Death Tax, bloody Death Tax – I thought it was April 1st when I read this !!!
The introduction of a death tax, to pay for the increased scrutiny of doctors by a new medical examiner corps, could be delayed as councils resist collecting a national charge levied on bereaved families.
Ministers have been surprised by the ferocity of opposition from local government. as Councillors fear they will become scapegoats for fees in a system of checks, covering England and Wales, which will try to ensure doctors give the right cause of death and fill in forms properly.
Better monitoring of death certificates was first ordered under Labour in an effort to prevent more killings like those perpetrated by the GP Howard Shipman, and to increase understanding of diseases. The system originally was to have been run by NHS primary care trusts but these are being abolished by the government.
The charges will pay for 1,000 part-time medical examiners, who will be experienced doctors, and hundreds of support staff. The Department of Health says the charges could be smaller than the £160.50 already paid by families of people who are cremated, amounting to nearly three-quarters of all those who die each year.
But councils say the cost of setting up the new national system could make the charge as high as £170.
The charge would affect all bereaved families and have to be collected separately by councils instead of being part of funeral directors’ charges, as cremation fees are at present.
The councils say medical examiners should be the responsibility of the NHS, not employed or commissioned by local authorities. The charges, which will be applicable for burials too, should still be collected via funeral directors, they say.
Formal consultation over the plan has been delayed until the spring, so the system might not come into force until October 2013, six months later than planned.
Council heads sense there might be a “change of direction” by ministers, according to Keith Mitchell, leader of Tory-run Oxfordshire county council, and vice-chairman of the Local Government Association’s community wellbeing programme board. Mitchell said: “The government is certainly aware of our concerns – in spades. It is going to be an unpopular death tax. The system would mean councils billing families for something that was not a local service.
“It is a cannon to destroy a gnat. It is not a local government issue. It is a health issue and it should stay there.”
The fee, he added, might not be “a huge sum in national terms but is big to people who are not well off – in terms of NHS national spending it is pence”.
At present, cremation forms have to be signed by two doctors. The fees are paid to the medics, a payment that will disappear under the changes. The forms are required at the moment because there can be no future checks on bodies. They also verify that pacemakers, which could explode during cremation, are not left in bodies.
The Department of Health said: “These proposals ensure that the weaknesses and inequalities in the current system of death certification are properly addressed.” The government was “in constant dialogue” with those involved in the changes and would decide the next steps after the formal consultation was complete.
Changes in death and cremation certification were demanded by the inquiry into how Shipman managed to kill at least 260 people. The GP, from Hyde, Greater Manchester, was convicted and sentenced to life imprisonment for murdering 15 patients. The system failed to spot that Shipman had killed anyone.
According to those drawing up the new system, a “significant proportion” of doctors are not sufficiently precise about the cause of death on certificates, which also are often not completed fully or legibly. Many forms are not completed fully or legibly, they say.
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