Coroners Amendment Bill

I move, That the Coroners Amendment Bill be now read a second time. I want to start by commending our 16 coroners and Chief Coroner on the excellent work that they do in New Zealand. Coroners investigate between 3,000 and 3,500 sudden deaths in New Zealand every year. Many of these involve tragic and difficult circumstances. Despite these challenges and the often intense public scrutiny that comes with the job, coroners conduct themselves with dignity and integrity. They have a critical role to play in our justice system and they carry out those duties admirably.

The Coroners Amendment Bill we are debating today will help improve the roles of our coroners, widening their powers, and making their jobs easier as they carry out these important roles. The bill makes a range of improvements to the Coroners Act 2006. These reforms stem from a targeted review of the principal Act initiated by the previous courts Minister, my colleague the Hon Chester Borrows. The review found that our coronial law was generally functioning well but that amendments could be made to clarify the role of coroners, to ensure their recommendations are better focused and more relevant, and to improve the efficiency of the coronial system.

The bill achieves these aims through a number of ways, and I want to touch on a number of key changes that will improve the way our coroners operate. Firstly, our changes will ensure coronial recommendations are better focused and more relevant by being clearly linked to the evidence before the coroner. In making a recommendation the coroner must show how the recommendation would have prevented the death in question. The coroner must also consult on draft recommendations with interested parties such as families or witnesses before finalising them. This will help ensure that coronial recommendations are more relevant and are more likely to be adopted by those to whom they are directed.

I note that the Justice and Electoral Committee considered and rejected proposals to require those receiving a coroner’s recommendations to respond to them. As the quality and relevance of recommendations improve as a result of this bill, voluntary response and implementation should become more common.

The committee has recommended a change to the provisions governing consultation with interested parties. If the interested party being consulted has not responded within 20 working days, the coroner will be able to assume that they have no comment to make and proceed to finalise the recommendations. This is a positive step. It will prevent unnecessary delays and allow the coroner to proceed with their draft finding, confident that they have given affected parties an appropriate opportunity to comment on the draft recommendations.

Another change in the bill is to remove the need for a public inquest to be held when it is clearly unnecessary, such as when a death in custody is from illness or old age. They of course will still have the ability to order an inquest in any case they feel needs investigation, and interested parties will continue to have the opportunity to request that an inquest be held. Coroners are independent judicial officers. It is important we allow them the freedom to make sensible decisions and ensure that proper oversight remains on the cases where it is needed.

Between 2007 and 2013 there were about 80 deaths in official custody or care for which the Act currently required a public inquest. In nearly 60 percent of those cases the cause of death was known and found to be natural causes. An inquest with a full oral hearing of evidence and witnesses is resource intensive and time consuming. One of the main goals of the Coroners Amendment Bill is to reduce delays in the coronial process and to ensure coronial resources are directed to where they are needed most.

The bill does not remove the requirement for a coronial inquiry to look into the case. This will still be mandatory for deaths in official care or custody but can proceed without an oral hearing. I know that the Chief Coroner, Judge Deborah Marshall, in her oral submission to the select committee welcomed coroners having this flexibility. It is also important to note that when an interested party such as family, medical experts, or witnesses asks to give evidence an oral inquest must still be held. Together these changes will help avoid unnecessary inquests into cases where the coroner considers the cause of death is plainly natural while ensuring appropriate cases continue to receive necessary scrutiny.

Another key change that has drawn some attention is the death of Defence Force staff in hostilities overseas. The bill specifies that coroners may not inquire into deaths overseas of New Zealand Defence Force personnel as a result of hostile action unless the Attorney-General directs an inquiry. This is a sensible and reasonable approach and I am pleased that the committee has recommended continuing with the bill’s proposal. Coroners will still be able to investigate other Defence Force deaths including those not resulting from hostilities or resulting from an accident or suspected suicide both in New Zealand and overseas. Our provision simply avoids duplicate investigations of Defence Force combat deaths, given that these are normally investigated by the Defence Force’s court of inquiry process. It also prevents coroners from considering matters that are not traditionally part of their jurisdiction, such as military tactics, national security, and operational decisions of military commanders in the fields. The provision requiring the Attorney-General’s direction is closely comparable to a similar provision in the Visiting Forces Act 2004, which requires the Attorney-General’s permission before a coroner can inquire into the deaths of visiting service personnel in New Zealand.

The committee has clarified the definition of “hostile action” and specified some criteria for the Attorney-General to consider in deciding whether to direct an inquiry—and I think these changes will be very helpful in practice.

The bill also seeks to ease and clarify New Zealand’s restriction on media reporting of suicides and suspected suicides, which has been in place to prevent copycat suicides. It implements the Law Commission’s recommendations in this area, which were based on considerable research and engagement with experts. Research has shown that certain kinds of media reporting—lurid, glamourising, and method specific—do tend to spur more suicides in the community, especially amongst young people. With New Zealand’s unacceptably high rate of suicides we need to be doing all we can to discourage people from taking their own life while also preserving the freedom of speech of our media.

At present no information about a death that appears to be self-inflicted can be made public until the coronial inquiry is completed. Under our changes if there is reasonable cause to believe that a death is suicide the person’s name, job, and address, and the fact that the death is suspected to be self-inflicted can be made public. Once the coroner finishes their inquiry and finds the death to be suicide, the death can be reported as suicide.

Some may want us to go further and permit all and any details surrounding the death to be published, but I do not want to see the situation in New Zealand that exists overseas where newspapers regularly report suicides in ways that may be likely to be harmful, including publishing photos of sites and gruesome, detailed descriptions of the methods used.

We have worked hard to ensure that the bill strikes a difficult but careful balance between the useful role that positive conversations around mental ill-health can have while minimising the risk of copycat behaviour. The Chief Coroner will also be able to grant an exemption from any restrictions that the bill proposes to retain. A new expert panel convened by the Director-General of Health will be able to assist the Chief Coroner in deciding these exemptions.

The Coroners Amendment Bill will improve the coronial system by making it more efficient and more responsive to the needs of families. I want to thank the Justice and Electoral Committee for its considerations and for the amendments the committee has put forward in its report. The proposed changes are well considered and will help the bill to achieve its goals. This bill builds on a major overhaul of the coronial system introduced by the Coroners Act 2006. Its proposals are practical, well considered, and generally well supported by submitters. I commend the bill to the House.

I want to begin by thanking the Minister for Courts for bringing the Coroners Amendment Bill to the House because, certainly, we could see from the very outset as a party what the intent of the bill was. Obviously, it was in 2006—from memory—that the initial enabling legislation was passed and putting parameters and good guidelines around how we expect the coronial system to operate and reviewing the effectiveness of those mechanisms is just good practice. But we did have concerns that in the attempt to try to narrow the scope of the work that our coroners do that we had gone too far. We did keep a broadly open mind going into this legislation, but, on balance, have concluded that we cannot support the legislation for a couple of key factors that the Minister raised and that I will give Labour’s perspective on.

Just to give that context again though, the initial briefing from the Ministry of Justice outlined that there are about 6,000 deaths reported to coroners every year. Coroners accept they have jurisdiction in about 3,500 of those cases, about 1,300 of those cases lead to the opening of an inquiry, and then about 300 cases are the subject of a public inquest each year.

Just to be really clear on the difference between an inquiry and an inquest, for those who may be listening and may not be clear on that difference, an inquest does allow for a coroner to undertake questioning, allows for there to be a more open and public hearing, and allows cross-examination. And, in contrast to that, an inquiry, therefore, is seen to be, I guess, a less in-depth version of an investigation in that it can be conducted on paper and without those individuals appearing or being cross-examined or questioned. There are, therefore, circumstances where, in our minds, the risk-averse approach would be to opt for an inquest, and, in our minds, that should include deaths in custody, by and large.

So I will cover off the issues where we had the greatest concerns—an area I know that you are very familiar with, Mr Deputy Speaker. The first I would put under the general heading of narrowing what a coroner is able to make recommendations around. So clause 30 of the bill under new sections 57A and 57B, requires a coroner, according to the Ministry of Justice advice, in making a recommendation to show how the recommendation, if implemented, would have prevented the death in question. So it is about making a direct causal link between the recommendation and the death.

That may seem on paper like a perfectly reasonable definition to have for making a recommendation, but let me put that into the context of an example. Say, for instance, a coroner has referred to them what appears, on face value, to be a traffic accident. It has occurred on a dangerous stretch of road where a number of deaths have occurred, and it is found, though, that the individual was intoxicated at the time of the accident. You could therefore say that the only recommendation a coroner could really feasibly make would be to make the recommendation about something around drunk driving, because that was obviously the direct cause of that death as discovered by the coroner. However, what of the fact that there were five or ten deaths on that corner of road? If the coroner cannot determine that that was the direct cause of death, therefore they cannot make a recommendation around a potentially dangerous stretch of road.

That is a little example. But even if anecdotes do not persuade you, I was heavily persuaded by the view of the coroners themselves, who believed that this provision did narrow beyond their comfort levels what they were able to issue recommendations on. That was compelling enough for my colleague Peeni Henare and me on the Justice and Electoral Committee to determine that that was something that we would continue to raise and take issue with.

The second area of concern the Minister has already given some context to, and that was deaths in custody. As she pointed out, according to the advice we received, from memory, we are talking about 60 deaths over 5 years. It may have even been less than that, but it is a relatively small number. Granted, that number will grow, particularly as we now have aged-care facilities, essentially, within our corrections infrastructure, but clause 41 and the replacement of section 80, means that it will no longer be mandatory for coroners to hold an inquest into deaths that occur in official custody or care.

We are concerned that that greater level of discretion, which means that now, obviously, there will be inquiries instead of inquests—we are not arguing that they are being ruled out altogether, but they will be to a lesser degree of investigation—could lead to inappropriate decision-making, less transparency, and, potentially, a loss of faith in the system by family members.

The Minister talked about the amendments that have been made to try to counter that, but it does go beyond just deaths, for instance, in a corrections facility. It could, for instance, apply to a death in a Child, Youth and Family residence. I had someone who worked in the coronial system raise with me a very specific example, for instance. When I issued an Official Information Act request some time ago for reports on deaths in Child, Youth and Family’s care, not all of them were inquests—some of them were inquiries—and that was determined by the nature of those deaths.

But, as a coroner pointed out to me, they had brought before them a death that, by rule, they could have conducted only an inquiry into. It was a suicide-related death, but he decided he wanted to conduct a full inquest, and, as a result of that, he identified that within a tiny, small community there had been a string of related deaths. It was his view that had he not opened up that process that officials and the district health board would never have been aware of that situation. So he saw real value in inquests, particularly when we are talking about those who are involved in State care of some form. So it is our concern and our belief that we need to maintain that higher level of scrutiny where the State has such a powerful role.

Thinking of corrections specifically, I can think of examples where family members have raised with me concerns about deaths that have been explained as being from suicide or natural causes by the Department of Corrections, and, in their minds, they have had doubts over whether that was the case. An inquest allows that transparency. So, again, that is one of the concerns that we have with that provision.

The next issue is of equal significance, and it has been raised repeatedly by Phil Goff as our defence spokesperson. It is the significant shift away from the current role a coroner can play in conducting inquests into deaths in hostile action. The Defence Force went specifically to the Minister and asked for that to be removed. It asked that instead the Attorney-General could simply recommend when they wanted the coroner to be involved in an inquest or inquiry into a death in a hostile action. In our minds, that, again, takes away that critical transparency and oversight of the Defence Force.

The argument that the Defence Force made was that it could reveal important information around security, which could jeopardise the safety of soldiers. It was our view that we should take on board the regulatory impact statement recommendation and the alternative option, which said that you could instead allow the Attorney-General to point out to coroner the circumstances under which they cannot conduct an inquiry but make the default that they still have that role. So it would be reversing the onus from what the bill currently has. In our minds, it would have created much greater transparency and much greater faith in the system.

We are concerned that the Government is creating a closed shop around the Defence Force with these provisions, and we know that that request came off the back of the inquiry by the coroner JP Ryan into the deaths of Private Richard Harris, Corporal Luke Tamatea, and Lance Corporal Jacinda Baker. We do not believe that the Ministry of Justice should have listened to that request from the Defence Force and we are disappointed that it has.

My final concluding remarks are that a coroner’s recommendations are in-depth, they should be listened to, and they should at least be responded to. We will be putting up a Supplementary Order Paper to make that simple request, because it has been suggested by coroners that it is a flaw in our system that you are not required to respond to a coroner, and you should be. I hope that members of this House will at least support that Supplementary Order Paper, because it put forward in good faith. Thank you.

In speaking to the Coroners Amendment Bill, and noting the comments made by the speaker who has just resumed her seat, Jacinda Ardern, I can say that the issues that were raised by that speaker were well-canvassed during the select committee consideration of this bill. I am satisfied with the advice that we received from officials, and we certainly looked into the issues that she raised in some depth and with a great deal of care. I am satisfied that the bill that has been returned to the House has got the balance right in terms of the rights and responsibilities of coroners.

It is to be remembered that at the heart of this legislation there are going to be grieving family members, and that grief is a force that remains raw and open until yet another milestone is achieved by the family and those left behind as the result of a death—until a finding has been made by the coroner. Previously, and up until now, those findings can, in fact, take a considerable amount of time—years, in fact—and for those family members, each time that that unexplained death, or sudden death, or death as a result of an accident is brought up again, either in the media or perhaps in a piece of correspondence from the coroner’s office, those wounds are reopened once again. I think that the committee, across the House, understood that concept very well. I regret that Labour cannot see its way to supporting this bill because, despite the matters raised by the previous speaker, there was broad agreement on the fundamental provisions of this bill.

I am not going to go through each clause; there are a number of speakers on our side of the House who are very well-equipped to make comment on different aspects of the bill. However, there are a couple of aspects that I wish to touch on this evening. I think one of the main provisions of the bill is that it aims to improve coroners’ recommendations by requiring their comments and their recommendations to be very specific to the case in hand and specific to the evidence before them, and to be very clear about how those recommendations would reduce the likelihood of future deaths in similar circumstances.

In talking to that point, the committee gave some care to the matter of suicide reporting. The Law Commission made a number of recommendations to improve and also to simplify the legislative restrictions on suicide reporting. This bill picks up on those Law Commission recommendations. The current restriction on suicide reporting is quite broad. There are variations about how suicides should be reported. Social media has changed the landscape of how suicides are reported. The New Zealand judicial system has no influence over the reporting of suicides overseas or offshore.

The concern for all of us, including the committee, is that there needs to be a balance between preventing harmful reporting, which may give rise to copycat suicide episodes, and enabling enough reporting to note that an event has occurred. The last thing that any piece of legislation would seek to do is enable or encourage copycat behaviour, particularly by vulnerable young people. We believe that the changes to this bill strike a good balance in that regard. There is a restriction around the publishing; the method; or the site, if it suggests the method of the suicide, it will be prohibited unless the Chief Coroner grants an exemption in that case. This is based on international evidence that strongly suggests that the reporting of these details gives rise to copycat behaviour.

I want also to acknowledge the submitters who came to the committee and made, in some cases, some pretty heartfelt submissions on this Coroners Amendment Bill—in particular, Mr and Mrs Still, whose daughter died in the hot-air balloon accident in the Wairarapa. Their submission was very strong, and they submitted that the bill should require coroners to advise family members at the scene of the death of their rights under section 25 of the Coroners Act. Those rights are around viewing a body and touching or remaining near a body in the coroner’s custody. For a number of families in New Zealand, it is of utmost importance that they have access to their loved one whilst in the coroner’s custody.

In the particular circumstance that Mr and Mrs Still brought to the committee, around the balloon crash in the Wairarapa, we looked very carefully at that incident, but we determined in the end—and taking advice and after much discussion—that there was no legislative remedy for it. It was a particular set of heartbreaking circumstances to them. Although Mr and Mrs Still asked for legislative change around their particular set of circumstances, the committee did not recommend any change. However, we wish to convey again our heartfelt thanks to them for their courage in coming to the committee to make their submission and to say to them that they were indeed heard and that the committee and this Parliament considered their request, but, regrettably for their particular circumstances, we could not find a remedy in the legislation.

In closing, I want to thank members of the committee for their careful consideration of this bill. I think that it makes great improvements to the coronial system in New Zealand. My regret is that it is not fully supported in the House, and we will explore that further as this bill goes through its passage in the House. Thank you.

I take a call on this, the Coroners Amendment Bill, because of my experience in representing the families of dead workers in coronial inquiries. I just note, by way of summary, what a missed opportunity this is to do something long overdue but also very important to the powers of coroners and the conduct of coroners’ inquests. Coroners occupy a very special place in the panoply of judicial inquiries into deaths. For many families of loved ones who have died suddenly or in an otherwise unexplained way, this is the opportunity to at least get to the bottom of what has happened and get some sort of truth.

Coroner’s courts are almost entirely dependent on the investigation that the police conduct around the sudden or unexplained death. The bulk of the evidence that goes before coronial inquests comes from the police. But every now and again family members want to bring their own evidence, or other parties to the inquest want to bring their own evidence, and that is very important. But the reason they do that is they want the coroner not only to make a thoroughgoing inquiry and get to the truth of the matter behind the death but often to make some recommendations that will either help others—whether it is a workplace death in the same industry; or a traffic death, to help other drivers; or a death that has been particularly distressing, to help other families who may, at some point in the future, go through the same thing.

But what has happened to this bill, having been through the Justice and Electoral Committee, is that the opportunity to give coroners and coroner’s courts the opportunity to come up with recommendations and make them powerful and binding—that opportunity has been passed up, and that is extraordinarily disappointing. So when the previous speaker, Jacqui Dean, expresses her disappointment that Labour cannot find itself able to support this bill, there is a very good reason, and that is that for those for whom the coroner’s inquiry is the last port of call to understand what has happened to their loved one, or their workmate, or their friend, denying a coroner the opportunity to make a binding recommendation, to require follow-through on their recommendation—a recommendation that the coroner generally believes will either prevent future deaths of a similar nature or help others—is what is more disappointing. That is where the Government has failed. It could have made that change, but it has not.

I think the obvious question arises as to what the point is of allowing coroners—as it will under this bill, if it is passed in its current form—to make some sort of recommendation, if there is no power to require those to whom it is made to have to comply with it, or at least account for whether or not they fulfilled it or have not fulfilled it and to explain why. When we look at clause 30 inserting new sections 57A and 57B, we see that what has happened is the power to make recommendations has actually now been further restricted. The coroner has to meet this test that any recommendation has to be accompanied by an explanation of how the recommendation or comment, if drawn to the public attention, reduces the chances of further deaths occurring in similar circumstances. Well, you cannot guarantee that. No one can be sure about that. A coroner may well come across a circumstance or a factor that is very important; it may not reduce deaths in that particular circumstance, but it may reduce the possibility of deaths in comparable or similar or even other circumstances. Why should they be deprived of making a recommendation in that regard? That is why this starts to look like a kind of a clamping down on coroners, who sometimes can make recommendations that are irritating to Governments. If that is the basis on which this power, the power to make recommendations and comments, has been restricted by this Government, then it reflects very poorly on it.

I think of one very important recent coroner’s inquiry, and I refer to it because it meets the description I talked about before, of the last port of call for people who otherwise would not have had the opportunity to explore and investigate the deaths of their loved ones. That is the coroner’s inquiry into the deaths of the eight people who survived the initial collapse of the CTV Building in the February 2011 Christchurch earthquake but who died during the course of the rescue operation and before they could be rescued—because what is pretty apparent to those families is that the conduct of that recovery and rescue operation was a shambles, and may well have been the cause of those deaths.

The Government has refused to conduct a commission of inquiry into exactly what happened during the course of that rescue and recovery effort. It simply would not allow it to happen. It did not want to expose the authorities involved to that examination and that inquiry. The only recourse the families had was to the coroner’s inquest. The coroner did his level best, and the coroner made some recommendations, but, of course, they do not mean anything, because there is no power to enforce them.

There is no power under the current law to require any organisation to which or about which a recommendation is made to follow through or to comply with that recommendation. That glaring gap, which we know is there now, has not been repaired by this bill, and it could have been. That is the disappointing thing. So I urge this House, as we go through the remaining stages of this bill—we will get to the Committee stage and we will put up some Supplementary Order Papers—to think very carefully about having a coroner’s inquiry and a coroner’s court that can do the job that people demand of it: to get to the bottom of why particular deaths happen and to make effective and binding recommendations as a result.

The coroner’s court is one of the oldest sorts of courts of judicial inquiries we have. It goes back to medieval times. It used to be a part of the church because the church wanted to be sure that the body that was going to be buried in the church cemetery had not arrived there as a consequence of evil purposes. It had to be established, for death that could not be explained, that the death could be explained and that it was right and proper that the person be interred in the local cemetery of the local village church. That is the origin of it.

It has come, of course, in the modern world to acquire a more important significance, and is now seen as part of our judicial system, which is why it is judicial officers who conduct the inquiries. That is largely because we do want to get to the bottom of the facts, and when there is conflicting information we want to make sure those conflicts are resolved—but also, when there are recommendations or comments to be made that could prevent other deaths, that those comments are then on the public record. That has been the case for a long time, but where we have not succeeded is in ensuring that those recommendations are followed through and are made meaningful.

I will just conclude by urging the House to make sure that, as we continue the passage of this legislation, we understand what it is that the loved ones of those who die in difficult circumstances want to know: that the background and the nature and the cause of the death is understood, and that it can be prevented. In the case of suicides, coroners need to be able to make recommendations, particularly to authorities. They may be about better recording or reporting, they may be to the local district health board about better treatment, and they may be about the management of staff. Why should they not make those recommendations? Why should the authorities, about whom coroners make those recommendations, not be required to demonstrate to the public—and at the very least to the family whose loved one’s death has been inquired into—that those recommendations have been heard and have been either made good or very good reasons for why they cannot be followed through have been made clear to the public and the community?

I think that this bill reinforces Parliament’s role in continuing to improve and refine the processes that the Parliament initially establishes. We know that the Coroners Act was put in place in 2006, and, like all legislation, we cannot simply let legislation just sit on the books forever and a day and not look to improve it or have better processes in place. This is what this bill does.

Following the last speaker, Andrew Little, I do just want to reassure the House and reassure any members of the public who are listening that our loved ones and family members are very much at the centre of this bill and what it is that we are trying to achieve. Behind this bill, the provisions within this bill are all about speeding up the coronial process. It is about making this less traumatic for family members in particular.

For family members or for families who have lost somebody through an accident, through a traumatic event, it is a very traumatic time. So when people are having to wait 400 days, or perhaps 700 days, for the outcome of a coronial inquiry or inquest, that is long time for people to wait before they can have closure. This bill absolutely and utterly looks to speed up the process, because family members—those who have lost loved ones—are absolutely at the forefront of what we are trying to achieve here. The potential is for victims to be revictimised at times by processes, and we want to make sure that the coronial process and the length of time that it takes in no way draws that process out any more than it needs to be for those people.

I want to acknowledge a number of the submitters who came to the Justice and Electoral Committee. They were very brave, in that they came and shared their own stories with us. That is not an easy thing to do in a public setting, and I think it was very valuable for us as a select committee to hear from them and to be able to acknowledge some of the difficulties that they have faced through the traumas that they have suffered. I think it was really helpful to us as a select committee, and I just want to acknowledge those families that came forward and shared their stories with us. We also heard from organisations like the New Zealand Medical Association, which, of course—because this is good legislation—was very supportive of the bill. That was positive for us.

There are a couple of aspects that I want to just briefly touch on. One is the removal of the requirement for there to be an automatic inquest if somebody passes away while they are in the custody of the State. A coroner still can conduct an inquest—they are not barred from being able to do this. They still can undertake an inquest where they think it is required. For example, if you have somebody who has been in prison for a long period of time, and perhaps they have contracted a terminal illness of some description, and then they clearly die of natural causes, I think we would all agree that it is pointless to go through the full formal inquest process. This gives coroners that ability to not go through that process where it is simply unnecessary.

Finally, I just want to touch on the new restrictions around suicide reporting. I think we would all agree that the suicide rates in New Zealand are far too high, and so it is beholden on us, where we can, to put things in place that will limit triggering people, in terms of copycat behaviour or otherwise. Under this bill, publication of the method or the site—if it suggests the method of a suicide—will be prohibited, unless the Chief Coroner grants an exemption. This supports international evidence that says this type of reporting, if it is not done properly, can lead to copycat behaviour.

In conclusion, I just want to say that I am really pleased with the way that this bill has come together. I think it is going to make things more practical going forward for the coronial service, and I think it is going to better serve the needs of those New Zealanders who have suffered the traumatic loss of a family member. I commend the bill to the House.

Thank you. I am pleased to take this call on the Coroners Amendment Bill. I sat in on the Justice and Electoral Committee, and it was an interesting committee. I think we did some good work there. It was challenging. Not having had any background in this area at all, I had a lot of misconceptions, I discovered, about what coroners do, and I suspect they might be shared by a lot of other people. But over the course of the bill I, certainly, and I am sure others, found out a great deal about the day-to-day work of coroners, the demands that are placed on them, and their roles and functions. As was just noted, the last significant amendment to the legislation was in 2006. That was a considerable change, not least of all I think in making coroners full-time judicial officers, which prior to that they had not necessarily been. But it certainly seems timely to have another look at this.

The committee was at times very difficult. We dug fairly deeply into the whole issue of suicide in New Zealand, and that is obviously a major, serious problem for us as New Zealanders. We heard from people, again as has been mentioned, who had lost family members in the most tragic possible conditions—accidents with multiple victims, those sorts of things. So it was somewhat gruelling, and I just reflected on that—that the coroners are confronting these sort of issues every day of the week, literally. It is a 24-hours-a-day, 7-days-a-week, 365-days-a-year service.

There are 16 of them spread around the country, and I suspect that that is not sufficient. I had a conversation with a couple of coroners, and what came through was a sense that maybe we are stretching them rather too thinly, that we ought to appoint another two or three, and certainly that the coroners who are there could usefully be given more administrative support. I do not think that the budget implications would be massive. I am sure they would not be, but it might just take some of the pressure off what is a very demanding, difficult job. Coroners hear something like 3,500 cases a year. That can get to around something like seven, eight, or nine reported cases a day that the coroners need to deal with at some level. So I do think there is a case to be made to increase the capacity there, to make sure that it is an effective—and, critically, that it is a sustainable—service.

In the course of the committee process, we looked at some of the key relationships that the coroners have—initially, with pathologists. There was some debate about whether or not pathologists had sufficient leeway to engage with families of people whose loved ones had passed away in whatever circumstances. The outcome was that they will still be required to go through the coroners in terms of engaging with families. I think to me it highlighted that it is a very strong and a very professional relationship that exists between coroners and pathologists. But I think others on the committee shared the view that maybe at the collective level—at the association level—there seems to be some tension between those two groups, and maybe that is something that could usefully be addressed and perhaps resolved.

We talked and discussed and found out a bit about the relationship between coroners and the police. Coroners, of course, do not have any independent investigative resource; they do rely on police to do the investigations, obviously. There was a little bit of a consideration of the boundaries, if you like, or the limits to the coroner’s ability or rights to direct police to undertake an investigation. There was a bit of to-ing and fro-ing on that. I think the outcome was quite good: that the coroner can, and undoubtedly will, direct police to undertake investigations. If the police believe that is unreasonable or unnecessary—if they are not happy with it—they may appeal to their commissioner who in turn will engage in a dialogue with the Chief Coroner. I think, again, that is quite a positive outcome. Sadly, I suspect we might see more of that. I say that with the utmost respect for the New Zealand Police, but, sadly, Police is being underfunded, it is being stretched beyond breaking point. That matter alone—that reality alone—could cause it on occasion to start perhaps questioning whether it wanted to pursue particular cases on behalf of the coroner. One would hope that would remedied sooner rather than later.

The issue of deaths in custody was one that we had serious concerns about going into the conversation at the select committee. Again, as has been said, and as you know, currently any death in custody must be subject to a full inquest—an inquest is mandatory in those circumstances. The proposition that there could be some discretion around that raised some serious alarm bells for us. Frankly, we do not have sufficient confidence, particularly in corrections to get it right, and we thought that it was important that the coroner would, as a matter of course, always conduct an inquest.

We were sort of discouraged from that point of view, in part by the submission from the Chief Coroner herself, and conversations with coroners. In part because of some unfortunate changes over time to sentencing law, the reality is that we are going to get more prisoners, older prisoners, and people who are in prison who suffer diseases—cancers or whatever it might be. Prisoners as a group have very poor health. A 60-year-old inmate who has been in and out of prison for a lot of their life is a very old person in terms of their general health and well-being. So we accept that, on balance, the coroner’s discretion is appropriate. They saw no point in imposing an inquest where there was a history of ill health, and we accepted that.

We did get considerable change in the language. Initially, I think, the wording of the original draft of the bill said that the coroner could only demand an inquest in those circumstances if they were satisfied there had been some negligence or some misconduct contributing to the death. It seemed odd—almost that you would need to do the inquest to discover that, even in itself. So that has now been turned around to say that there will be an inquest, or, rather, that the coroner’s judgment will turn on the question of would a medical practitioner reasonably have expected the death of that person, given knowledge about their health status and health records? That seems to us to have landed in a pretty good place. My own view is that the coroners will, if there is the least doubt about the cause of the death, go to an inquest. I think we have to have some confidence in them, but at the same time it is something we will continue to monitor to see if these cases do arise where perhaps there is that much grey area that inquests ought to be carried out that have not been.

The point has been made that there is another safeguard: that any other interested party to an inquiry can initiate a full inquest by request if they have concerns that something is not coming to light that ought to come to light. I think that issue particularly is pertinent at the minute to deaths in custody, as we see the phenomenon of private operators of prisons coming into the landscape. There are just too many perverse incentives around the issue of deaths in custody for us to have any particular comfort around what happens. I think we cannot but be alert to the possibility that deaths in custody are something that we need a lot of transparency, a lot of accountability on. As I say, I think this bill has landed in around the right place, given that we can have significant faith in the coroners themselves to pursue this matter.

So we spent a fair bit of time delving into issues around suicide, and suicide reporting particularly. We had one very animated—I would describe it—submission that proposed that there should be no restrictions on the media in terms of reporting on suicides. That did not win any favour. I do not believe, frankly, that the media has earned the right to be trusted about issues of reporting suicides. There would be simply too much temptation, I think, to glamourise, to make celebrities, to simply make reporting that was unhelpful. So, again, the proposition that the media can now make comment that a death is a suspected suicide, in advance of a finding to that effect, I think is reasonable. We all know there are certain codes and meanings within meanings that legitimate reporting can use to indicate that it was a suicide. The absolute prohibition on describing place of suicide, if the place could indicate the method, or, indeed, the method itself—I do think those are useful and necessary restrictions on the media. I think that that will present about the right outcome.

I mean, I must comment—living in Northland, youth suicide in particular has reached what has correctly been described as epidemic proportions. It is a very real, very serious, and very troublesome matter, and I think that we have to constrain the role of the media in that very carefully, frankly. And I think this bill does get to that place. So I will leave it there, and look forward to the Committee stage of this bill.

I want, first of all, to acknowledge the work of the Justice and Electoral Committee. It was a very good process, with some excellent submissions and some good work also provided by the departmental officers, and good input, in addition, by the Defence Force.

It is not an easy bill because there is a need to balance public and private interests throughout it. First of all, there is a need to balance between avoiding unnecessary inquests and the need to ensure full transparency. There is a need to balance freedom of the media to report deaths and their circumstances without sensationalising deaths or encouraging copycat suicides. And there is a need to balance the need to inquire into deaths in State custody with the need to avoid pointless inquiries, where some discretion can safely be used to avoid them. There is a need to balance independent inquiry into deaths of defence personnel in all circumstances where the deceased was not in a hostile action situation and to allow a discretion to be exercised where the death was in a hostile action situation, so that the need for independent inquiry can be balanced against the need for protection of the national interest. Some submitters do not always properly address the need for those balancing exercises to be done, and we in New Zealand First have done so. Although not agreeing with every aspect of the bill, we will continue to support it at this stage.

I want to address some key issues: first of all, coroners’ recommendations, which are obviously at the very heart of the legislation. New section 57A in clause 30 applies a new subsection (2), which says: “Recommendations or comments may be made only for the purpose of reducing the chances of further deaths occurring in circumstances similar to those in which the death occurred.” And new subsection (3) would impose further restrictions on recommendations or comments, especially in paragraph (c), which requires an explanation of how the recommendations or comments may result in a reduction of deaths. I initially had some reservations, as the Labour Party did, about those provisions, which did appear to be highly restrictive. However, I have now considered those provisions, in relation to section 57B, which requires notification of those people who are affected and gives them time to respond, and which I think provide a counterfoil to their restrictions in new section 57A, so that the balance that I spoke of has really been achieved. So I am now satisfied that those provisions are appropriate.

The remaining issue, however, on that subject is whether it should be mandatory for consulted agencies to respond. New Zealand First will support any amendment that may be sought during the Committee stage to make it mandatory, because we think that coroners’ recommendations and comments are already far too often ignored and it is time to make them mandatory.

Regarding deaths in hostile action, the current Act gives coronial jurisdiction for deaths of defence personnel regardless of circumstances in addition to the court of inquiry process, and that process also has a safeguard in that it is itself subject to an external legal review panel to be conducted by a Queen’s Counsel. But under this bill the coronial jurisdiction will continue where the death does not happen during hostile action. The select committee’s changes to the new section 59A(2) and (3) in clause 32 will operate to protect the national interest by preventing an inquiry where the coroner determines the death was caused exclusively by the hostilities during hostile action and not otherwise. But the section allows coronial inquiry into deaths during hostile action too, but only if the Attorney-General decides to direct it.

Phil Goff wanted instead for that section to always allow such an inquiry unless the Attorney-General prevented it. The difference is significant but I think not so great as to cause much practical difference in the end, provided the Attorney-General acts professionally and not politically, and we in New Zealand First expect, and accept, that that would be the case. So, as I said, I do not think the difference in practice would be very great. I would also point to new section 59A(4A), inserted by clause 32, which sets out the matters the Attorney-General must consider, and I want to read them out because I think they are important. They say that those considerations are “(a) whether the investigation or inquiry is likely to identify the cause and circumstances of the death; and (b) whether the investigation or inquiry could reveal information that may prejudice the security or defence of New Zealand; and (c) whether the investigation or inquiry is likely to examine military tactics; and (d) whether a court of inquiry has been, or will be, assembled …”, and so on. So for those reasons, New Zealand First is satisfied that the need for independent inquiry is properly balanced by national interest considerations.

Turning to inquests into deaths while in official custody, these, understandably, caused some disagreement in the select committee and also some interesting submissions. However, new section 80 in clause 41 will mean that coroners must decide whether an inquest is needed, rather than that being automatic, and, in doing so, the committee has added a new requirement in section 80(2), which says—again, something quite important—“(a) the death was a death in official custody or care and the death would not reasonably have been expected by a doctor who had access to the person’s health information (as defined in … the Health Act 1956): (b) an inquest would assist the inquiry into the death by providing an opportunity for persons who have not been involved in the inquiry to—(i) scrutinise evidence considered by the coroner as part of the inquiry; or (ii) offer new evidence in respect of the death.” So there is no need for all deaths in custody to be subject to an inquest. Most arise from natural causes, there are proper balances in the legislation as proposed, and in the end we do have to trust the coroner’s discretion, and I agree with David Clendon about that.

Another area of difficulty was the law concerning the reporting of suicides, and that is an important area because it is all too possible for the media to sensationalise things. New section 71 in clause 38 is welcome and necessary. It says that a death that is self-inflicted cannot be reported and that no person may make public the method of the death or the place—if that is relevant to suggesting how the death occurred—or describe the death as a suicide. Those things are all important if we are going to try to suppress suicides and not encourage them in New Zealand. There are provisions for exemption that I think are also appropriate.

Finally, I note with approval new section 116A, inserted by clause 52, which establishes a suicide and media panel to advise the Chief Coroner on applications for exemptions. Those are important matters, and, again, I think the balance has been properly achieved. There are many other important changes made to the principal Act; there are far too many to go through in a few minutes on the second reading. However, on balance we in New Zealand First think that the bill makes some significant improvements, that it largely achieves the appropriate balances that I described, and that it does deserve support, so New Zealand First will continue to vote for it.

I rise to take a brief call on the Coroners Amendment Bill in its second reading. I do want to commend the Minister of Justice and her leadership, and also the select committee, which I am a part of—the Justice and Electoral Committee.

In my speech I want to cover off some other areas of the process and who some key stakeholders are who were involved in the bill. The reason behind that is that the integrity of the process was important to ensure that we had all key stakeholders actively involved. The Ministry of Justice wrote to approximately 168 key stakeholders seeking feedback on the current system, and received 49 submissions from Government agencies, professional stakeholders’ groups, iwi authorities, and some interested members of the public. This information was important while we were amending the Coroners Act.

We know that there are 16 permanent coroners, and, obviously, the Chief Coroner, who plays quite a critical role in their main function: to oversee the coronial system to ensure that the inquiries are conducted in an “orderly and expeditious” manner. That really is the heart of this bill, because we know that many times families have grieved because of the process. Coronial inquiries, on average, are around about 400 days. If there are other investigations, that is around about 700 days. That is a very long time—that is the feedback we also received, so we thought it was important that this bill ensured that we have that in place. I know that other speakers have spoken about those parts of the current bill, with its amendments, that are important.

In regard to a couple of those, the consultation provisions allow, for all key stakeholders who are interested, that they must make some form of an inquiry or an application to that within 20 working days. Otherwise, that allows for the coroner then to be able to expedite that process to come to an end as well.

The other amendments that I think are also important are around removing mandatory inquests. We know these are costly and, again, in cases where there are deaths either in custody or in care, over 60 percent of those are known to be from natural causes. We believe that by removing the mandatory provision, this allows the discretion for the coroner to ensure that where it is proven that the death has happened through natural causes a mandatory inquest will not prolong the process.

I want to commend this bill to the House. I believe that the select committee has worked hard to ensure that we have a true balance in the areas of concern and need. I commend this bill to the House.

The next call is a split call. Kevin Hague—5 minutes.

I want to begin by saying that I was not a member of the Justice and Electoral Committee, which considered this bill, but it strikes me, listening to the contributions in this debate, that the select committee has made a good job. I pick up on Denis O’Rourke’s point about the various balances that are needed to be struck by the select committee, and it does seem to me that those have mostly been struck in the right places.

I want to start with a point that my colleague David Clendon made in relation to the stretched roster of coroners that we have. My experience with coroners has generally been an extremely positive one. I think they do a fantastic job, and I am going to come to one or two of those points in a moment, but it does strike me that we are at risk of under-resourcing this excellent network. That is obviously a problem from several perspectives. One is simply the fact that if we do not have enough coroners or if they are not properly resourced, it will be difficult for them to do their work. But the particular relationship that that fact has with this bill is that one of the areas that this bill changes the principal Act in is to move us away from routine inquests, routine inquiries, into the causes of deaths, and to bring in more discretion in those cases that have been well canvassed in this debate tonight—deaths in custody, in State care, and on certain aircraft or ships in the military.

Where discretion is introduced into those situations I agree with my colleague David Clendon that we can rely on the professionalism and the discretion of coroners to make good judgments about that, but what if it is a line call? What if it is a line call and the resources are constrained? I think it would be a situation that we really must avoid—getting into that position where, because of that constraint of resources, coroners will err on the side of not investigating a death when actually, if resources were not a consideration it would have been investigated. So that is just a little niggle in the back of my head.

I was a submitter to an inquiry that Coroner Mātenga undertook several years ago into a series of five deaths of people who had been riding bikes and who had been killed in collisions on the road. That is a really excellent initiative from Coroner Mātenga. It has led to a panel of experts being convened, which, again, has led to some pretty great recommendations for improving road safety. Again, this issue of resource constraint on coroners bothers me, because if we do not fix this—and maybe this bill is an opportunity to do that, in the Committee stage—then that sort of inquiry may not be held in the future.

The area I have the most expertise in is this area of self-inflicted deaths, or suicides. I have had to try to manage several situations of cluster suicides, and so I have been deeply nervous about the calls from the media to be able to publish more details about suicides that have taken place because I am familiar with the evidence about copycat suicides. So I reluctantly accept what the select committee has done by allowing the fact of a suicide to be reported, basically because I note that the media has already had created a code. Whenever we read now that there has been a “sudden death”, we all read that as a suicide, so, in fact, we do not prevent that risk of copycat suicides by having the current prohibition. I think the select committee has struck a sensible balance, and I am very pleased to continue to support this bill.

I call Poto Williams—5 minutes.

Tēnā koe, Mr Assistant Speaker. As members have heard before, Labour is not supporting this bill. I want to talk a little bit about what the role of the coroner—[Interruption]—this is a serious matter—is actually about. It is in the event that a doctor is unable to certify the cause of death, the coroner is there to establish how that death occurred and also to work out whether anything can be done differently to prevent similar deaths in the future. If that is the case, it is their duty to make recommendations. To quote from the Coronial Services of New Zealand website, the coroner “speaks for the dead to protect the living”.

Really, their role is to establish the cause of death—whether it was accidental, whether it was natural, whether it was because of misadventure, or whether it was at the hands of someone or some people. Where those deaths were preventable, their role is to think about the possible mitigations, remedies, and opportunities to ensure that those deaths are prevented from happening in the future. Also, it provides impetus for us to look at health and safety and employment practices to ensure that we are as safe as we can be when we go to work and that we return home safely to our families at the end of the day. And, most important, the role of the coroner is to provide the family of the deceased with some certainty.

The Justice and Electoral Committee has returned its report, and one of the discussions that it had relating to clause 30 talked about the response to the coroner on the coroner’s recommendations. With the insertion of new sections 57A and 57B in clause 30, the agency that has been subject to that consultation may choose to respond to the coroner, but many of the submitters—and some of those who sat on the select committee agreed with the submitters—said that in order to give full effect to the coroner’s recommendations, it should be mandatory for those consulted agencies to respond, whether that is by indicating how the implementation of the recommendations will occur or by providing reasons for the refusal for that implementation. In her submission, the Chief Coroner, Judge Deborah Marshall, made the comment that “the Amendment Bill should include a clause to provide the legislative basis for ‘mandatory responses’”. She submits that those sections that I have referred to should “be amended to state ‘the proposed recommendation or comment must be responded to by those persons or organisations within 21 days of the notification of the recommendation.’ ”

Secondly, what information should actually be reported in that recommendation? Again, I look to the submission made by the Chief Coroner, where she submitted that new section 57A(3) should be amended to read either “ ‘(a) be clearly linked to the issues to which the inquiry relates’; or ‘(a) be either: (i) clearly linked to the factors that contributed to the death … or (ii) considered necessary by the coroner in order to prevent deaths in similar situations’ ”.

Here we speak to situations where the cause may be one thing but where there are underlying factors that should be exposed to public view in order to prevent deaths in the future. My colleague Jacinda Ardern referred to a road death that may have been caused by the driver consuming alcohol, but where, on further investigation, there had been several accidents in that area. That is useful information to prevent future deaths.

Lastly, I just want to refer to new section 80 in clause 41, which we have some discomfort about. When a death occurs in custody, the first response to that by the coroner should be an inquest rather than an inquiry. An inquiry can sometimes be a review of papers, whereas an inquest can seek evidence and require people to appear before the coroner. Cost should not be the factor that determines whether it is an inquest or an inquiry. Thank you.

It is a pleasure to be talking in the second reading on the Coroners Amendment Bill. I have not been a member of the Justice and Electoral Committee, but I have got to say that this is a very important bill. I recognise that the bill is about improving the coroners’ recommendations by requiring them to be specific about the case and the evidence before the coroner and how they would reduce the likelihood of future deaths.

The bill really has a number of important things, and I do note in my background reading that, unfortunately, there are about 30,000 deaths a year, of which the coroner is involved in investigating about 6,000. So it is a very important role that the coroners undertake in New Zealand. The other changes in the bill that I found quite fascinating, firstly, were around the level of consultation. I think it is a really good provision that the coroner has got the right, after 20 working days, to actually proceed and finalise their coroner’s report in the event that the third party has not responded. Secondly, it removes the need for the coroner to investigate deaths when they occur in official custody, and I think that is appropriate.

The one around the Defence Force—and a number of speakers have spoken about that tonight—obviously, it removes the need for coroners to investigate when deaths happen overseas. I do note that the select committee did make changes and refinements around the definition of what a hostile action actually means, and I think that the tightening up of that clause is very good. Fourthly, the dispute mechanism involving the Commissioner of Police and also the Chief Coroner is a good mechanism. Finally, in respect of the sensitive area of suicides, the bill formally prohibits the publication of any information relating to a suicide.

On that basis, I commend the bill to the House.

Tēnā koe, Mr Assistant Speaker. Tēnā tātou katoa. I rise to take a call in the second reading on the Coroners Amendment Bill. I was and am fortunate to be on the Justice and Electoral Committee, which looked into this particular bill. As already mentioned by my colleagues this evening, it is with reluctance that we will not be able to support this particular bill, and, may I add, it is through no lack of effort—it is through no lack of effort. Other members on the select committee, I am sure, will be able to testify to the amount of good, robust debate that went on in the select committee.

If I may just digress very slightly but still keep on the topic at hand, it was actually during our consideration of this bill in the select committee that my father passed away unexpectedly here in Pōneke—in Wellington. I have got to be honest and say that for the majority of New Zealanders who are not directly affected by this particular process, it is a foreign one. But through my work on the select committee and the tragic circumstances that fell upon my whānau, it was interesting and important to gain an understanding of this particular process firsthand. I want to acknowledge that, as it was not that long ago.

But we entered into a lot of robust debate in the select committee. Colleagues across the House have mentioned some of those aspects, and I want to pick up on some of the ones that Ms Ardern and my other colleagues have mentioned this evening.

Before I carry on, I do want to also echo the sentiments made by many members across the House in acknowledging those who came to submit in front of the select committee. There were some very heartbreaking submissions, there were some that were actually more practical, and there were also some that seemed rather silly, in that the process had not been made a bit easier for those submitters throughout the tragic circumstances that involved their use of the coronial system.

The undertaking of the coronial system—it is important for the mind of our nation that it is robust and promotes consistency and timeliness. The papers here in front of us all talk about the need to rid the system of some of the red tape, if you like, and in particular the duplication that takes place when going through the coronial process.

But I want to touch on the point made by my colleague Mr Naylor around the consideration of the committee. At all stages, it was commendable that whānau and families were placed at the forefront of our thinking when it came to the submissions and also our considerations on the bill. I want to pick up on the words of my colleague Ms Ardern in relation to the debate and discussion around the Defence Force, and I want to acknowledge the Hon Phil Goff, who attended that particular sitting of the select committee. With his in-depth knowledge and expertise, he came to bring a case on behalf of some of the families with whom he has had contact in the past—and those families have been named this evening. He gave very good input, and it was cause for some solid debate within the select committee.

I do express some concerns. Ms Ardern, in particular, did a great job in raising this particular point, but I want to bring up some of the points raised by the Hon Phil Goff in that select committee. It is important that when we consider the plight of some of our families who are dealing with the loss of their loved ones while serving for the armed services, we consider what they are going through. He raised some important points about the long, drawn-out process and the lack of transparency around the process that the families had to endure, and those are some of the concerns that we have with that particular part of the bill.

Many on this side of the House have spoken about the recommendations and how they must be considered seriously, responded to, and, most important, implemented where practicable. I am thinking about underlying themes in some of the speeches this evening, and one of those is actually around the capacity of the coronial office. It has already been mentioned—the number of coroners across the country. My colleague and whanaunga Mr David Clendon spoke about the Bay of Islands and how, basically, from Auckland to Northland there is only one coroner, and how this does not actually help speed up the process so that it can allow whānau to grieve.

For example, if you pass away up in the Bay of Islands and you enter into the coronial process, your loved one must go to Auckland. Days pass, the loved one comes home, and we know that in Māori customs, in particular, we mourn for our loved ones over several days. With this process added on, we are now talking about a week, and that is just not practical. Already, some of the comments across the House are about making sure that this particular bill—not “speeds up” the process, because we want to give it due recognition and it must take its course, but we also want to consider our loved ones who are grieving at home. So it is important that the recommendations must be considered seriously, responded to adequately, and, like I said, given a bit of teeth.

It touches on the point made by our leader, Andrew Little, who spoke about the unnecessary deaths in the workplace. One of those workplaces, in particular, is forestry. I currently sit on a forestry trust board. We have been fortunate that our health and safety record on our land is very, very good, and we work hard to ensure that it is that way. But, sadly, for many whānau there have been a large number of losses of forestry workers over a number of years now. The purpose of the recommendations from the coroner’s office is to make sure that these deaths do not continue—that lives are not wasted unnecessarily. I touch on Mr Little’s point, when he said that this was probably the best opportunity for some time now to be able to get this particular piece of legislation right, so that we do not come back here and revisit this upon the unnecessary passing away of people on the job site.

The legislation has been talked about with regard to the reporting of suicides, and I congratulate the committee on striking a pretty fine balance in what is a very difficult subject to deal with. Indeed, in light of recent weeks, when suicide awareness in particular has been raised across the country, it is important that we allow the media to do its job but also that we protect the whānau who are grieving. It has been talked about—this copycat syndrome or mentality, which could potentially come about through reporting in the media. In some cases that I am familiar with, in and amongst the schools, arguably, the media did not play a part in that, but I do acknowledge that the media actually do have an important role in stopping it as well. That is the balance we are talking about there, and I want to commend the select committee for striking that balance.

In conclusion, during the Committee stage we do plan to put forward some amendments to this bill in the hope that, as I mentioned earlier, we can seize the opportunity to get this right and to support and assist the coroner’s office in its function and in the important role that it performs. I do want to just finish on the theme that I spoke about earlier, which seems to be running under many of the speeches, and that is around capacity. Where we can, I too hope that in the future we can address that, at some point in time. Kia ora tātou.

I rise in support of the Coroners Amendment Bill. As my colleague Mr Bayly pointed out, a key provision is to improve coroners’ recommendations by requiring them to be specific to the case in evidence and, importantly, to be clear about the recommendations—how they would reduce the likelihood of future deaths in similar situations.

I heard the Leader of the Opposition speak earlier on this bill. He seemed to me to be advocating for coroners’ recommendations to be given even more weight, but he was absolutely explicit that they should not have to show how the recommendations they make are actually going to reduce the likelihood of similar occurrences. Well, that is simply astounding. I cannot speak for the motivations of the man, as to what he thinks it would achieve, but it certainly would not achieve better public services.

This is a very sound bill, with very sound measures, and I commend it to the House.

The question was put that the amendments recommended by the Justice and Electoral Committee by majority be agreed to.