Coroners and Justice Bill

Amendments 92 and 95, like the other amendments in this group, concern the action that ought to be taken to prevent other deaths. At present, the Bill leaves it at the discretion of the coroner to decide whether to inform a person in a position of power of any action which he feels might eliminate, or at least reduce, the chances of other deaths, other deaths which might occur in a similar way. Given that one of the chief benefits of the coronial system must surely be the capacity to learn from mistakes, this is, in our, view a very lax requirement in the Bill. Our Amendment 92 changes the discretion to a duty. If the coroner feels that someone who is in a position to make changes which might prevent another death has the power to do so, it ought to be incumbent on the coroner to act on that opinion. Amendment 95 is a follow-up provision. It allows the coroner to keep an eye on what action is being taken on his recommendation. While the amendment does not, in fact, confer any substantive power to compel action to be taken, the pressure it creates would presumably keep the matter from being kicked into the long grass. In support of this argument I can do no better than turn to the speech of my honourable friend Mr Henry Bellingham in Committee in another place. ""If one considers what happens elsewhere—for example, in New South Wales— recommendations are an integral part of the inquest process and are logged in a detailed document at the end of the inquest. The document is then available to the public and is tabled in Parliament. Doing so obviously exerts substantial political pressure on the Government to take action. In Ontario, for example, the inquest jury gives a verdict and makes recommendations, which are published centrally and sent to all the parties involved. Implementation is monitored annually by a department of the chief coroner’s office. Although our amendment does not go as far as the provisions in Victoria, New South Wales or Ontario, it is a sensible move in the right direction. It would put a statutory duty on the coroner to make those reports. It would put the duty ""on the person involved—the Government agency, the Department or whatever it might be—to respond".—[Official Report, Commons, Coroners and Justice Bill Committee, 10/2/09; col. 171.]" I shall await the Minister’s reply with keen anticipation.