The Police Surgeon was formally established some 189 years ago by the Metropolitan Police Act when the prime role of the Police Surgeon was to provide medical care for Police Officers. During Victorian times most medical problems were dealt with by surgeons who operated, delivered babies and acted as today’s General Practitioners. Physicians graduated from Oxford or Cambridge and only diagnosed leaving treatment to apothecaries and surgeons.
The Police Surgeon’s care was so appreciated by the Police Officers that in 1947 98% of them voted to stay with the Police Surgeon rather than transfer to the National Health Service. The Metropolitan Police Association formed in 1889 developed into the Association of Police Surgeons the focus of the Police Surgeons work remained the occupational health of police officers.
Clinical Forensic Medicine came of age with the introduction of the Diploma of Medical Jurisprudence but there was a failure to professionalise the craft further. Changes to the law allowing nurses and other healthcare professionals to undertake certain procedures, encouraged private healthcare providers to claim that nurses and other healthcare professionals have the clinical skills to operate a forensic medical service.
The decision of the Association of Police Surgeons to rename itself to the Association of Forensic Physicians was timely, coinciding with the formation of a Faculty of the Royal College of Physicians, the Faculty of Forensic and Legal Medicine, followed swiftly by the demise of the Association. The aim of the Faculty is to promote for the public benefit the advancement of education and knowledge in the field of forensic and legal medicine and to develop good practice by ensuring the highest professional standards of competence and ethical integrity.
Forensic Practitioners, who may be Affiliated, Licentiates, Members or Fellows of the Faculty of Forensic and Legal Medicine may work as Sexual Assault Examiners in Sexual Assault Referral Centres where they collect forensic evidence from complainants of sexual assault and provide care to manage the medical complications of sexual assault or they may work as Forensic Medical Examiners in Custody Suites assessing fitness for detention or interview, documenting injuries and attending scenes of suspicious death.
Medically qualified Sexual Assault Examiners and Forensic Medical Examiners can call themselves Forensic Physicians. There have been calls that the title of Forensic Physician should be restricted to those with training and the possession of higher qualifications in Clinical Forensic Medicine and that only Forensic Physicians meeting those standards should give expert evidence in the courts. However, the Crown Prosecution Service and the courts define an expert as someone with knowledge or experience of a particular field or discipline beyond that expected of a layman.
The changes in Clinical Forensic Medicine that have taken place in the last decade, such as the outsourcing of Forensic Medical Services by Police Forces to services providers and the involvement of NHS England taking over the supervision of healthcare delivery is of greater importance than the semantic of naming healthcare professionals working in Clinical Forensic Medicine.
Improvement in the care given to detainees and reduction of adverse events in custody suites is of the utmost importance, but we must not lose sight of the value of forensic medical evidence not only in the prosecution of offenders but as importantly for the defence of the accused.
Although the significance of DNA has come to be better appreciated and DNA can be extracted from smaller and smaller samples, DNA alone does not provide all the answers in every case. The requirement for a medical opinion to place the findings made by police officers and healthcare professionals into context and present an opinion within the legal framework of the criminal justice system and the courts has never been greater. Whether that medical opinion is provided by a police surgeon, a sexual assault examiner, a forensic medical examiner or a forensic physician it is important that all recruits to this area of clinical practice hold or are working towards membership of the Faculty of Forensic and Legal Medicine, (MFFLM) and those working in the Sexual Assault Referral Centres should hold or be working towards the Diploma in the Forensic and Clinical Aspects of Sexual Assault (DFCASA).
Credit: Dr Martin Barrett
Dr. Barrett, is a forensic physician working as a forensic medical examiner for the States of Jersey Police and the Metropolitan Police Service and as a Consulting Forensic Physician to Foresight Clinical Services.
Dr. Barrett, gives forensic medical evidence in cases involving injury interpretation, road traffic medicine and adult and child sexual assault.
Dr. Barrett’s experience of all aspects of clinical forensic medicine is underpinned by a Master’s Degree on Forensic Medicine, and a Research Master’s Degree in Law. Dr. Barrett is a member of the Faculty of Forensic and Legal Medicine.