| The
preceding
chapters
have
described
the
main
features
of
the
joint
programme.
This
chapter
covers
two
aspects
of
the
programme
that
have
not
been
described.
|
|
|
|
Reports
to
Ethics
Committees
and
LRECs
|
|
|
|
| A
general
principle
of
the
operation
of
all
Ethics
Committees
is
that
researchers
whose
protocols
have
been
approved
should
submit
progress
reports
to
the
Committees,
and
should
inform
the
Committees
of
any
major
changes
to
the
methodology
of
the
approved
project.
Salford
EC
had
this
requirement
in
place
throughout
the
1980s
and
minuted
progress
reports
and
amendments
received
routinely.
|
|
|
|
| The
minutes
and
other
papers
of
the
Salford
EC
have
been
reviewed
for
the
years
from
1986
when
the
proposal
by
Dr
Soni
and
Dr
Deakin
was
approved.
There
is
no
further
mention
of
this
project
to
be
found
anywhere
in
the
Salford
EC's
papers.
This
was
notwithstanding
the
frequent
reference
to
'approval
by
Salford
EC'
in
submissions
that
were
made
to
other
ECs.
|
|
|
|
| The
records
of
the
other
ECs
that
approved
protocols
from
the
joint
programme
were
not
available
for
me
to
review
to
see
if
progress
reports
had
been
submitted.
|
|
|
|
| Dr
Slater
should
have
been
reminded
in
1991
of
the
obligation
on
researchers
to
submit
progress
reports
to
Ethics
Committees
when
the
Central
Manchester
REC
approved
the
application
he
and
Dr
D'Souza
had
submitted,
Chapter
14.
The
records
provided
by
the
joint
programme
do
not
contain
any
references
to
progress
reports
having
been
submitted
to
Ethics
Committees.
|
|
|
|
Implications
of
HSC(IS)153
and
the
1991
'Red
book'
|
|
|
|
| This
circular
was
described
in
Chapter
6.
It
made
clear
that
all
research
'on
the
recently
dead
in
NHS
hospitals'
should
be
referred
for
consideration.
The
circular
does
not
appear
to
have
prompted
any
action
by
the
joint
team
to
inform
LRECs
that
Coroners'
post
mortems
in
NHS
hospitals
were
the
main
source
of
the
brains
that
they
were
collecting.
|
|
|
|
| Fees
to
morticians |
|
|
|
| Morticians
in
NHS
hospitals
were
accustomed
in
the
mid
1980s
to
receiving
'item
of
service'
fees.
|
|
|
|
| Fees
for
Coroners'
post
mortems |
|
|
|
| Post
mortem
examinations
undertaken
for
the
Coroner
were
not
regarded
as
part
of
a
pathologist's
NHS
duties.
The
Coroner
paid
a
fee
to
the
pathologist
for
each
post
mortem
undertaken.
The
Royal
College
of
Pathologists
at
a
meeting
in
November 2001
commented
that
it
was
customary
for
the
pathologist
to
pay
the
mortician
ten
per
cent
of
the
fee
he
received
from
the
Coroner(1).
The
post
mortem
fees
received
by
the
pathologist
for
an
examination
'with
specialist
knowledge'
were
significantly
higher
than
the
standard
fee,
which
was
set
by
the
Home
Office.
The
mortician
could
expect
to
receive
ten
per
cent
of
the
higher
fee.
|
|
|
|
| Payments
by
undertakers |
|
|
|
| In
some
locations,
morticians
also
received
payments
from
undertakers
for
various
services.
These
arrangements
were
agreed
locally.
|
|
|
|
|
Payments
for
pituitaries
|
|
|
|
| Chapter
5
describes
the
national
pituitary
gland
collection
arrangements.
Morticians
in
hospital
and
public
mortuaries
had
become
accustomed
to
receiving
a
case-by-case
fee
for
each
pituitary
collected
within
the
scheme.
Morticians
were
aware
that
the
scheme
had
the
active
support
of
the
then
Ministry
of
Health
and
its
successor
departments.
|
|
|
|
| Payments
for
brains
for
medical
education |
|
|
|
| Chapter
4
referred
to
the
collection
of
brains
from
the
mortuary
for
the
Anatomy
Department
at
the
University
for
teaching
purposes.
The
practice
of
obtaining
brains
from
mortuaries
for
undergraduate
teaching
was
at
that
time
widespread
and
is
described
in
Chapter
36.
|
|
|
|
| Anatomy
departments
paid
morticians
a
small
sum
for
each
brain
supplied
for
teaching
purposes.
At
NMGH
Mr
Leatherbarrow
had
received
such
payments
from
the
University
Anatomy
Department
until
October
1985.
|
|
|
|
| Payments
for
brains
for
the
joint
programme |
|
|
|
| When
the
joint
programme
began,
morticians
who
provided
brains
were
offered
a
fee.
No
record
was
found
of
the
initial
fee,
but
the
letter
sent
to
Mr
Leatherbarrow
at
NMGH
on
17
October
1986
stated:
'We
can
arrange
payment
of
£10
per
brain
before
tax,
which
is
deducted
at
source'.
|
|
|
|
| A
similar
fee
was
offered
to
morticians
in
other
mortuaries
contributing
brains
to
the
programme.
Mr
Walkden,
the
mortician
at
Prestwich
and
later
at
Bury
mortuary,
and
Mr
Owen,
the
mortician
at
Rochdale
mortuary,
both
received
these
fees.
|
|
|
|
| By
1986
the
pituitary
collection
programme
had
ceased.
For
comparative
purposes,
in
1980
the
fee
payable
for
NHS
morticians
for
pituitary
collection
was
consolidated
into
the
pay
scale
agreed
through
the
Whitley
Council.
Before
this
consolidation,
the
fee
for
each
pituitary
had
been
20
pence.
|
|
|
|
| Against
this
background,
the
offer
of
a
fee
to
morticians
for
removal
of
each
brain
was
not
in
itself
remarkable,
although
some
research
teams,
including
the
Cerebral
Function
Unit,
did
not
pay
any
fees
to
the
morticians.
The
£10
offered
by
the
joint
programme
appears
generous
by
comparison
and
has
been
interpreted
as
an
inducement
to
encouraging
morticians
to
provide
as
many
brains
as
possible.
|
|
|
|
| It
is
not
clear
why
the
letter
to
the
mortician
at
NMGH
was
not
copied
to
the
hospital
management
or
to
any
of
the
consultant
pathologists.
|
|
|
|
| Professor
Deakin
refutes
that
a
fee
of
£10
for
removal
of
each
brain
was
unusual
or
that
this
level
of
fee
would
constitute
a
financial
inducement.
It
should
be
noted,
however,
that
the
Cerebral
Function
Unit
research
programme
did
not
offer
any
fee
for
brain
removal
although
this,
in
some
case,
involved
the
morticians
in
extra
work
undertaken
during
unsocial
hours.
|
|
|
|
Number
of
brains
obtained
from
NMGH
in
1994
|
|
|
|
| Mr
Leatherbarrow
has
retained
all
his
pay
advice
slips
from
the
University
in
respect
of
the
brains
he
collected
under
the
arrangements
discussed
in
Chapter
13.
From
1986
Mr
Leatherbarrow
only
ever
received
payments
from
the
University
for
brains
that
he
had
retained
for
the
joint
programme.
From
his
payslips
it
can
be
calculated
that
he
was
paid
for
providing
over
40
brains
in
1994.
|
|
|
|
| However,
the
brain
books
of
the
joint
programme
record
that
in
1994
only
three
brains
were
obtained
from
NMGH
mortuary.
|
|
|
|
| For
earlier
years
the
sums
paid
to
Mr
Leatherbarrow
relate
directly
to
the
number
of
brains
listed
in
the
brain
books.
This
highlights
the
discordance
between
payments
made
and
the
number
of
brains
recorded
in
the
brain
books
in
1994.
|
|
|
|
| In
this
context
three
other
points
are
relevant:
|
|
|
|
- when
the
collection
of
brains
from
NMGH
ended,
Mr
Leatherbarrow
was
told
that
the
reason
was
unspecified
problems
about
the
collection
arrangements
for
brains
of
Coroner's
cases;
|
|
-
Professor
McClure's
advice
to
Professor
Deakin
in
1995;
|
|
- Professor
Deakin's
conversation
with
Mr
Gorodkin
in
June
1995,
Chapter
22.
|
|
|
|
| Mr
Leatherbarrow
commented
that,
when
the
brain
collection
ended,
he
had
noticed
the
difference
it
had
made
to
his
income.
|
|
|
|
| The
discordance
between
the
number
of
brains
recorded
in
the
brain
books
and
the
number
for
which
Mr
Leatherbarrow
received
payment
has
not
been
explained.
|
|
|
|
| Summary |
|
|
|
| There
are
no
records
that
LRECs
received
progress
reports.
|
|
|
|
| The
1991
circular
did
not
prompt
any
action
by
the
team
to
inform
LRECs
of
the
main
source
of
the
brains
they
were
collecting.
|
|
|
|
| The
payment
of
fees
to
morticians
was
common
practice
in
the
1980s.
A
precedent
had
been
set
with
the
payment
of
fees
for
the
collection
of
pituitaries
within
the
national
collection
scheme.
|
|
|
|
| Morticians
were
accustomed
to
receiving
from
pathologists
a
proportion
of
the
fees
paid
by
Coroners
for
each
post
mortem.
|
|
|
|
| Fees
for
brains
provided
had
been
paid
for
many
years
to
morticians
by
anatomy
departments
of
Universities
who
obtained
brains
for
teaching
medical
students.
|
|
|
|
| The
offer
of
a
payment
for
each
brain
provided
did
not
appear
unusual,
but
no
fee
was
paid
for
brains
collected
for
the
Cerebral
Function
Unit.
|
|
|
|
| The
fee
of
£10
in
the
late
1980s
could
be
regarded
as
generous.
At
least
one
mortician
considered
the
level
provided
an
inducement
as
the
extra
work
involved
was
minimal.
|
|
|
|
| It
is
not
clear
why
the
letter
to
the
mortician
at
NMGH
was
not
copied
to
the
hospital
management
or
to
one
of
the
consultant
pathologists.
|
|
|
|
| Payments
for
brains
were
referred
to
in
some
of
the
grant
applications
made
by
the
research
team,
Chapter
9.
|
|
|
|
| The
discordance
between
the
sums
paid
for
brains
collected
and
the
number
of
brains
listed
in
the
brain
books
in
1994
has
not
been
explained.
|
|
|
|
| References |
|
|
|
| 1 Information
provided
by
the
Royal
College
of
Pathologists.
|
|
