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Coroners and Justice Bill

This is an extremely important matter, and it is crucial that we get it right. As my noble friends Lady Finlay and Lord Alton have made clear, many of the clauses in the Bill derive if not directly then indirectly from the report on the Shipman case, which was the result of an inquiry that was chaired by Dame Janet Smith. It is crucial that Clause 19 creates the new role of medical examiner, who will ensure the independent scrutiny and confirmation of medical certificates of the cause of death and will provide general medical advice to the coroner. However, my noble friends and the noble Lord, Lord Alderdice, have made the case for having a chief medical adviser to the Chief Coroner for exactly that purpose: to give general medical advice to the Chief Coroner, just as the medical examiners will give advice to the coroners at a local level. The Medical Protection Society has considerable anxieties about the details of these appointments. It says that, ""current discrepancies in resources between different PCTs and LHBs, may lead to inconsistencies in resourcing medical examiners. Subsection (1) gives Primary Care Trusts … in England and Local Health Boards … in Wales the power to appoint medical examiners"." It is questionable whether this is the best arrangement, particularly for ensuring, ""the true independence of the system"." As the Minister will be aware, the Justice Committee in another place pointed out that the role of the medical examiner requires, ""accountability between examiners and the new national medical advisor"," whom it hopes to see appointed to the new Chief Coroner. The need for more direct access to medical expertise, via coroners, is accepted and, because of this, the Justice Committee suggested that it would be more appropriate for the medical examiners to be employed by the Ministry of Justice, or by the coroners’ service, than by the NHS. Will the Minister comment on that recommendation? The role of these medical examiners must be monitored. A potential conflict could arise if PCTs or local health boards were to employ them because those bodies would be responsible not only for paying the medical examiner but also for monitoring performance, a role that I think is much better in the hands of the chief medical adviser to the Chief Coroner. For that reason too, an independent funding arrangement may be more suitable. Clause 19(3) proposes that: ""A person may be appointed as a medical examiner only if, at the time of the appointment, he or she—(a) is a registered medical practitioner and has been throughout the previous 5 years"." It is important to clarify the position with regard to registration because, from this year, doctors who are practising in any aspect of clinical medicine will require a licence to practise. Doctors who are retired may remain on the register and be registered medical practitioners but do not have a licence to practise. It is crucial that medical examiners must be individuals holding a licence to practise because they will have to undergo revalidation to demonstrate to the GMC on a regular basis that they remain up to date and fit to practise. It is therefore necessary that we should see details of the skill sets that medical examiners will have to demonstrate at an early stage. A number of clarifications are required from the Minister on these provisions.