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Ash Cash

George South
19 Apr 08, 12:57 PM

Our main story this week came to us via listener Pauline Levey. She emailed to suggest we take a look at 'ash cash'. This is a fee that's required in order for doctors to release a body for cremation. It's currently set at a level of £71 each for two doctors, paid in cash on top of the doctors' NHS salaries. Pauline - whose mother was cremated a year ago - says the charge is unfair and cruel. Here she explains why.

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Since the Shipman Inquiry the Department of Health and Ministry of Justice have been jointly working on overhauling the system of death certification. No ministers were available for interview, but the Department of Health did issue us an interesting statement promising that their planned reforms would:

...introduce a single system of effective medical scrutiny ... and replace the existing cremation certification process.

The British Medical Association negotiates the level of cremation fees on behalf of doctors. Dr George Fernie chairs the BMA's forensic medicine committee, which might be expected to defend the system. In fact, he's keen to see change:

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Finally, we spoke to Rohin Francis, a blogging junior doctor at St. George's Hospital in London. As a first year House Officer in 2006, he wrote the following:

Ash cash. The sixty two pounds a doctor pockets every time a patient they have certified pops their clogs and is burnt to a crisp is nothing short of infamous. Known as the house officer's privilege, it is the fund for Thursday night drinks all over the country.

A colleague working on care of the elderly has effectively gone up a banding due to the vast amounts of ash cash he rakes in. No comment on his quality as a doctor, of course. Ahem.

Yet when we are filling in the form, we all answer 'no' to the question 'Do you have any pecuniary interest in the patient's death?'

Despite some noble souls donating their cheques to charity, the rest of us catch ourselves secretly hoping that families opt for cremation.

If a terminal patient is known to several doctors, we also hope they survive just until we're on call and then we'll be the one called to confirm, see the body after death and head down to patient affairs before anyone else beats us to that cheque. Well, perhaps that's just me.

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