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Media Briefing: Autopsy Services Cease From Tauranga Hospital Facility

Fuseworks Media
Fuseworks Media

The Ministry of Justice (MoJ) has been responsible for coronial post mortems since 1858 and this includes responsibility to ensure that post mortems are conducted in a specialised environment to reduce the increased health risks pathologists and mortuary attendants are exposed to from this aspect of their occupation. These risks and mitigating strategies have been identified by the New Zealand Committee of the Royal Australasian College of Pathologists, with assistance from the Department of Labour DoL and published as guidelines for Managing Health and Safety Risks in NZ Mortuaries.

In response to a request from the MoJ to meet level-2 standards the DHB sought an external review of its mortuary facilities in January 2009 against the IANZ standard NZS/ISO 15189:2003. The review found that the mortuary does not meet the minimum standards required to be accredited as a level-2 post mortem facility.

A preliminary design report carried out by Matrixx Consultants in March 2009 indicated that the cost of getting the mortuary and the autopsy room up to the minimum level-2 standard required would be $2.5 million.

The facility is owned by the DHB and the MoJ has a contract with the DHB to use the building for the provision of autopsy services.

Pathologists are separately contracted by the MoJ to perform the post mortems.

In June 2009 the DHB formally notified the MoJ of their intention to exit the contract meeting their contractual requirement for six months notice. The MoJ requested an extension of the planned closure of the autopsy room for coronial post mortems while it identified an alternative option. The DHB was concerned about the level of risk posed to staff in what had been identified as an inadequate and noncompliant facility and took all necessary measures to minimise this risk while the MoJ completed its review of options with the expectation that an alternative option would be identified.

In June 2009 the DHB therefore advised the MoJ that it intended to exit the contract and gave the required six months notice of exit.

The MoJ did not acknowledge the exit notice for some months, and when they did, they requested the DHB to grant them an extension from the exit notices to a final closure date of December 2009.

The DHB agreed to this short extension to allow the MoJ to develop a process to identify alternate providers and for an orderly transition to occur.

A meeting was then held on 13 January 2010 between representatives of the MoJ, Coroners, Police Inspectors, Pathologists and the DHB to discuss options for the ongoing provision of a facility in Tauranga in which Coroner directed post mortems could be undertaken.

The January meeting also agreed a number of actions: oThe DHB and MoJ (lead agency) would develop a management of change plan which would include: A plan for an alternative service. A transition plan for service delivery. A plan for consultation with Iwi, key stakeholders and affected communities. A communications plan. oThe current mortuary would remain open and functioning until such a plan has been agreed, and a new or upgraded facility is operational; and it was hoped to achieved this within three months. oAnd the DHB would gift all current mortuary equipment/plant to the new facility.

The DHB has remained committed to maintaining access to the autopsy room until such a new facility had become operational.

Since making this agreement the MoJ has consistently failed to either engage with the DHB or progress the agreed project.

As the building owner the DHB is responsible for the health and safety risks to people working in the facility, and having carried this risk for 21 months since being advised by the MoJ of their accreditation compliance requirement, and nine months since the agreement for the management of change was agreed. The DHB is no longer able to accept this risk.

Evaluation of the health and safety risk

In August 2010 the DHB concerned at the lack of progress made by the MoJ in identifying an alternative option and the ongoing risk posed to staff, commissioned a health and safety review of the effectiveness of the measures in place pending a decision by the MoJ as to future options.

This review has indicated that according to the guidelines Managing Health and Safety Risks in New Zealand Mortuaries, the staff working in the autopsy room are exposed to significant health and safety risks due to the substandard facilities. The DHB Health and Safety Manager has developed a health and safety risk assessment which shows that staff are at significant risk and recommended the immediate closure of the autopsy room. Therefore the DHB has no choice than to close the autopsy room with immediate effect. (5pm Friday 8 October 2010)

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