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Civil Partnerships, Marriages and Deaths (Registration etc) Bill - Report

Part of the debate – in the House of Lords at 1:00 pm on 1st March 2019.

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Photo of Baroness Barker Baroness Barker Liberal Democrat Lords Spokesperson (Voluntary Sector) 1:00 pm, 1st March 2019

My Lords, in moving the amendment I want to return to the issues I talked about at Second Reading and in Committee. The matter is about the involvement of coroners in the investigation of stillbirths. As we acknowledged at earlier stages of the Bill, this is a very difficult and complex subject. I want to preface my remarks with an expression of my deep gratitude to the noble Baroness, Lady Hodgson, and to the Bill team for the discussions they have had with me and the spirit with which they have accepted my probing on this matter.

Like other Members of this House, over the years I have taken part in many discussions about the NHS, litigation and investigation of medical negligence. We know it is a very complicated subject. It is at its most difficult when one tries to find a way for medical professionals to be open about things that have gone wrong—tragically wrong, in circumstances such as these.

When Tim Loughton first came and introduced this Bill to a meeting of Members of your Lordships’ House, he was the first to recognise that this was a complex subject. Nevertheless, he felt that women and families who had been in this position needed the additional protection of the involvement of coroners to investigate cases of stillbirth. Since then, I have been indebted to the Royal College of Obstetricians and Gynaecologists for sharing with me its detailed briefings, which have gone to the department in the last couple of years. It is well known in this House, not least because of the work of a number of Members on the Conservative Benches, that in the wake of scandals there has been a great deal of work by the Royal College of Nursing and the Royal College of Midwives to improve practice in this area. Yet there is still more to be done.

Like the noble Lord, Lord Hayward, I will not press these amendments to a vote today; they are here to be a vehicle for this discussion to happen. In moving them, I simply ask a number of questions. The aim of all of them is to ensure that, whatever happens as a result of this legislation, the involvement of coroners—the legal process—does not, in ways that may be unintended, get in the way of women and families having fairly swift access to discussions with medical professionals about what has gone wrong in their cases. I firmly believe that, like most victims of medical negligence or poor practice, people do not want money or compensation but to know what happened and to try to stop it happening to somebody else. My efforts in this regard are to try to make sure we do not delay that process.

I make the points that I make in the knowledge that the Royal College of Obstetricians and Gynaecologists has moved a long way, with its Each Baby Counts programme and its involvement in a number of multidisciplinary programmes to try to monitor and improve performance in perinatal deaths.

When this Bill is passed, there will be a consultation, which I hope is widespread, about what exactly the involvement of coroners should be. I simply ask that that consultation include the Royal College of Obstetricians and Gynaecologists and other medical professionals, because only they will be there in future at a delivery to take into account the findings and the learning of what may happen and what may come out of any coroner’s inquiry.

Secondly, I ask that there be widespread consultation on the regulations. It was perhaps the misfortune of the noble Baroness, Lady Hodgson, to bring forward yet another Henry VIII power at a time when this House is knee deep in them, and we on this side feel an obligation to challenge them. But again, I want to know that there will be widespread involvement of the health professionals in the consultation on the regulations.

Thirdly, the training of coroners for this new responsibility must involve professionals such as those in the royal colleges who know about medical practice specifically in this area—an area that will be new to coroners.

Finally, will this new scheme be held under review? I hope that I am wrong and I am being unduly pessimistic about it delaying not improving transparency for parents, but if it does, I want to know whether it will be kept under review so that we swiftly begin to learn. I understand from Tim Loughton and the noble Baroness, Lady Hodgson, that it is envisaged that the involvement of coroners will happen in only a small number of cases. Happily, there are very few cases overall, but most of those are resolved within the existing systems of disclosure within hospitals. But it would be helpful to know at this stage roughly what percentage of cases it is expected will involve coroners. We will know from the review whether there has been a shift away from the existing processes within the NHS and a move towards a more legalistic, coroners’ procedure.

I want to look at whether the existence of a new process automatically means that there is more use of it. Classically, when the Government set up tribunals for a number of different reasons, they thought that it would lead to a decrease in court cases. In fact, it led to an increase in cases full stop. That is not what is intended with this measure, and I want to keep it under review to make sure that that is not what happens. With those questions, I beg to move.