Good morning and welcome to the Health and Sport Committee’s first meeting in 2016. I ask everyone in the room to switch off mobile phones, as they can interfere with the sound system. You will notice that some of us are using tablet devices instead of hard copies of our papers.
We have received apologies from Rhoda Grant, who is not able to attend.
Our first agenda item is the first evidence session on the Burial and Cremation (Scotland) Bill. I point out that bills, by their nature, have to be very precise in their meaning and in the language that they use. As such, language or terminology may be used this morning that some people might find upsetting. I wish to apologise in advance, if that occurs. It is not our intention to cause any offence with the language and terminology of the bill that we are working on.
I welcome to the committee Willie Reid and, from the Stillbirth and Neonatal Death Society, Ann McMurray. We are expecting Cheryl Buchanan, whom I will welcome when she arrives.
I believe that Willie Reid is prepared to make an opening statement to get us under way. Please do that, then we will ask questions.
Thank you very much for having me here today. I will give you a brief history and tell you where I stand.
I am an affected parent; my daughter died, sadly, in 1988, and was cremated at Mortonhall crematorium. I will not go into the full details of that, but will talk more about what happened since the story broke about the baby ashes scandal.
The big thing was the political side of the situation. Right at the start, I wrote to Mr MacAskill, who was then the Cabinet Secretary for Justice, but I got no reply from him. I wrote to the First Minister, Mr Salmond, and it took seven months for us to get a voice at Government level here in Parliament. At that point I was calling for a public inquiry. Although Dame Elish Angiolini was doing the Mortonhall crematorium report on behalf of the City of Edinburgh Council, Mr Salmond commissioned Lord Bonomy to chair an infant cremation commission. The downside was that there was a political fight between the Government and Lord Bonomy about having parents on the commission—no parents were on it. I thought that we were being sidelined at that point. Lord Bonomy suggested that the emotion of the situation would be too great for parents. I thought that that was how people thought about things in years gone by, as opposed to how they think about them in the modern day.
After Lord Bonomy reported his 64 recommendations, it was announced that the bill would be introduced and that Her Majesty’s inspector of crematoria for Scotland would be appointed. That announcement was made in a shining light, shall we say, but when the post was advertised it was under a 2 watt bulb. The post was part time and would last only 90 days. There are 27 crematoria in Scotland: how can they be snap-inspected? How can they be inspected by someone in such a low, part-time role? However, Mr Swanson was appointed and appears to be doing a fantastic job.
The bill was then sent out in draft form, and I worked with the cremation practice sub-group of the Scottish Government’s national committee on infant cremation.
The situation surrounding the death or loss of a baby normally begins at a hospital. It continues at the undertakers and then at the cremation authorities.
My personal experience was that I never spoke to anyone at a crematorium; everything was done through undertakers. I was a young lad of 22 who had lost my baby two days before, and I was asked to sign a form that they gave me. At that point, I was told that people did not get babies’ ashes. However, 25 years later, on sight of the form, I saw that the back of the form could be ticked to allow dispersing of remains. Why would I have wanted remains to be dispersed if they were never there?
My point is that the funeral directors have a big part to play, but they do not appear in the bill. As the first contact, they need to be licensed and regulated, as part of the bill. I do not know the right way to do that, but an extension to the role of Her Majesty’s inspector of crematoria for Scotland could incorporate it. It would be easy to say that they could be licensed at local authority level, but given the nature of the issue, they really have to be licensed and regulated nationally so that every undertaker in the land would be carrying out the same procedures, whether for an adult cremation, a baby cremation or whatever. It would be a hard job for an inspector to go round and inspect them on his own; obviously, I understand the current austerity measures, so I suggest bringing in a system that would be akin to custody visitors in police custody centres, and prison visitors. Those people would largely be volunteers and would go round to inspect what undertakers are up to, then report to Her Majesty’s inspector of crematoria for Scotland.
The big thing about the bill is that it must ensure that the procedures of the past cannot continue, and there has to be some sort of censure for those who contravene the legislation. For example, I know that if I got caught speeding I would get a £60 fine and three penalty points. If I carried a knife in public, I would be liable to five years’ imprisonment, and if I committed murder, I would be liable to life imprisonment. However, nothing in the bill suggests what the censures would be for someone who contravenes any of the procedures in it.
The other big thing that we have to ensure in the bill is that, when there are contraventions, the investigations and subsequent censures are robust, swift and, more especially, fair to the parents. We are now going into the fourth year since the scandal broke at Mortonhall, and I am personally still being played as a legal football between the lawyers of the City of Edinburgh Council and the lawyers who represent parents. Should such a thing happen in the future to parents—I hope that it will not—it would not be right to expect them to be involved for the length of time that we have been involved.
We will all die at some stage, but a baby’s death is slightly different; the mother and the father would have looked forward throughout the pregnancy to the arrival of the child. It does not matter at what time in gestation the baby is lost: joy turns to instant pain that takes a long time to get over. Revisiting the matter 25 years later has been the most horrendous thing that I have had to deal with in my life; I am sure that I speak on behalf of other parents who feel the same. Ultimately, the bill has to ensure that what happened cannot and will not ever happen again.
Thanks, Willie. Does Ann McMurray wish to add anything to that?
I agree with Willie Reid that the whole process has caused the parents who were affected renewed grief. I am a bereaved parent but was not, thankfully, affected by the ashes scandal. Those parents are taken right back to the very day that it happened to them. What concerns does the committee have for those parents and what mechanisms can we put in place to ensure that they get the right support to get through the renewed grief and trauma that the process has caused them?
09:45
Thank you. We will move on to questions that will, I am sure, pick up some of the points that have been made.
I thank Willie Reid and Ann McMurray for their opening statements and for being prepared to give evidence here today.
I want to reflect back a couple of things that Mr Reid said, so that you know that we are listening. You said that you are keen to ensure that when there is a breach of the legislation, there will be consequences, that there is effective enforcement of sanctions and that people are held to account—although how that will happen is another matter altogether. I listened carefully to what you said about that, and to what you said about ensuring that there is consistency, no matter which local authority or crematorium is involved.
I will initially restrict my questions to the provisions in the bill. We will help to shape the bill as it goes through Parliament. We have to be sure about the parts of the bill that you support and about the things that you would like to be improved. That is part of the process. I would like to find out whether you support a couple of specific bits of the bill. The reason for my asking the questions is that we have to prepare a stage 1 report that will make recommendations to the Scottish Government.
I am looking deliberately at the briefing that we have received for today’s session. Under section 38 of the bill, it will be expected that ashes will normally be recovered in the vast majority of cases, but where that does not occur, HM inspector of crematoria for Scotland will investigate. I understand that there might be concerns about what that means in practice, but would that be a positive step forward? It is expected that if there are no ashes after a cremation, there will be an investigation of some description.
I want to be specific about the different parts of the bill; I hope that that is okay with the witnesses. Under section 55, there will be a register of disposal of remains; there will be a duty on all health authorities to maintain a register recording the disposal of remains when pregnancy loss occurs. In such cases we are talking about loss before 24 weeks; the healthcare system is obviously not as good as it could be in relation to how it deals with pregnancy loss before 24 weeks. There has to be a register for that purpose and there has to be an investigation in each instance in which there has been a cremation but no remains are found.
We have to assure ourselves about which bits of the bill are fit for purpose and which need to be improved, so I deliberately picked two specific bits, which I hope was helpful. The committee would welcome comments on either.
It is certainly very welcome that the cremation authority will have to inform HM inspector of crematoria of any failure to recover ashes. The technical information supporting Dame Elish Angiolini’s report on Mortonhall states that ashes could normally be recovered from remains after 16 weeks gestation. The definition of “ashes” has been changed, which is highlighted in the bill. If every cremation authority adopts and abides by the procedures that have been recommended by the national committee, there should be ashes from remains from every stage of gestation.
I will ask Ann McMurray to comment on the registration of remains in pregnancy loss, because I am not overly familiar with that issue and did not look into it prior to coming here today.
There will be parts of the bill on which you feel the need to comment and other parts that you have not looked at, because they cover issues that were perhaps not at the front of your mind. That is fine. Thank you, Mr Reid. Ann, do you wish to add anything?
We welcome registration for pre-24-week babies. When such babies are cremated, it would still be possible in the majority of cases to obtain ashes. Only in cases of very early loss of babies—12 weeks and below—would there not normally be an individual cremation. There would be ashes from a communal cremation, but parents would not be able to get individual ashes because it would not be possible to identify them. However, there would, at the crematorium, still be ashes, which could be scattered in a sacred place.
Thank you.
Willie Reid’s opening statement was very powerful and I am sure that many members of the committee have taken on board what you said.
I turn to an issue on which I will bring in Ann McMurray, if possible. In one of the written submissions that we received, a parent stated that her daughter died at 23 weeks’ gestation and the cremation was organised by the local maternity hospital. She states:
“At that time, I was not given the option of burial, either via the hospital or privately. Minutes after her death I was handed cremation forms to sign, I had been sedated shortly beforehand for a procedure ... was not shown the forms and they were not explained to me”.
In your submission on behalf of SANDS, you welcome many parts of the bill, but say that SANDS
“disagrees with the proposal in the Bill to create a single application form to cover all cremations, both for adults, children and babies who die”.
You suggest that there should be separate forms. Willie Reid mentioned who should be involved and who should explain what is happening. Should it be the undertaker? Should it be the hospital? My question is to both of you, and I am sorry if I am touching on points that might be very sore. Should there be a multipurpose form or should there be separate forms for each type of case? Can you explain what you mean in your submission, Ann? Willie Reid might also say whom he thinks the forms should be with—the hospital, the undertaker or somebody else.
The forms should most likely be with the hospital because that is where the parent is most likely to be when the event occurs. The question whether there should be separate forms relates to very early losses. Parents who have a termination because of foetal abnormality or for other reasons might not want a form that has the word “baby” in it, because that might cause them more distress. That is the main reason why we suggested that there should be separate forms.
It is unlikely that parents would go directly to a funeral director, because the event normally happens within the hospital and it is therefore the hospital that deals initially with the parents. However, it is important that parents be given the choice to speak to a funeral director, and that the hospital cannot always take ownership of the process. It happens sometimes that parents are not given the choice. In the subcommittee that has been set up to examine training and procedures, we are looking at ensuring that staff who deal with parents have as much information as possible to pass on to parents so that the parents can make an informed choice about what will happen to their baby.
Willie—I am sorry, but can you comment on Ann’s point about undertakers?
Things might have changed; it is almost 28 years since the loss of my daughter. However, it was the hospital that guided me to the undertaker. Basically, I gave to the undertaker all the details about what had happened, and the undertaker filled out the form and told me to sign it. My mother passed away just eight months ago; I went to see an undertaker about her cremation and, again, there was the undertaker quite happily filling in the form. Because I was a wee bit more experienced, I checked everything before I signed.
However, as I have said to the committee, we are talking about a situation in which what should have been a joyous occasion is taken away from people. Forms are then put in front of them. There is an onus on the hospital—and, perhaps, the hospital chaplaincy—as well as undertakers; I do not think that responsibility for filling in the form should rest only with undertakers and the bereaved. If it does, there should be a 48-hour or 72-hour cooling-off period, after which the parents could be told what the options are—cremation, burial or whatever—and whether they are content with what will be gone ahead with. All that would be needed then would be a countersignature. That approach would probably be better than what was there before.
Parents would have some time—three or four days, I think—in which they could change their minds about their decision.
That sort of thing could be incorporated in the bill, which would mean that every undertaker and hospital unit would have to abide by it. At the moment, I would say that it is guidance rather than part of legislation.
Is the issue not more about communication?
It might well be.
We are talking about dramatic situations. Of course, some people will be able to cope but, on reflection, do you not think that this is about asking the right questions and communicating better? Do you think that there was a wilful element in the neglect over the form? After all, these things have been reduced to a form, and one might argue that there is something paternalistic in the attempt to alleviate some of the bureaucracy for the person who is dealing with this kind of traumatic event. Is it more about communication and helping people through the process? Do we need to look at every question on the form and the language that is used—for example, whether we are talking about a baby or a foetus? Can we really have a standard for dealing with this sort of thing, given that people cope with such situations differently?
You are right: my experience is that in years gone by people said, “Aw. You’ve lost a baby. That’s no so good. Off you go, have another one and crack on with your life.” That was society’s view of the matter back then, but society has changed. Reflecting on what happened in my life, I can tell you that, because I was the man, I had to organise the funeral and do this, that and the next thing. It took me 20 years to realise that I had not done the right thing, and it came back to bite me. However, that is another matter.
The forms have to be correct. On my daughter’s form, there was a tick-box for an option to dispose of the remains in the garden of remembrance, but the undertaker told me that there were no ashes. You asked whether there was a wilful element. I suggest that there was.
Communication plays a big part, so there needs, I think, to be a training programme for everyone across the board—not just health professionals, but funeral directors and crematoria staff—to ensure that they give a consistent message to parents who are arranging their baby’s funeral.
I do not believe that people set out to mislead us wilfully—I think that they think that they are doing their best for us. Nevertheless, hindsight is a wonderful thing, and honesty is certainly much more acceptable than leading people down a different route. Had we been given the correct information at the time, we would all have made different decisions. Parents must also be allowed space to reflect on the decisions that they have made, and they must be allowed the opportunity to change their decision.
Do you have any views on who in the hospital should provide the appropriate information to the parent or parents to allow them to make a decision with regard to a baby who dies at birth or, indeed, who is stillborn?
10:00
I think that it would probably need to be an experienced staff member. A lot of hospitals now use senior midwives who have a particular interest in bereavement, so they would have most of the information that they would need to pass on to the parents. As Willie Reid said, perhaps hospital chaplains could also be involved.
There is only one paid bereavement midwife in Scotland. Others do the job but are not recognised for it. I know that that is another issue, but it should be looked at.
If there is a disagreement with the parents about what should happen, the bill suggests that the courts should make the decision. Might there be another way forward or do you agree with what the bill proposes?
I agree with what is being proposed in the bill. Things would have to be pretty traumatic to get to that stage. If it became a legal battle or even a battle of wills between the cremation authority and the parents, a swift court judgment would be the best way forward.
Does Ann McMurray have any views on that? No? It is hard to imagine that things would get to that stage, but it has to be taken into account.
I thank the witnesses for their statements and their responses to the questions, which are helpful to us.
Willie Reid said that he wanted to see a bit more about funeral directors and he talked about inspections, which would be one way of dealing with the situation. Apart from inspections, should there be any requirements on funeral directors in the bill?
Yes. I could go out and start an undertaker business tomorrow with no training, no licence—no nothing. I could get a couple of hearses together and there I am. Like any business, we will always see rogue traders. I think that all undertakers should be licensed and regulated nationally, so that they all carry out not just their services but the procedures leading up to a cremation or a burial in the same way nationally. As I said, if anyone contravened those procedures, some sort of censure would have to be available.
Undertakers are the first point of contact for a funeral, and it was the undertakers who fed me the “there are no ashes” line. I never spoke to anybody at the crematorium or the hospital; it was absolutely the undertakers who fed me that line.
I know that a lot of the small, family-run undertakers are being taken over by the bigger businesses throughout the country. The bigger a company is, the more profit it will be looking for. I am not particularly interested in the profits that companies make; I am interested in the way that they treat families and how the forms are filled out, and there should be some sort of corroboration of what they do with the forms. There should be a 72-hour cooling-off period and a requirement for a second signature from the parent, so that there is not just one signature.
Does Ann McMurray want to comment on that?
Yes. A lot of us have concerns that there is no regulatory body for funeral directors. Some are affiliated to their own bodies, but there are independent funeral directors out there, too. We would like a consistent approach, in which funeral directors have all had the same training. That consistent approach should especially apply when funeral directors deal with vulnerable parents. It is traumatic to lose a family member, but the loss of a baby is unthinkable for anyone. It is something that you learn to live with; it is not something that you ever get over. Any death is bad, but when a baby dies, people’s instincts go completely awry and they need the person who gives them information to be compassionate and caring and to ensure that their wishes really are adhered to.
There has been a lot of discussion about ashes, and what the bill says in that regard is important. As I understand it, there will be a provision that says that ashes should be recovered whenever possible. Are the provisions strong enough, or could worries remain that ashes that could have been recovered have not been? Could anything more be done to ensure that ashes are always recovered?
The bill states that ashes are everything that remains after the last flame, excluding metals. As we have said already, it should be possible to recover ashes from every cremation of a baby, no matter the gestation, apart from very early losses, when they are in a communal cremation. Furthermore, the bill says that if there are no ashes, the reason will be investigated. I feel that the bill covers the issue and that parents can be reassured that, 99.9 per cent of the time, there will be ashes from the cremation of their baby.
When I sat on the national committee on infant cremation, one of the phrases that went about was that we should minimise the loss of ashes. I suggested that we should instead talk about maximising the recovery of ashes. I think that that was put into the guidance that went to all local authorities. It is all about putting a positive spin on what is required, rather than a negative spin—“This is what we don’t want.” The guidance that has been issued to all cremation authorities has been to maximise the recovery of ashes in every case.
I hope that I am not repeating points, but I want to be clear about a couple of things. First, you have made your point clearly about the regulation of funeral directors, although I have to get my head around how that would work.
Secondly, this is not just about identifying situations in which ashes have not been recovered, but about driving change in processes. What are the processes that lead to ashes not being recovered? If those processes are not satisfactory, how can they be made satisfactory in future? I hear what you say about that issue, and I think that the committee needs to ask questions about it.
My specific question is on the role of the funeral director. Let us work on the basis that—I hope—most funeral directors are sensitive and compassionate. Unfortunately, I recently had to use a funeral director because my mother passed away in December. The funeral director asked our family what we would like to happen and then sought to bring that about. Yes, they went through a form but, for me, what was important was not the form or what it looked like but that I understood and was very clear about what was happening.
I can only imagine how much more difficult it must be to go through the process when a baby or unborn child has died, which is why I want to return to the idea of having a cooling-off period and a single point of contact, whether at the hospital or the funeral directors, to take people through the process.
The cooling-off period would happen after an initial conversation about what was to happen, during which a person might or might not look at a form. If there was to be a cremation, that conversation would include whether there were likely to be ashes and what the process around that would be. That would be horrific for someone who has just lost a child, so I suppose that having that conversation a second time could be doubly distressing.
I am not making a point here; rather, I have a question to ask. Is it worth risking that additional distress in the short term when a person is grieving anyway to make sure that there is absolute clarity and certainty about the process? At the time, a lot of grieving parents may not be coping, or may not think that they can cope. Is there a tension there between putting something in place and not putting something in place? Maybe there is no tension; maybe we should put something in place and go back to a grieving family after a few days. They might have been struggling initially and the funeral director or a single point of contact could help to manage them through the process. However, going back a second time might have unintended consequences. Is there a balance to be found? If we were to recommend what you are suggesting—and I like the idea—we would have to ensure that there were no unintended consequences.
The best way to explain the situation is to highlight that the acts that are in place date back to 1905 and 1935. The bill needs to do not only what is right for today, but what will be right for 50 years’ time. As I said in my opening statement, the death of a baby 25 or 30 years ago was seen by society completely differently from how the death of a baby is seen today. We must give humans a bit of credit that, where there is distress, that distress might be required to do the right thing. It has become apparent that there were 153 cases alone at Mortonhall in Edinburgh—funeral directors and cremation authorities got it wrong 153 times. In 50 years’ time, we want there to be no such cases. In the past year, the ashes have been recovered from every single baby cremation in Scotland.
I do not think that people have to go back through the whole form again. We need checks and balances. There could be a phone call asking the person to pop into the funeral director’s office, when they would be told, “This is what we’re doing. Are you content with that? Are there any changes you want to make?” If there were no changes to make, they could be asked to countersign the form to say that everything was fine.
I hear where you are coming from, but I would rather that the potential grief that you are talking about was there at the time, instead of 25 years down the line.
It would be difficult but, again, if people had the right training, they would be able to approach parents so that they would not be so upset. They would not simply say, “Right, we need to go over this form again.” There are ways of speaking to the parents to ascertain that their wishes are the same and that they have not changed their minds.
Parents are told at the beginning that they have a cooling-off period—a period when they can reflect and, if they want to change their minds, they can do so. At that point, those involved could say to the parents, “We’ll come back to you in a few days’ time, just to check that that is still your wish.” There are ways to be gentle with parents, but they are not going to feel any worse than they already do.
I wanted the evidence to be absolutely clear, and I found those comments very persuasive and helpful.
Should the funeral directors’ role be set out clearly in the bill?
Yes.
10:15
I would say so, yes. We are looking today at what went wrong yesterday, but we really need to look at tomorrow because, in 10 or 15 years’ time, this story will have been sent away into history but bad pennies can turn up more than once in a lifetime.
At the moment, the beam is on the funeral industry because of the scandal. If we take that beam away—the legislation will become the beam—the rogue trader could be back to their old practices and procedures in 10 years’ time.
It is four years since the ashes scandal came out and, with regard to what I was saying about censure and punishment, no one has been put in a court of law in this country over what went on. I know that Dame Elish Angiolini is still conducting a national investigation, but I will go to my grave never knowing what happened to my daughter’s ashes. The person who is responsible for that is walking about scot free. I am not suggesting that we are looking for someone to go to jail right now, but if we do not ensure that the legislation is watertight, we could face another scandal in 50 years’ time.
When death comes to any family’s door, it is a traumatic experience. Sadly, most of us have been through that with loved ones. I do not take away from the point that you have made about your daughter, and I certainly agree with you.
You said that you welcomed the appointment of the inspector of crematoria, but you then talked about the 90-day period, and suggested that we should appoint local visitors who could visit undertakers and so on. Could you expand on that?
I have another question, too. What is not in the bill that you think should be in it?
Her Majesty’s inspector of crematoria is only one person, and he has the task of inspecting 27 crematoria. If any investigations are required because of failure to comply with the changed procedures and so on, he must undertake them, too. He is a one-man band. If undertakers were regulated and licensed, they would need to be inspected, too. That would probably be too big a job. I have no idea how many undertakers there are in Scotland, but I can guarantee that there are an awful lot more than 27.
It is easy enough to write to someone to say that you are coming to inspect their register but, when the ashes story broke, I went to the local undertakers who carried out my daughter’s funeral and found that they did not have records. They should have records, even if they just record the date and time of the funeral and say who organised it. That is probably the first thing: the undertaker, as well as the crematorium, should keep a register.
I suggest that there should be ad hoc inspections. The people who do those inspections could be volunteers who just get expenses or some sort of minimal remuneration, but they would be able to visit undertakers and ask them for, say, details of their last 10 funerals. The visits would be snap inspections, without warning. That would keep people on their toes. If undertakers know that that could happen, the likelihood of them not doing the right thing would be very much minimised.
Would those people—let us call them sub-inspectors—be appointed by the inspector, the local council or someone else? Earlier, you talked about prison visitors, but that system does not work in that way any more. Who would appoint those independent inspectors?
I think that they would have to be independent of the council, given that, ultimately, the council is the cremation authority. I do not have any issues with their being appointed and vetted by HMI.
That was the answer that I was looking for. Thank you very much.
Should the bill specify that all burial and cremation records be kept electronically and perhaps enable a transition period for anything that is currently recorded on paper—and indeed future records—to be put in electronic form for ease of access? After all, this is the 21st century. Do you believe that there should be an electronic register?
Yes. Twenty-five years on, I saw the records that the City of Edinburgh Council holds on my daughter’s cremation, and the register and forms were on microfiche that was difficult to read. In fact, Lord Bonomy recommended the creation of a national computerised record.
Should the bill specify that?
I would have no qualms about the bill doing that and making it clear that cremation authorities must have such a record.
And, for the sake of ease, access to the register should always be free of charge.
Very much so.
The bill says that records must be kept of every burial and cremation, which might lead to, say, women who had lost their babies before 24 weeks being identified. Do you have any concerns about such information being available not just to certain people, but to the public in general?
The information must be available to the public. However, I believe—I should make it clear that I am no lawyer—that, like anything else, once the information is computerised, data protection legislation comes into play. Names and dates of birth could be redacted, but information on the cremation procedures should be available. For official bodies such as Government organisations, that redaction could be removed, but I do not think that the public need to know names and dates of birth. I do not think that it is a big problem as far as adults are concerned, but the issue might be a little more sensitive with regard to babies.
I would not have thought it a matter of public record, but the information should be available to parents who want to check those records. Given the anonymity provision for parents whose babies are born before 24 weeks, there is an issue about how much information can be given, but it is important for these records to be kept and made available to parents who want to check them.
Under the bill, the records will be available to the public, but the point is to ensure that the women in question are not identified.
That is right.
I promise that this will be my last question.
Again, it all seems to come back to the process. We need to trust funeral directors, cremation authorities and crematoria, but we must also have checks and balances in place to ensure that they are doing what they have said they will do. Mr Reid talked about someone going in to carry out spot checks and ask about the last 10 cremations, burials or whatever. I realise that it is not your job to justify any alternative solutions that you might have, but I have a general question about that suggestion.
I suppose that a funeral director or a cremation authority could say that the forms had been filled in perfectly. However, forms could have been filled in perfectly 30 years ago, but that does not mean that people knew what they were signing up to or that they were complicit in how the forms were filled in. I imagine—again—that the only real way of ensuring that the process is carried out sensitively is by dealing with the vexed issue of going back to the parents and asking them how they feel about the process.
That brings me to my last question. I cannot possibly know, because I have not been in the situation, but three, six, nine months or however long after they have buried their baby or had them cremated, what parent wants a knock at their door, a telephone call or an email from someone asking, “Can we just have a little chat with you about what happened?” I can see issues with that. That is not a reason not to talk to parents; it is a reason to ensure that we think carefully about how we do it.
It is not for us to interrogate the detail of the suggestion that Mr Reid made—that would be unfair. Our job is to scrutinise the bill. What is not in the bill, I suppose, is how we go back to parents after they have been through that horrible experience and the process of cremations and burials to see whether they think that they have been dealt with sensitively and appropriately, and whether they think that they had clarity and assurances in the process. I suspect that that is not in the bill. Should we put it in the bill? How could we do that?
I do not know.
Last year, you and I lost our mothers. A month to six weeks after my mother died, the crematorium wrote to me to ask whether I wanted her name in the book of remembrance and to ask how things went. One way of adapting that approach would be to have it as part of the initial conversation. Right at the beginning, when people have come back after their cooling-off period and have said what they want in the cremation service, they could be asked whether they would object to HM inspector speaking to them in 12 weeks’ time, to ensure that everything went to their satisfaction. Some parents would say no, but I would think that the majority would be quite comfortable with that. The issue is how the message is given over. It should not be, “We’re the Scottish Government and we’re determined to come and see you in 12 weeks.” If it is given over in a more sensitive way, I do not think that there would be a problem.
I am in two minds about that. I am all for looking to see whether things have been done, but the period would probably have to be longer than 12 weeks. If questions were asked as part of that initial conversation, there would need to be another tick box on the form to say that parents would be comfortable with being contacted. When somebody did contact them, parents would have the option to say that they had changed their minds and did not want to make a comment.
I am in two minds. I think that the exercise would mean another tick box on the form.
I had those thoughts as well, so thank you for putting them on the record.
There are a couple of wee things that we would like to ask, for clarity. I am looking at page 6 of the committee’s briefing. We have looked at records with regard to funeral directors and cremation authorities. The bill explains that health authorities must keep a record of what a woman decides to do when a pregnancy loss occurs—in many cases, that is when the initial record is made—as well as what happens when the health authority is asked to bury or cremate those remains. That information will be anonymous.
I would like your comments on that approach, which was alluded to earlier. Should anyone check that the health authorities are keeping accurate records? Who would do that? How could we monitor that record keeping in the health service?
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I think that, in the majority of cases, parents are dealt with by the health professionals in the first instance and that information will already be in their health records, so the onus is on the health professionals to ensure that they update those records when they have spoken to parents.
The information should not be separate; it should just be part of somebody’s medical record.
That information should be there. Obviously, there will be information that a person has had a stillbirth, a baby has died before 24 weeks, or whatever the situation is. There should be some information that they have been spoken to about funeral arrangements, that they have been passed on to the funeral director, or whatever the action was.
That would prevent our having an overall check and monitoring of the system. I am looking around me. Medical records are private and are not shared generally, so we would not be able to ensure that the public could be aware that the practice that the bill hopes to establish could be monitored by the public, like some of the other measures.
But the hospital will have contracts—I do not know what the word is—with funeral directors if they are going to make arrangements on behalf of parents, so surely there must be a record trail of that.
I am looking to you, as you have experience. If we tried to examine some of those records, would they be there? The bill says that they should be in the future, so we presume that they are not regularly established now. We can explore that.
If the hospital has a contract with a funeral director to inter or cremate babies on behalf of parents because the parents wished not to be involved in that, there should be a mechanism in place so that those records are there.
Okay.
I would have thought that it would be very strange for hospitals not to keep such records, but I have no experience of that matter. Perhaps you guys want to check that out.
There are no right answers to those questions, but that is as good an answer as we will get. Perhaps we will ask those questions.
The bill says what should happen with record keeping if a woman loses her baby in the first 24 weeks of pregnancy. The catch-all in the bill is that, if the woman decides on arrangements for a funeral within a week of losing her baby, that decision must be recorded and signed, but nothing will happen for a further seven days. Is that sufficient?
On the other side, we know from our case loads—whether we are talking about children or, indeed, adults—that there are big cultural pressures in some of our communities. We regularly receive casework on the length of time that it takes to get a funeral. If the approach in the bill becomes standard, that will mean at least a fortnight before there can be a funeral. I do not know whether you support the catch-all as a standard, because if that became a requirement, it could cause cultural problems in certain defined communities that have a requirement to carry out funeral services pretty quickly.
My instinct is that, if someone has a particular culture, they would not adhere to that provision. They would not choose to wait a week or another week to make that decision; it would be decided that that was their culture and they wanted the child to be buried or cremated within a certain period of time. Whether that is right or wrong for that parent, if that is their culture and what they believe, they will just do that.
I think that the bill should give people the option to wait. Even if their culture says that they should go ahead with the funeral, they should know that the act gives them an option. I do not know the best way of writing that into the bill—I am sure that it would have to be accommodating. Does doing the right thing take precedence over a culture? I do not know the answer to that.
It is not a question that we can answer, because it might not apply to our given situation. However, the bill says that even once the decision is recorded there must be a waiting period—I think that Ann mentioned that that was very important—and that would be the rule. We can perhaps explore that issue further.
I do not know what the procedures are, but surely there would be a waiting time anyway for a cremation; regardless of culture, it would not be instantaneous. I imagine that there would be a post mortem for the death of a baby, particularly for a neonatal death, so a funeral would not take place until after the post mortem.
A waiting time might not matter.
If there are no other questions, I thank Willie and Ann very much for their time. We are sorry that Cheryl Buchanan has not been able to come, but we obviously have her written evidence, which we will take into account when we complete our initial report. As we have come to the end of this evidence session, I thank you both very much indeed. Ann wants to say something—on you go.
I did not realise that you were wrapping up. You started the session by apologising for some of the terminology in the bill because we might be upset or offended by it. I ask that, for any parent who wants to read the bill, there should be something in a similar vein in it about the terminology that says that it must be used for legal reasons.
You have just put that on the record—it is a good, final word. However, Willie is determined that he will have the final word. [Laughter.]
I know that more parents are coming to see committee members tomorrow in private. However, to finish what I have to say, I think that the Government needs to get the bill right. Failure to get it right—and it is not watertight—will just continue to allow the kind of trauma that I never want any other parent to go through. Babies are going to die, just like we are all going to die, but we have definitely got to avoid others having the double grief that we went through. I want to impress on the committee that we need to ensure that what we do is done right and with the best intentions.
Thanks very much to you both for your contribution. I suspend the meeting at this point while we set up for our next evidence session.
10:38 Meeting suspended.Previous
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