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Report of the Infant Cremation Commission

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Section 13 - Implementing the Recommendations

13.1 The encouragement of communication among, and co-ordination of the work of, the various bodies with a role in infant cremation is one of the themes of this Report. Achieving clarity and consistency in communicating with families is another. It is a striking feature of cremation that so much activity is duplicated because there are two major and very active bodies which represent Cremation Authorities and staff, and that the information and Guidance they publish is not entirely consistent. Obviously the members of both bodies have the right to form and belong to whatever association they choose. However there is clearly scope for greater co-operation between the ICCM and the FBCA. The Commission have recommended that they co-operate in certain specific areas. Perhaps that may lead to more co-operation in others.

13.2 The Commission have identified a number of areas where practices and policies in relation to baby and infant cremation can differ from crematorium to crematorium. Similar variations can be found in practices and policies at NHS Health Boards and among Funeral Directors. The Commission have made a number of recommendations to achieve consistency in policy and practice with the aim of achieving high standards across all aspects of baby cremation and ensuring that the interests of the bereaved are central to this work. These recommendations include the creation of a number of working groups of varying but overlapping composition. Since the improvements that are necessary will only be realised if the Commission's recommendations are delivered, it is important that there should be a focused mechanism for implementation and ongoing oversight.

13.3 It is also important to take steps now to provide a mechanism for identifying relevant medical, scientific, engineering and technical developments, with a view to ensuring that the best available practices continue to be followed throughout the country.

13.4 For these purposes, the Commission recommend that the Scottish Government should establish a National Committee with responsibility for baby and infant cremations. In keeping with the Commission's view that the central focus of attention of work in this field must be the baby and the family, that National Committee should include representation of parents, including those who have campaigned so effectively to discover the facts and ensure that in future babies and families are treated with dignity, respect and sensitivity.

13.5 The National Committee should be chaired by a senior Scottish Government official. In addition to parents its membership should be drawn from authorities, organisations, professions and other bodies with a role in baby and infant cremation and providing bereavement support.

13.6 The National Committee should have power to establish working groups of its membership, with co-opted members where appropriate, to consider specific recommendations from this report. For example recommendations relating to technical matters and cremation technology could be dealt with by a 'technical working group' reporting back to the full Committee. Other recommendations which could be dealt with in a similar way include, for example, a 'guidance and policy working group' which would deal with those matters relating to the review and creation of publications such as guidance and policy statements with a view to ensuring accuracy, consistency and clarity. Those bodies specifically assigned actions within this Report should not feel constrained from undertaking such actions in the interim period before the National Committee is formed, as they and their early work can contribute not only to the early implementation of the recommendations of this Report but also to the development and work of the National Committee.

13.7 The National Committee should report to Scottish Ministers annually on progress against the recommendations made by this Commission. That annual report should be published on the Scottish Government website.

13.8 The National Committee should, as a priority, develop a national Code of Practice for baby and infant cremation. Such a Code, which should be informed by the recommendations of this Commission, should set down the minimum requirements for organisations to adhere to when supporting bereaved parents and families through the baby and infant cremation process, and seek to identify best practice to be followed by all bodies involved in baby and infant cremation. The Code of Practice should include general principles and guidance as well as specific technical and operational guidance for Cremation Authorities, NHS Health Boards and Funeral Directors, with a view to achieving consistently high standards of practice among all with a role in baby and infant cremation.

13.9 The Code of Practice should be a live document that is not only responsive to developments, but also instrumental in promoting improvements, in practice, technology, policy and legislation. The National Committee should therefore continue to monitor developments in all aspects of activity related to baby and infant cremation and review the Code annually to ensure that it reflects contemporary standards and best practice.

13.10 The Commission noted at Section 6.8 the provision of Regulation 2 of the 1935 Regulations for the appointment of an Inspector[80]. That power is seldom used in practice and only on an ad hoc basis. Alongside the National Committee's role in developing and enhancing best working practices and standards in the field of baby and infant cremations, as set out above, it is the Commission's view that it would also be appropriate to create the permanent post of an independent Inspector who would separately monitor these same working practices and standards at crematoria, providing feedback to Cremation Authorities on how they are performing and reporting on this to Scottish Ministers.

13.11 A similar Inspector model exists in the role of the Inspector of Anatomy for Scotland, as set out in the Anatomy Act 1984, and as revised by the Human Tissue (Scotland) Act 2006. The independent Inspector should have authority to investigate complaints from the public about working practices and standards at crematoria, to adjudicate upon these complaints and report findings to the Scottish Ministers. The role of the Inspector should be extended to the funeral industry in respect of which there is no current provision for inspection. In view of the breadth of responsibility envisaged, further legislation would be required, but in the interim an appointment could be made in terms of Regulation 2 noted above, at least in as far as crematoria are concerned. That is the Commission's recommendation.

13.12 The Commission consider that such aligned oversight by both the National Committee and the Inspector would have an important part to play in maintaining public confidence in the working practices of Cremation Authorities and Funeral Directors across the country, including in particular securing the recovery of ashes in baby and infant cremations.

13.13 Some parents and members of the public have expressed concerns about the lack of general regulation of both crematoria and Funeral Directors. However the Commission considered that its remit, being confined to the particular issue of baby and infant cremations, did not extend to recommending general regulation of these industries. They have therefore confined their recommendations to the creation of this scheme for continuous monitoring of the working practices and standards of crematoria and Funeral Directors in respect of baby and infant cremations. However, the Commission recommend that Scottish Ministers should keep the cremation and funeral industries under review and should consider, in light of the reports of the National Committee and the independent Inspector, whether further regulation of either is required.

13.14 The Commission have endeavoured to identify improvements to a wide range of practices associated with cremation of babies and infants, with the aim of providing a sensitive and reliable system that will meet the particular needs of all, and restore public confidence in the arrangements for baby and infant cremation in Scotland. However, the Commission recognise that the system is only part of the solution. Much also depends on the qualities of the personnel engaged in its various branches. The system will only achieve that objective if those who work in it display the will to make a success of it.