Report to the Minister for Health and Social Services
February 2011
Cremation (Amendment No. 15) (Jersey) Regulations 201-
Purpose
Under the provisions of the Cremation (Jersey) Regulations 1961, only the Medical Officer of Health (MOH) has the power to grant or refuse an application for cremation, acting as a ‘medical referee’. This involves agreeing ‘authority to cremate’ when satisfied that the application is in order. It is the final check that there is no reason why a body may not be disposed of by cremation, after which time no post mortem examination of the remains would be possible. It is an important safeguard enabling further enquiries to be made, such as if there was any doubt as to the cause of death, any suspicious circumstances / any reason why the death should be referred to the Deputy Viscount (in his role as Coroner) or his advice sought. The vast majority of cremation authorisations are straightforward and simple to process and authorise.
Approximately 15 such applications are received each week although numbers vary week to week and day to day. The need to process the applications is often urgent, for example with funeral arrangements in place for the following day.
This situation creates practical difficulties in the absence of the MOH, and even when available, servicing this commitment can, and has created inconvenience and inefficiency in organising and prioritising work. The pressure has increased since Dr Rosemary Geller has been absent.
The proposed amendment to the Cremation Regulations (attached) would enable the power of the MOH in regard to cremation to be vested by the Minister for Health and Social Services in one or more Medical Referees, creating a more resilient and efficient team approach.
It is anticipated that Medical Referees would include the MOH, Deputy MOH and other medical practitioners appointed by the Minister of Health and Social Services, on the recommendation of the MOH, as Medical Referees. Without additional resources, and without any increase in funeral expenses, only doctors employed by Health and Social Services can perform this duty, incorporating it as part of their daily duties as required.
Medical Referees – appointment process
The Medical Officer of Health would make recommendations to the Minister to approve a number of Medical Referees, having satisfied her / himself that each doctor so recommended is:
- A registered medical practitioner of at least 5 year’s standing
- A colleague of good professional standing with the character, experience and qualifications required of a medical referee.
- A colleague with no record of any complaints, hearings or warnings to / by the General Medical Council
The Medical Officer of Health would have regard to UK Ministry of Justice guidance on appointment of Medical Referees. The criteria above are consistent with this.
Desired outcome
Once the amended regulations were in force, a new team of Medical Referees would be approved and a rota system set up. In anticipation of this change, the role has been incorporated in the job descriptions of the new Jersey General Hospital Joint Medical Directors. It is also envisaged that a small number of HSS employed doctors who work outside the acute hospital (Jersey General Hospital) setting would become approved medical referees also (examples – Consultant Psychiatrists, colleagues working in Sexual Health or Substance Misuse Services).
To minimise any perceived conflicts of interest, Jersey General Hospital (JGH) Medical Directors would not act as medical referee for deaths in JGH. For such deaths, the intention would be that the cremation would be authorised by the MOH or one of the other non-JGH approved medical referees. Similarly, Consultant Psychiatrists would not act as medical referee for deaths of patients at St Saviour’s Hospital.
Financial Implications
Within existing resources.
Manpower implications
This amendment to the law, if approved, will enable the workload of authorising cremation to be spread between a number of approved medical referees. This will avoid the current critical dependency on the availability of the (acting) MOH. It offers a more resilient solution.
Dr Susan Turnbull
Acting MOH
March 2011