HL Deb 03 April 1984 vol 450 cc674-82

7.58 p.m.

Lord Rea

My Lords, I beg leave to move that this Bill be now read a second time. It was guided through another place—largely on the nod, I may say—by an Opposition Back-Bencher, the Member for Blaydon, as a Private Members Bill, so it is appropriate for me to do likewise in your Lordships' House as an Opposition Back-Bencher. It is, I hope, a non-controversial Bill. It deals with an unusual and, some may feel, a rather macabre activity; namely, the anatomical dissection of the bodies of deceased persons for teaching or research purposes. This is another reason why it is perhaps appropriate for me to move this Second Reading since I have in fact as part of my medical training dissected a human body.

The Long Title of the Bill summarises its purposes clearly. It is, to quote the Long Title: An Act to make provision about the use of bodies of deceased persons, and parts of such bodies, for anatomical examination and about the possession and disposal of bodies of deceased persons, and parts of such bodies, authorised to be used for anatomical examination, and for connected purposes". It aims to ensure that there continue to be proper arrangements for the possession and use of dead bodies which have been donated for anatomical examination, and that the system is not open to abuse.

The original Bill of 1832 was necessary to curtail the sinister practice of body-snatching—that is the removal of recently buried corpses, or even unburied but laden coffins, and their sale to medical schools for the use of medical students for dissection. The practice was most prevalent in London and Edinburgh where the medical schools were concentrated. Until the early 18th century anatomy was taught largely by lecture and demonstration, but during that century personal anatomical dissection by students became the norm. At the same time the number of medical students increased greatly from 57 in 1720 to 400 in 1800 in Edinburgh; and from 1780 to 1823 in London they went up from 340 to 1,000.

The practice of body snatching became a scourge and public indignation grew. Bodies became more difficult to come by and the price went up to such an extent that even murder was committed to obtain bodies. The notorious so-called "resurrectionists" Burke and Hare were in fact finally executed for murder.

The 1832 Act, the Long Title of which was, An Act for regulating schools of anatomy was an immediate success and body snatching disappeared almost overnight. It required all those practising anatomy to have a licence to do so; appointed inspectors of anatomy; required that all bodies used for anatomical purposes should have a death certificate and that the permission of any surviving relatives should have been obtained.

Obviously in 150 years things have changed and new legislation, which impinges on the 1832 Act, is now on the statute book. The present Bill is in part a consolidation measure clarifying the provisions of the 1832 Act in relation to the Human Tissues Act 1961 which deals with the donation of parts of the body for therapeutic purposes.

The structure of the Bill is simple and I shall say something brief about each clause. Those of your Lordships who have read the Explanatory and Financial Memorandum will have read some of these notes already. Clause 1 contains definitions of the terms "anatomical examination", "anatomical specimen" and "body". It also states that the Bill is not to apply to any post-mortem examination undertaken to establish cause of death or any donation of a part of a body which is authorised for removal under the Human Tissue Act 1961.

Clause 2 deals with the control of anatomical examination and possession of anatomical specimens. It states that both of these activities are only lawful if the death has been registered or certified, the premises are licensed, the person is either licensed or has permission from a licensed person and, of course, that the body was lawfully donated. Some of these provisions are similar to those of the 1832 Act which it replaces.

Clause 3 deals with the Secretary of State's power to license premises where anatomical examination is to be carried out and to license persons either to undertake anatomical examination or to have possession of anatomical specimens. This clause also lays down that a licensed person has to keep proper records in accordance with regulations made under the Bill.

Clause 4 states that a body may be donated in one of the following ways: by someone in his lifetime in writing or orally before two witnesses during his last illness provided that the next-of-kin do not object: or by the person in lawful possession of the body, unless it is known that the deceased would have objected or the next-of-kin object. This clause also provides that a body may be retained for three years after donation and gives the Secretary of State power to vary the period. This is a new provision.

Clause 5 deals with possession of a body after anatomical examination has been completed. It allows a licensed person, or someone who has permission from a licensed person, to have lawful possession of a part of a body in certain circumstances after the expiry of the lawful period prescribed in the regulations.

Clause 6 lays down that parts of a donated body can only be retained after anatomical examination has been completed when explicit permission was given at the time the donation was made. As with the donation of a body, the next-of-kin has to agree to the retention of any parts of that body.

Clause 7 covers the system for issuing licences. Clause 8 gives the Secretary of State power to make relevant regulations. Clause 9 re-enacts the provision in the 1832 Act for the appointment of Her Majesty's Inspector of Anatomy.

Clause 10 gives the inspector power to enter licensed premises, to inspect records and provides for the information in the records not be disclosed except in certain exceptional circumstances. Clause 11 makes it an offence to carry out anatomical examination otherwise than in accordance with the provisions of the Bill.

Clause 12 says that the expenses arising under the Bill shall be met out of public funds. Any money received by the Secretary of State shall go into the Consolidated Fund. Clause 13, the final clause, deals with repeals and commencement orders.

It is possible that in the future all undergraduate medical students will not have to undergo this ritual experience. I believe there are equally, if not more, effective methods of teaching the anatomical basis of medicine. But there will always be a need for surgeons in training to dissect human bodies which will also be needed for research.

At present about 1,000 human bodies are needed annually for existing teaching and research programmes. This up-dated Bill is necessary to handle the arrangements for this practice. I am pleased to have this opportunity to promote it. I beg to move.

Moved, That the Bill now read a second time.—(Lord Rea.)

8.8 p.m.

Lord Winstanley

My Lords, at the outset perhaps I should say that the quite extraordinary speed, if not precipitancy, with which your Lordships dealt with the last business resulted in the fact that unfortunately—and I apologise deeply—I missed the first part of the speech of the noble Lord. Lord Rea. on the Bill. I was glad to hear what I believe was the bulk of his speech, and in hearing that I think I am right to say that I heard the only full analysis and description of this Bill that has yet been given.

Like other noble Lords when we knew that this Bill had come from another place, I looked up the previous Hansards and I found that the Second Reading in another place was taken on the nod. I found that the Committee stage was extremely brief. The Report stage was taken again on the nod, and the Third Reading, and the Bill passed on the nod. In other words, the Bill went through another place extremely rapidly without ever having a full explanation from anybody, although I would hasten to say that the Minister dealing with it in Committee, Mr. Patten, dealt very fully with the matters which arose during the Committee stage; but it was a very brief Committee stage.

I mention all this for reasons which will perhaps become apparent in a moment. I entirely agree with the noble Lord, Lord Rea, that it is high time that the Anatomy Act 1832 was brought fully up to date. It is high time that we recognised that the later Act of 1871 did not entirely do that. It is also true, as the noble Lord pointed out. that certain measures were necessary in relation to the Human Tissue Act 1961, in relation to the earlier Anatomy Act. Therefore, it is necessary to have a Bill and a tidying up measure in relation to that Act.

It is also right to say, as the noble Lord, Lord Rea, made clear in his interesting speech, that the circumstances in which the original Act came into being were totally different from the circumstances which now exist. Bodies in those days, which were necessary for anatomical purposes, for studying and for research, were obtained by a variety of means which it was necessary at that time to control. It is interesting, too, that even since more recent discussions in another place and in your Lordships' House on this matter, circumstances have changed very rapidly.

If we return to the time of the Human Tissue Act 1961, then there was much discussion about the Anatomy Act because it was much involved when people decided that when they died they would like their bodies to be used for some beneficial purposes for the people who remained. Many like to leave human organs to be transplanted so that they can be enjoyed and properly used by others who live after them, but many people donate their bodies for anatomical examination and to the universities. The situation now, as the noble Baroness knows, is that the supply is much greater than the demand.

The reason for that is fairly obvious. The universities deal with these things in a most expeditious and efficient manner; they engage to conduct a full funeral according to the wishes of the deceased and the next of kin and they pay all the expenses. For that reason, and other reasons which are perhaps less self-interested, the supply is very large and you will find now that the majority of universities and medical schools are not looking for donors. They already have enough. I am not discouraging anybody who would feel mindful of adding his name to the list at some later stage because this is a very necessary purpose. I merely mention those matters to show that times have changed very much. In the light of the change, undoubtedly we need a new Act, so that we now have a new Bill.

It struck me as rather extraordinary that a Bill of this kind and of this degree of importance should emerge—and this is no criticism of the honourable Member who produced it in another place—through the luck of the draw; that an honourable Member in another place, winning the ballot, elected to bring forward a Bill of this kind. It is utterly clear from the nature of the Bill that the Government gave him a considerable degree of assistance in drafting the Bill; so that that Member, Mr. McWilliam, will now have a Bill in good form which has an opportunity of coming on to statute law as a result of his winning a place in the ballot. But that a Bill of this kind should have emerged in that way has necessarily resulted in the fact that at no stage so far have the Government given any exposition at all, let alone a full one, of their present attitude to this whole area. I merely put this question and I do not press it particularly strongly at this stage; but put it up as a marker.

It strikes me that if we are going to legislate here and now in this particular field, it is perhaps unfortunate that at the same time we do not seize the opportunity to do something about the whole area of the donation of human organs for transplants and things of that nature which, I think noble Lords will accept, is an area which at the moment is extremely uncertain, controversial and which many people believe is an area in which we need further legislation.

The shortage of kidneys donated for renal transplant is well known and many people at the moment are existing on kidney machines because of the shortage of organs. Yet there is no doubt in our minds that there are many people who die who, had they known, would have liked their organs to have been used for transplantation purposes, had it been possible. But they had not taken the necessary steps; and the necessary steps are rather complicated and uncertain, involving the consent and agreement of the next of kin and others and involving a certain procedure. I know that we have the kidney donor card and a number of certain procedures.

If we look at the various organs which modern medical science is now able to transplant so that those are useful for some living person after another person has died, there are a large number, an increasingly large number. I think that that increase in number and the improvements in technique for the transplantation of human organs means that at some time, not too far ahead, we shall have to look again at the whole law relating to the consent for the removal of organs after death for use in transplantation and other purposes. I faintly express regret that, if the Government have seized this opportunity to take a Private Member's Bill to carry out the necessary reform in this area, they have not taken the same opportunity in order to bring in a more composite and far-reaching Bill.

Having said that, I have no criticism to make of this Bill. There are certain matters which we might want to look at in Committee although I cannot at the moment say precisely what they are. I do not think that I need give any advance notice to the noble Baroness because I do not think there are any real difficulties. It is an admirably drawn Bill so far as its purpose is concerned—and its purpose is very limited. It seems to me that it achieves it admirably and I see no particular difficulties in it. Having made those points, I think it is interesting that a Bill of this importance has arrived for a Second Reading in your Lordships' House having completed all its stages in another place without the Government ever having made a definitive statement about where they stand. We know where the Government stand because it is clear that the Government have assisted in the drafting. I am very glad that the Bill has come forward. I thank the noble Lord, Lord Rea, for introducing it and for having given an explanation of matters which had not previously been explained. I think I can promise the support of my noble friends on these Benches for the further stages of the Bill.

Lord Prys-Davies

My Lords, I shall be brief. From these Benches, we give full support to the measure and welcome its provisions. I am sure that the House will be interested in the Minister's response to the important questions which have been posed by the noble Lord. Lord Winstanley. I do not propose to address any awkward questions to the Minister this evening. We consider the Bill to be valuable and non-controversial. It is acknowledged that there is a need to make adjustments to the law governing the issues in this delicate field, and to update the law in the light of the experience encountered since 1871 and 1832 and the advances made during the last century in medical knowledge. It merely remains for me to thank my noble friend Lord Rea for introducing the Bill and for having explained in broad outline its provisions and its historical background. My noble friend was well qualified to discharge the task.

8.17 p.m.

Baroness Trumpington

My Lords, it is entirely appropriate that the noble Lord, Lord Rea, should have agreed to promote this Bill. The noble Lord who, as we now know, has himself dissected a body, will appreciate that, as it says in the preamble to the 1832 Act which was quoted by my honourable friend the Parliamentary Under-Secretary of State for Health when he spoke on 29th February 1984 in Committee in another place: a knowledge of the Causes and Nature of sundry Diseases which affect the Body and of the best Methods of treating and curing such Diseases and of healing divers wounds and injuries to which the Human Frame is liable, cannot be acquired without the Aid of Anatomical Examination". That, as my honourable friend has said, is as true today as it was in 1832. The original Anatomy Act was passed to allow for the lawful provision of bodies for anatomical examination and to ensure that such bodies were properly dissected in suitable places by bona fide students of anatomy; and, finally, that they were disposed of properly. Such is also the aim of the Bill now before the House.

The noble Lord, Lord Rea, has already described to your Lordships the details of the Bill but it seems important to me to stress the differences between the present Act and the proposals in this Bill. This Bill defines in Clause 1 what is meant by the phrase "anatomical examination". As the noble Lord, Lord Rea, has already said, advances in medical science have made it necessary to do this. It is also in line with other modern legislation. In 1832. there was no statute on death certification and registration, and reference has now been included in this Bill. The 1832 Act requires a person to notify Her Majesty's Inspector of Anatomy that an anatomical examination is to be carried out on certain premises, but there is no provision for such premises to be licensed. In this century the custom has rightly developed whereby Her Majesty's Inspector of Anatomy visits departments of anatomy in medical schools, post-graduate medical education centres and hospitals and approves premises. We think it correct for the Bill to require the Secretary of State to licence such premises.

This puts the matter on a formal footing. Further-more, the original Act says that anyone studying anatomy shall be licensed. This includes not only the teachers who work full time in departments of anatomy but all the students and professional colleagues who might just do the occasional session in the department. The new Bill proposes that there will continue to be licensed persons working in departments of anatomy who will be able to authorise someone such as a medical student or professional colleague to carry out an anatomical examination or have an anatomical specimen in his possession. I am sure this more flexible approach is the right one.

The 1832 Act was. of course, passed at a time when it was impossible to preserve bodies or parts of bodies for very long. Indeed, the Act originally said that they shall be disposed of after six weeks from the date of donation. Today, with better preservation techniques, it is possible to retain bodies for three years and even longer. Nowadays there are occasions when, either because the dissection of a part of a body has been particularly well done, or because it is needed as part of a student's practical examination at the end of his course in anatomy, a teacher would like to retain a part of a body for longer still or maybe indefinitely. The Bill therefore contains a provision to allow parts to be retained for a long time, provided certain conditions are met. These are set out in Clauses 5 and 6 of the Bill. I believe this provision is a sensible one and it has been welcomed by the people now working in departments of anatomy.

The present Acts are also specific about how a person is to apply for a licence and what sort of people are to be licensed. But. my Lords, we are not here dealing with large numbers of people, and the Bill proposes in Clause 7 to leave it to the Secretary of State's discretion to decide the conditions for granting a licence and how applications are to be made. This will result in a less cumbersome and more flexible way to proceed.

The present Acts only give the Secretary of State power to make regulations to vary the length of time for which a donated body may be retained. The 1832 Act makes detailed provisions about the records to be maintained and who is to do this, the way in which bodies are to be disposed of and so on. Modern statutes of this sort usually provide for such matters to be dealt with in regulations. Again, this is a more flexible approach and I am sure that this is the right one.

Those are the main changes introduced in this Bill. There are to be retained, first, the provision as to how a body may be donated for anatomical examination—detailed in Clause 4 of the Bill—and, secondly, the statutory post of Her Majesty's Inspector of Anatomy, whose duties are spelt out in Clause 9.

Finally, the Bill (like the 1832 Act) creates offences. I should just mention here that the Explanatory and Financial Memorandum says that the fines shall not exceed level three on the standard scale, the maximum of which is currently £200. This is correct, but from 1 st May the figure will be £400, as the maximum fine for each level will be doubled on that date.

On the question of resources, the Bill allows the Secretary of State to charge a fee for issuing the licences. Currently there are about 100 people who are licensed and there are 50 premises approved for anatomical examination. It currently costs my department about £60,000 a year to employ the Inspector of Anatomy and his small support staff. We are thus not talking about large sums of money. No decisions have yet been reached on the precise level of fees.

The current Act covers the whole of the United Kingdom, but your Lordships will know that this Bill covers only England. Scotland and Wales. This is because of the need to consult the Northern Ireland Assembly about new legislation. Northern Ireland intends to put through legislation on the same lines as this Bill when time permits. Until that is done, the 1832 and 1871 Acts will apply to Northern Ireland.

The noble Lord, Lord Winstanley, regretted that this Bill has not been combined with the Human Tissue Act. At the present time it is not clear that changes to the Human Tissue Act are needed. In recent months the number of organs being made available for transplant has gone up very significantly. The Secretary of State for Social Services is also keeping a close eye on the effect of recent greater publicity, asking people to carry donor cards.

I think that the noble Lord, Lord Winstanley, should be glad that this Bill has passed through another place in such an easy way. He may be interested to know that bodies donated for anatomical examination are usually disposed of two years after the donation was made and the departments of anatomy normally arrange for the burial or cremation. The present Inspector of Anatomy has instituted the practice of holding each year an inter-denominational service of thanksgiving, which the relatives of the deceased and and the people working in departments of anatomy are invited to attend. I think this is an excellent practice.

The noble Lord, Lord Rea, treated us to some history: it is now my turn. We have come a long way since, on the morning of Christmas Day 1828, the Lord Advocate, Lord Meadowbank, proposed sentence on William Burke, saying that he should be hanged in the usual way on the 28th January next and that his body be publicly dissected and anatomised. And I trust", continued the judge, that if it is ever customary to preserve skeletons yours will be preserved in order that posterity may keep in remembrance your atrocious crimes". Burke's skeleton still remains in the anatomical museum of the University of Edinburgh. Evil he may have been, but were it not for his atrocious crimes, the Anatomy Act would not have been passed when it was.

In 1832, the Earl of Minto, in moving the Second Reading of the Bill for regulating schools of anatomy, stated that as the law then stood the bodies of persons convicted of murder were alone legally subjected to dissection and that the number of those persons was so small as to prevent persons engaged in the acquisition of surgical knowledge from obtaining a sufficient number of subjects without resorting to that class of persons called "resurrection men", who carried on their trade in defiance of the law.

Today we have before us this Bill, fully supported by the Government; and I welcome the support of the noble Lord, Lord Prys-Davies. This Bill will provide an up-to-date statute on what is undoubtedly a delicate matter. I should like to thank the noble Lord, Lord Rea, and the honourable Member for Blaydon in another place for promoting this Bill, and I join with the noble Lord in commending it to the House.

Lord Rea

My Lords, I should like to thank the noble Baroness the Minister, the noble Lord, Lord Winstanley, and my noble friend Lord Prys-Davies for their contributions. I particularly thank the noble Baroness for the fuller explanation of the details and purposes of the Bill which she gave and with which I fully agree. I was also very interested in her historical research, which was rather wider than that which I was able to give to your Lordships.

The remarks of the noble Lord, Lord Winstanley, were of considerable interest and I hope that the Minister will note them further and agree that there is indeed a need for yet more publicity for organ donation, and particularly kidneys. A better supply of kidneys would enable many with renal failure to live a fuller and more active life without being too dependent on dialysis. To return to the Bill in question, it is, I think, a useful and timely bit of legislation.

On Question, Bill read a second time, and committed to a Committee of the Whole House.

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