Inquest reforms delay leaves relatives of the dead in legal limbo

13 August 2010 by Adam Wagner

David Kelly

It has long been accepted that the coroners’ courts, which investigate tens of thousands of deaths per year, are in urgent need of reform. But long-awaited changes are now under threat from Ministry of Justice budget cuts, leaving relatives of the dead with an inconsistent system of varying quality. This arguably places the state in breach of is obligations under human rights law.

A death is referred to a coroner when there is reasonable cause to suspect that it was violent or unnatural, or if the cause is unknown. In 2009, just under half of around 460,000 deaths were reported to the coroner, and 31,000 inquests were then opened. Inquests are rarely out of the news; for example, today calls were renewed for an inquest into the death of David Kelly. In the absence of obvious negligence or suspicious circumstances triggering a criminal investigation or compensation claim, inquests are often the only chance for relatives to get to the bottom of how a person died.

As well as providing closure for relatives of the dead, inquests also fulfil part of the state’s duty to investigate and prevent deaths under Article 2 of the European Convention on Human Rights (the right to life).

Whilst they still plays a crucial part in the legal system, the coroners courts have long been seen as needing urgent reform. According to Inquest, a charity, every year “tens of thousands of bereaved families grappling with the inquest process are forced to endure lengthy delays and an archaic, unaccountable system”. To that end, the Coroners and Justice Act 2009 was brought into law in November 2009 and made provision for wide-scale reforms of the system.

The changes were a response to the 2003 Shipman Inquiry and a fundamental review of the same year, which identified major problems with the creaking system. It found that the level of service provided was inconsistent, there was an absence of quality controls and independent safeguards, family and friends were not always involved in coroners’ investigations, there was a lack of leadership and training for coroners and there was insufficient medical knowledge in the system as a whole.

The recommendations were followed by a wide consultation and finally the 2009 Act, which promised to be the first significant change to the system since the 1920s. Part 1 to the 2009 Act will create a national framework for the coroners system led by the new post of Chief Coroner, assisted by a Medical Advisor to the Coroner. The absence of a national system has until now led to wide national variations in the style and substance of corners inquests.

The changes will also increase quality of service. In order to ensure national standards are complied with, the Courts Inspectorate will, for the first time, be able to inspect coroners’ courts. This will subject the relatively opaque courts to similar scrutiny as public inquiries have been placed under as a result of the Inquiries Act 2005. A Charter for Bereaved People is also to be introduced, along with a system of appeals against coroners’ decisions. At present it is only possible to challenge the decisions of coroners through judicial review, which is difficult and expensive.

Unfortunately, the reforms now look to be in danger of being endlessly delayed. They had been scheduled for August 2012 but after the May 2010 election the Justice Secretary asked civil servants to review their scope and timing. And with the Ministry of Justice now having to cut £2bn from its £9bn budget, it is quite possible that the changes would be shelved in order to save the £64m they will cost over 10 years.

It would be a great shame if the changes to the coroners system were shelved in a misguided attempt to cut costs. The cost of £64m is relatively small and, more importantly, a well-oiled coronial system provides a vital bulwark against unnecessary deaths. If lessons are learned from coroners’ decisions this will in the long-term save the state money otherwise spent on expensive compensation claims by relatives. A modern and efficient service, in contrast to current system which most accept is creaky and antiquated, is essential to ensure justice for relatives of the dead as well to fulfil the state’s obligations under human rights law.

• Previous posts on inquests and inquiries
• Feature | The duty to investigate deaths under human rights law: Part 2
• Bloody Sunday, human rights and the duty to investigate deaths [updated]

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