§ Order for Second Reading read.
§ 1.25 p.m.
§ Mr. Gerald Nabarro (Kidderminster)
I beg to move, "That the Bill be now read a Second time."
This is a relatively short Measure and one that I hope will commend itself to hon. Gentlemen in all parts of the House. The Explanatory Memorandum adequately and concisely explains its purpose. The Bill will enablethe Secretary of State to prescribe the fees and allowances payable to witnesses at coroners' inquests and to medical practitioners who make post-mortem examinations for coroners.At the present time, there is something of an anachronism in the matter of these fees, for they have not been amended in any way since 1926, and the law in many important respects, in this connection, dates from as long ago as 1887. The amount of the fee payable under existing statutes by a coroner to a medical practitioner who makes a post-mortem examination of the body of a deceased person by the direction or at the request of a coroner, or who attends an inquest in obedience to the summons of a coroner, is prescribed by Section 23 of the Coroners (Amendment) Act, 1926. To demonstrate the inadequacy of the provisions of that Section it may be helpful if I mention the sums it sets down. Section 23 prescribes the fees payable thus:
Those sums were related to monetary values and the cost of living as they existed in 1926—more than 27 years ago.
- "(a) for attending to give evidence at any inquest whereat no post-mortem examination has been made by the practitioner, one-and-a-half guineas for each day on which he is required to attend; and
- (b) for making a post-mortem examination of the body of the deceased and reporting the result thereof to the coroner without attending to give evidence at an inquest, two guineas; and
- (c) for making a post-mortem examination of the body of the deceased (including the making of a report, if any, of the result thereof to the coroner) and for attending to give evidence at an inquest on the body, three guineas for the first day and one-and-a-half guineas for each subsequent day on which the practitioner is required to attend."
1557 They are totally unrelated to current financial circumstances.
Not only are the fees in themselves inadequate, but they bear a rather unfavourable relation to increases in the scale of fees that has been granted for other work of a similar character during the post-war years. For instance, the right hon. Gentleman the Member for South Shields (Mr. Ede), when he was Home Secretary, introduced, in 1948, the Witnesses Allowances Regulations, which increased very considerably the sums that may be paid to professional witnesses and others who attend courts, other than coroners' courts. The coroners' courts were not mentioned in those Regulations. It is, therefore, equitable that the coroners' courts should be brought into line, in the fees payable to witnesses, with the fees and allowances paid for similar work although in a different connection.
The Bill repeals Section 23 of the 1926 Act and, instead of stipulating in the main statute what are the fees and allowances to be paid for witnesses and others attending a coroners' inquest, it places the power in the hands of the Secretary of State to prescribe by Statutory Instrument, from time to time, such fees as he considers may be desirable and in accord with the then current circumstances, cost of living and monetary values.
In referring to the history and the background of these matters, I might add that under Section 22 (1, b) of the Coroners(Amendment) Act, 1926, a coroner is empowered to ask a medical practitioner or any person whom he considers to possess special qualifications to make what is calleda special examination by way of analysis, test or otherwise of such parts or contents of the body or such other substances or things as ought in the opinion of the coroner to be submitted to analyses, tests, or other special examination with a view to ascertaining how the deceased came by his death;".The fees which may be paid for these "special examinations" are at present prescribed by a schedule of fees, allowances and disbursements made by the local authority under Section 25 of the Coroners Act, 1887. Here is a point which I consider of very great importance: special examinations will, of course, vary in type very considerably. Perhaps I may quote examples drawn from quite recent circumstances arising 1558 from coroners' inquests—two extreme cases—to demonstrate what I have in mind.
A person traveling in a motorcar is involved in a serious accident which results in the death of the driver or a passenger within a matter of perhaps a few minutes of the accident occurring. It is relatively easy for a doctor to carry out an examination in those circumstances. No very great costs would be involved. No very special costs would be involved at the coroner's inquest or any other examination which might follow.
On the other hand, and at the other extreme, one might think of the case of an exhumation— not by any means a hypothetical case—which might be carried out in accord with the coroner's direction. In those circumstances, the examination might be of a very difficult character. It might occupy a great length of time. Of course, in addition, it might call for the services of a highly qualified specialist.
I quote those two extreme cases because they clearly demonstrate how the costs of a professional person engaged in such examinations can vary very considerably, in themselves. The local authority generally prescribes a maximum fee in such circumstances, but it can be exceeded at the discretion of the county treasurer or the chairman of the finance committee of the local authority referred to in the statute of 1926.
It is now thought, in all the circumstances, that it is most convenient that the fees for special examinations shall continue to be fixed by the local authorities, and this Measure does not propose any change in principle in that important regard, but that the Secretary of State may, if he so desires, prescribe a uniform scale by rules— and that, of course, is by delegated legislation. The proviso to Clause 1 (1) accordingly states that the provisions of the subsection shall not affect in any way the fees payable in respect of one of these special examinations to which I have referred.
The fees and allowances payable to witnesses in coroners' courts—witnesses other than professional witnesses—are at present prescribed by schedules made by the local authorities under Section 25 of the 1887 Act as extended by Section 29 (1) of the Coroners (Amendment) Act, 1559 1926. Those schedules vary a good deal between different local authority areas and in some areas are considered to be very inadequate. It is desirable that these fees and allowances should be standardised, like those payable to witnesses in criminal courts which were standardised under Regulations made by the right hon. Member for South Shields in 1948, during the period of his office as Home Secretary.
I might mention, in addition, that Section 29 (2, b) of the Coroners (Amendment) Act, 1926, gives the Home Secretary power to prescribe a new schedule in any area in which he thinks that the fees prescribed by the existing schedule are inadequate, but, in fact, the use of this power on a wide scale would tend to be cumbersome and over a period of many years has never been exercised. This Bill therefore gives power to the Home Secretary to prescribe uniform fees and allowances for ordinary witnesses, by rule, or Statutory Instrument.
The provisions of the Bill— and it is important that I should mention this—have been discussed in close detail with the British Medical Association, who, of course, are intimately concerned with the proposals. Hon. Members will note that I have made many references to local authorities, and I might add that these provisions have also been discussed with the local authority associations and with the Coroners' Society. All these important bodies have given their unequivocal support to the proposals within this Measure. I therefore hope that they may commend themselves to the House without undue difference of opinion.
If the Bill passes into law, the Home Secretary will have power to make such regulations as he deems necessary from time to time to prescribe scales of fees in connection with witnesses, and it might, therefore, be assumed that the Home Secretary would consult each of these bodies as to the adequacy or otherwise of the proposals.
The Bill does not extend to Scotland or to Northern Ireland.
I have deliberately compressed my remarks into a few moments, and I have no hesitation in saying that that is a Parlia- 1560 mentary manoeuvre to enable the hon. Member for Sheffield, Park (Mr. Mulley) to have further time for the Second Reading of his Bill dealing with football pools.
§ Mr. Nabarro
I hope that this Bill will have the unanimous support of the House, as, indeed, it has the unanimous support of professional opinion in the country, as far as I have been able to ascertain it.
§ 1.39 p.m.
§ Lieut.-Colonel Marcus Lipton (Brixton)
The Bill will introduce a desirable measure of uniformity in what at present is a rather scattered and disjointed scale of fees. To that extent it must commend itself to all hon. Members.
It is further evidence of the diminishing monetary values, to which the hon. Member for Kidderminster (Mr. Nabarro) referred—a diminution which has been going on even since the present Government came into power. But that introduces another aspect which perhaps it would be inappropriate to discuss now. I therefore wish to associate myself with the hon. Member for Kidderminster in suggesting that the Bill be given a unanimous and unopposed Second Reading.
§ 1.40 p.m.
§ Dr. A. D. D. Broughton (Batley and Morley)
I should like to speak for a very few minutes in support of the Bill. First, in accordance with the usual custom of the House, I must declare a personal interest or, at least, a personal potential interest by reason of my being a registered medical practitioner. I am not engaged in practice at the present time, but if I were to return to practice when this Bill becomes law, and if I were called upon by a coroner to perform a post-mortem examination and attend at the inquest, I should benefit by the provisions contained in this Bill.
I have performed many scores of post-mortem examinations and I have given medical evidence on numerous occasions in coroners' courts. I need hardly inform the House that post-mortem examinations are unpleasant work; indeed, frequently they are extremely unpleasant 1561 work. In order that a doctor shall be able to perform this necessary duty he needs to have a considerable knowledge of anatomy, pathology and forensic medicine. He requires skill and he must be alert the whole time, keen and careful in his observations. On him falls a heavy responsibility, and he must give an accurate, careful and easily understandable report to the coroner and, possibly, to a jury at the coroner's inquest.
Sometimes when one is performing a post-mortem examination the cause of death is easily found, and the inquest may be little more than a mere formality. On those occasions the fee that is paid to the medical practitioner is comparatively easily earned. But there are other times when a post-mortem examination takes many hours; when the compilation of the report for the coroner occupies a long time, and when the inquest may take as long as half a day. On those occasions, the present scale of fees is, in my opinion, grossly inadequate. Taking an average, I would say that the present fees are insufficient for this work and the heavy responsibility that goes with it.
On 15th April, 1953, I received a letter from a Secretary of the British Medical Association telling me of the concern that was felt by the Association regarding these fees. I was informed that the Association had sent a letter to the Joint Under-Secretary of State for the Home Office in July, 1952, and that a reply had been received which stated:I am directed by the Secretary of State to refer to your letter of 23rd July about the fees payable to medical witnesses under Section 23 of the Coroners (Amendment) Act, 1926, and to say that while he sympathises with the suggestions that the existing scale should be improved, he is not yet in a position to say when it would be possible to introduce the necessary amending legislation.
§ Dr. Broughton
This is a copy of the letter sent in reply to one from the British Medical Association, dated 23rd July, 1952.
In December of that same year, my hon. Friend the Member for Cheetham (Mr. H. Lever) put down a Question for written answer to the Home Secretary, asking whether he would review the fee paid under the Coroners (Amendment) Act, 1926, to pathologists in respect of 1562 post-mortem examinations, in view of its inadequacy, having regard to present conditions. The right hon. and learned Gentleman replied:Legislation would be necessary to increase the fees which may be paid to medical practitioners under Section 23 of the Coroners (Amendment) Act, 1926, for making post-mortem examinations, and I regret that I cannot say how soon it will be possible to introduce legislation for this purpose."—[OFFICIAL REPORT, 9th December, 1952; Vol. 509, c. 47.]I submit that there is abundant evidence to show that the Government admit that the medical profession has suffered an injustice and yet, I suggest with disgraceful neglect of their duties, the Government had not brought forward the Bill themselves The hon. Member for Kidderminster (Mr. Nabarro) is now undertaking the responsibility and duties of the Government, because the Government would not find time to bring in this Bill themselves.
Since the tragedy of the last General Election, the Conservative Government have had control over Parliamentary time, and, in my opinion, have wasted it.
§ Commander C. E. M. Donaldson (Roxburgh and Selkirk)
I trust that the hon. Gentleman is not going to have a post-mortem on the last General Election.
§ Dr. Broughton
I was merely reminding the House of the manner in which the Conservative Government have been conducting affairs in Parliament since that unfortunate incident of the last General Election. I was doing so in order to make it quite clear to hon. and right hon. Members on both sides of the House that the Government could quite easily, if they had so wished, have brought in this Bill. It is only a very small Bill; it will take up very little time in Parliament and the Government could and should have undertaken this work themselves.
I congratulate the hon. Member for Kidderminster on introducing the Bill and on the speech that he made when asking the House to give it a Second Reading. The Bill, I feel sure, will go on to the Statute Book. It is the Government's duty to see that it does, and when it is on the Statute Book it will bring credit to the hon. Member and gain for him the gratitude of the medical profession.
§ 1.47 p.m.
§ Mr. Frederick Elwyn Jones (West Ham, South)
I rise briefly to support this useful and, if I may say so, long overdue Measure. Those of us who are connected with the criminal courts and the work of pathologists know the great importance of their work as an essential part of the administration of justice.
In that administration it has long been apparent to us that the coroner's court is the Cinderella in the matter of remuneration to the professional men engaged in the work of the courts—[Interruption.] I do not know whether we can pursue the Cinderella analogy too far within the sombre context of the work of pathologists and I will not be diverted by the friendly interruptions around me from my intention to restrict my observations to expressing my own enthusiasm for this Measure.
The figures which were read out by the hon. Member for Kidderminster (Mr. Nabarro) as the fees which up to now have been prescribed, are staggering in their inadequacy. The time spent on this Private Member's Bill today is time well spent. I will not enter into the merits of the dispute as to whether the Government should have introduced this Measure, but we may assume in anticipation that when the Joint Under-Secretary speaks for the Government he will give full Governmental blessing to the Bill and will do all that is necessary to expedite its becoming an Act.
§ 1.51 p.m
§ Mr. Somerville Hastings (Barking)
I shall not detain the House more than a couple of minutes. I suppose I ought to declare my interest, but I certainly hope very much that I may never be called upon to carry out another post-mortem examination. I should like to thank the hon. Member for Kidderminster (Mr. Nabarro), who has introduced the Bill, for considering the interests of a deserving if, perhaps, somewhat misunderstood profession. All I want to do is to raise one point and ask one question.
When a coroner has to decide whether to have an inquest, with or without a post-mortem examination, he sends the coroner's officer to make inquiries. But in most cases he also telephones the doctor in charge of the case, if there is one, and puts to him various questions. I am quite 1564 sure that all doctors reply to such questions on the telephone to the best of their ability, but occasionally it happens that in making up his mind whether to hold an inquest the coroner asks for a report in writing, and sometimes rather a long report, from the medical officer in charge of the case before death.
I understand that a fee can be paid for such a report via the local authority. I want to know whether the hon. Member for Kidderminster does not feel that the fee for such a long report, which may take the doctor a great deal of trouble to prepare, in looking up his notes and so on, ought not to be covered in the Bill in the same way as the fees to witnesses, persons summoned to attend as witnesses and medical practitioners who make the post-mortem examinations that are provided for in Clause 1 (1). If such cases as I have described are not covered by the Bill, I suggest that they ought to be.
§ 1.53 p.m.
§ The Joint Under-Secretary of State for the Home Department (Sir Hugh Lucas-Tooth)
This is, as every hon. Member who has spoken has acknowledged, a most useful Bill, and I am quite certain that the whole House is obliged to my hon. Friend the Member for Kidderminster (Mr. Nabarro), not only for bringing it forward, but for the clear and full explanation which he has given of its provisions. Perhaps the best I can say to him is that I hope it will seldom need to be used in his constituency. The Government will be glad to give the Bill every assistance in its passage through the House.
The hon. Member for Batley and Morley (Dr. Broughton) struck an unfortunate and partisan note. It would be very easy for me to reply by saying that everything he said applied to the whole of the six years when his party occupied this side of the House. He seems to have forgotten that. Perhaps he will remember it if ever he wins a place in the Ballot and finds that he needs the assistance of the Government to pass a useful Bill through the House. What he says amounts to saying that no Private Member should ever be entitled to bring a Bill forward because it is the responsibility of the Government to bring forward every useful Bill.
1565 If the Bill is passed it will, of course, involve a charge on public funds. The direct charge both for medical practitioners and for ordinary witnesses will be borne by local authorities, but there will be an indirect charge on the Exchequer through the operation of the equalisation grant. This means that a Money Resolution will be necessary before the Bill can make any further progress. I give the assurance that the Government will consider sympathetically taking appropriate action if the Bill gets a Second Reading today.
§ Question put, and agreed to.
§ Bill accordingly read a Second time, and committed to a Standing Committee