Death Without Debt’s proposals are just common sense. They will improve things from the point of view of the public, the medical profession and the industry.
It is important, indeed a basic right, that families should have the choice of handling their own dead so long as they do so responsibly. Increasing numbers of people want to DIY for both cultural and financial reasons. Changing the law so official paperwork requirements don’t trip the public up will allow people to DIY funerals from start to finish This in turn will provide the industry with competition and scrutiny. Competition and scrutiny will lower funeral prices for everyone – not just DIYers. Honest funeral directors have nothing to fear. Competition and scrutiny will reduce commercial predation and improve trust in the industry.
We’ve had doctors trial proper after-death duty of care. They were pleased to save families money and also to empower people to make informed decisions over whether to engage a funeral director and for what.
As an added bonus, proper after-death duty-of care improves community health outcomes. Less funeral debt = less stress.
The Details
Pre-cremation paperwork is at the heart of the problem.
Before a cremation can occur, a second, specially designate must sign off the first doctor’s paperwork. That second doctor is known as a medical referee. Getting that second signature is, clearly, a medical responsibility but medical professionals refer families to the funeral industry to get that second signature. This is standard practice and the results are disastrous.
What it means is that the general public have little-to-no chance to bypass the funeral industry when it comes to getting the medical referee’s signature. Even if they do know about the system – and almost no-one does, their chances of locating a medical referee and gaining their co-operation are remote.
And so the funeral industry enjoy a captive market. Not only does the secretive medical referee system allow them to charge exorbitant “professional service fees”, it hooks the public into the funeral industry’s business model. A family handling their own dead may need nothing more than that second doctor’s signature, and yet be forced to pay standard rates for the whole show – coffin, hearse hire and so on.
Although only 75% of NZers opt for cremation, the funeral industry actually enjoys close to 100% market capture thanks to the generalised mystery the industry have managed to cast over all after-death paperwork – whether it is cremation, burial or even death registration.
The Ministry of Health have long turned a blind eye to the situation and the Department of Internal affairs has also played along by making it difficult (by their own admission) for the public to register a death themselves. (After years of sustained pressure have they finally made the death registration form available to the public on their website. They still, knowingly, fail to provide adequate guidance on how to complete the form.)
There is a second major problem. Half of NZ’s districts have no council-operated crematorium. This means that instead of paying the local council $700 for a cremation, people living in those districts with only privately operated crematoriums have no choice but go along with “package deals”, customer fees” and “professional service fees” imposed by the private crematorium owners.
Medical professionals can help in two ways
1) Put your name behind our call to:
a) Explicitly include after-death duty of care in the Health and Disability Commission’s list of patient rights. Current standard medical practice violates nine out of ten of the Health and Disability Commission’s list of patient rights
As a matter of principle, the public should not be forced, by official paperwork requirements, into dependence on the private business sector to fulfill official paperwork requirements, especially at this vulnerable time.
b) Make it mandatory for privately owned crematoriums to accept for cremation properly-presented bodies at a set fee.
c) Provide timely attendance at a death by utilising nurses and nurse practitioners. Families must not be forced to hire a funeral director to transport the body to the doctor in the case of an expected death simply because the medical center does not send out a nurse.
2) Where possible, start providing proper duty-of-care in the after-death setting.
If you live in a district with a council owned and operated crematorium, find out who the medical referees are for that crematorium so you can contact them direct, or through the crematorium, to get cremations signed off.
You can also help bereaved families by providing friendly, supportive advice about a family’s options for staying out of debt and handling the funeral process themselves.
Besides having any pre-cremation paperwork completed for them, Families need to know that:
Burial can be organised by contacting the local council
WINZ funeral grants are available for those eligible
Coffins are in most cases optional
Embalming isn’t mandatory and there are other options for helping preserve the body
No special forms are normally needed to transport a body but there are strict hygienic and practical requirements.
That a death has to be registered within three days of cremation or burial and that the forms for doing so are available online. Also, if the family don’t know all the information required they should simply add a note saying so.
Paying one’s respects is not something that needs to be taken literally and that funeral debt can be a trap for many families.
What practical assistance and guidance, either voluntary and paid, is available in the local community
If you would like to support our proposed reforms, please email us, subject line “Medical Support”
Notes:
For cremation, it is important the medical referee is sent the MCCD, your normal pre-cremation paperwork and the family permission form. Instruct the medical referee to return the completed paperwork (Form F) back to the family and yourself, as well as to the crematorium so everyone knows what is going on.
The exact details of how to help a family through the medical referee system differs from district to district and can get quite complicated as the current systems are dysfunctional. Remember too that half of the districts in NZ have no public crematorium. So even if you are able to help a family through the medical referee system (not always easy) they may still be forced to pay full professional service fees to the operator of the crematorium (i.e. an attached funeral home).
In rare cases, a privately owned crematorium and their contracted referees may allow you to complete the paperwork on behalf of the family.