Thread by @MaherRonan

1. Changes to rules for recording deaths and certifying cremations came into action at the end of March. The rules, brought in under the Coronavirus Act (2020), significantly liberalised highly sensitive statutory procedures typically carried out by senior doctors. I studied -

2. - the new guidelines with a doctor, and what I found worried me. So I pitched my findings to several national newspapers, but they politely declined my story. I sighed, shrugged my shoulders, and assumed it was because I'm a no-name journo sending unsolicited pitches.

3. I went back to my quarantine zone and waited to read my macabre scoop scribbled by someone else. I thought, hey, that's the law of the jungle, as long as the truth gets out, that's all right by me. But something strange happened. The weeks rolled by, but the story never came.

4. So here's what I found.

Lawmakers wrote the emergency legislation under tremendous pressure and no doubt with the best intentions. But we all know which roads good intentions pave, and, in doing so, they radically liberalised the death system, for example removing strict -

5. - regulations which in October 2019 the Ministry of Justice said were 'to provide corroboration of the medical circumstances in which death took place.'

It was this very requirement of independent corroboration which led a GP from Stockport, Linda Reynolds -

6. - to expose Harold Shipman. If it was not in place, as now, he need not have made her suspicious by asking for an unusually high number of counter-signatures, to certify the untimely deaths of his patients who we now know he murdered. I tried to track down John Pollard, the-

7. coroner who investigated Shipman, to ask what he thinks of this, but he retired in 2016.

The government made the changes to free up doctors for clinical duties, to help them cope with added workload expected from excess deaths, and to reduce delays to funerals. In sum:

8. Cremation Forms.

* Ministers suspended the double-lock safeguard (which I referred to above) for doctors sending bodies for cremation. Normally, after first filling in an MCCD form (of which more shortly), a doctor completes an application for cremation (Form 4.), then -

9. another doctor (*always an independent, *senior* doctor) corroborates it with a second form (Form 5.). Form 5. is gone.

Medical Certificate of Cause of Death (MCCD - Issued by a doctor after a person has died; needed to release a body to family for burial. or cremation.)

10. * The time in which a person who has died should have been seen by a doctor before his or her death is registered has been extended from 14 to 28 days.

* If the attending doctor (the one that saw the patient in his or her final illness) is unavailable, *any registered -

11. - doctor* (retired doctors who have returned to work, first-years, and potentially fast-tracked students) can complete an MCCD, even if that doctor never saw the patient before their death. Also, as long as a doctor saw the person in the 28 days before death, the certifying -

12. doctor *need not examine the body* but can certify the death from notes alone. (These are significant liberalisations.)

* If no doctor sees the patient within 28 days before death, *any registered doctor* can certify their death, as long as "they can state the cause of -

13. death to the best of their knowledge and belief" and the coroner agrees, an agreement which could be made by a phone call. Normally, if a doctor did not see the patient (within 14 days before death: now 28), the deceased is sent to the coroner. (NB Coroners are in short -

14. - supply and also under increased pressure.) (This is a significant liberalisation.)

NB Before a doctor fills out an application for cremation (Form 4.), he or she first fills out an MCCD, and these changes apply there, too: this means even less scrutiny of cremations than

15. - I had already described.

Why should anyone care?

These rules and safeguards were put in place to protect vulnerable people and ensure that data taken from death records to do things like help shape health policy are accurate.

Doctors have a duty of care to to their -

16. - patients in both life and death. The changes increase the chances of mistakes being made, and undoubtedly make death records less detailed/vaguer, because of the greater distance between the person drawing the conclusions and the events themselves.

Many doctors are off -

17. - sick and less experienced doctors are being fast-tracked and given greater responsibilities. This means that inexperienced doctors with less oversight than before are being asked to perform vital statutory duties at greater speed.

Looking at it cynically, the really dark

18. - side is that these changes create the potential opportunity for medical malpractice; indeed, people might attempt to get away with things that they would not have otherwise. Remember, the safeguards were not there for nothing.

Thank you
Ronan Maher

@V5M1000

@DickDelingpole Hi Richard, please could you bring this to your brother’s attention? It’s very important. Many thanks

@lukedalygroves Can you and your historian friends look at this? I think it applies to your profession. And I would appreciate your thoughts. Thanks

Dear @JuliaHB1, thank you for reading my story. For perspective, how things were: cremation.org.uk/content/files/…. NB the language. Clearly, the MoJ considers (ed?) these regs (some now gone) very important. Please discuss on your show, with friends and colleagues, etc 🙏