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Who can remove a pacemaker and who is responsible for payment?

Q - Where can I find clear guidance about who should remove pacemakers after death, how much the fee should be and who should pay it?

Mortuary technicians have often in the past removed the pacemaker and charged a fee to the funeral director, who then recovers this from the next of kin.

Funeral directors are also now beginning to offer the service and to charge the next of kin.

The only clear documentation we can find is in the written answers to parliamentary questions documented in a Hansard entry from July 1991

The Secretary of State for Health was asked whether the practice of charging bereaved relatives for the removal of a heart pacemaker prior to cremation was customary throughout the UK, under what authority the charge was levied and what provision exists for the removal of pacemakers in these circumstances.

The minister replied that central guidance on the removal of pacemakers from people who have died in hospital was issued in 1983 through Health Notice (83)6.

The intention was that the health authority should meet the cost and that in no circumstances should bereaved relatives be charged.

As far as we are aware the 1983 Health Notice has not been superseded.

We believe, therefore, that the relevant PCT ­ since the health authorities no longer exist ­ should pay an appropriate fee to whoever performs the service.

As a GP you would therefore be permitted to remove a pacemaker. It is not legal to fix a fee and we would therefore advise you to charge a fee based upon the time taken to remove the device.

Most GPs currently charge at a rate of about £120-£130 per hour. (The fee quoted in one medical journal for pacemaker removal is in fact £69!)

If mortuary technicians or funeral directors remove a pacemaker they would also have to negotiate an appropriate fee with the PCT and should definitely not charge the next of kin.

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.

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