The Scottish Perspective

. 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?

University based ?

Chairs established

Edinburgh 1807

Glasgow 1839

Aberdeen 1857

.. a long tradition

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

1975

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

Glasgow 1931

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