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I note the two pieces on the coronial system in the last BMJ;
saddened by the personal view on p.481, but glad to see publicity shed
onto the system. After all, Britain’s best kept medical secret is that 22%
of everyone who dies is autopsied under a coroner or procurator fiscal.
And the same applies in Ireland.
Lots of local authority money is sloshing around there, lots of NHS
consultant time-shifting, quite a few zero-governanced independent
pathologists, lots of underused teaching opportunities, and an
unacceptable amount of poor autopsy practice (see the NCEPOD 2006 report:
“The Coroner’s Autopsy: do we deserve better?”).
The coronial system for England, Wales and Northern Ireland will be
revised under the new Coroner and Justice Act 2009. But there are two
critical issues:
1) what is the purpose of the coronial autopsy? This is not well defined
anywhere, and one view quite consistent with the current law is that it
(merely) provides coroners with information that enable them to dispense
with an Inquest;
2) the separation of the coronial system, and its output, from the NHS,
where most of its subjects come from. There is no indication that this
will change.
Perhaps the BMJ could help the cause for improved autopsy quality -
and utility for the nation - by actively supporting better leadership in
this important, but almost deliberately neglected, segment of medical
life.
Competing interests:
None declared
Competing interests:
No competing interests
02 March 2010
Sebastian B Lucas
Professor of Pathology
Dept of Histopathology, St Thomas' Hospital, London SE1 7EH
Leadership needed
I note the two pieces on the coronial system in the last BMJ;
saddened by the personal view on p.481, but glad to see publicity shed
onto the system. After all, Britain’s best kept medical secret is that 22%
of everyone who dies is autopsied under a coroner or procurator fiscal.
And the same applies in Ireland.
Lots of local authority money is sloshing around there, lots of NHS
consultant time-shifting, quite a few zero-governanced independent
pathologists, lots of underused teaching opportunities, and an
unacceptable amount of poor autopsy practice (see the NCEPOD 2006 report:
“The Coroner’s Autopsy: do we deserve better?”).
The coronial system for England, Wales and Northern Ireland will be
revised under the new Coroner and Justice Act 2009. But there are two
critical issues:
1) what is the purpose of the coronial autopsy? This is not well defined
anywhere, and one view quite consistent with the current law is that it
(merely) provides coroners with information that enable them to dispense
with an Inquest;
2) the separation of the coronial system, and its output, from the NHS,
where most of its subjects come from. There is no indication that this
will change.
Perhaps the BMJ could help the cause for improved autopsy quality -
and utility for the nation - by actively supporting better leadership in
this important, but almost deliberately neglected, segment of medical
life.
Competing interests:
None declared
Competing interests: No competing interests