The Scottish Perspective
Dec 27, 2015
. Dundee
Scotland
England, Wales and Northern Ireland
Procurator Fiscal
Coroner
Police
Instructing death investigations
Crown Office and Procurator Fiscal Service (COPFS)(a Department of the Scottish Government)
‘To provide the sole public prosecuting authority in Scotland’
‘To investigate all sudden deaths made known to the Procurator Fiscal and, in appropriate cases, conduct public enquiries and prosecutions’
Lord Advocate
Solicitor General
Procurator Fiscal ?
Crown Office
(Edinburgh)
Area Procurator
Fiscal
Area Procurator
Fiscal
Area Procurator
Fiscal
Area Procurator
Fiscal
Area Procurator
Fiscal
Area Procurator
Fiscal
District Fiscal
District Fiscal
District Fiscal
District Fiscal
PF Depute
PF Depute
PF Depute PF Depute
PF Depute PF Depute
Investigation of crime ?(all crimes)
Crown Office
Prosecution of crime ?(all crimes)
Crown Counsel• Advocates Depute• Solicitor General• Lord Advocate
High Court
Sheriff Court
District Court
Crown Court
Magistrates Court
Procurator Fiscal
Preparation of cases, decision to prosecute, conduct of trial COPFS
Instruction of pathologists, receipt of reports, further discussions COPFS
Role of police is to assist in investigation, but always subordinate to COPFS
Fiscal’s options when notified of a death:
No post mortem examination
GP, hospital doctor or FME issues death certificate
pathologist does ‘view and grant’ and writes certificate
Post mortem examination
single doctor
double doctor (not suspicious)
double doctor (suspicious)
and so get a pathologist
. Dundee
Post mortem examinations(approximately 6,400 per year)
approx. 70% by forensic pathologists
remainder by hospital pathologists
all suspicious deaths carried out by forensic pathologists (except Inverness)
all forensic pathologists based in four University centres
Glasgow
5
(5)
Edinburgh
2
(3)
Dundee
3
(?3)
Aberdeen
1
(?2)= 11 pathologists for about 5000 cases
How did this evolve?
McCluskey / Bowen Report
Pre 1980s
Those carrying out post mortems:
• forensic pathologists in University departments
• police surgeons
• hospital pathologists
• general practitioners
Issues
system patchy and of variable quality
no-one had any official duty to provide forensic pathology services
payment was only on a fee per case basis
University departments reliant on wider University funding
not sufficiently secure to attract recruits unless they had an alternative income
Main recommendations
as far as possible, only doctors with special training in forensic pathology should undertake work for the fiscals
forensic services should be consolidated in the four main Universities
recognition of the important part University departments of forensic medicine play in training doctors and lawyers
graduates training in pathology should spend time in a forensic department
forensic pathologists in the Universities should be paid salaries equivalent to their clinical colleagues
the Crown should make block grants to the Universities instead of paying individual fees – this would allow more staff to be appointed
rejected the notion of a single central institution outside the Universities
pathologists should be amongst their clinical and scientific colleagues; their duties are not just to provide a service for the Crown but to engage also in teaching and research
being in Universities prevents intellectual isolation and safeguards impartiality
‘We considered the feasibility and desirability of establishing a full time service of forensic pathologists to undertake all forensic pathology in Scotland.
The requirements of the criminal authorities and the defence however point to the need for an efficient service which is readily available locally, and it seemed to us that no useful purpose would be served by gathering together all the experts into a small discrete group in one centre.
Not only would they be at a distance from the point of need but they would be isolated from their professional colleagues in other branches of pathology and medicine, and from the police and Procurators Fiscal with whom a close working liaison and co-operation is vital.
Moreover, the setting up of such a national service would remove from the departments of forensic medicine much of the case work necessary for the staff to maintain their professional expertise. We do not recommend therefore that the service should be organised in this way’
Para. 83 ‘How should this service be provided?’
. Dundee
Scotland 2009
• forensic pathologists still all based in Universities
• no independent units (yet)
• in some areas non-suspicious cases carried out by local NHS pathologists
• funded by ‘Crown Office Contract’
• tenders and bids – currently 7 year contract
• paid to Universities or to NHS Trusts
• contracted to carry out certain number of post mortems each year
For Glasgow department
• ave. 2058 cases each year between five consultants
• ave. 395 ‘double-doctor cases’ - homicides - other suspicious - drug abuse and prosecutable RTAs
Could this be done in England and Wales?
Comparing forensic pathology practice north and south of the border
• number and range of cases dealt with
• corroboration of findings i.e. 2 doctor system
• physical groupings i.e. no-one working in isolation, colleagues to step in
• independence from police and (perceived) from legal authorities
• fewer court appearances – inquests, defence
• job security – sick pay, suspension with pay, pension etc.
• involvement with teaching – undergraduate, post graduate
• facilities for research
• technical support – histology, IT, secretarial
Comparing forensic pathology practice north and south of the border
• number and range of cases dealt with
• formal corroboration of findings i.e. 2 doctor system
• physical groupings i.e. no-one working in isolation, colleagues to step in
• independence from police and (perceived) from legal authorities
• fewer court appearances – inquests, defence
• job security – sick pay, suspension with pay, pension etc.
• involvement with teaching – undergraduate, post graduate
• facilities for research
• technical support – histology, IT, secretarial