Medical Examiner to Check Every Cause of Death
More than 20 years ago, rules were introduced to prevent criminal activity or negligence from going undetected, in response to the Harold Shipman murders.
The government has announced that a medical examiner will review the cause of death given in all cases not investigated by a coroner in a policy designed to uncover criminal activity or medical negligence.
The new measures for England and Wales come in the wake of the Lucy Letby murder trial, which saw the former neo-natal nurse found guilty of killing seven babies and attempting to murder six others at the Countess of Chester Hospital.
These safeguarding measures were proposed following the case of Britain’s most prolific convicted serial killer, doctor Harold Shipman, believed to have murdered more than 200 people by giving them lethal injections and certifying their deaths as “natural.”
The reforms to death certificates will mean several different professions, including doctors, coroners, and registrars, will have to change their practice. The new legislation will come into force from April 2024, although medical examiners have already reviewed 640,000 hospital deaths since 2019 without the statutory requirement.
Medical examiners will have to confirm the proposed cause of death and overall accuracy of the death certificate under the reform as well as support recommended referrals to the coroner.
While the new legislation will not necessarily lead to more inquests, it will introduce an extra layer of scrutiny into the death certification process and has been broadly welcomed across the medical profession.
National Medical Examiner Dr. Alan Fletcher said: “The NHS is pleased the government is putting the work of medical examiners delivering independent scrutiny of all non-coronial deaths in England and Wales on a statutory footing in 2024.”
Dr. Suzy Lishman, senior medical advisor on medical examiners at the Royal College of Pathologists, welcomed the legislation but said it was “long-awaited.”
Dame Janet Smith called for reform in the Shipman Inquiry third report back in 2003, where she said it was not merely criminal wrongdoing that a doctor might seek to conceal in certifying a death without scrutiny.
Several other inquiries following the Shipman review also called for public safeguarding to be strengthened through additional scrutiny into the medical causes of death.
Health Minister Maria Caulfield said: “It has taken time to get this right, but it was vital we had the backing of all involved in the process in order to make sure it protects people and supports bereaved families in the way they deserve.”
