Autopsy challenge for regional areas

THE availability of pathologists to perform autopsies in regional areas is an ongoing challenge for Queensland's coronial system.

State Coroner Michael Barnes, in his latest annual report for the 2010-11 year, detailed how the Chief Forensic Pathologist was actively involved in triaging cases with coroners in regional and remote areas to ensure internal autopsies were not performed unnecessarily.

He said government medical officers, who were more likely to be available locally, could perform external autopsies and therefore transportation costs might not be as high.

But Mr Barnes said the need for internal autopsies presented problems in many regional areas.

"A coroner's work is essentially interdisciplinary; he or she is dependant upon investigators, pathologists, counsellors and medical and other specialists to provide the information needed to make the findings and preventative recommendations," he wrote.

Forensic pathologists are located only at Brisbane, the Gold Coast, Toowoomba, Nambour, Rockhampton, Townsville and Cairns. There are specialist pathologists who can perform other less complex internal autopsies at Bundaberg and Maryborough.

Queensland Health Forensic and Scientific Services senior director Greg Shaw said they had already employed pathologists in regional areas which had improved reporting times.

He said the service performed about 1400 coronial autopsies each year and averaged less than five months to complete autopsy reports for coroners which was consistent with the national average.

Mr Barnes said the caseload of Queensland coroners had grown to 4416 deaths - the highest number to date ever - in 2010-11 which was a 45% increase over the number of deaths reported in 2004-05

He said despite coroners finalising more cases than in previous years, the number of pending cases had also grown with at least 300 families forced to wait more than two years for answers about their loved ones' deaths.
Attorney-General and Justice Minister Jarrod Bleijie said a new full-time "central coroner" at Mackay would help address the pressures facing Queensland's coronial system.

"The appointment is expected to be made next month and will improve the quality and timeliness of coronial investigations in this region and help to clear the backlog of cases," he said.

An expression of interest issued to the Law Society and Bar Association in Queensland is believed to have resulted in dozens of applications already.

Mr Barnes said significant growth for demand in coronial services could be attributed to an increase in reported hospital deaths in the wake of rogue Bundaberg surgeon Jayant Patel convicted of manslaughter for three patients he was treating.

He said the increase also coincided with the period following the Queensland Public Hospitals Commission of Inquiry and the introduction of the Health Quality and Complaints Commission Review of Hospital-related Death Standard in 2007.

"Clinicians are now more aware of the obligation to report certain deaths to the coroner," he said.

"There are also heightened public expectations of health care and a greater willingness to scrutinise treatment provided.

"The flow-on effect has been that treating clinicians are more likely to report deaths following health care to the coroner and doctors generally may be less willing to issue death certificates for their patients without coronial authorisation."

Mr Shaw said Queensland Health understood the importance of closure for families who had lost loved ones and tried to process cases as quick as possible.

But he said autopsy reports could be complex with the time taken dependent on the investigative testing and the type of death.

"Some tests can be undertaken relatively quickly whilst others may take considerable time," he said.

"The most complex cases can take up to a year, simply due to the nature of the tests concerned.

"Some testing is so rare it can only be performed by a handful of people in the nation. Other testing may involve interstate and international cooperation."

REPORTED DEATHS

  • Brisbane 1826
  • Southport 647
  • Cairns 583
  • Warwick 205
  • Maroochydore 177
  • Rockhampton 169
  • Bundaberg 151
  • Ipswich 136
  • Mackay 104


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