Report by the nsw state Coroner into deaths in custody/police operation
Assessment and Involvement by Department of Community Services
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- Formal Findings
Assessment and Involvement by Department of Community ServicesThe Deputy State Coroner took on board the submissions made by DOCs both oral and written. It is apparent that DOCs involvement was limited to the one mandatory notification and that there had not been any prior DOCs involvement with the P/K family or their children. With the benefit of hindsight, perhaps the events of 2 August 2003, if recognised as a Domestic Violence incident and bearing in mind the presence of the children and that self harm issues associated with the possession of a knife, should have been a mandatory notification. When Constable B obtained a more detailed statement from IP and made the mandatory notification on 5 August, it may well have been the case that it would have been treated as higher in priority on the basis of being a second notification. It would appear that current policies do not prohibit a case worker from contacting a complainant or notifier to seek further information. It is of concern that approximately 87% of notifications remained unallocated and are then closed as there is no further report. Clearly issues of resources are one factor, but not the only one as submitted. I do not propose to make any formal recommendations in regard to DOCs, however, I will refer a copy of the brief and transcripts to the Director general of the Department of Community Services for attention and consideration. In regard to formal recommendations the Deputy State Coroner considered that he should make the following. Firstly, to recommend that the Commissioner of Police review the circumstances surrounding the deaths of the P/K family with particular attention to be given to the following:
The Deputy State Coroner also proposed to make 2 recommendations to the Attorney General in regard to the provisions of Part XV of the Crimes Act. The first relates to the implications of the case of Woos v Evans, Justice Kirby, Supreme Court, and the provisions of Section 562H(I). There was no need at this stage to articulate the recommendations in more detail, as it was proposed to do that more fully at the completion of these proceedings. The Deputy State Coroner also proposed to seek that the Attorney general examine the provisions of Section 4 of the interpretation Section of the Crimes Act, which would appear to exclude an offence under the provisions of Section 31 of the Crimes Act (viz send threatening letter) as a domestic violence offence. Again there was no need to articulate that recommendation in detail at this stage. In closing this Inquest the Deputy State Coroner expressed his appreciation to Detective Chief Inspector L for the excellent work he put into preparing the investigation on his behalf. Appreciation was also expressed to Counsel assisting and other members of the bar table who assisted and represented their particular interests. The Deputy State Coroner’s final comments were understandably for the P family and IP in particular. He cannot begin to understand the grief and loss they had endured over the past 22 months. He can only say to all of you, personally and on behalf of the Court, that he extended his deepest sympathy for their tragic loss. The deputy State Coroner trusted that this Inquest has in some small way, and he was well aware of their initial reluctance to attend, provided them with an opportunity to express their feelings and views and hopefully in some small way given some closure. No truer words were said at this Inquest than those expressed by RP and IP, that ultimately, the loss of MK, SK and PP was due to the actions of PK. As was have repeatedly said, the actions of many have been examined, mainly of Police, with the benefit of hindsight. Sight should not be lost that the vast majority of NSW Police are hard working, compassionate and dedicated officers and if any lessons have been learnt from this tragedy and Inquest, it can only make the NSW Police Service a better service. In many respects the events between 2 August and 15 September 2003 and the behaviour of PK depict what is now clear, as being, a worsening mental and emotional time for PK and his inability to deal with it. Even the P family never expected that he would ever harm his children. The Deputy State Coroner recalled, vividly, a visit to the scene of this tragic event and seeing a photograph of IP and PK on their wedding day in Thailand. In that photograph they are both young, happy and no doubt looking forward to sharing a life together… it is so sad that it has ended this way. Formal Findings
Recommendations (Section 22A Coroners Act 1980)
1295/03 Inquest into the death of PC on 8 November 2003. Finding given 8 July 2005 at Westmead Coroner’s Court by Magistrate Carl Milovanovich, Deputy State Coroner. Inquest Summary: The deceased was an Australian Citizen, however, moved to Canada with his family and, was deported back to Australia following criminal activity in Canada. On returning to Australia the deceased again come under notice for criminal activity and was imprisoned on four occasions between 1998 and 2003. On the 10th October, 2003, the deceased was charged with Malicious Wounding and was taken into custody by Police. He was considered to be mentally ill and was assessed at a Hospital and then returned to Corrective Services custody. Upon been received at the Metropolitan Remand & Reception Centre, Silverwater he was assessed as being at risk of self harm and a mandatory risk assessment was undertaken which resulted in the deceased remaining under strict observation until the 18th October, 2003, when the risk assessment was lifted. The deceased was placed in Hamden Block, Pod 18, a section specifically designated for mentally ill patients. He remained in that unit until his death on or about the 7th November, 2003. Between the 18th October and the 7th November, the deceased did not come under notice for suicidal ideation. On the morning of the 7th November he deceased expressed concerns in regard to being harmed by others and sought to be placed in protection. While this process was to be assessed he was locked into his cell. On the 8th November, during the morning head count the deceased was found in his cell deceased. The Coroner examined the risk assessment procedures at the Reception Centre and could find no fault in the assessment of the prisoner. The central issue at Inquest was the fact that the deceased had hung himself, using a ligature attached to a wall mounted notice board. The death of the deceased was the 3rd death during a two year period in almost the exact same manner, viz, ligature attached to the notice board. It was also the 3rd death in similar circumstances at the same Detention Centre. The Coroner expressed concerns that following a death in 2001, informal recommendations had been made to remove the notice boards and following a further death in 2002, in which formal recommendations were made, another death in similar circumstances had taken place. It was noted that the death of the deceased took place on the 7th November, 2003, prior to the formal recommendations made on the 12th January, 2004. The Coroner was informed that a working party had been established in 2004 which was examining and prioritising the removal of all obvious hanging points in NSW Prisons. There were no suspicious circumstances associated with the death of the deceased, it was evident he had taken his own life, a suicide note was found. Finding. That PC died on or about the 7th November, 2003, at the Metropolitan Reception & Remand Centre, Silverwater, from hanging, self inflicted with the intention of taking his own life. Directory: Documents Documents -> Concept stage Documents -> Concept stage Documents -> The great global switch-off Documents -> Nonprofit grant application Documents -> The Truth about the Rwandan Genocide Documents -> Annual InStructional unit plan Documents -> Chaos equipment included Download 0.8 Mb. Share with your friends:
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