Following a request from Liberal Democrat group leader Cllr Tim Brett, Fife Council bereavement services have issued a briefing detailing the procedures for the cremation of infants at its two crematoria in Kirkcaldy and Dunfermline. This was as a result of the report carried out by Dame Elish Angiolini following concerns about the practices in Edinburgh’s Mortonhall crematorium.
Cllr Brett said, ‘In view of the disquiet about the disposal of infant remains in Edinburgh it was important that Fife reviewed its own practices. I am pleased that they have done so and note that since 2001 there has been close working between Fife Council, NHS Fife and SANDS, the stillbirth and neonatal death charity to ensure that infant remains are individually cremated, should parents opt for cremation.’
Cllr Brett urged any families with concerns about the practices in either of the Fife crematoria to contact the council’s Bereavement Service but warned that there could be difficulties with obtaining information from before 2001, as different arrangements were in operations and records have not been kept.
He concluded, ‘It is, however, good to know that there is a garden of remembrance at each of the crematoria, where the ashes of babies and children may be scattered should that be the wish of their parents.’
Fife Council Briefing :
There has been further public and media attention on the cremation of infants following the publication of the Mortonhall Investigation Report on 30th April 2014. This was commissioned by the City of Edinburgh Council after concerns were raised about practices at Mortonhall Crematorium and was authored by the former Lord Advocate of Scotland, the Rt. Hon. Dame Elish Angiolini DBE QC. The remit of the report was to establish the facts regarding infant cremations at the crematorium and to learn lessons that would help ensure best practice for the future.
Although the report does make some broader recommendations beyond what took place at Mortonhall Crematorium, the next key milestone nationally is the report due from Lord Bonomy’s Infant Cremation Commission. This was established by the Scottish Government on 16th April 2013 with the remit to examine the policies, practice and legislation related to the cremation of infants in Scotland. The Commission is now considering the Mortonhall findings in order to help inform its report which is now expected to be published by the Scottish Government by the end June 2014.
The Cremation (Scotland) Regulations 1935 regulate the provision of crematoria in Scotland. These have been amended on a number of occasions. Regulation 16 makes specific provision for the cremation of a stillborn child, although the term ‘stillborn’ is not defined in these regulations. However, it is defined in the Registration of Births Deaths and Marriages (Scotland) Act 1965 as a ‘child which has issued forth from its mother after the twenty-fourth week of pregnancy and which did not show any signs of life.’
The category of foetal remains (non-viable foetuses or NVF) includes all foetuses following cases of pregnancy loss before 24 weeks gestation. The disposal of foetal remains is not dealt with in any Act of Parliament or Regulations. If the pregnancy has not progressed to 24 weeks gestation, the 1935 Regulations have no application.
Because there is no applicable Act of Parliament or Regulations, the disposal of foetal remains has been dealt with according to policies and codes of practice issued by various bodies. The deficiency of the current legislation has been highlighted in the Mortonhall report and referred to the Infant Cremation Commission for consideration of legislative amendment.
Beyond 24 weeks gestation, the legislation stipulates that ‘if a child is expelled from its mother either before or after the twenty-fourth week of pregnancy and either breathes or shows any sign of life and then dies it must be treated as a normal birth and death and registered accordingly.’
CURRENT ARRANGEMENTS IN FIFE:
Fife Council has had a policy in place since 2001 developed in partnership with NHS Fife and Sands (the stillbirth and neonatal death charity) to ensure that infants who have died during 12 to 24 weeks gestation are brought to one of the crematoria for individual cremation.
Infants of 24 weeks gestation and older, or those who have been born, breathed and died at any time during pregnancy, are covered by the current legislation and funeral arrangements are made in the normal way.
In cases where bereaved parents opt for the cremation of an infant or of foetal remains, they are given information which warns that there are occasions when there may be no tangible remains left after the cremation process has been completed.
This will depend on the nature of the bone structure and stage of development. All foetuses and infants grow at different rates which means that two infants of the same age can be completely different in terms of their physical development.
In the majority of cases, no cremated remains are obtained from a cremation of an early stage foetus as the remains are essentially soft tissue. The potential for securing ashes from the remains increases as the length of gestation increases, although the retrieval of cremated remains cannot be guaranteed in all cases.
If there are ashes, these will be offered back to the family or Funeral Director or, if requested, they can be scattered in the specially-designated baby areas which sit within the Gardens of Remembrance of both crematoria.
The cremators used at both crematoria in Fife have been designed for adult cremations. The heat and combustion of air and gases causes a turbulence which the undeveloped remains of a foetus or infant in most cases cannot withstand, so the recovery of ashes can be variable despite the type of coffin used.
There is a regular dialogue between Bereavement Services, NHS Fife and Funeral Directors. The wording of information provided to parents now advises that it is very unlikely that there will be any ashes following cremation.
Previous advice reflected the guidance from the Federation of Burial & Cremation Authorities (FBCA) and Institute of Cemetery & Crematorium Management (ICCM) which referred to there being no remains. In practice, a significant number of foetal and infant cremations won’t produce remains, but where ashes are retrieved these will continue to be offered to the family.
The cremation process continues to be closely monitored and the use a special cremation tray for foetal and infant remains has recently been re-introduced to try and help improve the chances of ashes being retrieved. A full risk assessment is in hand to ensure safe working practices for crematoria staff.
Given some of the concerns highlighted in the Mortonhall report and anticipating what may emerge from the Infant Cremation Commission, a review of the paper trail between Bereavement Services, NHS Fife, Funeral Directors and families is in hand to ensure that this is as clear and concise as it can be.
At a national level, managers from Bereavement Services are involved via the FBCA in discussions with other local authority and private crematoria operators to review and, where appropriate, improve current working practices.
Lord Bonomy’s report is expected to make a number of recommendations to the industry, some of which might require legislative change and the issuing of new national guidance. There may be other changes relating to how infant cremations are managed, performed and recorded in the future. These recommendations will be considered carefully including any changes we might need to make to the current arrangements in Fife.
Finally, if any Councillors would like to visit either of the two crematoria (Dunfermline/Kirkcaldy), please contact Liz Murphy, Bereavement Services Manager, on 03451 555555 Ext. 476681 or via e-mail at email@example.com.