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Sunday, 14 October 2007
Brian Patterson
Ministry of Justice
Coroners Unit 5th Floor
Steel House
11 Tothill Street
London SW1H 9LH
Dear Mr Patterson,
Re: Cremation Regulations – Consolidation and Modernisation
The Faculty of Forensic and Legal Medicine is pleased to respond to the above discussion document. We recognise that the cremation regulations will become redundant if proposed reforms to the death certification process are implemented.
Question 1: Do you consider that giving families the right to see the forms prior to authorisation by the medical referee is practicable and useful?
We believe it will be helpful for the ‘near relative’ to be allowed to see the paperwork and are pleased to see that this term is clearly defined in the proposed new Regulation 2. We suggest that in any explanatory notes the term ‘near relative’ is used throughout and any references to “families” and “the bereaved” are deleted in order to avoid raising public expectations that anyone claiming to be bereaved might have a right to see the paperwork.
Question 2: Are there any amendments which might make the proposed process referred to in Question 1 more effective? Please note the terms of the 48 hour rule as set out in regulation 17(2) of the Regulations.
No – we are pleased to see that weekends and Bank Holidays are to be disregarded when applying the 48 hour rule as failure to have done so may have imposed an impossible administrative burden on crematoria administrators.
Question 3: Bearing in mind that the regulation dealing with pandemics (Reg 13) will only be brought into effect as and when required, does it seem a practical way forward?
The proposals to simplify the cremation process during a pandemic seem sensible. However, it is not clear why [pandemic influenza] is included in brackets under this regulation. It would be wise to make the regulation wide enough to deal with other pandemics, whether infective in origin or, for example, the result of chemical or radiological mass disaster.
We also suggest that it would be sensible to allow registered medical practitioners to issue certificates and not just coroners, as implied in 13(b).
Question 4a: Are the definitions used within Regulation 2 of the draft regulations sufficiently clear?
We note that a literal interpretation of ‘body parts’ would include samples of bodily fluids, such as urine and blood, as well as histological slides prepared during the course of post mortem investigations. It seems sensible to find a form of words that would exclude samples such as these from being included in ‘body parts’ that have to be cremated under 14(3).
Question 4b: Should any other words used in the regulations be defined and if so how?
Under Regulation 13(2)(b)(ii)(cc) the term ‘work colleague’ should be defined, see response to question 9 below.
The terms “human remains” and “the remains” of the deceased are used in regulations 9, 12, 13, 15 and 16. If it is intended that the term “remains” is to differ from “body parts” we suggest that “remains” should also be defined in Regulation 2 in order to avoid confusion.
Question 5: Is it right that the power to appoint a medical referee is transferred to the cremation authority with the Secretary of State giving consent to the appointment?
No comment
Question 6: Is it right that the Secretary of State should have a power to remove a medical referee from post for the reasons as stated?
No comment
Question 7: Should there be an explicit power to issue guidance to anyone other than medical referees?
No comment
Question 8: Do you have concerns about the wording of regulations 10, 11, 12, 18 & 19?
Regulation 10 refers to the forms in Schedule 1. Many of these forms still refer to the Cremation Regulations 2006, not 2007, in the header.
Question 10 of Form 3 asks “has a post-mortem examination been made”. If this is intended to mean a hospital/consented post-mortem examination rather than a coroner’s post-mortem we suggest that the question be posed in such a way that it asks explicitly if ‘a hospital (consented) post-mortem’ was performed in order to remove ambiguity.
At the end of Forms 3 and 4, in asking for the signature and registered qualifications of the doctor signing, the General Medical Council registration number (rather than “reference number”) should be also be requested.
On Form 5 (coroner’s certificate) we suggest there should be a box to indicate the jurisdiction of the coroner concerned.
Question 9: Does the exclusion of work colleagues being able to sign the confirmatory medical form cause any practical problems which might prevent doctors from performing the functions required of them?
Other than suggesting that the term ‘work colleague’ should be clearly defined so that it is clear it applies, for example, to doctors working in the same hospital team as opposed to the same hospital, we do not envisage any practical problems.
Question 10: Is draft regulation 16 relating to the cremation of exhumed bodies adequate for all such cases?
No comment
Question 11: Do you consider that funeral directors should no longer be allowed to countersign the application form?
No comment
Question 12: Do you consider that the order of the draft regulations is logical and easy to follow?
Yes
Question 13: Should any other words used in the regulations be defined and if so how?
See answer to 4(b) above.
Additional comments
Please note the following typographical errors:
a)Incorrect numbering under Regulation 12 (1)
b)In Regulation 18(c)there is reference to “regulation 0”, which does not exist
We would be happy to discuss any of the above responses in greater detail should this be considered desirable.
Yours sincerely,
DR GUY A NORFOLK
MBChB, LLM, FRCP, FFFLM, MRCGP, DMJ