Highlights from COPMM's latest Annual Report
A list of key Council of Obstetric and Paediatric Mortality and Morbidity (COPMM) recommendations based on the data arising from the review of perinatal, paediatric and maternal death cases reported in 2020 has been highlighted in its latest Annual Report that was tabled in the Tasmanian Parliament in October 2022.
Some of the highlighted issues based on 2020 data include the following:
- Survival for very preterm infants admitted to the RHH NPICU in the epoch 2016-2020 is comparable to that of the Australian and New Zealand Neonatal Network (ANZNN).
- While Tasmania’s child death rate was similar to 2019, the number of children dying in 2020 as a result of injury was significantly higher than reported in the previous year, with the deaths of four teenage cases having been associated with suicidal behaviour in 2020. The deleterious effects of COVID-19 and subsequent isolation cannot be discounted and the work of the Mental Health, Alcohol and Drug Directorate to inform the next Tasmania Suicide Prevention Strategy by including a consultation campaign for younger Tasmanians to gain a better understanding of their needs and experiences and strengthen the final strategy, is welcomed by Council.
- With the four reported child deaths following motor vehicle accidents reported in 2020, the current work of the Road Safety Advisory Council to deliver an Action Plan focussed on Saving Lives to reduce road trauma for children and young people is welcomed by Council.
- The higher caesarean section rates reported in 2020 in Tasmanian private hospitals is a trend consistent with national findings reported in 2020. Through the work of Professor John Newnham (Preterm Birth Prevention initiative) and as identified in the 4th Atlas of Health Care variation, clear evidence suggests that the planned births should be delayed until at least 39 weeks to optimise the best outcomes for baby’s development, unless there is a medical reason for an earlier birth. As such, Tasmania through its Preterm Birth Initiative and Safer Baby Bundle Implementation Programme, are providing effective steps to encourage both parents and specialists to consider birth plans that are best for mother and baby.
Please refer to the Council of Obstetric and Paediatric Mortality and Morbidity (COPMM) page to access a full copy of the annual report.
New child safety regulation in Tasmania
On 22nd November, the Tasmanian Government introduced ground-breaking legislation into the Parliament designed to protect and promote the best interests of children and young people. The Child and Youth Safe Organisations Bill 2022 is a direct, albeit belated, response to the recommendations that came out of the Commonwealth’s Royal Commission into the Institutional Responses to Child Sexual Abuse, which were delivered in December 2017.
The proposed legislation has several critical features:
A. It stipulates that certain organisations, including health service providers, must comply with legislated Child and Youth Safe Standards after 1 January 2024.
B. The Child and Youth Safe Standards are a list of things organisations must do to protect the wellbeing and safety of children they meet. They reflect the National Principles for Child Safe Organisations and are as follows
- Child safety and wellbeing is embedded in organisational leadership, governance and culture.
- Children and young people are informed about their rights, participate in decisions affecting them and are taken seriously.
- Families and communities are informed and involved in promoting child safety and wellbeing.
- Equity is upheld and diverse needs respected in policy and practice.
- People working with children and young people are suitable and supported to reflect child safety and wellbeing values in practice.
- Processes to respond to complaints and concerns are child focused.
- Staff and volunteers are equipped with the knowledge, skills and awareness to keep children and young people safe through ongoing education and training.
- Physical and online environments promote safety and wellbeing while minimising the opportunity for children and young people to be harmed.
- Implementation of the child and youth safe standards is regularly reviewed and improved.
- Policies and procedures document how the entity is safe for children and young people.
C. As well as complying with the ten Standards above, organisations must provide an environment that ensures the right to Cultural Safety for Aboriginal and Torres Strait Islander children and young people. This is known as the ‘universal principle’.
D. The Child and Youth Safe Standards are complemented by the second major part of the legislation, a Reportable Conduct Scheme. The Reportable Conduct Scheme requires leaders and organisations that have a high degree of responsibility for children to report concerns about conduct related to child abuse involving an employee or volunteer of their organisation to an independent body.
E. The legal definition of “reportable conduct” for the purposes of the Reportable Conduct Scheme is set out in clause 7 of the Bill but it is broader than suspected criminal behaviour alone and includes significant emotional or psychological harm, significant neglect, physical violence, a sexual offence or sexual misconduct, and grooming.
F. An independent Regulator, which is yet to be identified, will have oversight of the Reportable Conduct Scheme, and will monitor how organisations handle allegations, conduct, or convictions related to harm to children and young people. The Independent Regulator will be supported by a Deputy Regulator. At least one of these two roles- the Independent Regulator, or the Deputy Regulator- must be known to be an Aboriginal or Torres Strait Islander person.
Organisations that provide health services for children, including those that provide counselling services, will be required to comply with Child Youth Safe Standards and reportable Conduct Scheme by 1 January 2024. This includes clinicians and health care providers working in public hospitals, private hospitals, approved facilities within the meaning of the Mental Health Act 2013, or day-procedure centres. A full list of the organisations required to comply with the Standards, and the Reportable Conduct Scheme, are set out in Schedules 2 and 3 of the Bill respectively.
The Bill also enables the Independent Regulator to delegate one or more of its investigatory powers to an entity regulator, such as the Australian Health Practitioner Regulatory Agency. The Independent Regulator will prescribe who these entity regulators are by name and the extent of their powers to investigate reportable conduct.
At this stage, it is planned that the proposed legislation will be considered and debated in the Autumn 2023 session of Parliament. Once the proposed legislation is made law, a concerted effort will take place to educate, provide advice to, and build the capacity of organisations and professionals to comply with the Standards, the universal principle, and the reportable Conduct Scheme. Failure to comply with the legislation may result in severe penalties. Failure to comply with a notice in relation to the Child and Youth Safe Standards may result in a fine up to 120 penalty units for an individual ($21 720) and up to 360 penalty units for an organisation ($65 160). Failure to comply with a notice in relation to the Reportable Conduct Scheme is the same as above. The monetary penalties in the proposed Bill are the highest in the country, compared with equivalent legislative frameworks in other jurisdictions.
As well as introducing the legislation on the Child and Youth Safe Organisations Framework on 22nd November, the Government also introduced an amendment to the Criminal Code by introducing a new crime into the Code of “failure by a person in authority to protect a child from a sexual offence”. Under the proposed offence provision, a person in authority in a “relevant organisation” is required to protect children from a “substantial risk” of a sexual offence being committed by an adult associated with that organisation if they know of the risk. A person must not fail to take “all reasonable steps in the circumstances to reduce or remove that risk”, which they have the power or responsibility to reduce or remove. A relevant organisation means an organisation that exercised care, supervision, or authority over children, whether as its primary function or otherwise, and includes hospitals.
More information about the framework and the proposed legislation is available on the Child and Youth Safe Organisations Framework page of the Department of Justice website.
Tasmanian Suicide Prevention Strategy 2023-2027
On Friday 9th December 2022, the Premier released the Tasmanian Suicide Prevention Strategy (2023-2027) (TSPS). This strategy has been developed following broad consultation with various community groups, suicide prevention workforce representatives, and people with lived experience. This strategy Compassion and Connection (2023-2027) aims to adopt a whole-of-community and whole-of-government approach to suicide prevention in Tasmania. The Tasmanian Government has been commended for its commitment to elevate suicide prevention to a Premier’s priority, and to create a “compassionate and connected community working together to prevent suicide in Tasmania”. Together these will raise awareness of the importance of suicide prevention in this state.
For COPMM, youth suicide prevention in Tasmania is a key focus. As such, COPMM supports the recent submission by the Tasmanian Commissioner for Children and Young People to the Department of Health to highlight that “youth suicide prevention needs to be reprioritized through the establishment of a dedicated stand-alone 5-year Youth Suicide Prevention Strategy”. Full submission details can be viewed on the Commissioner for Children and Young People Tasmania website.
The Child and Youth Wellbeing Strategy Report 2022
This first Annual Report showcases personal stories and highlights activity and achievements that have occurred over the first 12 months of the Child and Youth Wellbeing Strategy- It Takes a Tasmanian Village. The report also details how we are changing the way that government works, by working more collaboratively and implementing longer term system changes. Children, young people, their families and caregivers, have been at the heart of developing this Strategy and their voices continue to shape it as it comes to life. The government is committed to continuing to listen to and act upon these voices, and to work collaboratively with community partners as the Strategy actions are implemented. The full report can be accessed from the Have Your Say – Wellbeing in Tasmania website.
CCYP Annual Report 2021-2022
The Tasmanian Commissioner for Children and Young People has recently released the CCYP Annual Report 2021-2022 following its tabling in the Tasmanian parliament in November. The report details some important steps taken in the way we value and protect the wellbeing and safety of children and young people in Tasmania with children and young people increasingly taking center stage in government policy and decision making. The Commissioner had previously recommended the development of this strategy in 2020 and strongly encouraged the participation of young Tasmanians in its development. As outlined in a recent media release (22 November 2022), other important developments that the Commissioner highlights in her annual report include:
- The establishment of an Advocate for Young People in Detention role, which significantly bolstered the Commissioner’s capacity to advocate for and behalf of children and young people who have been detained, including those at Ashley Youth Detention Centre.
- Successful advocacy by the Commissioner in the youth justice sphere, including legislation to end the harmful practice of routinely strip-searching children and young people in custodial settings.
- The launch of the picture book, “OK, so a nest is a home”, which gives the views of children and young people with experience of out-of-home care centre stage and shares their insights into the system and how to improve it.
- Following extensive advocacy by the Commissioner and others, the commitment by the Tasmanian Government to develop a comprehensive Child and Youth Safe Organisation Framework.
The Commissioner has vowed to continue to promote the wellbeing, views and best interests of children and young people in Tasmania into the future. The annual report can be accessed from the Commissioner for Children and Young People Tasmania website.
Committees of COPMM
Paediatric mortality and morbidity
This Committee will continue to be chaired by Dr Michelle Williams in the new term to progress the review and classification of reported statewide paediatric death cases. Council representatives on this committee welcome the formal appointment of non-council committee members to the new term including Dr Ingrid Els (Specialist Paediatrician, LGH), Dr Andrew Reid (Director, Statewide Forensic Medical Services), Dr Don Ritchey (Forensic Pathologist) and Dr Chris Williams (Specialist Paediatric Intensivist, RHH).
Perinatal mortality and morbidity
The Committee will continue to be chaired by Professor Dargaville in the new term to review and classify all perinatal deaths reported in this state. Council representatives on this committee welcome the formal appointment of non-council committee members to the new term including Dr Tony DePaoli (Specialist Neonatologist, RHH), Dr Kristine Barnden (Specialist Obstetrician and Gynaecologist, RHH), Dr Frank O’Keeffe (Specialist Obstetrician & Gynaecologist, NW) and Ms Jo Reid (Nursing Director, WACS, NWRH). It is recommended that Tasmania’s private hospitals use PSANZ guidelines to report on perinatal cases to provide COPMM with more comprehensive information on reported stillbirth cases as required. The updated Tasmanian Perinatal Data Collection Form can be accessed on our website. Clinicians are requested to use the Clinical Practice Guideline for Care Around Stillbirth and Neonatal Death Third Edition Version 3.11 for classification of all perinatal deaths.
Maternal mortality and morbidity
This Committee will continue to be chaired by Associate Professor Amanda Dennis in the new term and will finalise its review and classification of maternal death cases reported in Tasmania in 2021-2022 as soon as possible. Council representatives on this committee welcome the formal appointment of non-council committee members to the new term including Dr Kristine Barnden (Specialist Obstetrician and Gynaecologist, RHH) and Dr Frank O’Keeffe (Specialist Obstetrician & Gynaecologist, NW).
Data management
This committee will oversee preparations for COPMM’s next Annual Report based on available audited 2021 data. It is expected that this report will be tabled in Parliament sometime in October 2023. The Committee will continue to monitor national developments in the Congenital Abnormality Registers as well as a national push to improve data timeliness and in-principle support for earlier supply of mortality data to AIHW.
Council news
Council’s Operations Report and latest Annual Report were both tabled in Parliament on 27th October 2022. The first Council meeting in its new term (2022-2025) was held on the 24th of November 2022.
Membership on Council for this new term in accordance with the Terms of Reference includes:
- Associate Professor Amanda Dennis (new COPMM Chair & UTAS rep)
- Dr Michelle Williams (Paediatrics & Child Health Division of RACP rep)
- Professor Peter Dargaville (employed in the delivery of Neonatal Services)
- Dr Anagha Jayakar (UTAS rep)
- Dr Jill Camier (RACGP rep)
- Ms Kate Cuthbertson, Barrister at Law (Council nomination)
- Ms Lynne Staff (ACMTas rep)
- Dr David Gartlan (RANZCOG (Tas Branch) rep)
- Dr Scott McKeown (Department of Health Representative) and
- Ms Leanne McLean (Commissioner for Children and Young People).
Enquiries: To Manager, Dr Jo Jordan; email: [email protected]
Learn more about the Council of Obstetric and Paediatric Mortality and Morbidity (COPMM)