London's Pulse: Medical Officer of Health reports 1848-1972

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Hillingdon 1971

[Report of the Medical Officer of Health for Hillingdon]

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PREVENTION OF BREAK-UP OF FAMILIES
With the retirement of the Children's Officer the previous arrangements for formal meetings
attended by a variety of social agencies from different departments within the Council and from
other statutory bodies were discontinued. This responsibility was transferred by agreement to the
Director of Social Services, but no formal meetings were held during the year following the transfer.
BREAKSPEAR CREMATORIUM
The Borough Council continues with the Harrow Borough Council to be a constituent
member of the Breakspear Crematorium Joint Committee. The crematorium is situated in Breakspear
Road, Ruislip.

On 1st January, 1971, the Director of Health Services took up additional duties as medical referee to the Joint Committee. The Deputy Medical Officer of Health and a Principal Medical Officer were appointed during the year to assist with such duties.

YearTotal CremationsYearTotal Cremations
19653,43919693,802
19663,39919703,929
19673,41219713,870
19683,677

The number of cremations, 3,870 showed a slight reduction compared with the previous
year, the first since the crematorium was opened at the end of 1957. It is one of the objectives
of the Council to encourage cremation in appropriate cases. Arrangements were made with Her
Majesty's Coroner (Dr. J. D. K. Burton) for post mortem (autopsy) examinations to be undertaken
in cases referred by the medical referee. During 1971, three cases were referred for an autopsy
in this way.
The proportion of cremations authorised as a result of a Coroner's certificate in 1971 was
30.5% compared with 26.5% in 1966 and 27.3% in 1965. The increasing proportion of cremations
which have been referred for a coroner's examination has been noted for some years, and carries
implications for the role of the medical referee. A small survey of 212 consecutive cremation
certificates received during two weeks in December showed that 35.4% were authorised under
the Coroners certificate E. Nevertheless, of the remaining certificates 28.5% presented problems
requiring further elucidation by the medical referee before the cremation could proceed.
Report of the Committee on Death Certification and Coroners
A Committee appointed in March 1965 under the Chairmanship of Judge N. J. L. Brodrick,
Q.C., issued its report on this subject in November 1971. Sweeping changes in the present death
certification process were proposed which would introduce some much needed improvements
and result in greater precision concerning the cause of death. As far as cremation was concerned,
the Committee saw no need for the present special arrangements for cremation certificates and
recommended that they should be abolished together with the office of Medical Referee.
Most of the criticism of present practice centred upon the value of the confirmatory medical
certificate which, it was concluded did not provide much additional information and upon the
role of the medical referee whose task was considered to be an impossible one. Although the
statistical evidence presented in the Committee's report was impressive, it must be questioned
whether it provided all the information relevant to such major changes in established procedure.
Thus, although it was noted that the Cremation Regulations do not require any particular answer
to the question on the confirmatory medical certificate, the Committee's own enquiries showed
that medical referees, who have an absolute right to refuse cremation, in practice always require
the second doctor to see the body of the deceased and to discuss the case with his colleague
who gave the first certificate. Similarly the nature of the Committee's enquiry into the practice of
medical referees did not provide information concerning any additional requirements which might
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