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Meeting of the Parliament 16 March 2011

16 Mar 2011 · S3 · Meeting of the Parliament

Item of business

Certification of Death (Scotland) Bill

Scanlon, Mary Con Highlands and Islands Watch on SPTV

I thank the witnesses, in particular Professor Stewart Fleming and Ishbel Gall, who scrutinised the bill effectively at all stages.

I am pleased that we have reached stage 3, at the tail end of the parliamentary session, but I remain uncertain whether the bill will lead to a system that is more robust than the current arrangements and more likely to identify a potential Harold Shipman or even provide us with more information on cause of death, as Professor Fleming said when he gave evidence and as Richard Simpson said in the debate. Although I remain unconvinced by the bill, I am a non-clinical member of the Health and Sport Committee. I am concerned, however, that the two highly experienced doctors on the committee also have reservations about it.

The bill has changed radically since it was introduced, as a result of the evidence that the committee heard and the minister’s evidence at the end of stage 1. That demonstrates how poorly the measures on certification of death in the bill as introduced reflected 21st century life, and it calls into question the extent to which the minister and the bill team took on board the written evidence that was submitted during the consultation. The committee heard the same concerns expressed in oral evidence at stage 1.

Although up to 1,000 level 2 reviews will be more detailed than is currently the case, level 1 review and certification, which it is alleged will cover up to 25 per cent of deaths, will be significantly less detailed than is currently required. The minister has assured us that the number of level 1 and level 2 reviews can be adjusted up or down and that the matter will be covered in guidance.

However, the bill will be passed in the final days of this session of the Parliament. In May we will have new committees with responsibility for health and subordinate legislation, and, perhaps, a new health minister. The members who agree to the statutory instruments that provide for the guidance will likely be unaware of the serious critical written and oral evidence that has been provided and there is the potential for the number of reviews to be adjusted downwards to the unacceptable levels that were provided for in the bill as introduced.

We have been given assurances on the two pilots that will take place prior to full implementation. However, given discomfort at a review rate of 4 per cent of death certificates—that is up from the 2 per cent in the bill as introduced—will the minister consider having one of the pilots review 4 per cent and the other review a much higher number, for example 10, 20 or perhaps 30 per cent of certificates? Such an approach would enable the new system to be evaluated and might be better than having two pilots—one in an urban area and one in a rural area—in which the rate would be exactly 4 per cent.

Currently, 62 per cent of deaths in Scotland result in cremation. Three doctors check the death certificate in cremation cases, two of whom are not part of the professional practice of the first doctor. After the bill is passed, not three doctors but one doctor will check the death certificate—yet we are told that that is an improvement.

How many of the 25 per cent of deaths that are currently referred to the procurator fiscal are subject to medical examination and review? I understand that the number is likely to be low, and clarity on the issue would be helpful. Will the minister respond in writing on that?

The Scottish Conservatives will support the bill, given that further changes will be made through guidance. We trust that the reservations that have been expressed throughout the bill’s passage will be taken on board by the Government and whatever Administration is tasked with issuing guidance after the election in May.

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