Written evidence from Kent County Council

 

Context

Kent County Council is the lead authority for the four Kent & Medway coroner areas that make up the administrative areas of Kent County Council and Medway Council - North West Kent, Mid Kent & Medway, Central & South East Kent and North East Kent.  The total cost of the service in 2020-21 is estimated to £5.9m and Medway Council meets 15.3% of the total cost (based on the mid-year population estimates whereby the population of Medway is expressed as a percentage of the total population for Kent and Medway).

 

The Coroner Service is unique within the local government setting.  It is a statutory demand led service and the senior coroners, not KCC are legally responsible for providing it, and they have time constraints placed on them by the Coroners and Justice Act 2009 for the timely progression of cases.  KCC is though legally responsible for meeting all the costs of the service and for ensuring that the senior coroners have enough staff and courts for them to be able to discharge their statutory responsibilities.  However, KCC has very little control over how the budget is spent and this is demonstrated by Table 1 below which sets out the broad costs of the service over five headings. 

 

Table 1

Item

Heading

Cost

%

1

Salaries and fees for coroners

£950K

16

2

KCC staff salaries

£1.55m

26

3

NHS PM costs, Pathologist fees, Toxicology

£2.5m

42

4

Specialist fees (FD’s, experts, case legal costs)

£800K

14

5

Incidental support costs

£120K

2

 

Expenditure can be grouped into two main elements:

Salaries (items 1 and 2) which accounts for 42% of expenditure but of this, KCC is only able to exercise any degree of control over staff costs.  This is because once appointed Coroners hold office until they are 70, or unless they resign or retire; they cannot be dismissed or made redundant in the way that staff can.  The KCC staff numbers have been determined using the guidance in the Chief Coroners Model Coroner area which states one Coroners Investigation Officer for every 350-450 death referrals, and 1 support post for every 3 Coroners Officers. 

NHS for post mortem, pathologist fees, toxicology and specialist fees which accounts for 56% of expenditure.   Whilst KCC is able to exercise a very limited degree of control over NHS PM costs through the contracts that it has in place with the Trusts, this entire element of expenditure is directly attributable to, and flows from the judicial decisions and directions of the coroners in the normal course of their duties over which the council has no involvement due to coroners judicial independence. 

 

Current funding challenges

The Council is particularly concerned about the unprecedented escalating cost of the service and what it sees as a lack of accountability of Senior Coroners across England and Wales in respect of (a) their performance and (b) for the expenditure they incur from the public purse. This does of course vary from one authority to another, but there are underlying themes that are common to most.  By way of an example, the Council has had to increase its base budget for the Coroner Service by £1m in the last year to address service pressures over which it has little or no control; such increases means diverting funds from other services with the inevitable impact on service delivery and performance.

Earlier this year the council wrote to the Secretary of State for Justice setting out our main areas of concern and whilst we received a reply from the Minister, Alex Short it was unhelpful to the point of being dismissive, and did absolutely nothing to allay any of our concerns.   

System of appraisal and performance management for all Coroners

On a positive note we are delighted the Chief Coroner is putting in place a long overdue system of appraisal for all Coroners. The system has been rolled out to Assistant Coroners and we understand it is to be rolled out to Area and then Senior Coroners in due course.  Unfortunately, despite some local authorities raising their concerns the Chief Coroner has indicated that he sees no role for local authorities to play in the appraisal of either Assistant Coroners or Area Coroners. He has, however, indicated there may be a role for local authorities in the appraisal of Senior Coroners and we await the specific details of this.

Our point is that all Coroners interact with the local authority and its staff daily and the working relationship between Coroners and Coroners Officers in particular, is critical to the success of the service in meeting the needs of bereaved people. Given this daily interaction and the significant sums of public money that Coroners commit from the public purse, the local authority is well placed to provide feedback on the performance and behaviours of Coroners.

 

To be clear, the local authority has no intention of involving itself with the judicial decision-making process or indeed being responsible for the appraisal, but we suggest it must be allowed to feed into an appraisal process on issues that affect service performance, cost control and behaviours, especially those affecting morale and staff interaction. Indeed, accountability to the organisation that funds all activities, including salaries, would be the expected norm in any other situation and this could only lead to improved service provision and cost control.

The Minister responded that coroner appraisal must remain a matter for the Chief Coroner and in a manner, which recognises and upholds coronial independence.   It’s disappointing that our concerns continue to be dismissed out of hand and illustrates how powerless local authorities are to effect any meaningful change. 

 

Mortuary Provision - coroner post-mortems and pathologists Fees

Mortuaries are in general provided through the NHS and the cost has been increasing steadily in recent years as the NHS looks to increase its income and cover its costs. This is again a cost the local authority has little or no control over and in some locations the local authority has invested considerable capital funds in building their own mortuary facility to control these costs.  In 2015, the Hutton Review of Forensic Pathology in England and Wales reported to Government and concluded that the non-forensic pathology service to Coroners is "fragile and corrective action needs to be taken now". It highlighted a fee structure that was problematic and that there is predicted to be a severe shortfall in consultants available to undertake this work in the near future. This is indeed the case now with many areas experiencing shortages of Pathologists through either retirement or leaving because the fees, set in 2007, are too low. Unfortunately, there are few if any new pathologists coming through to replace them, principally because it is no longer mandatory for histopathologists to carry out post-mortems during their training.

We are now very much in a sellers' market where Pathologists can demand much higher fees via agencies, because they know that local authorities and Coroners are simply not in a position to say no, indeed two of our SE7 areas have recently had to increase the statutory fees under threat of no pathology provision. We know that many areas across England and Wales have experienced similar problems, yet when challenged the MOJ says it has no plans to review the fee.

The situation continues to deteriorate almost daily and unless government acts now there is a very real danger that sooner rather than later some areas will find themselves with no Pathologists leading to the inevitable collapse of the coronial system for death investigation.

We suggested to the Secretary of State that the fee system is urgently reviewed, and consideration given to other models. For example, consideration could be given regional variations in fee levels and measures taken to avoid the risk of local authorities competing against each other to secure pathologist services. Additionally, it would be helpful if there were incentives in place for histopathologist to be trained in post mortem.  The Minister acknowledged this and stated that the MOJ is considering how best to address this issue, in conjunction with the Chief Coroner and the relevant government departments.  No mention was made of the timescale for this or the urgency, and the extent if any to which local authorities would be involved.  It is now only a matter of time before a coroner area finds itself with no pathologists leading to the inevitable collapse of the coroner system and the unthinkable consequences for bereaved people.

Changing landscape for coroner's body removal contracts

Historically, funeral directors have either fully or partially subsidised the cost of providing this service, typically on the basis they would convert some removals into funerals. However, the landscape has changed, and many funeral directors are moving to full cost recovery as it is no longer sustainable to subsidise the cost, with some withdrawing from the work altogether, as it is a distraction from their core business.  As a consequence, recent re-tendering in some areas has resulted in a decrease in bids and a significant increase in costs. For example, Kent has seen a 540% increase (from £107k to £560K/p.a.), Thames Valley 330%, Hertfordshire - 450%, Oxfordshire - 300% and South Manchester - 500%. As you can imagine, increases of this magnitude are locally unsustainable with no increase in ring-fenced Government funding.  The Minister simply suggested we raise our concerns with the Competition and Markets Authority and completely ignored our point about the escalating costs and the challenges this brings to the council in terms of balancing its books and the impact on other council services from where funds have to be diverted to the coroners budget.

              Rationale for determining coroner FTE

The Chief Coroner has very helpfully issued guidance to local authorities for assessing the number of Coroners Officers and support staff necessary to support Coroners to carry out their statutory duties. However, no such guidance exists for determining the number of full and part time Coroners for each area and numbers vary greatly across England and Wales. By way of an example Kent has two full time Senior Coroner, three full time Area Coroners and 14 part time Assistant Coroners for a referral caseload of 7,726 and a population of 1.8m. However, Essex has one full time Senior Coroner, one full time Area Coroner and two part time Assistant Coroners for an almost identical population and a referral caseload of 6,914.

Whilst we appreciate that the complexity of the area will have some bearing on numbers, these two examples appear to be at the extremes of the spectrum. The Chief Coroner is of the view that Coroner numbers is a matter for discussion and agreement at a local level between the Senior Coroner and the local authority, however local authorities have little or no say in the decision process and are expected to fund a senior post without the due process any other such post would go through. This is clearly leading to significant variations and we believe there needs to be a much more consistent and transparent approach to calculating Coroner numbers and the associated costs.

The Minister simply stated that coroner numbers are a matter for determination locally between the Senior Coroner and the local authority.  Again, there was no acknowledgement of the regional variations which in the councils view leads to a postcode lottery in terms of service delivery to bereaved people.  There are 87 coroner areas and there appears to be 87 different ways of Senior Coroners doing the same the job and this inevitably leads to each service being different to the next in terms of staff and coroner numbers and overall cost, and in our view that has led to a fragmented service that is not in the overall interests of bereaved people.

Future funding arrangements

The ongoing pandemic has placed a spotlight on the coroner service and has presented it with some significant challenges.  We have been working closely with our senior coroners to deliver the service in new and innovative ways whilst the majority of staff and coroners have been working remotely.  Some small savings have been achieved for example in postage and printing costs by moving to electronic distribution of inquest documents and we see no reason not to continue with this when we reopen our offices.  However, overall there has been an increase in service costs for example abortive inquest costs, and additional fees for Assistant Coroners who have been hearing inquest whilst full time salaried senior and area coroners have either been shielding or working remotely. 

The funding pressures the council is facing are unprecedented and other council services which are controlling costs more effectively, are in effect having to subsidise the coroner service. We do not believe this is fair on local residents or is indeed sustainable and if coronial services are to remain within the local government system then a ring-fenced model of funding to reflect the true cost should be implemented to provide some protection to other more cost effective frontline services. For a locally accountable authority to have no say or influence over the running cost of a service cannot be right or indeed democratic.  If that is not possible, then our view is that funding for the coroner service must be taken away from local authorities and a national service created and fully funded by government should be established in its place. 

 

September 2020