Section 1 - Eexcutive Summary
1.1 Death always evokes grief. To some it brings release and to their families relief from the distress of observing a loved one in decline and pain. For others the grief and distress of suffering untimely bereavement can seem unbearable. That is particularly so for many who suffer the loss of a longed-for and much-loved baby at or before birth or in the early months of life. To learn later of uncertainty about the existence and disposal of their babies' ashes has compounded the grief, caused further distress to many, and given rise to mixed emotions in others. That highlights the importance of taking steps urgently to ensure that future cremations of babies are handled with sensitivity that has due regard to the duty to lay their remains to rest as and where their families wish.
1.2 The work of the Commission has been confined to the cremation of babies and infants. It may coincidentally have an impact on arrangements for the cremation of older children and adults. However, it must be recognised that there are special features of baby and infant death and cremation of which it is important to be aware in trying to devise systems to avoid repetition of past failures. Perhaps the most significant are the practical result of cremation of a baby and the proper understanding of that by the three separate groups who have roles in arranging and conducting funerals and cremations, namely, healthcare staff, Funeral Directors and crematorium staff. Public concern about the current situation and the need for change was clearly expressed within a submission made by the parent of a baby who died shortly after having been born prematurely:
"I feel that it is essential that national standards are established to inform the work of crematoria and that bereaved parents of the future are not left with any doubt about what has happened to the remains of their deceased children. If there are no remains then time should be taken to explain to parents why this might be the case. Parents also need to understand why apparently remains can be retrieved 100% of the time in some crematoria, but almost never in others. The current situation is not acceptable."
1.3 The aim of the Commission has been to identify where the problems lie and to devise arrangements for cremation which address these problems in order to ensure that those involved have a clear and consistent understanding of the whole process that will enable them to assist families to make informed decisions, have their babies laid to rest as they wish, and have confidence that their wishes have been implemented. In doing so the Commission have been careful not to lose sight of the many examples of good practice already available to tap into, in all areas, and the widespread ethos of aiming to provide a dedicated public service.
1.4 In the Sections which follow, the circumstances which led to the creation of this Commission are set out along with details of the work undertaken in the course of the investigation and a summary of the 57 submissions received. The extent to which cremation is practised in Scotland and how cremation is carried out are explained. At the core of the Report are Sections addressing the nature of "ashes" and the means available to ensure the recovery of ashes in baby and infant cremations. Sections are then devoted to how baby and infant cremation is regulated and the attendant formalities, including the forms to be completed and registration of the outcome. Two important legislative changes proposed are that there should be a statutory definition of "ashes" and statutory regulation of the cremation of babies of less than 24 weeks' gestation. Since the Commission have identified a fairly widespread lack of appreciation of the impact of the cremation process on babies and infants and a failure to appreciate what the public expectation of cremation is, the subsequent Sections deal with training, education and communication.
1.5 Full consideration of all the material gathered by the Commission in the course of their work has led to the following recommendations which have the support of all members of the Commission. These recommendations are set out below along with reference to the parts of the Report where they are particularly addressed.