summit conclusions call for Afghan election candidates this August to produce manifestos. Worthy though it is, door-to-door leafleting is rather more perilous in parts of Afghanistan than some parties in Brussels may realise. Will the noble Baroness tell the House of any additional troop commitments made by member states?
On Pakistan, we welcome financial assistance for displaced people. We also note the warm words about possible reconstruction aid. Is the noble Baroness able to give any details on that? Has any progress been made towards a free trade accord between the EU and Pakistan?
Finally, the decision on how Iran is governed is a matter for the Iranian people. But does the noble Baroness agree that when we say “the Iranian people” we mean the people, not those who carry guns? The summit was trenchant in its condemnation of violence against protesters and journalists. In view of the singling out of Britain, quite absurdly, as a promoter of violence in Iran, was any solidarity expressed with the UK? If so, what practical form will that take? We support the measured but firm response of the Government to these provocations. The summit declaration is vague on Iran's nuclear programme, which is surely an extremely dangerous issue of foreign and security policy. Did the Prime Minister argue that, if Iran does not negotiate,
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On the economy, the Council reiterated,
Did the Prime Minister have his fingers crossed behind his back when he signed up to that? Will the noble Baroness confirm that, after 12 years of a Labour Government, Britain now has the highest youth unemployment in Europe? Will she also confirm that Britain is heading for the biggest deficit in the G20? Were Mrs Merkel and other leaders queuing up for a teach-in on the so-called British miracle?
Despite the errors of recent years, no sector is more important to the British economy than finance. I declare an interest as a director of companies regulated by the FSA. Does the noble Baroness agree that no other EU member state has comparable skills in or reliance on this sector? We on this side welcomed the assurances given by the Prime Minister on the nature of proposed EU financial regulation. On 9 June in the Financial Times the noble Lord, Lord Myners, said,
The Prime Minister told Parliament that he did not want any new body to have powers over national supervisors. So why does the communiqué say that the decision-making powers of the European System of Financial Supervisors will be “binding”? Why did President Sarkozy say that Mr Brown had performed a sea-change? Take my word for it, that is French for a U-turn.
Is it not the case that, as President Sarkozy also boasted, new EU institutions end up doing much more than foreseen? What assurances can the noble Baroness give Parliament on the record that the City of London was wrong to warn that we now have,
The City has precious few friends in other EU states and many envious rivals. It would be a disaster to find national control ceded in a core area of national competitiveness.
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