§ 7.48 p.m.
§ Lord Ahmed rose to ask Her Majesty's Government whether they will modernise the working practices of H M Coroner Service to meet the needs of a multi-faith Britain.
§ The noble Lord said: My Lords, I thank the Government Chief Whip for allocating time for this debate and the Minister for taking time to participate in it. I also thank my noble friend Lady Whitaker and noble Lords opposite for giving their precious time to be here. The right reverend Prelate the Bishop of 335 Bradford had indicated that he would take part in the debate but due to a prior commitment, he is unable to be here this evening.
§ Her Majesty's Coroner Service dates back to 1194 when a council held by Hubert Walter, Archbishop of Canterbury, led to the promulgation of the Articles of Eyre. Article 20 provided that in every county there should be elected three knights and one clerk (a clergyman) as keepers of the pleas of the Crown. Those powerful landed men were below the ranks of Lords spiritual and temporal. They were the first coroners. They were elected by the freeholders of the county. Soon the need for the coroners to be knights or clergymen was abandoned. However, the requirement of elections by freeholders continued until the Local Government Act of 1888, which substituted such elections for elections by county councils.
§ The office of Coroner was an honorary one so there was no pay. In 1487 a statute was enacted by Henry VII that provided that a coroner should receive a fee of 13 shillings and 4 pence for any inquest held upon the view of the slain body. In 1751 another statute, enacted by George II, raised the fee to 20 shillings per inquest, together with travelling expenses of 9 pence per mile. Those fees were to be paid out of the county rates and were to be in addition to, not in substitution of, 13 shillings and 4 pence required by the statute of Henry VII.
§ In 1860 the County Coroners Act provided for salaries for county coroners and coroners sitting in boroughs or liberties and franchise coroners who were paid on a differing basis. Most of the substantive law relating to coroners was in the common law until the Coroners Act 1887 which consolidated much of the legislation relating to coroners. The common law is still of some importance, not least in relation to coroners' powers as to contempt.
§ Since the early 19th century most coroners were lawyers or doctors, but the Coroners Act 1926 required that coroners be either barristers, solicitors or legally qualified medical practitioners; that is, doctors on the medical register. The principal legislation in relation to coroners is the Coroners Act 1988, which consolidated (with amendments) the Acts of 1887 and 1926 and which has itself since been amended.
§
Section 8(1) of the Coroners Act 1988 provides that if the deceased:
(a) has died a violent or unnatural death;
(b) has died a sudden death of which the cause is unknown; or
(c) has died in prison or in such a place or in such circumstances as to require an inquest under any other Act",
then, whether the cause of death arose within his district or not, the coroner shall as soon as practicable hold an inquest into the death of the deceased either with or, subject to subsection (3) … without a jury".
In that context "violent" means death by any application of force; death in a road traffic accident or even death by falling down stairs is deemed "violent" for the purposes of the Act.
§ The 1926 statute provided that if it seemed to the coroner that the post mortem examination may show the sudden death was natural (so that an inquest may 336 be unnecessary) he could request or order a post mortem. That provision is now set out in Section 19 of the 1988 Act and is used in over half of the cases of sudden deaths reported to coroners and obviates the need for inquests. Over a third of deaths reported to coroners are dealt with via the pink form "A" where the coroner, after making investigations and inquiries of the deceased's medical attendant, is able to say that there is no need for an inquest without there being a post mortem examination.
§ In 1997 Her Majesty's Coroner Service reported 201,191 deaths, of which 105,168 were dealt with by post mortem examinations (Section 19); 72,073 were dealt with by the pink form "A"; and 24,050 out of 200,000 deaths required an inquest.
§ The greatest concern among the Muslim and Jewish communities in particular is the possible delay in holding a post mortem examination, as the burial should take place as soon as possible. Regrettably, post mortem examinations cannot be avoided in a great number of cases—about 66 per cent in 1997. Perhaps post mortem examinations could be undertaken by a pathologist nominated by the local community outside normal hours. Of course, that service would need to be paid for by local communities.
§ There is also a disparity in the service provided by the Coroner Service in different regions of the country. The service provided by my local coroner, Mr Stanley Hooper, in South Yorkshire, is of an excellent standard, as is the service in Leicestershire. In recent months the service has improved in Bradford. However, in other parts of the United Kingdom the service is unacceptable, including in Birmingham, some parts of London and elsewhere.
§ Coroners Rules provide that no inquest be held on a Sunday, Christmas day, Good Friday or a bank holiday, unless they consider that one should be held on such a day. They also provide that a coroner, his deputy or his assistant deputy, shall at all times be ready to undertake any duties in connection with inquests and post mortem examinations. The phrase "at all times" excludes Sundays, Christmas day, Good Friday and bank holidays. Coroners are required to make themselves available at all times in connection with post mortem examinations and it is not unusual to be called at any hour, particularly when serious crime is suspected.
§ As I said earlier, Muslim and Jewish religious requirements are that burials should take place as soon as possible. I propose that, in order to make some coroners in England and Wales more amenable to dealing with applications to remove a body outside normal hours, a fee of £50 to £100 be paid. I suggest that Her Majesty's Coroner Service could delegate to deputies or assistant deputies out of normal hours. The police coroner officers could also be involved, as they are on call for 24 hours a day. Payment of fees as per the Act of 1487 induced coroners to perform their duties with regard to inquests more diligently.
§ The Muslim and Jewish communities are fully aware that a body cannot be released immediately in cases where there is some suspicion about the cause of 337 death. That is completely understandable. However, where the cause of death has been established and a doctor's certificate has been issued, the coroner or his officer should be available to release the body.
§ Delays in funeral arrangements cause enormous problems for the families and for the communities. Relatives from other towns gather together at the deceased's house which can cause traffic problems and tension with neighbours. There can also be a detrimental effect upon health as so many people are stuck together in the same place until a funeral takes place. Also families overseas can experience the burden of waiting for the release of bodies as many are taken for burial abroad and some medical visitors may die in the United Kingdom while undergoing treatment.
§ At present, there are over 312 coroners; 26 coroners are full time and the rest work part time. Most part-time coroners are solicitors who are or who were in private practice and some are medical practitioners.
§ The composition of Her Majesty's Coroner Service should reflect the multi-ethnic and multi-faith nature of modern Britain and it should reflect its sensitivity to the religious requirements and practices vis-à-vis the different faiths and cultures in the United Kingdom. That should be the case especially in those regions where there is a high concentration of Jewish, Muslim, Hindu, Sikh or other communities.
§ The service should also encourage more people from ethnic minority backgrounds to enter its ranks, which would bring great benefits in that those individuals could advise with regard to and draw attention to the needs of a diverse Britain.
§ Perhaps I may ask my noble friend the Minister what percentage of those working within HM Coroner Service are from ethnic minority backgrounds and also what percentage of those people are from the Muslim, Jewish, Sikh and Hindu communities. Furthermore, what type of training is given to coroners in relation to the religious needs of communities?
§ I remember one coroner saying in a meeting that when one is in England one should live by English laws. Perhaps I may respectfully suggest that we should change those laws or rules which do not reflect the needs of our communities. Britain is now a multi-religious, multi-ethnic and diverse society and our services to the citizens should reflect the needs of the people.
§ 8.1 p.m.
§ Baroness WhitakerMy Lords, I am grateful to my noble friend Lord Ahmed for initiating the debate and I support him, not least because so few others seem to have taken an interest in a pretty clear example of how our avowedly multi-cultural society does not take into account the needs of different faith communities.
I want to make a brief contribution. I am not expert in the relative practices of different faiths. Indeed, as many of your Lordships may be, I was unaware of these issues until I had the honour to chair a session of a conference on religious discrimination organised by the Council of Europe's Commission on Racism and 338 Intolerance and the European Union Monitoring Centre on Racism and Xenophobia. There I heard several examples of distress caused by the insensitive handling of the requirements of different faiths on the death of a family member. All could have been alleviated by simple, practical and inexpensive steps.
There is not only the question of more rapid post-mortems, where these are necessary, as they are in the majority of cases, as my noble friend says, and the strange fact that few, if any, coroners are from minority backgrounds, even in areas where they predominate.
There is also the important underlying question of the ordinary services of the state being performed in such a way as to make separate groups of our fellow citizens feel excluded. In particular, members of our Muslim communities are already likely to be marginalised, much more likely to be unemployed, more likely to have below average health, in some cases less appropriate healthcare, and very much more likely to experience racial and religious harassment. Should they also be made to feel excluded from the custom and practice of the services which may accompany the sad circumstance of a violent death in the family?
Some kinds of exclusion in employment or racial harassment are complex and difficult to put right and may take time, and in any case are not wholly within the power of the state. But arrangements for coroners' work are wholly within the power of the state. It is a state system. I hope that the Government can assure us that it is their intention to adapt the Coroner Service and to modernise it.
§ 8.3 p.m.
§ Lord DholakiaMy Lords, in my working career I have on a number of occasions attended inquests and post-mortems and I have been involved in discussions with a number of coroners on many occasions. I am therefore delighted to have the opportunity to debate the working practices of HM Coroner Service. The matters relating to our multi-racial, multi-cultural and multi-religious communities have been adequately expressed and I fully endorse what has been said.
Religions and religious beliefs are at the centre of the lives of our ethnic minority communities. Any variation from that process causes a great deal of distress. It is important that there are some problems which are within our scope to put right; others may require further thought.
Before contributing to the debate, perhaps I may clarify an anomaly. When debating the Coroner Service we should remember that the same service does not apply to Scotland. A different situation exists in Scotland; there are no coroners there. Whenever an unusual death occurs the matter is referred to the procurator fiscal. After investigation, the need for a fatal accident and sudden death inquiry is decided. The inquiry is held in the local sheriff court before the sheriff.
339 Will the Minister draw the debate to the attention of his counterpart in the Scotland Office? Our diverse communities are also settled in many parts of Scotland and it is right that they are not isolated from the good practices that we recommend here.
It has taken me some time to discover when your Lordships' House previously debated the Coroner Service. It may surprise your Lordships to learn that I was advised by the Library that it was during the passage of the Coroners Bill 1988. Obviously, I cannot hold the Minister responsible because neither he nor I were then Members of this place. However, I suspect that since the establishment of the coroners' courts in 1194 there have been very few attempts to examine the relevance of their functions today. I confirmed that the coroners courts date back to 1194. My source was not the Library; it was the Encyclopaedia Britannica. I am also told that it may be that the courts date back even before then.
Some fundamental appraisals of training needs in the criminal justice system have been identified by the noble Lord, Lord Ahmed. We find that great strides have been made in training and building sensitivity of people working in that system. Looking at the police service, the probation service, prosecutors and the Prison Service one notes that the building of race sensitivity has been an important part of their training curriculum.
I am delighted that even judges and the noble and learned Lords the Attorney-General and the Lord Chancellor have participated in such training. Indeed, the noble Lord the Minister is no exception. It brings great credit to those professions and helps to build the confidence of minorities in the services which are provided.
My point in raising this matter is that I have not been made aware of what training coroners receive about our diverse communities. Perhaps the Minister can enlighten me with that information. It would also be helpful to have an ethnic breakdown of the service. Ethnic minorities are the major provider of services in the field of medicine. Much of our National Health Service depends on them. Many have excelled in this field. Do we encourage them to apply to be coroners? If not, why not? How many coroners are from ethnic minority communities?
I want to move away from faith and diversity issues and concentrate on the main function of coroners; that is, inquests. The proceedings and evidence given at an inquest are directed solely to ascertaining who the deceased was; how he died; when he died; and when or where he died. The historic role of inquests to ascertain who should be charged with murder, manslaughter or infanticide has been taken over by the Crown Prosecution Service. In summing up when all the evidence has been heard, a coroner will instruct the jury along the lines that an inquest is a fact-finding investigation to discover how a person died; it is not a matter of apportioning blame. Those words are often used in the coroners' courts.
340 I raise this matter because, according to records in the Library, as early as November 1971 the Brodrick report, entitled Death Certification and Coroners, was published. That report recommended reforms which to this day have not been implemented. For the Minister's assistance, those included recommendation 54 in paragraph 16.34 that,
the term 'verdict' should be abandoned and replaced by 'findings??.Recommendation 57 was that the,right to attach a rider to the findings of a coroners court should be abolished. The coroner should confine his inquiry to ascertaining and recording the facts both medical and circumstantial which caused or led up to the death and where he thinks action should be considered to prevent recurrence of the fatality. He should have a right to refer the matter to the appropriate expert or public authority, and he should announce that he is doing so".The form to be used by coroners recommended by Brodrick clearly states that it should avoid the issue of blame. When can we expect progress on the implementation of those recommendations? Surely, 30 years is a very long time to wait for action.I was a member of the Police Complaints Authority from 1994 to 1997. The PCA each year produces information about two or three deaths in police custody, or deaths involving police officers, which result in verdicts at inquests of unlawful killing but no prosecution by the CPS and possibly no disciplinary action recommended by the Police Complaints Authority. There may be innocent explanations for such cases. The inquest may conclude that CS spray, a baton strike or police officer's restraint contributed to the death. The inquest jury may conclude that the deceased had therefore been unlawfully killed. The use of CS spray or a baton might, however, have represented "reasonable force in all the circumstances" within Section 3 of the Criminal Law Act and no officer would then be charged.
It might not be possible to ascertain which officer had inflicted the injury, and no officer would then be charged. An officer might have been following the training that he had been given. There are very important lessons to be learnt from the case for the training of officers, but again no officers will be charged. The actions of officers may not have been unreasonable under case law which is unknown to the coroner or jury but well known to the CPS. Again, no officer will be charged. It is also possible that the CPS may decide not to charge officers when others may conclude from the evidence that the case should be placed before a court. I back that up by referring to the case of Richard O'Brien, which was investigated by the PCA. Mr O'Brien was arrested for being drunk and disorderly outside the English Martyrs Hall in London SE17. He was taken in a police van to Walworth police station where he was found not to be breathing. He was pronounced dead in hospital. The cause of death was positional asphyxia following a struggle. The inquiry included copies of extracts from the American Journal of Forensic Medicine and Pathology dealing with positional asphyxia during law enforcement.
341 In January 1995 the CPS decided not to bring criminal charges. In November 1995 the inquest decided that Mr O'Brien had been unlawfully killed. In October 1996 there was a second decision by the CPA not to prosecute. In February 1997 the Police Complaints Authority decided that two officers should face charges of neglect of duty. In July 1997 the High Court quashed the decision not to bring criminal charges. In February 1998 three police officers were charged with manslaughter. In July 1999 the officers were found not guilty.
Two other examples have been highlighted in the reports published by the Police Complaints Authority. Without going into details, I ask the Minister to study the case of Brian Douglas who was detained in Kennington police station and later escorted to St Thomas' Hospital, where he died. There is also the case of Wayne Douglas, who died in HM Prison Brixton in December 1995. I cite those cases because of the apparent contradictory conclusions of an inquest jury and the CPS which bring the criminal justice system into disrepute. That contradiction also causes great distress to bereaved relatives who hear the jury say that a member of their family has been unlawfully killed and yet nothing is done and the officers continue to serve in the police service.
I should like to place on record a number of initiative taken by the Police Complaints Authority in dealing with cases of death in custody. I urge the Minister to study the good practices outlined by the PCA. Will he ensure that those practices are implemented in all coroners' courts? In particular, I draw to the attention of the Minister the PCA's last annual report on openness which states:
We have argued for several years that bereaved families should not have to wait until the inquest before they receive any information about how a member of their family died. We warmly welcome guidance issued by the Home Office and hope that all parties will comply fully with it".It is worth spelling out that guidance: that all material which is supplied to HM Coroner Service should normally be made available to those whom the coroner considers to be interested parties; that disclosure should not include material which would result in genuine risk of prejudice to any subsequent proceedings, which could cause concern or distress to the family or which would disclose personal information about third parties; and that disclosure should normally be at least 28 days before the inquest proceedings.The Inquest Lawyers Group has also done some valuable work. In an article about inquests and deaths in custody published in January 1998 it states:
Families are in an appalling position of disadvantage compared with the institutions or corporate bodies involved in the case. In the absence of legal aid for representation, families can be confronted at the inquest by teams of lawyers, paid from unlimited public funds, or professional associations, many of whom will have intimate knowledge of all the available evidence. The inequality of access to legal representation and information is unacceptable and severely inhibits the fairness and proper function of the process.If bereaved families attend the inquest without legal representation, it is very rare for coroners to conduct the same searching questions of witnesses that occurs when families are 342 represented. Coroners organise the presentation of evidence, decide which witnesses to call and the scope of questioning to be conducted by the legal representatives. They alone sum up the evidence, address the jury and decide the acceptable verdicts that the jury can consider. Jurors are no longer allowed to add riders to their verdict and are, effectively, prevented from making comments about the evidence that they have heard".The following matters cry out for reform of the inquest system: access to quality legal preparation; advance disclosure of information and witness statements; the right to call witnesses; the right to argue a case as well as to ask questions; and the restoration of the right of the jury to make recommendations to avert future deaths. Simple changes are required to ensure that bereaved families are informed of their rights and given information and access to proper advice and support.We are dealing with an archaic system which cries out for reform. There is a need to make a fundamental review of the role and function of coroners and the services that their courts provide. We need a high level inquiry into the inquest system, possibly undertaken by a judge or other person of integrity and objectivity. That inquiry is not to criticise those who deal with this difficult work but to draw up proposals to take into account difficulties that coroners face and how good practices can assist them. We have waited for over 30 years since the Brodrick report, and now is the time to make the service more relevant to the present day.
§ 8.19 p.m.
§ Viscount BridgemanMy Lords, noble Lords will be grateful to the noble Lord, Lord Ahmed, for raising this matter this evening. Over the centuries this country has followed the custom of accepting and absorbing the cultures of those communities which have come to settle here, and I suggest that this multi-faith and multi-cultural society is the richer for it. There is an interesting contrast with France, where Muslim girls are not permitted to attend school wearing the veil: French culture is imposed.
I do not know the result of the fight by the Sikh community over motor cyclists wearing hard hats, but it certainly provided a lively debate in this country.
There are many people who are unaware that dietary customs, particularly, originated from communities which came from hot countries before the days of refrigeration. Notwithstanding that we have refrigeration, the customs have passed into the culture of the people in this country. The requirement to bury a body, if possible, within 48 hours—a particular requirement of the Muslim and Jewish faiths—derives from the same issue of hygiene.
The noble Lord, Lord Ahmed, has a reasonable point. It is significant that he does not require the coroner to short-circuit any of the forensic requirements of his work. He simply requires the removal of bodies for transportation overseas. He referred to the custom under Muslim law of families being required to remain in their houses, both in this country and the destination country, until the body is received.
343 I cannot think of a more unnecessary way to create civic unrest. It causes problems in communities. The noble Lord referred to the problems of parking and the question of hygiene. This creates unnecessary tension.
The noble Lord, Lord Ahmed, requested that the Minister consider under any reform of coroners' practices, which the noble Lord, Lord Dholakia, outlined with such professional detail, that there should be common practice among all coroners; that the practice in some communities where the role is delegated to the police should be made more universal; and that there should be a requirement, particularly in the case of removal of bodies overseas, that there should be the minimum of delay.
Those are simple requests. We also support the encouragement of members of ethnic communities to enter the Coroner Service. In that way the career will become more popular and the best men will be recruited. Those are simple suggestions to the Minister. I shall be very interested to hear his reply.
§ 8.23 p.m.
§ The Parliamentary Under-Secretary of State, Home Office (Lord Bassam of Brighton)My Lords, I am grateful to the noble Lord, Lord Ahmed, for putting the Question before your Lordships' House this evening. He and others, particularly the noble Lord, Lord Dholakia, have made a very compelling case for the modernisation of practices of Her Majesty's Coroner Service.
It is beholden on government to ensure that services like the Coroner Service are as inclusive, as it were, for those who are deceased as we are attempting to make all other public services for those of us who are living. We must ensure throughout our consideration of these matters that we do everything we possibly can to reflect the multi-faith and multicultural nature of our country. That should inform our thinking as we look to the Coroner Service.
I shall spend some time looking at the history of the service. Two noble Lords have done that expertly. These matters bear some reflection. As has been said, coroners have been a feature of legal processes of this country for more than 800 years. Their duties have evolved considerably over that time. To the credit of the Coroner Service, they have moved with the time. Only since the nineteenth century have coroners consistently performed their current duties: the investigation of violent and unnatural deaths, deaths of unknown cause, and treasure trove.
Coroners have a long history of adapting to the needs of the state and to the needs of society. History shows that criticisms of inflexibility or resistance to change cannot be sustained. They have a difficult job. They must investigate the facts surrounding a death reported to them, but they are expressly required not to determine any question of criminal responsibility on the part of a named person or civil liability. We need to remember that.
344 Their duty is to investigate deaths, fully, fairly and fearlessly, not on behalf of relatives but on behalf of society at large. The noble Lord, Lord Dholakia, reflected that issue very well in his comments. Nor do all the members of the family involved with a death have the same interest as the legitimate interests expressed by close relatives. Coroners must pick their way through a maze of conflicting interests and disputed facts, acting fairly and openly and seeking to arrive at the objective truth of the cause and circumstances of the death.
That is for four main reasons: first, to reassure the public that any untoward or uncertain death will be investigated impartially by an independent judicial officer; secondly, to enable any rumour or suspicion surrounding the death to be fully dispelled; thirdly, to maintain and enhance the integrity of our mortality data in the interests of public health; and, fourthly, to underpin arrangements to detect and deter crime. That last point is very important. Coroners may also report cases so that others can take action to prevent deaths in similar circumstances. I am sure we can all recall cases like that.
The Coroner Service is a service which is held in tripartite responsibility between the Home Office for law and practice, the Lord Chancellor's Department for rules and discipline and the local authority for pay, rations, appointments and facilities. The cost to local authorities is about £50 million each year. We receive very good value for that investment. There are just over 140 coroners in England and Wales. As the noble Lord, Lord Dholakia, said, there is a very different system for Scotland. I undertake to ensure that our Scottish colleagues have their attention drawn to the issues of concern raised during the debate.
Each of those coroners has a deputy and an assistant to stand in for him when required. Interestingly, only about 25 coroners are full-time appointments. The others work either as doctors or solicitors in private practice. About one-third of all deaths are reported to coroners-200,000—but only 24,000 cases result in an inquest; 125,000 post-mortem examinations are ordered. Most of these enable the cause of death to be confirmed and the death registered without the need for an inquest. The inquest verdict summarises the circumstances in which the deceased died. Nearly half, some 9,600, are accidents; and sadly one has to reflect that nearly one in five, 3,700 annually, are suicides. Most inquests are completed within six months and just under half are completed within three months or less. So the performance of the Coroner Service can be described as very satisfactory.
It is crucial that coroners should act, and be seen to act, independently of government. But the Government have a legitimate interest in how coroners discharge their duties. That matter goes to the heart of our discussions and the debate this evening. Coroners should be efficient, expeditious and courteous. Unlike many other services, coroners have to deal with the public at a time when they have suffered personal distress and are feeling most vulnerable. The bereaved must be treated with the utmost care and consideration. Many will be sustained by their 345 religious beliefs and will attach considerable importance to the observance of their religious customs and practices. This debate has reinforced the importance of that point.
We believe that more can be done to assist the bereaved of all religious beliefs, or of none. It is important that the practices and priorities of minority religious communities, such as the Jews, Muslims and Sikhs and many others are properly understood and respected. It is also important for the leaders and members of those communities to understand the legal constraints under which coroners perform their duties, and the wider social needs that they are seeking to serve. I am very grateful to the noble Lord, Lord Ahmed, for his acknowledgement of that point.
Although it has a long tradition, the Coroner Service is not immune to modernisation. There have been a number of modernisation measures, though perhaps not as many as some of us would like. We have encouraged coroners to provide, in advance of formal inquest hearings, more information about deaths and the circumstances in which they occur. This helps families to understand what is happening and to get more out of the inquest process. We have revised our standard information leaflet about the inquest system to make it clearer and more understandable for the bereaved. There is one deficiency in this respect, which we shall obviously need to address, namely, that there is a need to ensure that information about the Coroner Service is posted in a range of ethnic minority languages. That is a matter to which we shall have to give careful consideration.
We have introduced a model coroners' court charter. Coroners and their local authorities have been asked to develop their own charters, setting out local information and making clear what sort of advice can be expected. In particular, information should be given about how long it will take for an inquest to be held. New procedures have been introduced aimed at reducing delays in releasing the body in cases where the deceased has been murdered. We recognise the importance of that. So far, the results have been encouraging.
I now want to reflect on some of the main concerns for the religious minorities. It seems to us that the religious minorities of this country are aware of the particular problems that they face, including invasive post-mortem examinations and delays to funerals in this country or abroad.
No one can be comfortable about post-mortem examinations. The prospect of the violation of the body of a relative or friend is distasteful and distressing to all of us. Such examinations present a particular dilemma for those whose religious beliefs and teachings are opposed to them. Coroners are not required to hold post-mortem examinations. However, if they decide that they are necessary, the consent of the family is not required. We believe that that is right. Otherwise, the coroner could be prevented from achieving his primary purpose, which is to determine the cause of death.
346 Can medical science provide an alternative to the traditional invasive post-mortem examination? A possible alternative is magnetic resonance imaging. We have listened carefully to proponents of this technique. We have recently asked the Chief Medical Officer to consider whether more work can he undertaken on this technique. The best medical advice at the moment is that MRI does not offer an adequate substitute for traditional procedures. Therefore, we cannot recommend that at present this technique should be adopted.
The noble Lord, Lord Ahmed, made a number of proposals on which I wish to reflect very carefully. One was to take account of the issue of delay to extend out-of-hours services. I was interested in his suggestion with regard to nominated pathologists appointed by the local community. That is a matter to which we can give careful consideration but about which I can make no promises. The noble Lord also made the point, which was supported by the noble Baroness, Lady Whitaker, about the need to have a service which reflects the multi-faith, multi-ethnic basis of our society. Quite understandably, the question was asked, "How many of our coroners come from ethnic minority backgrounds?" Information on this question is not robust. I can tell your Lordships that, to our knowledge, of the 25 full-time coroners, there are two who come from an ethnic minority background. We shall need to give further consideration to monitoring. The noble Lord, Lord Ahmed, raised the important point, which was supported by others, about training and encouragement in this important area of policy. We shall take further account of that point, which this debate has very usefully and valuably highlighted.
I briefly address the reasons for delay. They need to be understood. Delays arise because of the need to investigate the cause of death. Each case will vary. Only 12 per cent (24,000) of deaths referred to coroners in 1999 needed to be the subject of an inquest. In 40 per cent of cases, coroners were able to release the body without a post-mortem examination. In nearly all cases, the body can be released for the funeral within a week, if no inquest is needed. In almost 90 per cent of cases, release can be authorised in a week, even if an inquest must be held at a later date. Even a delay of a few days can present real difficulties for some religious communities. It is, of course, a matter for individual coroners to decide whether they can give priority to deaths in particular sections of the community. We have to recognise that priority for one bereaved family can mean a delay for others.
What more can be done in this regard? Why are coroners not available at weekends and Bank Holidays? Coroners and their deputies are already required, under the Coroners Rules, to be available at all times for duties in connection with inquests and post-mortem examinations. Coroners are always ready to respond to urgent cases arising outside normal office hours. A regular out-of-hours service would increase the cost of the Coroner Service. It would also require an out-of-hours service to be provided by all those on whom coroners depend—pathologists, doctors of deceased persons, appropriate 347 laboratory facilities, the police and perhaps other experts. The costs and practicality of making provision for these other services would fall to the local authority. We have to ask whether this would be a proper use of public funds. That is an important question. The noble Lord, Lord Ahmed, mentioned improvements to certain coroner services, particularly in Leicester, Bradford and elsewhere. It is clear that changes to practice are being made. We should give further consideration to those changes, so that we can establish the best practice.
If a body is to be taken abroad (in accordance with the custom and practice of some communities) the permission of the coroner is required. That is necessary, of course, whatever the cause of death. If an early funeral is required, the pressures on the Coroner Service can become acute. Coroners are sympathetic and will do what they can to help, but any volume demands for this service would be beyond the responsibility of individual coroners. We must not forget that the purpose of the checks is to ensure that evidence of suspicious deaths is not put beyond the reach of the police and the prosecution services.
The appalling and dreadful case of Harold Shipman has demonstrated that existing procedures are not infallible. We have carried out a review of death certification arrangements. Changes must make procedures more effective, without those procedures becoming intolerable, especially for the minority religious communities. We have received valuable views from a wide range of professional and lay sources, including representatives of the Muslim, Jewish and other communities. Following our review, we hope to reach conclusions in the next few weeks. In that process, the concerns of the minority religious communities will certainly be given proper and due weight. If significant change is required, it may be that this review will best address many of the problems to which noble Lords have averred this evening.
Coroners' practices and procedures are being modernised, but we are not complacent and we shall continue to keep them under review. We have a close working relationship with the Coroners' Society of England and Wales. That society is aware of ethnic minority concerns and issues, which are regularly drawn to its attention by our officials. I must place on record the fact that much has been achieved with its assistance and support. Coroners are fully seized and aware of the importance of the family in the 348 investigation of deaths and appreciate the special sensitivities for certain sections of the community. We shall certainly draw their attention to the important points raised in this debate.
In conclusion, more work is required to achieve the right balance between the wider needs of society and the rights of individuals. We are anxious to ensure that all bereaved persons are treated considerately and with respect. We have very carefully listened, and shall continue to do so, to suggestions for easing the distress of families at a time of great difficulty for them and for their communities.
This has been an extremely valuable debate. I am fully seized of the need for further modernisation of the service. Although, strictly speaking, it does not fall within my range of ministerial responsibilities, the point made by the noble Lord, Lord Dholakia, about the Brodrick report, which was published 30 years ago, being in need of further appraisal was a telling one. I shall reflect further on that and on all the other important matters raised during what has been an enlightening debate on what is sometimes viewed as a quiet backwater of the practices of government and state services.
§ Lord DholakiaMy Lords, before the noble Lord sits down, I wonder whether he will consider a practical suggestion. This issue particularly affects minority communities. As there are matters which need to be reviewed and considered and as there is now doubt that the co-operation of the minorities is available to the Home Office—they co-operated, for example, on the issue of forced marriages—I ask whether the Home Office could not instigate the type of conference at which minority communities, Crown prosecutors, coroners, the Police Complaints Authority and organisations such as Inquest could come together to produce some practical ideas which the Home Office could take forward as a basis for improving the service. I am not asking for an answer today. I am asking the Minister to reflect on that point.
§ Lord Bassam of BrightonMy Lords, I give a commitment to reflect on it. It is an important point to which I shall give very careful consideration; and I shall share the fruits of my consideration not only with the noble Lord but with all noble Lords who have taken part in this important debate.
§ House adjourned at eighteen minutes before nine o'clock.