PAPER B
FIRE AND PUBLIC SAFETY SELECT COMMITTEE – 15 NOVEMBER 2004
HM
CORONER’S SERVICE FOR ISLE OF WIGHT
REPORT OF THE PORTFOLIO HOLDER FOR FIRE, EMERGENCY PLANNING AND CONSUMER PROTECTION
REASON FOR SELECT COMMITTEE CONSIDERATION
To consider
the Coroner’s Service, its responsibilities, accountabilities and costs.
|
ACTION REQUIRED BY THE SELECT
COMMITTEE 1.
To note the report and that from HM Coroner. 2.
To comment on proposals to place the transportation of bodies service
out to tender. 3. To make such other recommendations as the Select Committee may deem appropriate concerning the Coroner’s Service. |
BACKGROUND
1. This report will give an overview of the Coroner’s service for the Isle of Wight.
The supplementary report from HM Coroner (Appendix 1) gives further information. In particular, there is an overview of the work of the Coroner and implications for the future.
2. The Coroners’ Act 1988 states that the appropriate Council (i.e. in this case the Isle of Wight Council) shall appoint a Coroner for its jurisdiction and pay him/her prescribed fees and salaries. All costs relating to inquests must be promptly paid by the Council. It is Consumer Protection that takes primary oversight of the service on the Island.
3. The Coroner, Mr J Matthews is a qualified solicitor and employed on a part time basis to investigate reported deaths. Last year this figure was 736. To assist him, Mr Matthews has a full time Coroners’ Officer, Mr D Webb. He is a Police civilian and due to retire in April 2005.
There is also currently a part time (0.6 FTE) Deputy Coroner’s Officer, Mrs A Rowsell. Secretarial support is provided by a secretary within Mr Matthews’s law firm. This post holder is employed part time and costs are paid by the Council. Mr F. Basford is a designated Honorary Coroner’s Officer for Treasure Trove purposes.
4. The budget for the service is £269,100 in the current year an increase of £10,534 over 2003/04. This figure crudely equates to £370 per death.
Six categories of expenditure make up 90% of spend: post mortems (44% or £113K); staff (19% or £49K); mortuary rents & transportation of bodies (both 9% or £22K); medical fees (6% or £15K); and Coroners’ expenses (4% or £11K)
Compared with 2002/03 costs are fairly consistent (£258, 133 v £258,566) with some notable exceptions. Building maintenance, equipment and computer expenditure headings were insignificant in 2003/04, but accounted for 8% (£21K) in 2002/03. Medical fees were 16% of budget in 2003/04, but only 6% last year. The biggest change in the costs is for the transportation of bodies. In 2002/03 the share of the budget was 0.5% (£1,400). This had increased to 9% (£23K) last year: an increase of 1,543%.
5. All violent and unnatural deaths, and deaths the causes of which are either unknown or are in serious doubt and all deaths in custody are reported to Coroners. If the law requires it or an initial post mortem examination suggests the death was unnatural, an inquest will be conducted. Inquests require Coroners to ascertain the medical cause of death as well as when, how and where the deceased came by their death.
A variety of investigative tools are used to determine the required information. Post mortems are a significant contribution.
6. Nationally the number of deaths reported to Coroners has been increasing since 1920, to a level where last year Coroners were coping with three times more deaths than in 1920. At the same time, the numbers of post mortems carried out has been declining: 57% of all cases reported to them last year compared with 88% in the early 1970s. Where an inquest is held, post mortems are carried out in 95% of cases but in only 51% where an inquest is not called. Two years ago, it was rare for an inquest to be held without a post mortem examination. By 2003 this proportion had risen to 5%: a three fold increase since 1993.
Whilst Post mortem examinations have declined by 40% since 1987, inquests have remained fairly static at 13% over the same period.
7. On the Island last year, there were 736 reported deaths, only 12% (86) of which required an inquest. This is slightly below the national average. Where an inquest was called, a post mortem was carried out in 99% of cases (slightly above the national average of 95%). In total, 486 (66% of those reported) post mortems were conducted or 9% more than the national average.
8. If an individual dies more than 14 days after being seen by a medical practitioner and the cause of death cannot be ascertained, a doctor may not sign the death certificate stating cause of death. Such cases are referred to as “sudden deaths” in the Coroners Act 1988 and in general parlance. From the above it can be seen that nearly two thirds of deaths are referred by the Coroner for a post mortem investigation to be carried out, as permitted by the Act. These post mortems are usually carried out at St Mary’s Hospital. Whilst the number of post mortems has declined in the last 20 years, they still provide good evidence on which the Coroner may draw conclusions. As such there is an irreducible number of post mortems that must be carried out.
Transporting the bodies of those ordered by the Coroner to be post mortem examined at the hospital has become an increasingly significant cost. Costs of transporting the body from the hospital to the funeral directors’ premises and thence to disposal are borne by the estate of the deceased or the Council if there is no will and/or relatives.
9. Initial discussions and correspondence between the Coroner and the Head of Consumer Protection suggested a maximum number of sudden deaths at 50 per year. In 2001 there were 38 sudden deaths without known relatives. For a time the funeral industry on the Island had provided the body transportation service for free. However, the system began to break down as some funeral directors withdrew from this informal arrangement to such an extent that on occasions, in certain locations it was difficult to obtain transport.
The Coroner met with the industry and an agreement was struck whereby, in the main, each sudden death body collected anywhere on the Island and at any time attracted a payment of £100. The agreement runs for 3 years.
10. At the anticipated 50 sudden deaths per year, this service was expected to cost £5,000 p.a. From the figures above, it can be seen that costs increased to £23,000 in a year.
Inquiries have been made to see how the service is operated elsewhere. The Home Office confirms that there are wide discrepancies, nationally, in the costs of providing the service. Plans are afoot to remove control from local authorities from 2007 and place it with the Home Office. Economies of scale may be possible from such a scheme.
11. National Statistics of Coronial jurisdictions in England and Wales have been examined to identify jurisdictions with similar workloads to the Island in 2003 (736/ 86/ 486). The numbers in brackets are (N0 of deaths/ N0 of inquests/ N0 of post mortems)
East Cornwall (897/ 108/ 685); Eastern Somerset (903/ 100/ 680); Mid and North Shropshire (981/ 102/ 748); Milton Keynes (670/ 80/ 451); North East Cumbria (811/ 105/ 597); North East Hampshire (944/ 126/ 652); Telford & Wrekin (720/ 78/ 477); Wolverhampton (758/ 127/ 519).
The Coroners of all these jurisdictions were contacted by telephone and asked 10 standard questions: How much does your service cost? How do you transport sudden death bodies to the mortuary? Who pays for this service? Are relatives charged for initial transportation if they can be traced? How much is charged? How many full time staff have you got? Do you have a prison? A hospital? Would you describe your area as a holiday resort? What is you proportion of individuals in the community over 65 years of age?
The results bear out the assertion made by the Home Office that the transportation of bodies varies considerably in cost. Of those who responded, costs for the whole Coronial service ranged from £235K - £530K. The lowest figure is comparable to the Island.
12. There are a variety of charges and charging strategies. Some authorities pay a flat rate with out of hours and bank holiday/weekend supplements. A few also pay a waiting time charge (the police may not have concluded their initial enquiries on the deceased when the undertakers arrive at the place of death). Some pay mileage which varies with distance from a nominated main town. The amount paid in mileage varies between 40p per mile and £1.22.
13. Of particular interest is the rate arrived at for the actual removal of the body to the mortuary. Significant reductions have been made possible by tendering. Even here there is no unanimity. Milton Keynes has the whole district tendered to a single undertaker who charges nothing for the service. This individual relies on the “loss leader” approach: Relatives usually contact the company to carry out the funeral. Tenders varied between £10 - £55 initially. Costs started to rise towards the end of the first tender period. On re-tendering, the service was provided for free.
Mid & North Shropshire have tendered for 3 years and have seen their costs dropped from £100 per body (currently charged to this Council) to £13.00 per body.
In Cornwall, because the County is so large, it has been divided into areas. Some areas have gone out to tender, and others haven’t. The rate charged varies in Cornwall between £20 - £100: the lowest figure is where the area has complete tender, the highest figure is where there is no tendering.
In all cases where tendering has taken place, strict eligibility criteria have been prepared covering suitability of equipment, decorum, dignity towards the deceased and professionalism.
The results suggest that where this element of the service is put out to tender, costs are dramatically reduced to a level between free and £10 per body.
14. There is a concern that if the Island put the sudden death body transportation service out to tender, there would be no interest expressed from the trade.
RELEVANT PLANS, POLICIES, STRATEGIES AND PERFORMANCE
INDICATORS
§ Improving health, housing and quality of life
§ Providing high quality Council services
§ CP Service Plan Target (2003 – 04): To resolve uncertainty with the Coroner surrounding sudden deaths.
CONSULTATION PROCESS
1. Home Office [ a number of occasions June – October by telephone and e-mail]
2. Attendance at seminar in June chaired by Civil Servant recommending review of Coronial service.
3. Coroners’ Jurisdictions of similar caseload as the Isle of Wight [ August & October by telephone] (East Cornwall; North East Cumbria; North East Hampshire; Milton Keynes; Mid & North Shropshire; Eastern Somerset; Telford & Wrekin; Wolverhampton)
4. Plymouth City Council, in answer to general e-mail regarding coroners’ costs. [June by telephone and e-mail]
5. HM Coroner for IoW and Coroner’s Officer
Mr J Matthews, H M Coroner for Isle of Wight has been invited to attend the meeting and deliver his report and answer questions, his report is appended.
FINANCIAL, LEGAL, CRIME AND DISORDER IMPLICATIONS
§ Financial implications are the potential savings to be made as outlined in the background section.
§ The current agreement with the Funeral Directors runs until March 2006. By virtue of the Coroners Act 1988, this Council must pay all reasonable expenses to the Coroner. The Coroner is empowered to require any body to be examined by post mortem or other technique. The Coroner has no means of transporting bodies from their place of death to the place of post mortem/holding. Vehicles for the conveyance of bodies must be specially adapted for the purpose to maintain the dignity of the deceased.
APPENDICES ATTACHED
BACKGROUND PAPERS USED IN THE PREPARATION OF THIS REPORT
1.
The Work of
Coroners. Home Office Website (www.homeoffice.gov.uk/justice/legalprocess/coroners/work.html)
2.
Appointment of
Coroners. Home Office Website (www.homeoffice.gov.uk/justice/legalprocess/coroners/appointment.html
3.
Report on the Provision
of Coroners Officers: Coroners’ Officers’ Working Party
4.
The Isle of Wight Table
1: Deaths by Local Authority of Usual Residence, Numbers & Standardised
Mortality Ratios England & Wales, Government Office Regions (Within
England(, Unitary Authorities/ Districts) Home Office
5.
Table 7: Inquests &
Post Mortems, By Jurisdiction, 2003 Home Office.
6.
Home Office Statistical
Bulletin: Deaths Reported to Coroners England & Wales, 2003. National Statistics. 2004.
7.
Coroners’ Circular No
45. 21. 07. 2004
8.
IWC Financial
Information Database: 2004
9.
The Shipman Inquiry
(III) 2003. HMSO
10. Exchange of correspondence between HM Coroner &
Council 2002 – 2003
11. Burial Law & Policy in the 21st
Century: The Need for a Sensitive & Sustainable approach. HMSO.
January 2004.
12. The Coroners Act 1988. HMSO.
Contact Point : Gareth Davies, Principal Environmental Health Officer , ' 823169 [email protected]
CLLR DAVID KNOWLES
Portfolio Holder for Fire, Emergency Planning and Consumer
Protection