Coroners Amendment Bill — First ReadingText is incorporated into the Bound VolumeCoroners Amendment Bill — First Reading[Sitting date: 19 February 2015. Volume:703;Page:1775. Text is incorporated into the Bound Volume.]Coroners Amendment BillFirst ReadingHon AMY ADAMS (Minister for Courts):I move That the Coroners Amendment Bill be now read a first time. I nominate the Justice and Electoral Committee to consider the bill. The Coroners Amendment Bill makes a number of changes to the Coroners Act 2006 to provide better services to families by improving the quality consistency and timeliness of the coronial system. The 2006 Act instituted a major reform of the coronial system and was a significant step forward. It established the Office of the Chief Coroner to provide leadership and coordination it moved to a smaller number of mostly full-time legally qualified coroners it ensured family members are notified at significant steps of the coronial process it introduced a specific regime for retention and release of body parts and body samples and it enhanced inquiry and inquest processes.In 2012 my colleague the Hon Chester Borrows the former Minister for Courts initiated a targeted review of the Coroners Act to look at how well the Act was working after 5 years. The review found that good progress had been made since the Act came into effect but that there was room for further improvement. Following on from that review the main changes in this bill include better focusing coroners’ recommendations; improving processes in the coronial system including giving the Chief Coroner more tools to manage the overall system; better defining the cases that need to be reported to the coroner or should have evidence heard at a public inquest; and making the restrictions on publicly reporting self-inflicted deaths clearer and better targeted to matters most likely to cause harm. Many of the changes in this bill are small but taken together they will help to speed up the coronial process to make things easier on grieving families.Coroners play an important role in helping to prevent deaths by investigating the cause and circumstances of certain deaths and making recommendations to help prevent similar deaths. There is public debate from time to time about the merits of coroners’ recommendations. For example there has been debate about whether the recommendations are workable and whether they would have prevented the particular death the coroner is investigating or about why the recommendations have not been implemented. The bill will require coroners’ recommendations to be specific to the case and the evidence before the coroner and also to be clear about how the recommendations will reduce the likelihood of future deaths in similar circumstances. This will make it easier for the public to understand how the recommendations relate to that death.The bill will also strengthen the requirement for coroners to consider who should be notified of the inquiry or inquest so that they have the opportunity to contribute to the evidence before the coroner. If the coroner proposes to direct any recommendations or comments at individuals or organisations they will be notified and given the opportunity to respond before those recommendations or comments are finalised. There has also been discussion on whether there should be a mandatory requirement for organisations to formally respond to the coroner about any recommendations directed at them. This is not proposed in the bill. Many organisations already respond voluntarily to the coroner and to compel all to do so in every case would place a considerable burden on them particularly for smaller agencies. Once a coroner has issued his or her findings that coroner’s role ends and so they are unable to formally deal with any response. Where organisations do however respond to coroners’ recommendations as often happens the responses will be made publicly available alongside the coroners’ recommendations.The Chief Coroner provides important leadership in the coronial system. The Coroners Act sets out a long list of functions of the Chief Coroner. The bill reprioritises the Chief Coroner’s functions to make it clear which functions have a higher priority gives the Chief Coroner more flexibility to manage coroners’ workloads and establishes a Deputy Chief Coroner position. The bill also encourages the use of practice notes to improve consistency between coroners and emphasises the importance of maintaining good relationships so that the coronial system works effectively. The bill will also allow the Chief Coroner to direct that no further investigation is needed if another authority has already investigated the death and has dealt with the matters a coroner is required to determine. Some aspects of the pathologist’s role are clarified such as the ability to answer questions from the family about the pathologist’s report. There are also some small improvements to the processes for notifying and returning human tissue samples to families. Other improvements will better protect the rights of people whose conduct may be called into question in an inquiry. It requires the coroner to notify them of their right to be represented at the inquest and cross-examine witnesses.Medical deaths can pose a particular difficulty in deciding whether a death should be reported and some of the terms used in the Act such as “operation” “procedure” and “treatment” can be broad and difficult to define. The bill will reduce uncertainty by requiring deaths to be reported only where the death would not have been expected before the operation procedure or treatment commenced. Coroners have adopted a process requiring all overseas deaths to be reported to the coroner if the body is brought back to New Zealand for burial or cremation; however many of these deaths are not suspicious and have been adequately investigated by an overseas authority. The bill makes it clear that such deaths may be reported if the body is in New Zealand and someone has concerns about how the overseas authority responded to the death but that there is no requirement to report the death to the coroner. If a member of the New Zealand Defence Force is killed by enemy action while on operational service overseas a coronial investigation into the death could raise some concerns about the kinds of questions the coroner can ask about military matters. The bill will give the Attorney-General the role of determining whether a coronial inquiry is required and clarify that the scope of the coronial inquiry is on establishing the person’s identity and the cause and circumstances of the death.The current Act restricts the information that can be made public about a self-inflicted death without the authorisation of the coroner. There has been much public discussion about the appropriateness of these reporting restrictions and what impact they have on public understanding of suicide as an issue. The Law Commission undertook a first principles review and recommended a number of changes that are reflected in the bill. The bill restricts making public the method of the death and the place where the death occurred if the place suggests the method unless the Chief Coroner has granted an exemption. The Chief Coroner will be able to grant an exemption only if satisfied that any risk of copycat suicidal behaviour is small and outweighed by other matters of public interest. The bill prevents anyone from describing a death as a suicide unless the Chief Coroner has granted an exemption or a coroner has made a finding that the death is suicide. However a death can be reported as a suspected suicide if the facts support that conclusion. The reporting restrictions apply to anyone including individuals using social media or traditional media. However any enforcement is likely to be targeted to the more serious and persistent breaches of the Act.Although many of the changes in the bill are small as I mentioned earlier in the speech they reinforce the public expectations of an effective coronial process which allows deaths to be investigated in a timely and efficient way so that lessons learnt from the death can be addressed quickly and bereaved families can move on with their lives. I commend the bill to the House.JACINDA ARDERN (Labour):It is my pleasure to take a call on the first reading of the Coroners Amendment Bill. I thank the Minister for Courts for her summary and explanation as to what this bill hopes to achieve and I would like to indicate upfront that Labour will be supporting this bill. We do think that it makes some sound and necessary changes. The Funeral Directors Association I noticed put out its support very publicly—obviously there are some ties there with the new chief executive keeping a keen eye on what Parliament is doing—and I understand that the association had some input into the review.There are some additional areas though that we would like to see at the Justice and Electoral Committee and if they are within scope—and I am sure we will be asking the Minister that question—perhaps we would like to explore them given that we have the opportunity to look at the way coroners are functioning generally. I want to come to those extra issues at the end of my address but for now just to give a sense of scale I note that in 2012 there were 3286 incoming coronial cases so there are a reasonable number of cases that our coroners have to deal with on an annual basis. Not all cases will lead to inquiries but for those that do we are looking I think at something like at least 1 year on average before the inquiry takes place. They are significant pieces of work so we want to make sure that when they are undertaken there is no duplication that the expectations for our coroners are very clear and that we make the most of the advice that they then produce. So let us see how the Coroners Amendment Bill makes sure that it does that.The bill as the Minister has set out does a couple of things around the way that coroners make recommendations. It will require a coroner’s recommendations or comments to be specific to the case and the evidence before the coroner to be clear about how the recommendations will reduce the likelihood of further deaths in similar circumstances. Making coroners’ reports relevant to family members or relevant to the organisations they affect is of course very important. I would say that many of the reports or inquiries currently probably already do that but being very clear about the need to be focused in that way of course is useful.Also strengthening the requirement for the coroner to consider which individuals or organisations have an interest in the death and ensuring that those individuals or organisations have the opportunity to give evidence I think is particularly important if we are going to ask those organisations to pick up recommendations and particularly if we for instance down the track ask for mandatory responses. Having that natural justice process upfront allowing those organisations to have input will I think lead to a greater likelihood that those findings are then likely to be implemented.What I will be looking for at the select committee however is to ensure that those recommendations do not limit a coroner from making recommendations and findings as a consequence of their review that are relevant from their perspective but that they may consider to be constrained by this Act because of how specific their recommendations need to be. So that is just a general test I think that we should perhaps test at the select committee.We then come on to a few things around process. The bill sets out that it wants to improve the use of practice notes. That suggests that there is some perhaps regional variation in coroners’ reports. I would be interested to see whether any specific issues have raised that concern but I think it is simply just good practice to have that greater sharing. It also suggests that there needs to be clarity of role for pathologists and improved guidance around the retention of human tissue samples. We have seen examples in the past that have caused considerable distress to families and having clarity there is useful.The bill also sets out to better protect the rights of people whose conduct may be called into question in an inquiry by allowing them to be notified and represented. Again that is good natural justice process and if we are going to do anything around the mandatory response to coronial inquiries then good process upfront and applying those natural justice principles means that that will be a fairer process.We then come to duplication of other investigating authorities and making sure that the Chief Coroner has the ability to ensure that no further investigation is needed if another authority has already investigated the death. I will be keen at the select committee to seek some examples of where that duplication has occurred. I would hope that what we are aiming for is that the highest bar is applied.So for instance if we have two authorities investigating a death the one that has the greatest independent mandate where there might be crossover is the one that is undertaking that inquiry. This is just to make sure that we are not losing our oversight by saying simply: “Well it’s already being undertaken by X inquiry and authority and therefore the coroner does not need to be involved.” I think we just need to make sure that we maintain the appropriate standard there. That is something that I will be interested in asking questions on.Then we come to better defining which cases need to be reported to the coroner. There is one provision here that I am particularly interested in. The bill as the explanatory note states removes “the requirement for a mandatory inquest into deaths in official custody or care to provide the coroner with more flexibility particularly when the death is from natural causes and there are no suspicious circumstances”. I think we have to be incredibly careful in this area to make sure that we are not removing from within the coroner’s authority deaths in care where there may be more than meets the eye. It is a question I will ask at the select committee.It may be that this can be dismissed out of hand. But what if for example a death in care—in corrections for instance—is classified as being of a natural cause because an offender has had a heart attack but actually it is found after you look at the circumstances that the offender had been in considerable distress and in confinement for a long period of time? That could be deemed to be natural causes but I would imagine that we would have an interest in ascertaining whether that finding was appropriate. It may be that there is a good explanation as to why it would not fall under coverage but I would be interested to explore that at the select committee. Then there are a number of clauses that cover off deaths overseas which I think are useful as well.There are some changes to suicide reporting. The Law Commission has done considerable work in this area and I think this will be a particular area of interest for the select committee. We have got to make sure that we are making evidence-based decisions in the way that we are guided in both the recording and the reporting of suicide in this country. There has been conflicting evidence in this area. I think that most of this House would agree that we would want to be guided by the evidence and ensure that we are doing right by the general public when we talk about the very sensitive issue of suicide.I come now to the issues that are not included in this bill which I am disappointed by—there is still the opportunity though. In January of this year in fact a study was carried out as to whether or not we could improve the coronial system. It was funded by the New Zealand Law Foundation and carried out by Otago University. The report was released at the beginning of this year and it argued interestingly that this Act was the place where we could make some useful changes. The co-authors stated: “It is disappointing that the current government does not wish to adequately consider whether the lack of mandatory follow-up to coronial recommendations limits coroners’ ability to put preventive principles into practice.”They reviewed coroners’ findings and basically suggested that although roughly 31 percent of recommendations directed to the organisations they interviewed were taken up 20 percent were rejected. But for them it was the fact that there was no mandatory follow-up around those recommendations—no mandatory requirement for response. They also said that making some of the changes in this bill first would be a very good thing so I applaud the Government for doing that.They also said that we need to make access to coronial inquiries easier to find. But ultimately if we are going to make sure that the coroners’ work is put to use then requiring a mandatory response seems like an absolute no-brainer. In fact it was supported by the Chief Coroner. Back in 2012 the Chief Coroner at the time said that he would like it to become mandatory for coroners’ recommendations to be responded to—not implemented but simply responded to. Why would we not? I would really like to hear arguments from any side of the House as to why that is a bad idea.I will just give a quick example Rotorua coroner Dr Wallace Bain told the Rotorua Daily Post that if his recommendations after a Taupō jet-ski accident that resulted in the death of Genevieve Lewis had been followed teenager Bishop Thompson who died after a jet-ski accident would be alive today. Surely we would want to make better use of all that work and all that time—up to a year per inquiry. Something like $16 million I think goes to our coroners. Surely we could make better use of that.JACQUI DEAN (National—Waitaki):It gives me a great deal of pleasure to speak in the first reading of the Coroners Amendment Bill. I will move straight to the matter raised by the previous speaker Jacinda Ardern around the mandatory response to coroners’ recommendations. Before I do that I want to thank the Labour Opposition for its intention to support this bill. I think indeed that this is an important bill that builds on the Coroners Act 2006.To address the member’s question around mandatory responses to coroners’ recommendations—and I believe this is something that we will have a pretty good look at in the Justice and Electoral Committee—my response and the Government’s initial response to that query is that it sounds good on the face of it and of course heed should be taken of the coroners’ recommendations because after all the coroner is charged with considering all aspects of his or her inquiry but to make a response mandatory in the first instance will require a significant amount of time and a significant amount of resources particularly for smaller organisations. It may be that in a particular instance of an inquest an organisation might not have a direct interest or need to respond and so that mandatory requirement might have a bit of a perverse effect in that it ties up a number of smaller organisations with responding to a matter that is not necessarily of direct concern to them. One would expect that those organisations and groups and agencies that do have a direct interest in that particular coronial inquest would no doubt be responding anyway because it is in everybody’s interests for them to do so.The other point I would make around mandatory responses to coroners’ recommendations is that perhaps it is more beneficial that we are moving towards the inclusion—and it is contained in this bill—of those relevant individuals and organisations early on in the process of the inquest and the investigation itself. So it is a matter of bringing those interested parties on board in the process so that when the recommendations are made those parties that have a view or a response to make are brought inside as part of that report. Having said that the previous speaker raised a valid point—and it is one that the Justice and Electoral Committee will be considering during its consideration on this bill.The whole purpose of this bill is to make more timely and more efficient coronial decisions in what are in anybody’s terms very very difficult situations for grieving families. That will be at the forefront of the consideration of all members of the select committee and all members of this Parliament when we come back to debate it throughout the course of its passage. It is a fact that the average coronial inquest takes around 400 days. That is over a year for the grieving family and friends and those involved to have the matter still unresolved for them both on a personal level and also if it involves perhaps an air accident or some other form of mishap or misadventure there may well be consequential legislative or regulatory changes that the Government may need to look at as a consequence of that death. Expediting an inquest has got to be for the benefit of all New Zealanders not only those who were involved and who have sadly passed away but also those who may be impacted and affected in the future. Even more disturbingly perhaps with an inquest that is a little more complicated and involves other agencies such as perhaps the Air Accidents Investigation Commission there might be multi-agencies involved in an inquest and that can take up to 700 days which is a couple of years. That is too long for a family to wait for closure and resolution.There will be families out there today perhaps taking an interest in this debate. I know there are people with many many personal stories who will come and speak to us and I welcome those people. This matters to them so for those people who are listening or watching the debate today this Parliament is determined—and I do hope we enjoy the support of the rest of the House—to speed up the process to make it more relevant to those people with a personal interest and also to those Government agencies and other sectors of New Zealand that will have an interest in the result of inquiries.One of the bill’s main provisions is to require a coroner’s recommendations to be more specific to the actual case that they are considering and the evidence before the coroner and to be clear about how the recommendations would reduce the likelihood of future deaths in similar circumstances—so maybe tightening up the criteria around what the coroner is reporting. The bill will give the chief coroner better tools to improve timeliness and I have already made reference to that. One such tool—and I think it is a very good provision—is a requirement to monitor the progress of older cases. I would not like to think that due to perhaps caseload management there are older cases waiting for resolution because these are not just cases; these are inquests into the deaths of people. So we want a sharper focus on providing resolution for those.I want to acknowledge the input of a number of organisations into the drafting of this bill. The Law Commission of course—let me just go through my notes because we met with the Law Commission this morning and it made a submission to the Justice and Electoral Committee and it made reference to its work on this bill. The commission made 17 recommendations to the Government on coroners’ inquests and the Government fully accepts 14 proposals for changing the Coroners Act and generally accepts three further recommendations about developing reporting standards around inquests. I want to acknowledge the Law Commission for its work on this but also other organisations. The Funeral Directors Association of New Zealand is a relatively small association and it has a new chief executive who was mentioned by the previous speaker and that is the former MP Katrina Shanks. Katrina Shanks as its new chief executive has made an absolute focus of the care of families at the time of death but in particular in this instance the care of families in times of sudden death unexplained death or suicide.In the couple of moments I have left I just want to talk about suicide and the suicide of young people. I want to talk about a meeting I attended in Alexandra and there was another one in Kurow and another one in Ōāmaru. I am describing my electorate but this happens throughout New Zealand. At the meetings groups of parents and educators are getting together to discuss youth suicide. In those meetings that I attended late last year Mike King came along and spoke of his experience of depression and the prevention of youth suicide. At each of those meetings the town halls were absolutely full of concerned parents and concerned children. Youth suicide suicide and suicide reporting are a critical part of this bill. There will be new regulation around suicide reporting. We do not want copycat suicides through misreporting to continue in New Zealand. It is a concern that has been raised in many quarters.I look forward to the examination of this bill. I look forward to working collegially with members across the House and on to the second reading and the Committee stage.PEENI HENARE (Labour—Tāmaki Makaurau):Tēnā koe kia ora Mr Assistant Speaker and thank you for allowing me the opportunity to take this call. Seeing as this is the first time I am speaking in the House in 2015 can I echo the sentiments heaped upon yourself and your colleagues and wish you and indeed all of us in the House a happy New Year and a prosperous New Year.It is my pleasure to speak on the first reading of the Coroners Amendment Bill. My colleague Jacinda Ardern has mentioned the Labour Party’s support for this bill and its proceeding on to the select committee. I would also like to take this opportunity to thank the former Chief Coroner for his hard work in steering the coroner’s office since 2006. We understand that recently the former Chief Coroner has moved on and we wish him all the best in his work in the field of ACC. Can I also in that vein—I am sorry that was Judge Neil MacLean. Can I also in that vein congratulate the Labour Government and Helen Clark in particular in 2006 who allowed for the Coroners Bill to enter into this House set up the coroner’s office and of course Judge MacLean was the first Chief Coroner appointed to that office. I would just like to take the time to highlight that fact.Of course we move on to the amendment bill we are discussing here today. I have already mentioned that we support this bill moving on to the select committee deliberations. I want to point out some things within the bill especially around some of the amendments that are being proposed strengthening the coroner’s recommendations.I am reminded of other such arbitrary groups or tribunals such as the Waitangi Tribunal whose recommendations although well researched and well founded often fall on deaf ears. We know that that particular tribunal is often considered to be a toothless lion and I would hate to see the same happen to the coroner’s office. I would hate to see that the important recommendations the coroners make after their inquiries fall on deaf ears.I want to highlight a particular case if I can—a recent case of two young people who passed away sadly following inhaling butane. They were a 19-year-old and a 12-year-old. One of the recommendations of the coroner’s office was: “determining whether there needs to be support for Māori communities to develop their own solutions to the problems of the abuse of butane and other volatile substances”. This is because statistics show that 30 out of the 63 butane-related deaths between 2000 and 2012 were people of Māori ethnicity. I am not too sure whether or not that recommendation was taken seriously but I would like to think that these types of amendments will allow for those recommendations to have some real teeth so that we can stop the sad and tragic cases around the inhaling of volatile substances that I have just pointed out. That is just one particular case.I support the amendments being proposed to strengthen the recommendations of the coroner but I think they just do not go quite far enough. I look forward to hearing some of the submissions from interested parties at the select committee because I feel that these particular amendments just stop before the try line. We want to see that the recommendations gain a bit more mana.We want to see that the proposed streamlined processing and administration of particular inquiries in the coroner’s office puts people and families at the forefront of its thoughts. I raise that point because of having had experience with such tragic cases. Sadly a lot of Māori tūpāpaku—or loved ones who have passed on—end up travelling very far distances for an autopsy. If for instance they pass away in Kaitāia too often the tūpāpaku is sent to Auckland. What needs to be done is done there. By the time the tūpāpaku makes its way home 2 days have passed. In Māori terms and in tikanga—in our custom—that is not a very good thing. So when we make recommendations—and the recommendations made in the Coroners Amendment Bill—I would like to think that people loved ones and pragmatism are put to the forefront of all submissions put forward on the amendment bill.I want to carry on around the proposed improvement of the coronial system. The coroner’s office is already extremely overworked. I say this from some indirect experience; the coroner for the far north is a relative of mine and discussions with him point out that he is extremely overworked. He points out to me also that there are many cases that are just sitting gathering dust in particular places in his office because he is overworked at this point in time. So I would like to think that the proposed amendments in the Coroners Amendment Bill will allow for not just a streamlined process but for more resourcing—more resourcing to allow a streamlined process of the coroner’s office and the important work that they do. The hope is that the recommendations will indeed ease the workload as I have already spoken about and will also provide the tools to the coroner and to the coroner’s office. We have heard some kōrero some discussion already on this bill from the previous two speakers around pragmatic solutions.I want to pick up the case around self-inflicted deaths. We do know that there needs to be responsibility around the open publication of the way that people who sadly suffer that fate pass away for fear that others may copy the person who has passed away. I support that but I wonder whether much thought was given to particular cases in the far north in particular at Kamo High School where there was a suicide ring or a suicide pact. No form of silencing through non-publication of self-inflicted deaths will stop the types of ring and pact mentality that sadly afflict our youth today when we talk of self-inflicted deaths. I wonder whether there could be any more thought or recommendations—and I look forward to submissions—concerning those particular instances because it is not just about the publication of names; it is about dealing with the issue itself.I look forward to hearing submissions on this particular amendment bill not just from interested organisations but I would encourage families who have experienced the coronial process in the past to come forward and share their experiences in the hope that it can best inform the amendments that are being proposed in this bill. I have already mentioned that we the Labour Party are supporting this amendment bill moving forward and going into the select committee of which I am a member. I look forward to hearing those submissions and thank you for your time. Tēnā tātou katoa.Hon CHESTER BORROWS (National—Whanganui):I appreciate the opportunity to be able to speak on this bill. With a change of roles it is the first opportunity I have had to speak in the House this term and I am pleased it is on this bill having previously had some responsibility for the bill in another role. The bill seeks to correct some anomalies and to fix some concerns that have been identified in recent times.I want to start with one in particular. People will remember the Iraena Asher investigation from Pīhā Beach a number of years ago. The result of that coronial inquiry has thrown up some anomalies and some unfairness around some people who were involved in respect of that case. This bill seeks to make a change in respect of that. I am speaking specifically around the coronial inquest. Some negative comment was made by the coroner in respect of a witness on the night—someone who sought to give assistance to Ms Asher and that was Bobbie Carroll.What happened was that the coroner made some comment around the ramifications of actions that Ms Carroll took and speculated on what could have happened if other actions had been taken. In the end of course the Chief Coroner came to a position where we needed to change this law to make sure that if any comment was going to be made that might negatively impact on a witness or someone who had previously appeared or had some connection with a case then the coroner must identify what those comments are and make them known to that person before they are released publicly and give that person the opportunity to be able to speak on them.I know that this has been a terrible concern for that particular family and for Ms Carroll particularly her partner and the people who supported her. It is unfortunate that no apology has ever been given. For instance she was not given the opportunity to be represented or advised of her opportunity to be represented at the inquest or that comments were going to be made and the effect that that would have. So I would like to state here and have it recorded in Hansard that as a former Minister for Courts with responsibility for coroners I am sorry that that was not done and that those comments and those errors were made and I am pleased to see that there has been some attempt to rectify that now.I would also like to talk about suicide and the provisions around suicide reporting. The fact is that New Zealand has a terrible record in respect of suicide. About 500 people take their own lives each year. We know a lot about the statistics and we know very very little about the whys. We raise a lot of questions about suicide and have not necessarily sought answers hard enough although there is some good work going on at the moment at the behest of the Prime Minister and his Chief Science Adviser to find out more of the answers to the questions we have around suicide. For instance we know that of the 500-plus suicides a year about 100 of them are Māori which is four times the number of Pacific Islanders who take their own lives but we have no understanding of why that might be. We know for instance that about one in five is under the age of 25 and our youth suicide statistics in this country are among the worst if not the worst in the Western World. We have no understanding really as to why in this country that we take huge pride in that should be the case. We also do not necessarily understand why for instance those people in the lowest decile are just as represented as those people in the highest decile when it comes to income and social deprivation indexes—why they are equally represented. In fact we know very very little.When it comes to an investigation around suicide the cause of death which is what the coroner is chiefly charged with establishing is frequently blatantly obvious and having attended probably 100 suicides and several hundred sudden deaths I suppose I speak with some experience sadly in that respect. But to do some sort of psychological autopsy on what the contributing factors were—what was weighing on the mind of that person who took their life at the time they did the various stresses and strains that come upon somebody that drives them to the conclusion that those whom they love would be better off without them there is something we know very little about.I would like to see us as a community have a very broad discussion around suicide and its causes. I would also like to see authorities take a lead in implementing what has come to be known as a psychological autopsy into the issues that were weighing on the mind of the person who went on to take their life.I would also like to pay respect to Sir Grant Hammond who was the member of the Law Commission who worked on this the most and gave us advice on the reporting of suicide. We have had law around the reporting of suicide for some time. It has prevented what would most be of interest and helpful not only to professionals but also to the public in the investigation and the understanding of suicide. They have been prevented from being able to do that. Then there have been breaches that have been unable to be constrained as well. The previous speaker Peeni Henare made the point for instance that social media took over and breached all the laws around the publication of matters around suicide. Mainstream media which would have had some sort of integrity and credibility and could have been the vehicle for getting some facts out into the public domain were prevented from doing so under threat of prosecution. So the advice that Sir Grant Hammond has given has been very very helpful.I would also like to pay respects to a group of young South Taranaki people who have recently over the last week ridden the length of the South Island and raised $150000 towards supporting people affected by suicide. This came out of a South Taranaki situation. One of the women Nicola Symes who is very involved in the arrangement of that event lived in a community called Manutahi and within her own family was affected by the suicide of close relatives including her husband. She then grasped the nettle and raised the awareness. In this small community within a 5-year period there were about six different suicides of people mainly from the farming community. You can imagine then that within this small community which incorporates only about 50 different farms it had a huge effect on the local community.There has been some discussion around recommendations and whether or not there should be mandatory responses. I have to say that this is something that we thought about long and hard. The problem was that various coroners have differing results differing recommendations from similar deaths and those recommendations frequently conflicted. If one looked for instance at the recommendations made around cycling deaths or around quad bike deaths they conflict with each other quite frequently and often the coroners making those reports went far beyond the facts surrounding the particular death that they were investigating.I have to say that and I know time is short my main theme around this particular bill and what needs to happen in respect of coroners’ matters in the future is that we need to sort out the relationships. There has been an almost toxic relationship between coroners and pathologists over the years. There has been some strife between coroners and police—the ability for coroners for instance to direct the police to make inquiries which ran in conflict with the duties of the police to prosecute matters for instance. So effectively you had members of the judiciary being able to instruct the police to make inquiries but members of the executive such as the Minister of Police could not instruct the police to do absolutely anything.In the end though what we need to remember is this. All of us whether we be community members or people who have had a close association with these matters—such as myself as a police officer then as a lawyer and over that time as a funeral celebrant and then recently as a member of Parliament and a Minister with some sort of responsibility—need to remember this: who do we work for? We work for the public of New Zealand. They are the customers. Anything we can do to assist them in dealing with the tragedies that they are confronted with has to be good and it is incumbent on us to do all we can. Thank you.DAVID CLENDON (Green):I would have to say that I am genuinely looking forward to the debate on this bill. I think it is an important bill. It is challenging. It will cover some very sensitive topics and I think there is some space for controversy within some of the proposed provisions in this. Having said that I would hope that we are able to avoid a political contest over this bill. Yes I think we should politicise things like taxes but death I think we should endeavour to simply come to the best outcome and put our evidence-based hats on our serious debating hats. I have to say that I am reassured by the quality of some of the contributions we have heard already from Jacqui Dean from Mr Borrows from my whanaunga Peeni Henare. People are engaging at a very serious level with this and that is a very positive beginning I think to this piece of legislation.I think there is a popular view that coroners are people who are to be found in morgues wearing white coats and waving scalpels about. I think that is due to the influence of television programmes and the like. That is completely false of course. The Chief Coroner is a District Court judge. The coroners are all typically lawyers or have some legal training. And their task of course is to discover the cause and circumstances of sudden or unexplained deaths with a key focus on seeking to prevent or at least reduce the likelihood of similar deaths occurring be they by accident or by whatever means that the death occurred.In just doing some background reading about this stuff it seems that the Budget of the coronial service is rather modest and this might reflect the comments we heard about the Kaitāia coroner and his or her difficulty in meeting the workload demands. The last figure I saw was something to the tune of $17 million. About half of that was devoted to paying for specialty services pathological services lab tests—those sorts of things. So it seems it is a service that may be under some financial pressure and no doubt that is something we will hear about in the submissions if that be the case. I do not think I have ever made the point actually that the Greens are intending to support this legislation; just to put that out there.What we are amending is legislation that is not particularly old. It was from 2006. It saw a fairly major overhaul of the coronial services and the establishment of the Office of the Chief Coroner. The intention and the purpose of that change at that time were to streamline services. It created a network of full-time coroners with legal qualifications whereas I understand that earlier there were perhaps more people. It was a sort of a hodgepodge of part-time positions or part-time services which were found to be unsatisfactory. So it is fair to say I think that 8 years down the track we are looking at the outcome and clearly the results—or the anecdotal evidence at least which is presented in the regulatory impact statement—would indicate that the system is still far from perfect.Some of the perceived problems have been touched on already. Particularly in procedural delays processes that are not delivering swift resolution is obviously significant and very damaging potentially when it is around issues of the return of bodies. Allowing families to reclaim their loved ones after their sudden deaths is enough stress enough grief without the clumsy legal processes layering another level of concern and stress on to that. So I think we need to bend our minds to anything we can do to resolve those procedural and process issues and make some significant effort to ensure we are streamlining the processes to the extent that we can. I think the point has already been made—and again this is evidence or at least anecdotal evidence as presented in the regulatory impact statement—about the overlap of jurisdiction about the lack of clarity about who is in charge about who can do what and about who should be doing what and these are things that are amenable to improvement I am sure. Clearly as I said where we have these procedural and process bottlenecks or imperfections that creates not only financial cost but significant social cost as well and we need to do as much as we can to remedy that. None of these things look to be straightforward but some as I say are amenable to attention to the more mechanistic aspects of the Act—just trying to make it work better.I think that where the real controversy will kick in—in my assessment anyway—is around two provisions of the Act. One of those is changing the requirements around deaths in custody and the other one of course is around the issue of suicides. In terms of deaths in custody I guess the primary change as discussed in the explanatory note is in “removing the requirement for a mandatory inquest into deaths in official custody or care to provide the coroner with more flexibility particularly when the death is from natural causes and there are no suspicious circumstances (however the corner would still be required to hold an inquiry):”. Putting aside for a minute the difference between an inquest and inquiry—it is a key difference of course in the matter of holding a hearing—we have had recent examples of significant concern challenges and quite high-profile cases around deaths in custody where there has been considerable unhappiness about the results the findings and the outcomes of those deaths. I am not going to comment on specific cases because I am aware that some of them are still either in some sort of legal process now or there will potentially be legal issues arising around them. In general terms I think it is fair to say that deaths in custody have been seriously challenged as to liability and the circumstances leading up to a death.I think part of the problem there—and I perceive it as a problem; others may not—is the fact that in medical services within our prisons the people providing those services are employees of the Department of Corrections. I advocate very strongly that there ought to be an independent organisation be it a district health board or whatever that provides medical and health services in our prisons simply to draw that bright line between a focus on containment if you like and that on delivery of health services. I think some of that has come through in the controversy around some of the more recent high-profile deaths in custody. It is not only prisons of course; it is people detained under alcohol and drug addiction legislation young people who are kept in residences mental health detainees people in police custody and people in custody of security officers while being transported. There is a raft of situations where people in custody have passed away and often in circumstances that are obviously unnatural. But I am sure there will be unease about this change from a mandatory inquest to simply an inquiry. It is something that I think we need to investigate and invite submissions about and to look very hard at the costs and benefits of.The other issue of course is around suicides. I think I entirely understand what the legislation seeks to do and that is to manage the reporting of suicides to take away the opportunity for these things to be sensationalised and to try to manage the risk of copycat suicides particularly with young people. So on that side there are very sound arguments which I generally agree with to control the release of information about suicides.Alongside that and not necessarily in conflict with it though is an advocacy for actually talking more about suicide particularly with young people. I have been involved around the margins with groups in Northland—Riders Against Teenage Suicide is one of them. We discovered that a bunch of people on noisy shiny motorcycles coming into a town attracts the attention of young people and that they open their ears. I will just acknowledge Arthur Harawira who has been driving some of that having suffered a tragedy in his own life around this and who is passionate about trying to ensure that our young people do not see suicide as an option. We can only do that by talking to them and by very carefully managing situations to endeavour to get that plague of suicides out of our communities and out of our young people not least of all in Northland where there is a very serious problem. That has already been mentioned. So I think we will have to carefully manage that to ensure that people do not perceive that by endeavouring to manage better the reporting of suicides and events around suicides we are trying to shut down the debate. I look forward to this ongoing debate. We will support this legislation.DENIS O’ROURKE (NZ First):New Zealand First will support the Coroners Amendment Bill to the Justice and Electoral Committee. The work of coroners is often underrated but it is very important work. The Coroners Act 2006 has gone a long way to modernise and improve the service and this amendment will hopefully deal with some of the remaining issues.Strengthening coroners’ recommendations is covered in new section 57A. New subsection (1) reconfirms that a coroner can make comments or recommendations during the course of an inquiry or as part of the findings. New subsection (2) 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.” 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 in deaths.These two subsections will require some very careful consideration by the select committee. I have some concerns that new subsection (2) is in fact too restrictive. I accept that there is a need for coroners to have clear limits on how far a coroner may go with recommendations or comments but the words “only for the purpose of reducing the chances of further deaths occurring in circumstances similar” will I think cause rather too much limitation on what a coroner may legally comment on.An example I would give is the 118 people killed in the CTV Building in the Christchurch earthquake. The cause of that was clearly the earthquake itself but the building failure and also the command failures and rescue methodologies during the rescue phase also caused significant concerns and there were allegations made that deaths resulted from those. So it should I think be possible for a coroner to have a little more freedom to discover and comment on or recommend on those kinds of issues. Whether or not fewer deaths may result in similar events is not really all that important. So those are words that we should I think take another look at otherwise we might end up with an Act that does less than we need it to do.That amendment may in fact remove a coroner’s ability to comment and make recommendations on matters that are of great importance thus creating a gap in the system. So I will likely be seeking some amendment or at least some robust discussion in the committee. I would ask that Amy Adams and Jacqui Dean having heard their comments take another look at it and perhaps think about it again.Overall I seek a better coronial authority to comment and recommend rather than less authority to do so. The CTV building disaster also needed a commission of inquiry of course but the coronial and commission inquiries could both have been much more valuable in dealing with the many complex causative issues involved. There was much overlap between causes of building failure and of deaths caused potentially by rescue efforts and so on. So we must be very careful not to be too restrictive as far as coronial inquiries are concerned.There are many people in Christchurch like me who are deeply concerned about the lack of clear findings in that case of cause of who contributed and about accountability. There was so much illegality and so much negligence that it deserves thorough and robust inquiry wherever we can get it and that includes in the coronial system. We have seen far too few of those responsible identified and brought to book. This Government seems to be more interested in sweeping it all under the carpet instead of ensuring that its agencies have ensured full accountability.Regarding new sections 59 and 59A I see no particular issues at this stage with these. New section 59A prevents a coronial inquiry into the death of a member of the Defence Force only if it was caused by hostile action. So deaths such as those in the recent RNZAF Anzac Day helicopter crash would still be subject to coronial inquiry and that is appropriate. There was a lot of confusion in that case about who was responsible to investigate what as some of us will remember.Regarding new section 60 I agree with David Clendon. It must be mandatory for a death from any cause in official custody or care to have a coronial inquiry. New section 14(3)(c)(i) will include in the definition of a person in official custody or care a child or young person who has been placed in custody or care under the Children Young Persons and Their Families Act 1989. It is essential that deaths in these circumstances always be subject to coronial inquiry for what I think are obvious reasons. The avoidability of the deaths of babies can too often be hidden issues needing full investigation even if the death was regarded as resulting from natural causes. This is also something that I think we need to look at and discuss thoroughly at the select committee stage.New section 71 is very welcome and necessary. It says that if a death is self-inflicted or there is reasonable cause to suspect that the death was self-inflicted no person may make public the method or any suspected method of the death or the place where the death occurred if the place suggests the method or any suspected method of the death or a description of the death as a suicide. There are exemptions provided for. The Chief Coroner may grant an exemption only if the Chief Coroner is satisfied that granting exemption does not present an undue risk that other people will attempt to copy the behaviour and that any risk that people will attempt to copy the behaviour of the dead person concerned is outweighed by other considerations that make it desirable in the public interest to allow the publication of the details.I also note with approval the new section 116A establishing a suicide and media panel to advise a coroner on applications for those exemptions. These are important matters. On the one hand it is important not to unduly restrict the media’s freedom to report but it is also essential that the reporting of suicides will not encourage copycat attempts by other people. So these new sections appear to provide for what I think is an appropriate balance and on behalf of New Zealand First I say we are very happy with those new provisions regarding section 71 and suicide.I look forward to further discussion at the Justice and Electoral Committee. I have identified some matters—some very important matters—that I particularly wish to investigate and hopefully as a result of that discussion there can be further amendment of the bill. If so New Zealand First will then be happy to support it further.JONO NAYLOR (National):It has been just great so far to hear the various things that have been said around this room and the level of support there is from right across the House for this Coroners Amendment Bill to move to the next stage. I think it is critical for us that we do support bills like this because as Mr Clendon said earlier when it comes to talking about death when it comes to talking about the effects of death on families and on the general population of our country I think it is beholden on all of us to take a really mature approach to it to take a very broad approach to it and to really just ensure that what we do absolutely serves those people because that is what we are here to do: to serve the people of New Zealand to serve families who have suffered trauma who have suffered grief and to make sure that we get processes like this right.Before talking about the bill specifically can I also just acknowledge the work that is done by our coroners around New Zealand. It is not a task I do not think that anyone would actually get a whole lot of pleasure from when you have to investigate and probe and look into sudden or unexplained deaths. You are dealing with very important matters. You are dealing with grief. You are dealing with the feelings of families who have been affected by it and often you are dealing with really quite unpleasant details as well. I think those people who—I guess we all have to do different things in our jobs but being a coroner I do not imagine has too much upside at the end of the day other than knowing that you are going to bring some level of resolution and perhaps some closure for people and perhaps prevent deaths in the future. But I do just want to acknowledge the great work that is done by those people in serving our country in the way they do in that regard.Yesterday we spoke to the Judicature Modernisation Bill which was substantially bigger than the one that is before us and so it was quite nice to see that we had 36 pages to get through today rather than the 1226 we had yesterday. I think the thing we have to take into mind as well is that actually this bill is equally as important as part of the ongoing process of this Government to improve our judicial processes to ensure that they are more efficient that they are working better and that we are putting victims whether it be victims of criminal acts or simply people who are suffering grief through sudden loss at the centre of what we are doing.That is very much what this Government is committed to doing. We are absolutely committed to ensuring that those people are at the forefront; that we are not just devising processes that suit the professionals who are involved and that we are not just devising processes that suit any kinds of administrative tasks or other people involved in the process but that we are in fact putting those people who are most adversely affected by these events at the centre of our process.So it is really encouraging to see that in this bill we are aiming to streamline the processes for families and for those people. It was for me a little bit disturbing when I was reading through it to discover that actually often coroners’ cases that involve an inquest or hearing take over 400 days to complete on average. I know that there is a lot involved but if you are grieving and you are looking for some answers as to the exact reasons why you have lost a loved one well 400 days or perhaps 700 days if a further investigation is required is an awfully long time to get some answers.I believe we owe it to those people to improve these processes and that is what this bill sets out to do. I think we need to ensure that those people who have suffered that level of loss can in an appropriate manner and at an appropriate time receive the closure they need. And if there is an outstanding coroner’s inquiry if there is an outstanding inquest then no matter how much you may have emotionally moved on there will always be a part that is left open. It is difficult I think for people to have complete closure on that sudden loss of a loved one until that process is completed. So as I said it is great to see that we are going to be speeding up those processes; that for the sake of those families who are involved we are going to be speeding that up.A number of people have also already talked about this but I want to touch on the issue of the suicide reporting provisions within this bill. I have had the privilege in some respects of working with young people for a lot of my working career. At times that has involved working with teenagers in particular who have either attempted suicide or are planning to or are at different stages of a depressive state of affairs. I have sometimes had to deal with the aftermath of events like that as well and I think it is really important that we ensure we keep the young people of our country as safe as possible.Over time we have had the suicide prevention strategy in place which is I think a really great piece of work. It is ensuring that we try to work towards keeping our younger people safe—and not just younger people I might add—as we go through. That strategy has a number of goals whether they are to promote mental health and well-being improve the care of people who are experiencing mental disorders or reduce access to means of suicide. There are a number of things but in particular the strategy says we should promote the safe reporting and portrayal of suicidal behaviour by the media.We know that it has been proven that actually if these things are talked about inappropriately in the media it can lead to copycat-type behaviour from young people. It can lead to at times glorifying the act of suicide. We need to ensure that that never ever happens. So I think it is important that we ensure there are appropriate provisions in place. I think it is great that we are not just including conventional media in this but actually in this day and age of social media where things can spread so quickly where there is a medium by which young people—I keep picking on young people and I should not I know. People within society spread information so so quickly that it is important we capture those social media mediums as well to ensure that we are not advocating for or allowing the glorification of copycat-type suicides.I think though that it is really important when we have all been talking about the importance of not portraying it inappropriately in the media that we do not also then send out the message that it is not OK to talk about suicide. I think we need to stress that although it is at times not beneficial to put too much information out there in that regard it is important that we do talk openly about depression that we do talk openly about mental illness and that we do ensure that people are keeping themselves safe. We are not looking to clamp down on people talking about those things; we just want to ensure that media whether it be social media or conventional media are not talking about the events of somebody’s death in an inappropriate way that may lead to further harm being caused.I just want to touch finally on the fact that I am encouraged by the level of input that has been sought already on this bill. It has been great to see that coroners have been spoken to. It is great to hear that the Funeral Directors Association—there is a group that clearly has to deal with death all of the time as coroners do. Families have already been listened to as this bill has been drafted. I am sure that as we take this bill through to the next stage as we take it through to the select committee we will hear from those people again and they will be able to give us perhaps some insight to fine-tune this in some ways to ensure that we really are putting forward the best legislation we can.I am certainly glad that I am going to be a part of that process as a member of the Justice and Electoral Committee. I am looking forward to hearing those views and looking forward to ensuring that the kind of legislation we are putting forward as I have said is going to put families particularly grieving and struggling families at the middle of our thoughts and our processes. I commend this bill to go to the next stage. Thank you.The ASSISTANT SPEAKER (Lindsay Tisch): The next call is a split call—Eugenie Sage.EUGENIE SAGE (Green):Tēnā koe. I am pleased to speak on behalf of the Green Party on the Coroners Amendment Bill. As the Minister has noted the aims of the bill are to improve the accountability and transparency of the coronial system and its efficiency and timeliness. As David Clendon has noted we endorse the bill and will be supporting it. It is important to put families at the centre of the coronial system and some of the changes will help do that.It is really important to safeguard the independence of coroners and as other speakers have noted we also want to ensure that they are adequately resourced. The coronial system has dealt with some major inquiries: the Pike River mine disaster the Christchurch earthquakes and the collapse of the CTV Building and it has done that on a limited budget of $17 million annually. Improving efficiency and timeliness may have more to do with increasing resources rather than changing the law.The issue around the independence of coroners is important. They act in different ways and it is important that the public can be confident in their impartiality and independence. We welcome the provisions in the bill that improve the transparency around the appointment process and around dealing with conflicts of interest. Submissions on those provisions that seek to clarify the coroner’s role and claim to reduce the duplication with other agencies will be very important to determine whether there has been any attempt to just by the way the law is drafted constrain the independence of coroners.We are very interested in submissions because as the regulatory impact statement noted the bill has been prepared after consultation with key stakeholders but not with full public consultation which the department said would have been desirable and that was not done because of the time frames that the Minister imposed.In the brief time remaining I would like to comment on the provisions around suicide reporting. There are over 500 self-inflicted deaths in New Zealand each year which is far higher than the road toll. All of those deaths are desperately sad for families and friends. Most escape public notice but some do attract significant media attention. New Zealand is quite unique in the way it deals with reporting self-inflicted deaths. We are the only country that uses the law to restrict reporting and for more than 50 years our law has had restrictions on reporting the method of self-inflicted deaths. There is certainly no restriction on the reporting of the problem of suicide in general and I endorse the comments of Jono Naylor that there is sometimes a bit of confusion there and there is certainly no restriction on that.The whole issue of constraining the reporting on the method of death has been because of a desire to avoid an inquest by media before the coroner in his or her judicial role has been able to rule on the cause of death and because there has been a number of studies as the Law Commission noted that show that reporting the method of a suicide has significant imitative effect on subsequent suicides especially when the victim is a celebrity and when people identify with the age and sex of the victim. It is particularly young people and people experiencing depression who are vulnerable here.Those restrictions have a strong purpose in preventing social harm but there has been a widespread recognition through the review that the ministry did in 2012 and the very insightful report of the Law Commission that the current law is not working or is working inadequately. There is uncertainty about the meaning of the law. It is uneven in its application. It does not apply to deaths overseas but it does apply in New Zealand and because of social media and changes in technology there has not been a lot of compliance with the existing law. So it is very timely that we have this bill and we in the Green Party will be very interested in submissions as to whether the way it is drafted actually improves the situation and gives more clarity around the restrictions on media publishing the details of the method of death. Thank you.POTO WILLIAMS (Labour—Christchurch East):It is a pleasure to be able to make a contribution to this particular bill. I would like to use this time to do three things. Firstly I want to talk a little bit about the aims of the bill. Then I would like to look at a couple of aspects that I hope the Justice and Electoral Committee will take particular note of and that I believe some robust submissions will come through on.Firstly it is important to note that for families who go through the coronial process one of the aims of course is to improve the quality consistency and timeliness of the coronial investigations and decision making. For those families as has already been expressed in the House this afternoon it is really important that the investigations are conducted well that the issues come out in debate and that families are not having to extend the time that they grieve for their loves ones and are allowed appropriate time for the grieving process to occur.The second aim of this bill of course is to clarify the role of the coroners to identify any areas where there might be a duplication of services and to ensure that they have got the adequate resources to appoint and involve those people who are important in the investigation—maybe pathologists; it could be requiring information from the deceased person’s own health practitioner—to ensure that there is robust health information available during the process. Thirdly it is about clarifying the role of coroners in making recommendations to prevent future deaths. I will talk a little bit more fully about this later when I talk about what I hope the select committee process will engage in. Lastly it is about ensuring that resources are effectively used. Here I want to pick up on the comments that have already been made about how the resources should also include adequate funding to ensure the timeliness of coronial investigations.What is important of course is that this bill aims to ensure we recognise that the cultural and spiritual needs of the family and others who are close in relationship to the deceased person are fully taken on board and that public good associated with the proper and timely understanding of the causes and circumstances of the death is understood.Further to that this bill really wants to ensure that recommendations and comments are drawn to the public attention so that they may reduce further deaths occurring in circumstances similar to those that have occurred. So this bill adds clarity to the function of the Chief Coroner to the effectiveness of the coronial system in managing and overseeing the workloads and the processes that are engaged and additional to that to supporting coroners and pathologists and others to provide effective coronial services.The bill also establishes a process to report overseas deaths if there is some ambiguity or doubt as to the accuracy of the conclusions reached regarding that death. Here I also want to make just two comments about what I hope the select committee process will investigate further. We have already spoken a lot about the sensitive nature of suicide and the reporting of such I know has already been explored. But I want to make just one comment about the coroners’ concerns that they raised that their reporting and recommendations potentially do not have the ability to be acted upon. Here I want to comment on the work of a colleague of mine Darien Fenton the work that she did with families of forestry workers. She did significant work with those families in trying to establish appropriate reporting so that these deaths did not occur in the future. Thank you.CHRIS BISHOP (National):It is a pleasure to take a call on this very important bill. It is my first contribution on a justice matter in the House. Can I say it is a very exciting time although quite a sobering piece of legislation. But it is a very important piece of legislation and it is good to see from listening to the debate which I have been doing that it largely has the widespread support of the House I think at first reading because it is important that we discuss the matters at select committee contained within it. I want to limit my remarks a little bit to the suicide reporting measures contained in the bill. This has obviously been a vexed issue in New Zealand society—the issue of the appropriate limits that are placed on the news media in reporting on suicides or self-inflicted deaths. It has obviously been a vexed issue in New Zealand for many years. In some ways the two extremes in the debate can be summed up as this. One side says “Publish everything.” I guess that is the pure libertarian view—that there should be no restrictions placed on the reporting by the news media of suicide or of self-inflicted deaths and that we should have total freedom of speech. Allied to that are arguments about the educative or therapeutic nature of that reporting. Then of course there is a very strong counterargument to that which is that the harm that arises from the reporting of suicides through contagion effect and through copycat suicides outweighs the freedom of speech for media to report that.Working through those two conflicting arguments is obviously difficult and challenging but necessary and I think it was appropriate that the Minister of Justice and the Government referred this issue to the Law Commission because the Law Commission in my view is the appropriate body to work through a sensitive and difficult issue where there are two competing viewpoints and come to some sort of recommendation. I think it is the right body. It is interesting just to note that New Zealand is actually the only jurisdiction—or one of the only jurisdictions in the world—that uses legislative force to prohibit the reporting of suicides. Every other country that the Law Commission could find uses a mixture of education and voluntary guidelines. I for one find that interesting but I do not necessarily think it means it is wrong. It just means that New Zealand uses a slightly different mechanism to say other countries.I think there is widespread acknowledgment that the status quo is not working and that the current measures in the Coroners Act 2006 have been proven to need improvement. The Law Commission in its report outlines a range of failings and a range of things that have gone wrong with that Act. It pointed to the uncertainty in the current law—uncertainty that puzzles or at least confuses in some ways the news media and the general public about what exactly is allowed to be reported. It pointed to the fact that the current law is not actually observed in some cases. The Law Commission study suggests that around 20 percent of the time the law is at least not complied with in some way. That is even in clear breaches of the law.It also pointed to the unevenness of the law so that overseas suicides are allowed to be reported—the example pointed to in the Law Commission report is Marilyn Monroe—but New Zealand - based suicides have a prohibition placed on them. The Law Commission also pointed out that the law has not kept pace with social media. This is another classic example of technology running a little bit ahead of the law—something that we are grappling with in a number of different circumstances. So the Law Commission wisely in my view recommended some changes to the Coroners Act which have been included in this Coroners Amendment Bill.I would like to talk a little bit about the free speech elements of this bill because section 4 of the New Zealand Bill of Rights Act protects freedom of speech or freedom of expression and that obviously applies to the news media. But it is trite also to observe that freedom of speech is not an absolute right. I am as I think I said in my maiden speech a strong believer in the importance of freedom of speech. As Justice Anderson as he then was in Hosking v Runting said: “Freedom of expression is the first and last trench in the protection of liberty.” I think that quote for me has always summed up what freedom of speech is all about which is liberty. But it obviously has its limits and this is the issue that we are grappling with today.I went and looked up the legal advice that was provided to the Attorney-General under section 7 of the New Zealand Bill of Rights Act. Members will be aware of course that the Attorney-General is under obligation under section 7 of the New Zealand Bill of Rights Act to report to the House when he finds that a measure is inconsistent with the New Zealand Bill of Rights Act. It was thought for a while that just a prima facie inconsistency in a piece of legislation would require the report to the House by the Attorney-General but I think starting from the outset of the New Zealand Bill of Rights Act successive Attorneys-General have taken the view that it requires a report to the House when in the legal advice—or at least in his or her view—not only is there a prima facie inconsistency with the New Zealand Bill of Rights Act but where it is an unjustifiable inconsistency and that justification process is actually at the heart of the Act. So we have not had a report in this case from the Attorney-General which suggests obviously that in his mind it is a justifiable limit on section 14 of the New Zealand Bill of Rights Act but I went and looked up the actual legal advice. Since 2003 all the legal advice that goes from either the Crown Law Office or the Ministry of Justice to the Attorney-General has been placed online.I have to say just noting it for the House’s record that I was a little bit disappointed in the analysis in the legal opinion provided to the Attorney-General. In my view it was quite a cursory analysis and it did not fully engage in that very important justification process that the Attorney-General is required to undertake. That justification analysis is in some ways actually contained in the actual Law Commission report which in some ways is the genesis of this legislation. So it was slightly disappointing to see a very cursory—I would not go so far as to say glib but somewhat cursory—analysis within the legal advice. The officials simply said that they have found this to be a justified measure and there is not a huge amount of analysis or substantive detailing of why that is.That is a little bit disappointing but if members go to the Law Commission report they will find some substantive analysis as to why the measures the Law Commission is recommending are a justified limit on freedom of speech. There the Law Commission goes through whether or not this is a significant and important objective and whether or not the limit that is placed on the freedom of expression is a rational and proportional limit. Those words are very familiar to me from my law school days doing New Zealand Bill of Rights Act analysis. I think they come from the Moonen test later revised to R v Hansen—things that I thought I would not have to think about again but now I fortuitously find myself in this very privileged position.I think it is obvious that trying to prevent harm from suicide reporting is a significant objective and it is an important objective and the question then is whether or not the limits that are proposed in this legislation which are very narrow limits are rational and proportional. The evidence that the Law Commission points to suggests that that is the case. The Law Commission points to the fact that “The evidence is irrefutable that some forms of reporting are strongly associated with a risk of further suicides.” and it points to the fact that “There is some evidence of a causal link between some forms of reporting and subsequent suicide …”. There is a huge amount of detail in the Law Commission report and in the appendices which I commend to members. In my view the recommendations from the Law Commission that are enacted in this legislation are appropriate and they are wise and the select committee is the appropriate place to consider any further refinements to those proposals if they are required. I commend this bill to the House.LOUISA WALL (Labour—Manurewa):Tēnā koe te Māngai o te Whare. Ngā mihi o te Tau Hou. This is actually the first opportunity I have had in the new year to make a speech in the House and I want to begin with a little bit of indulgence please Mr Assistant Speaker just to acknowledge some of our fallen leaders. I particularly want to acknowledge Api Mahuika a rangatira from Ngati Porou. I want to acknowledge Dr John Angus a former Children’s Commissioner—it was sad to hear of his passing in mid-January—and also Celia Lashlie who passed away this week. I know that all of us in different capacities have had engagements with some of these people and I think that their contribution to New Zealand should be acknowledged.It is my pleasure to take a call on this the first reading of the Coroners Amendment Bill. Unfortunately I am not a member of the Justice and Electoral Committee. I wish I was because I am actually incredibly interested in this piece of legislation and I am interested from the perspective of having worked with the Hon Chester Borrows who I want to acknowledge has led a lot of the development of this piece of legislation. My engagement with Chester was around suicide reporting specifically and whether or not there was an opportunity to increase the mandate of the Chief Coroner not only to look at individual deaths but to actually provide an analysis at the end of every year on suicides.Particularly important for me was the suicides of young people and whether or not there are themes that could be extrapolated such as regional themes themes pertinent to young Māori males Pacific and LGBTIQ. I wanted to know whether there were discernible groups for whom we could actually look at having preventative initiatives led by the Chief Coroner. So as this bill is before us I think that it is timely to also look at extending the mandate of the Chief Coroner to specifically be able to look at such things.The other interesting part of being able to speak on this bill is just reflecting back on when this bill was introduced. It was introduced on 31 July 2014. It was interesting to note that nearly 2 weeks prior to that on 18 July 2014 the acting director of the legal issues centre of the faculty of law at University of Otago Dr Jennifer Moore actually released a very interesting study about coronial cases. She looked at a discrete cohort between July 2007 and June 2012. She looked at 607 cases. Just for those listening we have about 29000 deaths in New Zealand every year and of those 20 percent or 5800 deaths are reported to the coroner. So in that 5-year period she looked at 2 percent of those cases and actually came out with a number of recommendations. Her analysis of our coronial system was that we did have issues about poor information-sharing. But one of the findings that is incredibly relevant was that this area is hugely under-resourced. So if you look at the fact that we spend $17 million in this area and there are approximately 5800 deaths referred to the coroner that averages out to only $2931 per case that we invest in the coronial process. So I think it is worth looking at whether or not the recommendations from this particular report are relevant to this bill given the bill was drafted before this evidence became available.One of the particular recommendations I want to focus on is about the introduction of a mandatory response regime. I want to note that that mandatory response regime would not be unique if New Zealand were to enact such a regime because in England and Wales they have a mandatory response regime. Looking at amended section 7(2)(e) as set out in clause 6 of the bill we are actually going to require the Chief Coroner to expand their function “to set up and maintain a register which must be publicly available of coroners’ recommendations and comments …”. So it seems to me that under this legislation if we are going to require the Chief Coroner to establish a register of recommendations actually we should just go to the next step and therefore establish a mandatory response regime to those recommendations. It seems a simple step from getting the coroner to set up a register to then monitor that register and empower the Chief Coroner to follow through on the recommendations and actually build on the capacity of the Office of the Chief Coroner to actually do what it is empowered to do under the legislation.I just want to focus us back to what the purpose of the Coroners Act is. The purpose is to help prevent further deaths in similar circumstances it is to promote justice but it is also about identifying causes and circumstances of deaths that ensure that we as a society and a country are being responsive to creating the change that is necessary to prevent further deaths and injuries. I think the whole integrity of the Coroners Act and in fact the coroners’ position in our society means we should be ensuring we actually follow through every step of the way to realising the purpose of their establishment. So I found it incredibly interesting that given our Chief Coroner Neil MacLean has just retired after 8 years in the job one of the first things he said upon his retirement was that the recommendations that they make need to be mandatory and that we as a country need to be a lot more responsive to those recommendations. I also found it really interesting that one of the things that he chose to highlight in his departure was around quad bikes. He said that if he could he would recommend that children be not allowed to ride quad bikes because there has been a number of deaths related to children riding quad bikes. I think there was a death earlier this year of a young person under the age of 10 a young girl. I think it is incumbent on people who hold these positions to be able to fully realise I guess the mandate that we give them.So I would hope that in the deliberations of the select committee it looks at the latest evidence available to it and actually make some amendments to this piece of legislation which obviously we on this side of the House support. But I think there is an opportunity for all of us to add a bit more value to the process that we are engaged in and I guess recognise that when the legislation was drafted we did not have all of the information available to us. I think if we look at the processes of the House that is in fact what the select committee process enables us to do. It is about catching up on the most up-to-date information so that we have laws that are actually fit for purpose not for yesterday but for today and into the future. So I look forward to being involved in this bill if I can in any way.This is really unusual but I will say to our whips that if they need cover on the select committee please assign me. I would love to be part of the submissions. I am on the Health Committee and I love being on the Health Committee but actually in respect of pieces of legislation like this I would welcome the opportunity to have input into them. And for me as I said earlier around issues to do with youth suicide I would absolutely welcome the opportunity to feed into the process so that we can produce a piece of legislation that actually is going to prevent preventable deaths and actually benefit our country. Nō reira tēnā koutou katoa.ALFRED NGARO (National):Kia orana tātou katoatoa. E te ora matoa o te atua. Louisa Wall can I just commend you for expressing what I think is something that is universally accepted throughout the House: that the essence of this bill is important and that it is going to the select committee. I am sure that as my colleague Chris Bishop said we would welcome you. I acknowledge your experiences. I know you and we have had some experience of working together in the community. I know that your connections especially to youth have become really important. So I am sure that there will be a number of others but I particularly want to encourage your contribution which I think will be important in ensuring that we have good law. That is what this is about. This is a bill that needs us to make a good law that helps our communities that are in need of this bill.This is the Coroners Amendment Bill. My remarks I will preface firstly by saying that this bill will be important for me being a member of Parliament and in my fourth year. This will be one of those bills that I would regard as being important because some 6 years ago when I was in the community and on a board of trustees of a local high school within the space of a month two young girls took their lives tragically. One of them was even close to my youngest son—she was one of his best friends. The impact that that had not only on the family but on the community was one that I imagine—often the talk is that at that time in a sense of hopelessness and despair the person feels that in order to remove the pain of the burden it may be easier to take their life. Yet out of that there has been a lot of tragedy and pain and I know that many families around our country have experienced that. So it behoves us to do a good job with this bill to ensure that the role of the coroner is important.I want to pick up on the aspect that the role of the coroner becomes important in this situation because it is also about ensuring that the information gets out. We know that on average most reports take around about 400 days and then at the same time too if there is another inquest it then increases to about 700 days on average. But in most cases it does take a long time. And we know that when that process is prolonged it prolongs the grieving of families who are struggling to find answers to the reasons why. And that is one of the tragedies that happens that people are constantly in this mode of inquiry saying: “So why did this happen to us? Why did this person in this situation take their life so tragically?”. And so we know that it is important to reduce that time. To have at least some understanding is an important part of the grieving process and for people being able to work through their trauma into some form of healing and restore family life. And so we believe that that is important.We knew that the bill when it came out in 2006 was important. It changed the coronial system. But at the same time two key stakeholders were not included. We know that pathologists and also funeral directors had an important contribution along with other families. Hence part of the Law Commission’s recommendations is for us to amend this Act. It was only in 2006 that this legislation was enacted and received the Royal assent and yet we know now that it is time to continue to improve this legislation in the roles that it plays. I want to cover just some of the recommendations that we believe are also going to be important in achieving this. I want to cover a couple of things too while we talk about that—some of the other contributions that I think are happening right across Parliament at the moment.Cyber-bullying is another part of the intimidation and bullying that happen. We know that the Harmful Digital Communications Bill which is now being processed is another important bill. Some of the surveying and research have shown that one in 10 New Zealanders experiences cyber-bullying. We have seen the impact of this especially on our young people and again the contribution that that makes. It is important that we take this into consideration. We know that cyber-bullying increases from the ages of 19 to 29; it almost doubles. So that is another form of bullying that is out in our communities. We believe that the Harmful Digital Communications Bill is an important contribution to addressing this issue as well.In regard to the parts of the bill that were covered by Louisa and were mentioned by her around the mandatory responses there has been a lot of talk about this and the importance of this in other jurisdictions—that there is a mandatory requirement for agencies and organisations to be able to respond. I suppose that throughout the submission process we will hear some of those views. What we already know is that there is no one-size-fits-all. We need to be mindful of the fact that where there is a tragedy and a trauma that has happened in a situation it is not as simple as just saying: “Well we need to remedy this by certain changes whether they be physical or operational.” There may be other areas and demands that may be there. So I think that what we will do during the submission process is that we will hear what those issues are at this point in time. But I think it is something that we are taking into consideration—whether we do make a mandatory response. And again we need to be mindful of the range of organisations—whether they be from schools or from other bodies sports clubs and so forth—where some of these tragedies may happen as well.We know that in improving the coronial system though some of the changes are small they do contribute to improving public safety reducing unnecessary deaths and speeding up the coronial system to make these changes easier on the grieving families. So the question I suppose is why we are making changes to the coroners’ recommendation-making powers. Coroners’ recommendations are an important way to learn from a death and hopefully prevent similar deaths in the future and I think that is the important aspect. Many New Zealanders do not realise in a sense the role that the coroner plays and especially in a sense the usefulness of that information to all those services that are out there supporting whether it be NGOs with counsellors and social workers and youth workers whether it be the police who often have to triage a tragic situation when they are met with this tragedy and trauma whether it be the other support services victim support services that are wrap around. There are a number of different services I think and key stakeholders that need to fit into this. So that is the reason that extending those powers becomes important for improving the system as well.The other thing is that while we are doing that we are improving public safety. We know that the coroners’ recommendations are sometimes criticised for not being relevant to the particular deaths that they are investigating or for not taking expert evidence into account. We believe that the proposed changes will focus the recommendations on the facts and circumstances of the death in front of the coroner and will involve individuals and organisations such as Government departments at an earlier stage and will ensure that relevant people contribute to the evidence and help develop robust and workable recommendations.I also like Louisa Wall want to commend the Hon Chester Borrows. I know that some of the work that was done around the Suicide Prevention Action Plan—and I was actively involved in some of that in our communities—was critical and was important. We know that it was all-encompassing—the contribution that was made to preventing suicide deaths in our communities. I think that work will go a long way in focusing our efforts on reducing suicide and putting better support in place as well. As part of the Justice and Electoral Committee I look forward to the submissions and to hearing from the committee. We do encourage as many as possible of those who are involved in our community providing necessary support and services to take the time to submit to the select committee just to ensure that we have covered all the necessary aspects of this bill so that it is a good bill and does empower the coroners in their role and responsibility. But at the same time too at the end of the day this bill is also focused on the families in our communities just to ensure that they have adequate information and that support services are able to operate efficiently effectively and in a timely manner to be able to address these issues. I want to commend this bill to the House. I look forward to the work in the select committee. I commend this bill to the House.Bill read a first time.Bill referred to the Justice and Electoral Committee.