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Coroners and Justice Bill

Clause 20 looks at the issue of medical certificates detailing the cause of death. Amendments 64 and 66 in this group stand in my name and that of my noble friend Lady Finlay of Llandaff. These two amendments need to be read together. The effect of Amendment 64 would be to make an alteration in line 4, page 12, leaving out the word "may" and instead inserting the words, ""will, having consulted the Chief Coroner"." As it presently stands the Bill says that the Secretary of State, ""may by regulations make the following provision in relation to a death that is required to be registered under Part 2 of the 1953 Act"." It then goes on to list a considerable number of provisions. My amendment would require the involvement of the Chief Coroner. "Amendment 66 would make an addition at page 13, line 19, by inserting the words:"""An attending practitioner's certificate prepared under subsection (1)(a)(i) will replace the existing separate certificates issued for Cremation and Burial under the Cremation Acts 1902 (c. 1) and 1952 (c. 31), and the Births and Deaths Registration Act 1953 (c. 20) respectively"." Current arrangements for death certificates reach back to the 1800s and there has been little change since 1935. The Shipman inquiry stated that the existing arrangements for certification were confusing and provided inadequate safeguards for the public. That is a view with which Tom Luce—who chaired the fundamental review of death certification and the coroner service in England and Wales—concurred. I was surprised when looking at the death certificates that are currently in use to see how long ago it was since we made any fundamental change to the death certification process. The certificates authorising cremation were given statutory standing in 1902 and 1952 and the burial certificates were prescribed by the Deaths and Births Registration Act 1953, with regulations following in 1987. There is, I think, broad consensus and support for the general thrust of the Government's intentions to reform the system of certification, and I certainly welcome that. I note that the British Medical Association has, for instance, given a guarded welcome, although it does raise two questions that perhaps deserve a response from the Minister today. It says that it would like to see the introduction of short death certificates alongside the medical certificate of cause of death as proposed by the 2002 Office for National Statistics report, Civil Registration: Vital Change: Birth, Marriage and Death Registration in the 21st Century. It also argues that the right to confidentiality extends beyond death and that the bereaved should have the option of withholding the cause of death when disclosure is not required. Although it may be necessary—for instance, as a requirement stipulated by an insurance company—to know the cause of death, or, as we debated earlier in Committee, for statistical information vital to the construction of public health policy to include cause of death, we have to accept that it can also be distressing to relatives to be required to disclose sensitive information to organisations such as utility companies for which it is not necessary to have access to that information. I think that these are reasonable concerns which the BMA has raised and which we should ponder on. I wonder whether the Minister, with his usual alacrity, sees a way through that dilemma. I should be grateful to him for his response on those important points. I would also be grateful if the Minister will tell us about the funding of the PCTs and the local health boards which will be required to make available to medical examiners the disclosure of their functions and whether we are satisfied that there will be adequate funds to deal with the changes to the certification process. If we were able to accept the two amendments tabled today, it would abolish the two certificates currently in use and open the way to the introduction of the sort of streamlined procedures advocated by Dame Janet Smith in the Shipman inquiry. Indeed, she has produced a prototype form, copies of which I have here in the Chamber and which can be found in Appendix G of the third report of the Shipman inquiry at page 563. She believes that these integrated forms would overcome the weaknesses in the present system of certification which were identified in her inquiry. At Appendix M, pages 611 to 615, she sets out the details of how the new death certification would work in practice. It is indeed those proposals that are incorporated in these amendments. At the very outset of her report, on page 3—I referred to this earlier—she talks about the disadvantages of the present system. At the very minimum, I hope the Minister will agree that a pilot scheme trial-running Dame Janet's proposed system of certification might well be in order. My amendments would pave the way for the introduction of such certification and replace it—if I may be mildly critical of the half-hearted wording in the Bill, which simply suggests that the Secretary of State "may" proceed, a point which was referred to by my noble friend Lord Neill of Bladen in another context earlier today—with new certification and a duty on the Chief Coroner to get on with it. What possible justification can there be in reserving this question to the Secretary of State? Surely this is a classic example of something that should be devolved through subsidiarity, in this case to the new Chief Coroner whom we are appointing in this legislation and whose duties should clearly include the production of new certification. We should trust him to get on with that, and mandate him to get on with it. That is the substance of my amendments. I beg to move.