---

Coroners Bill

First, I thank the noble Baroness for allowing us to debate what is clearly a very important matter. I can assure noble Lords that in responding to the points that have been made, our debate will be invaluable in assisting the Government in thinking through the further changes that will be necessary. I can give an assurance that we will pay close attention to the substantive points that have been raised. I thought that the noble Lord, Lord Thomas, illustrated graphically the importance of the inquest and the coronial process, and I agree strongly with him about that. On the question of legislation, as I said in our debate on the Queen’s Speech, I deeply regret that we have not been able to find legislative time, but I want to confirm again that the Government remain committed to legislation in this area. Naturally, I cannot go further than that in terms of exactly when, but I want to reassure noble Lords that we see this as a very important measure. Obviously, we are looking at ways of bringing it forward at the earliest possible stage. Although imperfections have been identified in the current system, Dame Janet’s report, the Tom Luce report, other reports, the Select Committee and, very importantly, families, have raised issues of concern, I want to place on record the Government’s thanks to all those in the current system for the work that they do. Of course we can do better. The legislative reform to which the noble Lord, Lord Kingsland, in particular, referred, attempts to do a number of things: first, to put families at the heart of the inquest process; secondly, to have a chief coroner to set national standards, to hear appeals, to improve training arrangements and to oversee the operation of a statutory charter for the bereaved. It aims to give flexibility in the system to transfer cases easily from one area to another, if it is in the interest of families to do so; to begin the process towards the formation of a predominantly full-time group of coroners, completely focused on coronial duties, rather than the large part-time group that we have at the moment; to improve medical expertise available to the service with a new national medical adviser to work with the chief coroner and to provide better advice available locally. In a moment, I will describe to the Committee what can be done in the absence of legislation. On the question of the inter-relationship and links between the coronial system and death certification, that is of course vital. We are working with other government departments, not least the Department of Health, as it develops parallel proposals on reform of the death certification system. I assure the noble Lord, Lord Kingsland, that, although there has been a development of ideas since Dame Janet's report, we want to ensure that the respective work in my department and that of the Department of Health closely inter-relates. On medical certification, I make a number of comments. First, the noble Lord, Lord Kingsland, referred to the proposal that all deaths should be reported to the coronial service. We are not taking that forward. We believe that to have all deaths reported to the coronial service would not be an effective response in targeting resource where the risk is greatest. I want to respond later to the specific question of delays. We also think that such a system could bring unnecessary delay to families wishing to proceed quickly with funeral arrangements. The focus under the proposals and the changes that the Department of Health has made on control of drugs—it is also consulting on the better regulation of doctors—will, we believe, reduce the likelihood of a Shipman operating undetected in future. More generally, the single system of effective medical scrutiny applicable to all deaths will be of great assistance there. The work of the Department of Health on certification will bring obvious benefits, including better quality and accuracy in the certifying of deaths and improved local public health monitoring more generally. The proposals will also tackle the lack of independent scrutiny in the system, which was so ruthlessly exploited by Harold Shipman. I assure noble Lords that we are working very closely with the Department of Health in this matter. Since I was responsible for this area in the Department of Health last year, and gave evidence to the Select Committee, I should say that we are working very hard together to make sure that we match the work of both departments and that there is integration of approach. What are the non-legislative changes that we can introduce in advance of legislation? First, subject to the agreement of the Lord Chief Justice, there are some changes we can make to the current coroners’ rules, which we are already working on. I refer particularly to the comments of the noble Lord, Lord Thomas of Gresford, concerning the coroner’s duty to report to an organisation to take action to prevent future deaths. We want to improve that system. He has identified some of the current weaknesses in it. We want to make the process much more transparent. Organisations will for the first time have a requirement to respond. In the absence of a chief coroner, my right honourable friend the Lord Chancellor will oversee the reports made and responses to them. He will bring them to the attention of ministerial colleagues and, when appropriate, to Parliament. I say to the noble Lord that as a Minister at the Department of Health, I received such reports from time to time and we responded to them. I felt that, while it was not always right to respond immediately to the recommendations made by individual coroners, that could be an extremely useful part of the process in terms of reassuring families that lessons are being learnt and taken account of by public organisations, as well as demonstrating ways in which government departments may need to look at weaknesses in systems that have been identified in individual inquests. We are also planning to introduce a new rule to ensure that coroners and local safeguarding children boards have the correct framework to work together effectively with their respective responsibilities to investigate child deaths, again making sure that there is close collaboration and that some of the current loopholes and gaps are identified and dealt with. I also assure noble Lords that we will work closely with coroners to consider any other changes to the rules that will enable them to carry out more effective investigations and inquests, or that would lead otherwise to better services for families. The Department of Health is piloting its plans for medical examiners. As part of those pilots we can see whether the list of deaths we have drawn up to guide doctors in their referrals is effective and helpful. Modifications can be made in the light of experience. We believe that too many cases are referred to coroners that they ought not to receive, while they do not receive some that they should. This is the first time that the definitive list of deaths has been drawn up for national dissemination, and it is intended that it will eventually become statutory guidance on the implementation of the Bill. We are working with the Press Complaints Commission to review its code of conduct in the reporting of inquests. Clearly, we do not intend to prevent inquests being reported; however, we want all steps to be taken to ensure that they are reported sensitively. Some inquests provide very good copy to editors, but we want to encourage editors to give some more thought to the impact that will have on the lives of surviving family members, not least any children concerned. A number of noble Lords have mentioned the charter for the bereaved. We will be issuing that for further consultation. It will contain the minimum services that families are likely to receive in the future, and we will be working with coroners and their officers to establish what service improvements they can offer to the bereaved within the existing system—particularly when it comes to the timely provision of information; I take the point that was made about that. I thought that the noble Baroness, Lady Finlay, made some very important points, particularly on post mortems. As, by necessity, post mortems have to be carried out as soon after death as is practical, it is important that procedures are in place to ensure that the next of kin of the deceased person can be properly informed and consulted. In addition, there will be in legislation appeal rights to the chief coroner if a coroner chooses not to order a post-mortem or a particular type of specialist examination. We think that that will provide a safeguard for families who want to know whether the death of a loved one has been caused by a genetic defect that can be treated in other family members if the problem is diagnosed sufficiently early. We are also working with the Royal College of Pathologists and the Department of Health to ensure the most effective post-mortem system. I accept the noble Baroness’s point that this presents some considerable challenges. I was the Minister concerned with Alder Hey some years ago. I shall never forget that time and, in particular, meeting the families who suffered so grievously from the way in which the organs were retained. As the noble Baroness knows, some families went through the trauma of at least three burials when new body parts were discovered. That, of course, led to the Redfern report and then legislation in the form of the Human Tissue Act 2004. The noble Baroness referred to a number of issues that were raised in that Act, particularly in relation to keeping material in perpetuity. At the time, we took the view that the compulsory retention of tissue could not be justified in circumstances where the coroner had fulfilled the coroner’s function. I am sure that it will be a disappointment to the noble Baroness when I say that we have not moved from that position. She mentioned Scotland, but clearly that is a matter for Scotland. We feel that the view that we took with the Human Tissue Act was the right one and it was endorsed by Parliament. I shall need to come on to the question of military inquests but perhaps I may respond quickly to a very important question raised by the noble Baroness on post-mortems on children, and babies in particular. I well understand the problem of the shortage in particular specialties, and the Department of Health is working very hard with the royal college to see what can be done. It remains a challenge and I would never seek to deny that. I very much agree with all the comments that noble Lords have made about information given to families. In taking through reform of the system, we will emphasise the critical importance of information being made available to families as early as possible. I thank my noble friend Lady Dean, who raised, on behalf of the War Widows Association, very important matters in relation to military inquests. The noble Earl, Lord Attlee, for whom we have enormous respect, also has much knowledge of these matters. I assure noble Lords that my department works, and liaises closely, with the Ministry of Defence to ensure that inquests into the deaths of our courageous service personnel are held as promptly as possible. I am well aware of the trauma that the delays have caused to their families. A total of 144 inquests have been held since the conflicts began in Iraq and Afghanistan. I shall come on to funding generally in a moment, but we have made additional funding available to both the Oxfordshire and Wiltshire coroners. I believe that good progress has been made, although I accept that there are still a number of issues concerning the transfer of single deaths to coroners closer to the next of kin. Of course, we want to ensure that that happens wherever possible. I understand the cost implications for families. The Government will pay overnight expenses to enable two family members to attend any pre-inquest hearings which may take place, as well as the inquest itself. On the more general point of support to families, I agree with my noble friend about the teams. We have established a dedicated team within the Ministry of Defence to improve liaison between boards of inquiry investigators and coroners. On the question of legal aid, the noble Lord, Lord Thomas of Gresford, will understand that because the procedures are inquisitorial, legal aid is not provided as of right, but families may be provided with legal aid for those inquests if they meet the necessary criteria. Several families have been assisted. The Legal Services Commission considers these matters, and if it believes exceptional funding should be made, it comes to me as the Minister concerned at the Ministry of Justice. I assure the noble Lord that I take this matter very seriously and give it careful consideration. Some of the reasons for the delays in military inquests are because of the military boards of inquiry. Special investigations have to take place in the field; they also have to be listed on dates that suit the families. All that aside, though, I well understand the need for us to do everything we can to help the coronial service keep those delays to a minimum. My officials are in weekly contact with the coroners who are handling these inquests to check progress in this matter and to give what assistance we can. My right honourable friend Mrs Harriet Harman, who has the responsibility for this, has taken part in a number of meetings with families in this area, and I hope that that will continue. On the question of specialist coroners or a centre of excellence for military inquests, which my noble friend raised, we do not support that idea. We think it might even create a backlog of inquests and increase the time—and, indeed, the distress to bereaved families—by requiring more families to travel further to their inquest. We have to ensure that all coroners, wherever they are in the country, are able to handle those inquests. As my noble friend will know, a number of inquests have been held outwith both Oxfordshire and Wiltshire and we believe they have been handled effectively and quickly. However, I will keep a close eye on that matter. I shall finish with a comment about resources. This is a local service. We think there is sufficient resource within local authorities’ budgets, but the Select Committee thought there should be a mechanism for auditing the expenditure and it is our intention that the chief coroner will indeed look at comparisons of expenditure. We are not moving to a national service, however, so it must be a matter of local discretion. I defend that; it is perfectly possible to maintain a local service but with the benefit of a chief coroner to ensure that there is auditing in order to establish that every coroner is carrying out their responsibility effectively. It is better to have that kind of national leadership but local provision. I have taken a lot of time because this is an important matter. I hope that at the very least I have assured your Lordships that we are keen to proceed with legislation. I cannot guarantee when that will be, but I give a guarantee that we will look at all the other issues that noble Lords have raised.