Critical gap 2

The process for assessing the risk of harm to a child is too narrow and one-dimensional

The Poutasi report found that, at various points, the views of other agencies as well as those of Malachi’s whānau
Whānau refers to people who are biologically linked or share whakapapa. For the Monitor’s monitoring purposes, whānau includes parents, whānau members living with tamariki at the point they have come into care View the full glossary
and community should have been sought or shared by agencies so they could be considered in assessing and responding to Malachi’s needs. This might have resulted in a decision by Oranga Tamariki to go and see Malachi.

The Poutasi report made three recommendations to try and close this critical gap. Those recommendations were focused on enabling decision making at a community level to address harm and the risk of harm before it escalates to needing a statutory response, on giving health practitioners a wider view of interactions a child has had with the health system and on using health practitioners to help assess harm and support training under the Child Protection Protocol (CPP).28

In its report following the death of Malachi, the Ministry of Health made a similar recommendation to the Poutasi report about joining up medical records. In addition, the report by the Chief Social Worker following Malachi’s death noted a need to involve community agencies in decisionmaking processes.

There is still no consistent, structured process for considering perspectives from other agencies or community organisations when assessing the risk of harm to a child.

While there are models of multi-agency teams in place, these primarily focus either on responding to an incident of family violence where police have attended or where Oranga Tamariki has assessed a report of concern as not requiring its involvement. The issue of inconsistent risk assessment for family violence and sexual violence victim-survivors, including tamariki
Children (plural) aged 0-13 yearsView the full glossary
and rangatahi
Young person aged 14 – 21 years of ageView the full glossary
, is a recognised gap within family violence and sexual violence responses.

Reports of concern tables triaging notifications that Oranga Tamariki has assessed as requiring no further action are promising, but they are not in every community and there is no consistent approach to how they operate. We could not identify any multi-agency models where professionals discuss concerns or worries about tamariki and rangatahi before the point of making a report of concern. If they did, and had resources to act, it would be a useful preventive measure – to provide help before harm occurs or escalates.

The Centre for Family Violence and Sexual Violence Prevention told us that, while this is mostly accurate, practice and capacity vary widely across Aotearoa
New ZealandView the full glossary
and some multi-agency responses consider risks to tamariki prior to a formal report of concern being made. It told us that some multi-agency responses will bring whānau
Whānau refers to people who are biologically linked or share whakapapa. For the Monitor’s monitoring purposes, whānau includes parents, whānau members living with tamariki at the point they have come into care View the full glossary
to the table even if a family harm incident or report of concern has not occurred. This is because community providers sitting around the table often have knowledge of whānau within the community who are experiencing harm but are not known to Police or other statutory agencies.

The Centre for Family Violence and Sexual Violence Prevention also told us it has identified the need to strengthen the visibility of tamariki within multi-agency responses and ensure a more consistent approach and will be progressing this as part of work to respond to the recommendations of the Poutasi report. It told us that the Executive Board for the Elimination of Family Violence and Sexual Violence approved a target operating model in August 2025.

Models that have greater visibility of tamariki and can discuss concerns prior to lodging a report of concern could help to determine what whānau may need and how they can be supported by iwi
TribeView the full glossary
/Māori or community agencies before harm occurs.

Work in Health NZ to give health practitioners a wider view of a child’s interactions with the health system has not advanced since our 2024 review. Implementation of the Shared Digital Health Record is at such an early stage, it is not possible to measure its impact. Approval of a business case is still needed to progress work to deliver on the full intent of this work.

A decision has been reached for Health NZ to join the CPP, but this is yet to be implemented. Until we can see how this is working in practice, we cannot measure whether and how this will contribute to closing this critical gap. Child death reviews suggest that, even when tamariki are known to Oranga Tamariki and Police, they can still fall through gaps in the safety net. Since Malachi’s death, at least five further tamariki who were known to Oranga Tamariki and/or Police have also been killed by someone who was meant to be caring for them.

Widening the agencies that are involved in assessing risk to tamariki and rangatahi with a view to supporting earlier interventions to prevent harm may help to close this critical gap. More needs to be done to achieve this. Later in this review, we look at the ability of the child protection system to respond to reports of concern and why they are not necessarily acted upon.

As well as setting up multi-agency teams in communities, the Poutasi report recommended that medical records held in different parts of the health sector should be linked to enable health professionals to view a complete picture of a child’s medical history. This would further widen the view of the risk of harm to tamariki
Children (plural) aged 0-13 yearsView the full glossary
and rangatahi
Young person aged 14 – 21 years of ageView the full glossary
and could support medical practitioners to make reports of concern at an earlier stage and with more information to support an assessment of the risk of harm.

Our 2024 review noted the linking of medical records was expected in 2026. We reported that Health NZ advised the Hira programme will give approved whānau
Whānau refers to people who are biologically linked or share whakapapa. For the Monitor’s monitoring purposes, whānau includes parents, whānau members living with tamariki at the point they have come into care View the full glossary
and health providers a comprehensive view of a child’s medical history and health system interactions. We were told the new system will help health providers monitor wellbeing indicators over time regardless of where healthcare is accessed and will give them secure, easy access to a child’s real-time information when needed but that this was still some years away from being realised.

We further noted that development of the business case for Hira began in early 2021. At the time of our last review, funding had only been confirmed for tranche one of the business case, which would make patient summaries available to individuals and their healthcare providers via My Health Record by mid-2024. Tranches two and three of the business case would enable consistent nationwide access to a child’s primary care medical records, but funding still needed to be confirmed for those tranches.

Limited progress has been made towards linking medical records since our last review

The Ministry of Health and Health NZ have been working to link medical records across the health sector since early 2021. This was also recommended in the Poutasi report and in the Ministry of Health’s own report following Malachi’s death. The intent of this work is to enable health professionals to view a complete picture of a child’s medical history, which in turn will allow for a greater assessment of risk.

We asked Health NZ about progress on this work. In response, it told us that this initiative is part of a multi-year programme to link medical records across relevant healthcare settings. Some regions already have record sharing between general practitioner and hospital providers, and functionality. Over the next year, Health NZ will progressively deliver integrated access to hospital and primary care records through existing systems, connected nationally.

The Poutasi report recommended that the health sector should be added as a partner to the CPP between Police and Oranga Tamariki to enable access to health professionals experienced in the identification of child abuse and to facilitate regular joint training.

Our 2024 review noted that the CPP was under review and that a decision had not been reached on health sector involvement in it. Options included full operational membership of the CPP, partial membership in areas such as governance, participation in review and training, and not joining but adopting other measures to enable access to health expertise and services in the context of the CPP.

We were told that a phased approach will be taken to Health NZ joining the CPP. Health NZ told us that its Board agreed in mid-October 2025 to it joining the CPP in a leadership and governance capacity as an initial step.

Health NZ also advised that an updated draft CPP that includes Health NZ is being developed by Oranga Tamariki, Police and Health NZ. However, it cannot confirm when or if full partnership will happen until it fully understands the likely resourcing implications for its frontline staff as part of the next phase.

It noted that, in some regions, additional clinical staff are likely to be required. In this next phase, Health NZ would also consult with clinicians about which tamariki
Children (plural) aged 0-13 yearsView the full glossary
and rangatahi
Young person aged 14 – 21 years of ageView the full glossary
require health involvement and how to implement this practically. Subject to the outcomes of the scoping for this next phase and approval to proceed to full partnership, Health NZ anticipates fully joining the CPP from 1 July 2026.

In his evidence to the Coroner’s inquest into the death of Malachi Subecz, Dr Patrick Kelly, consultant paediatrician at Te Puaruruhau,32 said he supported Health NZ joining the CPP, stating that “in my view, it is the only way we have to work to eliminate the variability in practice shown by both the police and Oranga Tamariki, when it comes to deciding which children should be referred for a health assessment”. However, he raised concerns about the current ability of Health NZ to respond to the need for child abuse assessments.

Dr Kelly noted that there are no dedicated resources for these assessments, despite requests for regional centres with child protection expertise. Starship is the only hospital to have a dedicated, multi-disciplinary child protection team in the country. In areas outside Auckland, when acute assessments of injuries are sought by Oranga Tamariki or Police, they must be “somehow squeezed into the busy inpatient and outpatient clinical workload of general paediatricians or join the queue in equally busy emergency departments”.

Dr Kelly raised concerns about the limited training many frontline health professionals receive in interpreting childhood injuries. He noted that the only national standardised training is provided through the Violence Intervention Programme. However, he also noted that, while this training is mandatory for all Health NZ kaimahi, almost no doctors attend. Similar training for GPs was almost entirely voluntary.

Within his evidence, Dr Kelly raised concerns about Oranga Tamariki practice in relation to the identification of physical injury. Dr Kelly described Oranga Tamariki social workers receiving photographs and making decisions about the safety of tamariki, without any input from experienced health professionals. He also noted that this practice is embedded within the culture of Police.

The Poutasi report noted that a cousin of Malachi emailed Oranga Tamariki and included a photograph of what was thought to be bruising around Malachi’s eye. This photograph was only reviewed by Oranga Tamariki social workers, and the report of concern was closed.

“Oranga Tamariki and the police routinely make their own decisions about the significance of injuries observed in children. Decisions about which children are referred for a medical opinion are arbitrary and widely variable and largely made by statutory officers with little or no training in injury interpretation … One simple and achievable change to information sharing that might make a difference right now, is this. That every time Oranga Tamariki or the police receive a notification which involves an allegation that a child has visible physical injuries, that information (including any photographs of the injuries or possible injuries that the police or Oranga Tamariki receive) must be shared with a health professional with expertise in the assessment of injuries in children”. DR PATRICK KELLY

To achieve this, Health NZ would need to put considerably more resource into training of health professionals and providing adequate child protection expertise in all parts of Aotearoa
New ZealandView the full glossary
. It was for this reason that Dr Kelly asked the Coroner to broaden the terms of reference for their inquest into Malachi’s death to ask “whether actions taken by the health system … are sufficient to reduce the likelihood of further deaths occurring in similar circumstances in the future”.

Until Health NZ provides child protection expertise in all parts of Aotearoa, the risks associated with Oranga Tamariki and the Police making health decisions in isolation remains.

The importance of working closely with health professionals was commented on in an Oranga Tamariki child death review.

“While Health is not currently a partner in the CPP, inviting Health to CPP consultations with Police about [the child] could have provided an opportunity to develop a more holistic understanding of the safety risks and wellbeing needs of [the child] at each point in the site’s work with [the child], his family … and to make more informed decisions about [the child’s] future safety.” ORANGA TAMARIKI CHILD DEATH REVIEW

Understanding of current CPP requirements is mixed, with inconsistent responses from Oranga Tamariki kaimahi and stretched Police

We heard concerns from some Oranga Tamariki and Police kaimahi about how the current CPP requirements are functioning on the ground.

Police kaimahi were concerned that some Oranga Tamariki social workers lack understanding of the CPP process and their role and there is inconsistency in responses from the sites. For example, we heard initial joint investigation plans are not always recorded in CYRAS or actioned by Oranga Tamariki kaimahi while the police are conducting their investigations under the protocol. Police kaimahi said that this can result in delays and unaddressed risk to tamariki and rangatahi, particularly when Oranga Tamariki closes cases during delays.

Police kaimahi in one region we visited also noted their own delays, telling us that they too are “swamped” by many CPP investigations.

“The timeliness and the delay in investigation causes kids stress. Kids have disclosed, and six months later, we are still having conversations.” POLICE KAIMAHI

We were told by a few Police kaimahi that individual Oranga Tamariki sites appear to have shifting priorities, with different demands, funding and resourcing that affect how they prioritise serious allegations that require a joint CPP response. We heard that some sites have more understanding of what the Police Child Protection Team does, and some Oranga Tamariki site leaders are more willing to attend meetings and work together than others.

“Some site managers have no idea what CPT is – and they’re ultimately in charge. We have quarterly meetings where we want the site managers and district managers [to attend]. We’ll be there but getting [Oranga Tamariki site managers] there is a struggle.” POLICE KAIMAHI

There is a similar picture in some child death reviews that shows interaction between Police and Oranga Tamariki regarding the CPP.

Five of the 24 tamariki
Children (plural) aged 0-13 yearsView the full glossary
who have died since Malachi because of confirmed or suspected abuse by a person who was supposed to be caring for them had reports of concern made prior to the incident that led to their death and resulted in a referral to the Police under the CPP. One of these cases did not meet the threshold for an investigation under the CPP.

For another child aged under 2 who was killed only a few months after Malachi, the CPP was not followed by Police. The PFVDR found that “a report of concern should have been submitted by the Detective or [Child Protection Team and] this would likely have triggered a follow-up response from Oranga Tamariki”. Nonetheless, this death review had no specific recommendations for Police.

“While there is clear evidence of working under the CPP, there were opportunities to work more closely with the Police and Health at key decision points. There was a lack of clarity about Oranga Tamariki’s [sic] role within the CPP which may have influenced our decision about ongoing involvement with [the child] based on the initial Police decision to close their investigation.” ORANGA TAMARIKI CHILD DEATH REVIEW

28 The CPP is the agreement between Police and Oranga Tamariki to work together where abuse or neglect is expected
29 Ngāti Toa, Wesley Community Centre, Taeaomanino Trust, Porirua Whānau
Whānau refers to people who are biologically linked or share whakapapa. For the Monitor’s monitoring purposes, whānau includes parents, whānau members living with tamariki at the point they have come into care View the full glossary
Centre and ASK – A Safe Kapiti.
30 Centre for Family Violence and Sexual Violence Prevention. (2024). Te Aorerekura | Action Plan 2025–2030:
Breaking the cycle of violence. preventfvsv.govt.nz/assets/Uploads/Second-Te-Aorerekura-Action-Plan.pdf
31 Te Puna Aonui Business Unit. (2024). Understanding the current state of family violence: Multi-agency responses.
Centre for Family Violence and Sexual Violence Prevention. preventfvsv.govt.nz/assets/Resources/Data-and-Insights/Te-Puna-Aonui-Understanding-the-current-state-of-family-violence-multi-agency-responses-2024.pdf