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Coroners and Justice Bill

My Lords, I am even lower in the batting order than the noble Lord, Lord Neill of Bladen, so I have been busily crossing out parts of my speech. I want to speak briefly about two aspects of the Bill. I express an interest as an ex-president of the Medical Protection Society, which is a mutual organisation providing indemnity for health professionals. It has had a keen interest in the Bill for obvious reasons. The Bill has been a long time coming, but it is clearly necessary and welcome, even now. I am happy to see, for example, that the original proposals in Part 8, previously Clauses 152 to 154, have been tightened up. Many medical organisations have had concerns about the issue of confidentiality. It is good to hear that the Government will be consulting further on this. It will be important for the medical profession to be involved in that consultation. Leaving that aside, I believe that a number of areas need some clarification. Here I focus mainly on the roles and responsibilities of the medical examiner. This is clearly going to be an important job. I make no apology for returning to this matter, about which the noble Lord, Lord Alderdice, waxed eloquent; I will, however, truncate my remarks in view of that. It is essential that the medical examiner is well trained and experienced in every aspect of the role and is able to give a view that is seen to be independent of the employing authority, as has been said. I have several questions for my noble friend. First, what steps will be taken to ensure that these doctors have the right skills and experience, are well trained and can be attracted to the job? Secondly, would it not be preferable for medical examiners to be employed by the coroners’ service, for example, rather than by health trusts, to ensure their independence? Would it not be better if these doctors were monitored, as described in the Bill, in such a way that their professional judgment was not compromised? Here I resonate to what the noble Baronesses, Lady Williams and Lady Finlay, had to say. I should like now to turn to something a little different: the coroner’s need to determine the cause of death by post-mortem examinations. The usual pathologist’s open post-mortem is something that many relatives, if they know what it entails, find somewhat disturbing. That is especially the case for Orthodox Jews and Muslims, for whom the deceased should, where at all possible, remain intact and be buried in the shortest possible time. To both religions, post-mortems of this type are an anathema. If there were alternative ways of determining the cause of death, clearly those would be preferable. Just as in life a diagnosis can be made in many instances by means of a variety of scans without recourse to a surgeon’s knife, so it seems likely that the use of MRI scans, for example, can reveal the cause of death. This technique has been used successfully in a number of instances in Manchester, in the north-west, and invasive post-mortems have been avoided there in carefully selected cases. I understand that a trial of MRI scanning versus the usual practice is being carried out in Oxford. If, as seems likely, this is shown to be helpful to coroners in some although probably not all cases, it will be welcomed not only by Muslims and Jews but almost certainly by many others. There are of course a number of issues that will need sorting out, such as costs. I understand that MRI scans are currently running at about £500 to £600 in the private sector, where post-mortem scans are being carried out now. There is also the issue of the availability of scanning equipment. However, my point in raising this is that these are likely to become less serious obstacles in due course. My question now for my noble friend is therefore whether he will encourage coroners to consider including non-invasive ways of determining the cause of death, such as MRI scanning, alongside the usual, more invasive methods currently used. This is certainly mentioned in the Explanatory Notes to the Bill, but can he give this possibility a greater push? Such encouragement either in rules of practice or verbally in response to my question would be very well received in religious communities.