It is pretty fundamental, is it not? At the end of the day, if the purpose of the inquest to determine the cause of death, the most important bit of the evidence in that respect will often be the pathologist’s report, so it seems strange, to put it mildly, that what is a very modest proposal in the overall scheme of things has not been pursued.
The Government said they were not convinced that the level of fees was the reason for the shortage of pathologists. I ask the Minister politely, in that case, what they think it is? If it is not the level of fees, what is the problem? The Royal College of Pathologists certainly thinks it is an issue; it says 62% of its members giving up post-mortem work cite poor remuneration as a major cause of their decision. If it is not the sole consideration, it sounds to me as if it is one of the major ones, and one that could be easily and swiftly resolved.
There are other issues that we suggested, such as working with the Department of Health and Social Care to make sure that pathologists’ work is planned within their NHS contracts. The problem is that the work they do for coroners is outside the NHS contract. If it is outside their contract and they are being paid a wholly out-of-date fee for it, no wonder it is difficult to get people to do it.
Is there a proper workforce plan for recruiting adequate numbers of pathologists? As the hon. Lady says, we almost cannot get past first base in many inquests without having the pathology services there to start with. I hope the Government will be able to look at that again. What do the Government intend to do to improve recruitment and retention of pathologists? If it is not increasing the fee levels, what else will they do? Things are clearly not sustainable as they are—having 580 vacancies is simply not viable.
The other point I wanted to touch on briefly is something I mentioned early on: the procedure for addressing fatal risks identified by coroners and juries, the prevention of further deaths reports. As I said, they have become increasingly important, and we have all seen their value in many highly publicised cases, but there is currently no consistent mechanism to ensure follow-up. Again, that is due to the highly localised and diffuse system that we have.
What progress have the Government made? They said that they recognised that more could be done and they would consider options, and I welcome that, but what progress have they made in considering how preventing future deaths reports could, first, be made more accessible and, secondly, followed up routinely? The whole point is that they ought to be out there in the public domain to change working practices, to change behaviour and to stop such things happening again.
However, as we found out with prison inspectorates and other things, all too often recommendations are left sitting there and are not followed up. The difference that was made when Her Majesty’s inspectorate of prisons had the ability, and some funding, to follow through on its recommendations was quite marked. What will the Government do to learn from what happened in the prisons system and put in place a mechanism for consistent follow-up and action? Could the Chief Coroner be given greater powers here? It would sit very logically within a coroners inspectorate system, which is perhaps another strong argument for going down that route, but in any event there ought to be a system of consistent means of follow-up and proper transparency and scrutiny.
The Government accepted our recommendation on bringing stillbirths within the coroner’s remit. That will be a considerable benefit to many bereaved families. A joint response from the Ministry of Justice and the Department of Health and Social Care was promised; can the Minister tell us when that response will be forthcoming?
I have not touched on everything, but I hope that gives an overview of what was a very substantial report, and the substantial issues it raised, by no means all of which have yet been satisfactorily answered. I know the Minister brings a fresh mind to this matter, and he is a can-do politician, so I hope he will use this opportunity to reassure us that the Government have not just closed the book on this and said, “No, thank you, that’s the
end of it,” but that we can continue to have a constructive engagement with the Government about improving the system—because clearly, it does need improving.
2.5 pm