Source: Radio New Zealand
The Child Protection Investigation Unit has run into the same problem that contributed to the murder of five-year-old Malachi Subecz. Supplied
The country’s newest child abuse investigation unit has run into the same problem that contributed to the murder of five-year-old Malachi Subecz – agencies not sharing information with each other.
The Child Protection Investigation Unit was set up to look into serious harm to children who are in state care and identify systemic failures to fix systems and practices at Oranga Tamariki (OT).
It began its first inquiry a year ago and for at least the first three months lacked enough visibility to investigate properly.
“Due to limited visibility into the activities and operations of certain work groups, the unit is unable to investigate all the issues it is expected to address,” said a report newly released to RNZ.
“This lack of oversight compromises our ability to fulfil our strategic objectives.”
The unit reports to the OT chief executive.
It had so far completed three investigations, while two others awaited sign-off and 15 others were on the go as of the end of February.
RNZ obtained the 10-person unit’s monthly status reports through the Official Information Act (OIA). Its individual investigation reports are not made public and even their titles were blanked out of the OIA.
The status reports from July to February this year repeatedly raised an issue of “high severity” with a risk level that remained “high” even after mitigations.
“There are systemic issues that are preventing cases from progressing as expected,” they said again and again.
“These delays have impacts on progressing cases.”
Earlier this year, a coroner said changes made by relevant government agencies since Malachi’s death were “not sufficient to reduce the likelihood of further deaths occurring in similar circumstances”. Supplied
The September report spelled it out. “We are currently experiencing delays progressing some of the cases due to issues with information sharing.
“If the unit fails to deliver timely or meaningful reports their recommendations may not have a positive impact,” it added.
The consequences were “reputational damage to the organisation or team and/or lost opportunities and/or delays” as well as “staff frustration, due to inefficiencies, unclear priorities, or increased workload”.
The October report said, “This continues to be a live issue.”
In February, “This is still being worked through.”
Elsewhere the reports said the delays increased the risk the unit would fail to put out investigation reports on time, or meaningful ones, so “their recommendations may not have a positive impact”. The investigations manager was in charge of quality and timing.
It was one of four matters arising out of its three completed investigations – “issues with information sharing between both government agencies and NGOs cause delays and compromise accuracy in risk assessments”.
The unit began recruiting from late 2024. It was set up to improve safety of children Oranga Tamariki was involved with, and was independent of the Children Ministry’s day-to-day operations.
However, the status reports showed its struggles.
“The unit currently lacks visibility into the activities and operations of certain work groups where we should be exercising oversight of serious cases and concerns,” its status reports said in July, August and September.
The unit’s directer Peter Douglas told RNZ the lack of visibility was fixed in October.
He said an information-sharing protocol had been drafted and was currently being reviewed.
“This protocol will ensure appropriate information sharing with partner agencies.”
The unit’s brief included cutting down on “systemic failures” highlighted by the Royal Commission of Inquiry into Historical Abuse in State Care.
The failure of information-sharing by agencies was one of five critical gaps identified in the 2022 investigation into agencies’ interactions over Malachi Subecz.
“Everyone has a piece of the jigsaw but no one has the full picture,” wrote Dame Karen Poutasi in that inquiry.
Dame Karen Poutasi in 2022. RNZ / Angus Dreaver
She made two recommendations aimed to turn this around.
One of the new investigation unit’s first recommendations picked up on that: “Dame Karen Poutasi’s recommendation relating to information sharing across child protection agencies is progressed,” said the recommendation.
Work was going on into that this year. The other two recommendations were mandatory clinical supervision for all front-line OT staff; and training in “critical analysis”.
The government did not accept all 14 of Poutasi’s recommendations until last October. By then, only a couple had been completed.
A coroner in February this year said, “Changes made by relevant government agencies since Malachi’s death are important, but not sufficient to reduce the likelihood of further deaths occurring in similar circumstances in the future.”
The new investigation unit’s status reports showed in October it was trying to draft an information-sharing agreement. Its investigators, advisors and managers had meetings with social workers, Police, the Ministry of Social Development, youth justice facility managers and non-government organisations.
In January Oranga Tamariki set up a multi-agency hub in January connecting it, Police, Corrections, the Education Ministry and Health NZ. In February the hub began reporting any tamariki whose sole parent was remanded in custody or imprisoned, setting a 48-hour clock ticking for the hub to share all information the various agencies held on the child.
The independent Children’s Monitor Aroturuki Tamariki was pleased to see the hub but added its concern “if the hub is not sufficiently resourced”.
As well as individual investigations, the unit continued to do three wider reviews, one into deaths of children known to the ministry between January 2023 and June 2025; another of youth homicide in the year prior to October 2025 that had completed a “thematic review of the 13 young people’s lives”; and the third into complaints by children in care and protection or youth justice facilities.
The three individual investigations it had finished in its first year found four main issues:
- Frontline social workers needed ongoing professional development and training on topics such as sudden unexpected death in infancy (SUDI) and critical risk analysis;
- They needed regular external clinical supervision to support their welfare;
- Sustained high workloads could undermine effective decision-making and staff wellbeing;
- Info-sharing problems could delay and compromise risk assessments.
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– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand
