Ex-pathologist angry at inspectors
The retired state pathologist in Northern Ireland has said he is angered by inspectors who misunderstood the difficulties facing his department when drawing up a critical report.
Professor Jack Crane said obtaining the services of outside specialists could take some time but was necessary to uphold the high standards of the pathologist's office.
He recognised the impact on bereaved families if autopsy reports were delayed but said experts working for health trusts or the forensics laboratory often had competing demands on their time.
Criminal Justice Inspection Northern Ireland (CJINI) has said the pathology department was beset with issues surrounding timeliness of reporting and recommended it be merged with forensic services.
Professor Crane said: "I feel despite trying to explain these reasons to the inspectors that they were not prepared to listen and that has angered me, that they have not fully understood the difficulties and the problems that we are facing.
"It is not a question of blame, it is a question of understanding why some cases take longer to complete than others."
The department plays a key role in handling unexpected or suspicious deaths by preparing reports for coroners and supporting criminal investigations. It carried out 1,176 post mortems last year.
The inspectorate said the scientific quality was good but the organisation continued to face issues surrounding its management and accountability.
Noting strains with Forensic Science Northern Ireland (FSNI), which tests the blood of victims for the presence of drugs or other toxins, the watchdog said the creation of a new body would reduce the propensity to blame another agency for systemic failings.
Professor Crane said: "This idea that some overarching body would solve it is nonsense.
"What we are trying to do is work with the Belfast Health and Social Care Trust to see if we can improve our relationship with them but theoretically at the end of the day consultants could turn around and say this is not part of my job, I don't have to do this."
He gave examples where delay had produced important results for public health.
Deaths involving infants and young children require the services of a paediatric pathologist. Professor Crane said recent work carried out by his department in conjunction with a paediatric specialist had highlighted the risks of co-sleeping.
He said enlisting experts who work for health trusts inevitably meant cases were going to take longer.
"We have to accept that they have other things and commitments and claims on their time."
He added: "This is not appreciated by the coroner's office or by the inspectorate."
Toxicology experts enlisted by the pathologist's department have identified an increased number of deaths related to an unregulated stimulant drug. A total of 20 fatalities were connected to the substance.
Professor Crane added: "It took the forensic service many months before they could find what this drug was but this was necessary work and had to be done unavoidably.
"These cases take longer but if we had not been doing them we would not have been able to alert the chief medical officer (Dr Michael McBride)."
He said a small team of pathologists provided a round-the-clock service to quickly produce post-mortem results, faster than in England in many cases. He is still working at the department as a locum because medical chiefs have been unable so far to fill his vacant position.
"This report does not help that because it is very negative."
He added: "Anybody coming from England who is already aware of the difficulties they are having there is going to say why would I want to come to Northern Ireland and be subjected to this criticism."
He understood that delays in compiling reports can cause distress to relatives.
"Our primary function is to ensure we do our work to the highest standard. We are not going to compromise the quality of our work to expedite a report that may not be particularly useful."
CJI's chief inspector Brendan McGuigan said the pathologist's department should consider releasing information to the coroner in stages to be passed to families.
He added: "The problems that we saw on this occasion were the same problems we saw in 2004 and the suggestion around an overarching body was first made in 2000 when the criminal justice review was taking place.
"That was a missed opportunity, there is another opportunity."