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Details of coroners’ reports that aim to improve health and safety by
identifying action to avert future deaths have been published for the
first time by the Ministry of Justice.
An amendment to Rule 43 of the Coroners Rules in July 2008 introduced a statutory duty for organisations to respond to these reports, and coroners may now share their reports more widely.
Over the period 17 July 2008 to 31 March 2009, coroners issued reports under Rule 43 in 207 inquests, of which 19 per cent related to road deaths; and 10 per cent were in respect of deaths involving either an accident at work, or health and safety issues.
Kevin McLoughlin, a barrister and an assistant deputy coroner, told SHP that under Rule 43, the recipient merely has to respond to the coroner’s report and is not compelled to take action. However, he warned that the existence of an unheeded Rule 43 report could become hugely important in the future if another fatality were to occur in similar circumstances.
“In any corporate manslaughter prosecution, for example, the jury will decide whether there was a gross breach of the duty of care by reference to the factors set out in section 8 of the 2007 Act,” McLoughlin explained.
“These include ‘attitudes, policies, systems or accepted practices’, which tolerated the failure, or any other matters the jury consider relevant. A Rule 43 report, which drew attention to the potential for harm but has not effectively been dealt with, could prove to be the centrepiece of the prosecution case.”