CHAPTER 8: MORTUARIES AND CREMATION
INTRODUCTION
8.1 Legislation relating to mortuaries and cremation in the public health context invite review to ensure they fit modern circumstances, with particular regard to the following points:
- the option for the competent person to order cremation as well as burial as necessary or requested for different individuals, who, on death, were suffering from infectious disease;
- the option to ensure safety of the living from the careful disposal of bodies of those dying from chemical, biological, radiation or nuclear ( CBRN) incidents;
- clarity of responsibility for the provision of mortuaries.
CURRENT POSITION
8.2 The 1897 Act defined powers concerning the removal and care of dead bodies ( Annex I). Currently there are three, generally separate, systems for mortuary and post mortem facilities. Local authorities have the following, slightly ambiguous requirement in the 1897 Act. Section 68 states "every local authority may provide and fit up a proper place or places for the reception of dead bodies before interment (in this Act called a mortuary) and may make byelaws with respect to the management and charges for the use of the same". These premises act as a repository for bodies that cannot be allowed to lie in houses, etc. after "life has been pronounced extinct".
8.3 Local authorities however, do not have to provide autopsy facilities for the Procurator Fiscal or the police and they charge for such provision where it exists. In most instances, the mortuaries and autopsy suites used by the police and the Procurators Fiscal are known as City or County mortuaries. These are to be found in Aberdeen and Edinburgh where they are owned by the City Council and in Dundee and Glasgow where they are owned by the local police forces. In all other locations, the NHS hospital mortuaries double up as forensic mortuaries and the police pay for usage on a contractual basis.
ISSUES FOR CONSIDERATION
Responsibility and charging structures for mortuaries
8.4 In the long term, it was thought to be more efficient and cheaper to provide one building serving both requirements, repository and autopsy. In this respect, local authorities in Scotland in geographical areas with no City Mortuaries usually devolve this responsibility to local NHS hospitals because they do not want to be involved in building, commissioning and running their own separate facilities.
8.5 Some mortuaries are old buildings and a need has arisen in a number of local authorities for replacement. The buildings are subject to new guidelines from the Health and Safety Executive "Safe Working and the Prevention of Infection in the Mortuary and Post Mortem Room ", and the need for modernisation has cost implications. That aside, there is a case for clearly assigning responsibility for the provision of mortuaries to either local authorities or NHS Boards. Given the general availability of mortuary provision in hospitals, the balance of advantage is arguably in revising section 68 to place the primary responsibility on NHS Boards for arranging for the routine day to day availability of mortuaries. The exception would be death in circumstances of suspected foul play. In these latter circumstances, police forensic mortuaries would be used or the NHS mortuaries could charge for the services in those areas without a police forensic mortuary.
Question 6
Mortuaries Options
Views are invited on whether:
6.1 the routine responsibility for resourcing and provision of mortuaries in Scotland should become the responsibility of NHS Boards
6.2 the NHS should be allowed to charge the police for the use of mortuaries
6. 3 the provisions identified in Annex I should be updated and retained in new legislation with provision, in particular, made for cremation to take place as appropriate.