CORONERS (AMENDMENT) (Hansard, 11 July 1978)

§ Mr. Wigley

I beg to move, That leave be given to bring in a Bill to amend the Coroners (Amendment) Act 1926, with reference to the power of removal of a body for post-mortem examination. Last Friday at Llanberis in my constituency there was a demonstration, when 500 people walked 300 yards in a protest march. The House may not think that 300 yards is a very great distance for them to walk, but in this case the procession had to stop twice in that distance for the marchers to get their breath. These were the former slate quarry men of Gwynedd, suffering from pneumoconiosis, and the widows of those who died from this disease. This is the group of people for whom the Bill is very relevant.

There are hon. Members who represent coal mining constituencies or other areas where pneumoconiosis, silicosis and associated lung diseases are endemic. They will be very familiar with the problem which I hope can be slightly alleviated by the passing of the proposed Bill. My knowledge of the problem arises from the prevalence of these diseases in my own constituency of Caernarvon as a result of the slate quarrying industry.

At the turn of the century this industry employed about 20,000 people in the Gwynedd area. By now it is employing only 400 people, but we still live under the shadows of the effects of that industry, with middle-aged men prematurely ageing as a result of the dust, old men struggling to live, and dying from it, and widows—who gave many years of their lives, perhaps a decade or longer, to nursing their ailing husbands—now left with nothing 1251 but the miserable pittance, if they are lucky, of the additional 55p a week on their pensions.

These are the people who, unlike the coal miners, do not receive the benefits of a State-funded compensation scheme and, because most of the quarries have gone bankrupt, they have no redress to tort action through the courts.

I say this by way of background, for a Bill introduced in this way is limited in the fields it can tackle, and my Bill deals with one small but traumatic area of suffering endured by such communities, and particularly by bereaved families.

The agony which I seek to reduce by the Bill is that caused by the almost inevitability of the body of a deceased person, who had suffered industrial dust diseases, being subject to a post mortem examination. We have the experience so often of a wife being told of her husband's death and, in almost the same breath, being informed that his body will be carved up in order to "identify the cause of death". It is pouring agony on to grief, and in many cases it must seriously be asked whether a post mortem examination is really necessary to confirm the cause of death of a person who may have been visibly dying from the effects of choking lungs for weeks and months, if not years.

I should like to quote from letters from my constituents. The first reads: I want to draw to your attention the unfairness and insensitivity which relate to circumstances surrounding death from slate dust. This is the experience which I suffered. At 5 a.m. on Monday morning my father died in hospital from this disease, and within a short space of time I was asked to fill forms to concur to a post mortem examination. After returning home, and pondering over the matter, I recalled that the doctor had told me that a post mortem would be held, and that we had no choice in the matter; why, then, were we given these forms at a time that was so painful to us? Subsequently, the same day, a police officer came to our house for my mother to make a statement for him to take to the post mortem. The question seemed to be totally irrelevant to the inquiry; namely, how many years we had lived in the house, what insurance policies my father had, where he had been working, and many irrelevant questions. I put no blame on the policeman who was sent to ask these questions of us at such a difficult time. But can nothing be done to bring in a little sympathy for the position of a bereaved family? Another constituent, referring to a relative of his, writes as follows: 1252 In 1964, he was told that he was suffering from pneumoconiosis, and was assessed at 20 per cent. disability. By 1973, he was 100 per cent. In 1974, he was confined to sitting in his corner, suffering severely from shortage of breath. He deteriorated rapidly, becoming no more than a shadow of his former self. He could not go to bed, and slept in his chair, when he could sleep, but was awake most of the night, fighting for breath. He died in December 1976. The local doctor, who treated him, said that he could not give a death certificate, because he was not allowed to put silicosis as the only cause of death. I he family were informed that a post mortem would be required. This was vociferously contested, but a policeman came to the home and announced that the coroner had directed that the body had to be taken away for a post mortem examination. Another letter, not from a constituent, refers to the death of the writer's father in an area of Wales where pneumoconiosis was prevalent from the silica quarries. He writes: The cause of death was plainly obvious to everyone, and the GP had practically predicted the date and the way it would occur…. I later pursued the matter in a half-hearted sort of way and got the astounding explanation that the request for a PM had been a 'routine' one with the object of compiling statistical information. Medical science should not be unnecessarily impeded. But neither should distressed families be further pained without good reason. It is the objective of the Bill to allow the next of kin of the deceased person to object, on grounds of conscience or of religious belief, to a postmortem examination being undertaken where the medical practitioner of the deceased is confident that he knows the cause of death. To secure this provision, the Coroners (Amendment) Act 1926 needs to be amended.

We have to go back, however, to the Coroners Act 1887 to establish the background to present requirements. That Act stipulates a general duty on coroners to hold an inquest where the person has died an "unnatural death". Death from an industrial disease is regarded as an unnatural death. The Coroners (Amendment) Act 1926 provided that a coroner could require a post-mortem examination to be carried out on a dead body if he had reason to believe that the examination might prove that an inquest might be necessary.

The Broderick committee on death certification and coroners summed up the position in law as follows: A coroner is required to consider in every case whether a death which seems likely to 1253 have been caused by a prescribed industrial disease is, or is not, unnatural. In practice coroners invariably have the results of a postmortem examination to assist them in this consideration. I should perhaps at this point remind the House that it is not necessarily the cause of death found by a coroner which decides the question of entitlement to industrial death benefit. The Industrial Injuries Acts laid down an entirely separate procedure for deciding whether death was the result of an industrial disease or accident. Members will be aware of this from their own experience of the dismay that has been caused to widows when the coroner has attributed death to pneumoconiosis, but following the pneumoconiosis medical panel report, the insurance officer has decided otherwise.

It could have been argued until last year, however, that a post-mortem examination would have been necessary for the purposes of paying benefits, even if it had not been necessary under the Coroners Acts. However, the situation has changed somewhat since the passing of the Social Security (Miscellaneous Provisions) Act 1977, which, in section 9, provides that where a disablement pensioner with an assessment of 50 per cent. or more for pneumoconiosis or byssinosis dies as a result of any pulmonary disease, his death is automatically treated as due to industrial disease.

Many people have argued that 50 per cent. is too high a threshold at which to pitch this most sensible innovation, and in clause 2 of my Bill I provide for the reduction of this threshold from 50 per cent. to 30 per cent.

The overall effect of my proposed Bill is therefore as follows. When a medical practitioner notifies the coroner of a death, he will also, where appropriate, indicate that he is satisfied that he knows the cause of death. In those circumstances, the coroner shall inform the next of kin of the deceased if he still wishes to hold a post-mortem examination, and the next of kin shall have a right, within 24 hours of receiving such notification, to object to the holding of the post mortem on grounds of religious belief or conscience. In practice I hope that this will lead to a situation where a post mortem will be asked for by the coroner only in a genuine case of uncertainty as to the cause of death.

1254 I have no doubt that certain elements in the medical fraternity may object to this relaxation of the supply of bodies, and I acknowledge the needs of research. However, in all conscience, this House must agree that there must remain some sanctity and respect for a human body even after death, and that where the next of kin so desire, and where there is no good medical reason to the contrary, the wishes of the next of kin should be respected.

I acknowledge that the Broderick committtee recommended otherwise and envisaged an increase in the number of post mortems. However, as can be seen from paragraph 17.08 of its report, the reason was that the committee thought it helpful to determine claims for industrial death benefit. This is no longer so valid an argument after the 1977 Act, and would be even less so if the threshold were dropped to 30 per cent.

I have had numerous letters from constituents, and others, relating harrowing tales of anguish caused by this sloppy, callous and unnecessary law. In my office I have had widows in tears when recalling their experiences of bereavement compounded by horror. I have seen grown men cry because they knew that this would be their likely fate, and they also knew the grief that it would cause to their beloved ones.