Coroners' data: is secrecy serving the public interest?
The coroner who held the inquests into the victims of Harold Shipman has said that all deaths of babies in hospital should be reported to the local coroner.
John Pollard, coroner for Stockport and South Manchester, told the BBC’s File on Four that he believed all baby deaths should be reported, even when doctors have certified it as natural. The law makes no distinction between the deaths of babies and adults, so only those that are sudden, unnatural or violent must be reported to the coroner. (The programme is broadcast at 8 pm tonight on Radio 4 and repeated on Sunday 6 June at 5 pm.)
Mr Pollard said that to gain “a consistent overview of what was happening” it would be better for all deaths of babies and young children to be reported. He already operates such a system in his own area of jurisdiction, but there is no legal sanction to force doctors to disclose the information. He fears unnatural deaths may be missed as a result.
But the truth is that such inadequate sharing of information cuts both ways. Coroners have often been criticised for failing to release details of suicides, for example – most recently in Health Service Journal (26 May 2010), which reported that commissioners of mental health services are struggling to get the data they need from coroners.
HSJ quotes mental health consultant Steve Appleton as saying: “I think it’s fair to say that it is extremely varied across the country. Sometime they can operate a closed-door policy.” NHS Havering head of mental health commissioning Bob Barr said his team had a good relationship with its local coroner, but the law was unclear. “Without suicide data we will never be able to tell whether the interventions we make are effective.”
Their remarks echo those of a team from Oxford University Centre for Suicide Research, who carried out a study funded by the Department of Health into methods of suicide, designed to assist the National Suicide Prevention Strategy.
Their conclusion were: “While coroners in general appear willing to assist with studies associated with suicide, there is considerable variation between coroners in the extent to which some information is included in their records. Some relatively important items are often not recorded, e.g. contact with psychiatric services, date of last contact with GP, blood levels for drug overdoses, source of drugs taken in overdoses, source of ligatures for hanging, and whether firearms used for suicide were licensed and whether they were kept in a locked cabinet ... standardisation of information recording by coroners could be valuable for investigations of suicide.”
Coroners are, deliberately, given considerable freedom of action to interpret the law as they see fit. Many regard details of suicides as sacrosanct as medical records, not to be shared with anybody; others evidently take a less restrictive line. Last year the then Government removed a clause from the Coroners and Justice Bill that might have opened up data-sharing to the benefit of public and patients.
Clause 152 of the bill, inspired by a report on data-sharing written by Richard Thomas, the Information Commissioner, and Mark Walport, the Director of the Wellcome Trust, would have opened up a lot of personal data. The review concluded that greater use could be made of the ability to share personal data safely, particularly in the field of research and statistical analysis.
But the clause fell foul of the British Medical Association, the Royal Colleges, the Conservatives and the Liberal Democrats, whose concerns about breaches of personal data were swept along by a series of incidents in which personal data had been lost by the Home Office, the NHS, and other government departments. The clause, criticised as being far too broad, was withdrawn by Jack Straw, then Justice Secretary, who as a face-saver launched a consultation into ways in which data could be shared “in a way that is safe”. That is presumably now dead in the water.