The Home Office Register of Forensic Pathologists is maintained by the National Policing Improvement Agency and there are only 36 such pathologists for the whole of England and Wales. It takes about 14 years from becoming a doctor to registration - training being rigorous and controlled by the Royal College of Pathologists and GMC (Postgraduate Medical Education and Training Board).
Of the 500,000 deaths each year in England and Wales, about half are referred to a Coroner, and in half of those the Coroner orders an autopsy ( post mortem examination). In the vast majority, these are performed by hospital pathologists and the cause of death is natural.
The Coroner decides, if the circumstances as reported by the police are suspicious, to ask a Home Office pathologist to conduct an autopsy. The original Coroner in the Tomlinson case, Prof Paul Matthews (who subsequently stood down) called in Dr Patel. Had the DPP brought charges against the police officer then, and called Dr Patel, justice would not have been done, since he had concluded "natural causes".
Now that the inquest has concluded "unlawful killing" in the light of new evidence, the DPP was better informed and justice is more likely for Tomlinson's bereaved family.
There are serious questions as to why Dr Patel was allowed to continue practising - an independent panel for the GMC has imposed a period of suspension, supervision and mentoring. A GMC fitness to practise panel will review his case at the end of July.
Thirty six forensic pathologists for England and Wales is not enough, their training is long and demanding, and their work involves antisocial hours. Of course there are "complacent, irresponsible, unprofessional" doctors - Harold Shipman is an example - as in other professions. But we should be grateful that justice is done in most suspicious deaths thanks to the minority of doctors who choose this specialty.
