Cremation (Amendment No. 15) (Jersey) Regulations 201-

Information about the publication of Ministerial Decisions

A formal published “Ministerial Decision” is required as a record of the decision of a Minister (or an Assistant Minister where they have delegated authority) as they exercise their responsibilities and powers.

Ministers are elected by the States Assembly and have legal responsibilities and powers as “corporation sole” under the States of Jersey Law 2005 by virtue of their office and in their areas of responsibility, including entering into agreements, and under any legislation conferring on them powers.

An accurate record of “Ministerial Decisions” is vital to effective governance, including:

demonstrating that good governance, and clear lines of accountability and authority, are in place around decisions-making – including the reasons and basis on which a decision is made, and the action required to implement a decision
providing a record of decisions and actions that will be available for examination by States Members, and Panels and Committees of the States Assembly; the public, organisations, and the media; and as a historical record and point of reference for the conduct of public affairs

Ministers are individually accountable to the States Assembly, including for the actions of the departments and agencies which discharge their responsibilities.

The Freedom of Information Law (Jersey) Law 2011 is used as a guide when determining what information is be published. While there is a presumption toward publication to support of transparency and accountability, detailed information may not be published if, for example, it would constitute a breach of data protection, or disclosure would prejudice commercial interest.

A decision made 4 April 2011:

Decision Reference: MD-HSS-2011-0010
Decision Summary Title :	Cremation Regulations - amendment		Date of Decision Summary:	22 March 2011
Decision Summary Author:	Acting Medical Officer of Health		Decision Summary: Public or Exempt? (State clauses from Code of Practice booklet)	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	-
Written Report Title :	Cremation (Amendment No. 15) (Jersey) Regulations 201-		Date of Written Report:	22 March 2011
Written Report Author:	Acting Medical Officer of Health		Written Report : Public or Exempt? (State clauses from Code of Practice booklet)	Public
Subject: Cremation (Amendment No. 15) (Jersey) Regulations 201-
Decision(s): The Minister approved the draft Cremation (Amendment No. 15) (Jersey) Regulations 201-, together with the accompanying report, and requested that they be lodged ‘au Greffe’ with a view to securing the earliest practical date for debate.
Reason(s) for Decision: This amendment is necessary to enable the Minister to delegate the role of Medical Referee to a team of suitably experienced doctors, each to be approved by the Medical Officer of Health (MOH). This will reduce the current critical dependency on the availability of the MOH.
Resource Implications: No resource implications.
Action required: The Regulations and the accompanying Report to be forwarded to the Greffier of the States for lodging.
Signature:		Position: Minister for Health and Social Services
Date Signed:		Date of Decision (If different from Date Signed):

Cremation (Amendment No. 15) (Jersey) Regulations 201-

Report to the Minister for Health and Social Services

February 2011

Cremation (Amendment No. 15) (Jersey) Regulations 201-

Purpose

Under the provisions of the Cremation (Jersey) Regulations 1961, only the Medical Officer of Health (MOH) has the power to grant or refuse an application for cremation, acting as a ‘medical referee’. This involves agreeing ‘authority to cremate’ when satisfied that the application is in order. It is the final check that there is no reason why a body may not be disposed of by cremation, after which time no post mortem examination of the remains would be possible. It is an important safeguard enabling further enquiries to be made, such as if there was any doubt as to the cause of death, any suspicious circumstances / any reason why the death should be referred to the Deputy Viscount (in his role as Coroner) or his advice sought. The vast majority of cremation authorisations are straightforward and simple to process and authorise.

Approximately 15 such applications are received each week although numbers vary week to week and day to day. The need to process the applications is often urgent, for example with funeral arrangements in place for the following day.

This situation creates practical difficulties in the absence of the MOH, and even when available, servicing this commitment can, and has created inconvenience and inefficiency in organising and prioritising work. The pressure has increased since Dr Rosemary Geller has been absent.

The proposed amendment to the Cremation Regulations (attached) would enable the power of the MOH in regard to cremation to be vested by the Minister for Health and Social Services in one or more Medical Referees, creating a more resilient and efficient team approach.

It is anticipated that Medical Referees would include the MOH, Deputy MOH and other medical practitioners appointed by the Minister of Health and Social Services, on the recommendation of the MOH, as Medical Referees. Without additional resources, and without any increase in funeral expenses, only doctors employed by Health and Social Services can perform this duty, incorporating it as part of their daily duties as required.

Medical Referees – appointment process

The Medical Officer of Health would make recommendations to the Minister to approve a number of Medical Referees, having satisfied her / himself that each doctor so recommended is:

A registered medical practitioner of at least 5 year’s standing
A colleague of good professional standing with the character, experience and qualifications required of a medical referee.
A colleague with no record of any complaints, hearings or warnings to / by the General Medical Council

The Medical Officer of Health would have regard to UK Ministry of Justice guidance on appointment of Medical Referees. The criteria above are consistent with this.

Desired outcome

Once the amended regulations were in force, a new team of Medical Referees would be approved and a rota system set up. In anticipation of this change, the role has been incorporated in the job descriptions of the new Jersey General Hospital Joint Medical Directors. It is also envisaged that a small number of HSS employed doctors who work outside the acute hospital (Jersey General Hospital) setting would become approved medical referees also (examples – Consultant Psychiatrists, colleagues working in Sexual Health or Substance Misuse Services).

To minimise any perceived conflicts of interest, Jersey General Hospital (JGH) Medical Directors would not act as medical referee for deaths in JGH. For such deaths, the intention would be that the cremation would be authorised by the MOH or one of the other non-JGH approved medical referees. Similarly, Consultant Psychiatrists would not act as medical referee for deaths of patients at St Saviour’s Hospital.

Financial Implications

Within existing resources.

Manpower implications

This amendment to the law, if approved, will enable the workload of authorising cremation to be spread between a number of approved medical referees. This will avoid the current critical dependency on the availability of the (acting) MOH. It offers a more resilient solution.

Dr Susan Turnbull

Acting MOH

March 2011