MEDICAL REFEREES last night said they were being stricter about authorising the go-ahead of cremations in Dundee because paperwork was not always being filled out properly by doctors.

Speaking on behalf of the partners at Downfield Surgery who jointly work as referees to the crematorium, Dr Jason Twinn said that in light of guidance from the Department of Constitutional Affairs they felt that cremation paperwork was often being filled in “the fastest and most convenient way”—contrary to guidelines.

The Courier reported yesterday that difficulties with the signing of cremation papers could lead to funeral services being delayed or postponed.

Lindsay Martin, of the National Association of Funeral Directors, said the problem had arisen because the crematorium’s medical referee had questioned the ability of A&E doctors to complete the cremation papers if they practice in the same ward.

Two doctors must sign the cremation papers certificate B (completed by the attending doctor) and C (confirmatory certificate from an independent doctor of five years standing).

Dr Twinn said yesterday, “As referees to Dundee crematorium we are charged with ensuring all cremation forms are filled out properly before we can sign the certificate authorising cremation to go ahead.

“In light of guidance from the Department of Constitutional Affairs we felt that in some instances that cremation forms were not always being filled in properly.

“In particular the filling in of both of the doctors’ forms when a death occurred in hospital was often being done by doctors who worked within the same department, which is contrary to this guidance.

“Whilst this was the fastest and often most convenient way to process these forms, getting a second independent doctor from outwith the department where the patient died is an essential part of the procedures that need to take place. This should and need not delay any funeral arrangements.

“It was felt in the interests of both transparency and correct procedure in light of the guidance, that we should require that two doctors working within any one department should not sign both parts of the cremation form.”

Dr Twinn said the guidelines were to ensure that there are no circumstances which should prevent cremation from going ahead, such as doubt or suspicious circumstances surrounding the cause of death.

Dr Twinn said “Clearly there are still practical issues to be ironed out” and discussions are ongoing to try to ensure that families and funeral directors are not inconvenienced by any procedural changes.

The need for stringent checks and regulations in monitoring and analysing death and cremation information was one of the fallouts in the wake of the Harold Shipman mass murders.

“The purpose of having two doctors is to ensure that there are no circumstances which should prevent cremation from going ahead,” added Dr Twinn.

“Such circumstances might include doubt over the cause of death, ongoing complaints about the care of a patient, medical mishaps or suspicious circumstances surrounding the death.

“Thus, without questioning the integrity or ability of any doctor completing the forms, we need to ensure that the second doctor is completely independent both of the care of that patient and of the doctor filling in the first part of the form.

“The role of the second doctor is to view the body and examine the facts of the case to ensure that there are no reasons for cremation not to go ahead.

“This second doctor should speak to either the family members, or another doctor involved with the case (other than the doctor filling in the first part).

“Once the second doctor is satisfied there is no reason for cremation not to go ahead then he or she can sign the form, which is then further scrutinised by the medical referee prior to cremation going ahead.”

Speaking on behalf of the NAFD in the local area, Mr Martin had said the difficulties regarding the signing of cremation papers must be resolved as soon as possible so that families are not left in an awkward situation that will cause “nothing but distress and delay funerals”.

A funeral service at Dundee Crematorium earlier this month almost had to be postponed, he explained, because of problems with vital paperwork and “it wasn’t the first such case.”