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 District Fiscal 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 discussionsCOPFS 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 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 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