Forensic Pathology-international perspectives

Helen L Whitwell-Durham, 2009

• Home Office Accredited Forensic Pathologist-since 1988

• Consultant Neuropathologist NHS, Birmingham, 1986-1998

• Senior Lecturer in Pathology, University of Auckland, NZ, 1998-2000

• Professor and Head of Department, University of Sheffield, 2000-2004

• West Midlands Group Practice since 2004

Current situation in England and Wales

Mixture of self-employed, University, NHS and Forensic Science Service (whole and part time)

Variable departments and mortuary facilitiesRecruitment and retention issues Governance (?) NPIA-issues of independence

within the judicial systemCareer development Research and teaching

Financial

• Fee per case• Onus on police to decide if a case is

suspicious or not

New Zealand model

• Until early 2000s-mixed with University, health service and private

• New Zealand-4.2 million population• Majority –Auckland

• Crisis with recruitment and retention• Use of local non forensic pathologists• Review lead by Rex Ferris-implemented in

2005

National service model

• Centrally funded from the Ministry of Justice-salaries, support costs

• Pathologists contracted to Auckland Health Board (nationally)

• Current 7 WTE• Paediatric pathologist 0.4• Neuropathologist 0.5

• Hospital based with access to other medical specialities

• Cross cover on a national basis

Australia

• Current national shortage of FPs• Variable structure and funding models-eg

hospital /University, forensic science providers, Victorian Institute of Forensic Medicine

• Work out of centrally based units-salaried

Canada-Ontario

• Toronto plus 4 other units-funded via health service or other employer

• eg Ottawa-based in the hospital alongside the other pathologists

• Population 9 million

BAFM

• Centralised organised service• Regional centres

Future

• Implement stable structure with career development as well as research, teaching and organisational opportunities

• Salaried service-advantages and disadvantages

Location of service

• GMC revalidation-essential to have close links with the medical profession

• Issue of being ‘police pathologists’• Academic work does not fit easily with current

university policies• Trusts not generally keen to have FP• Wider role in death investigation-not in the

current system

• Central funding via national special health authority model-similar terms to NHS Consultants

• Potential for development of wider role in autopsy work

• Essential to be seen to maintain independence as expert witness