
Last month, Leader of the House Sue Ellery said that the backlog of coronial inquest cases in WA was at its lowest in the past three financial years. This was in response to the questions raised in parliament by Greens MLC Alison Xamon who drew attention to the high number of backlog coronial cases in the system.
Coronial backlog cases are unexpected deaths that are reported to the coroner for investigation and have been incomplete for longer than a year. The findings in these cases can include the identity of the deceased, the cause of death, the place of death, and the time of death. As such, Ms Xamon told Parliament that the completion of backlog cases is important to not only the family of the deceased, but the health, justice, and care systems too.
“The coronial court provides much-needed advice to families and loved ones, including—this is probably the bit that is most important to me—providing advice when changes might be introduced, so that we can ensure that similar deaths will not occur in the future,” Ms Xamon said.
“In addition to identifying ways to protect deaths in the future, inquests can be really important ways to identify where our police or our departmental staff may have got it tragically wrong.
“It also has the effect of exonerating them from wrongdoing and answering really important questions that the family and those left behind grieving might have.”
This sentiment has been echoed by the health department and actioned through their From Death We Learn publications which take lessons from coronial findings to start conversations around how to improve health services through such insights.
“It is obviously really concerning when we are waiting an average of two to three years to learn from these deaths,” Ms Xamon said.
Annually, over the past six years, an average of 278 cases have been unable to be completed as the coroners have been waiting on reports from external agencies such as ChemCentre and PathWest; and WA Police. According to Ms Ellery, these reports’ wait times range from an average of 25.6 to 40.9 months.
When asked about the wait times for reports, a ChemCentre spokesperson said: “The expected turnaround time for coronial cases is determined in close communication with the Office of the State Coroner and to meet investigative and court requirements.”
WA Police declined to comment on the wait times and recommended that queries on the subject be directed to Ms Ellery. A spokesperson for PathWest said they were in no position to comment on the matter. Both parties also recommended that queries be directed to the Coroner’s Court.
Apart from external agency wait times, to address the cases being held back by staffing, the Department of Justice temporarily employed additional coroners at the beginning of last year.
Over this decade, the state coroner’s annual reports show that total finalisation numbers have been increasing over time and last year’s number of finalisations was the highest to date. Similarly, the number of deaths reportable to the coroner has also seen its highest number to date in 2020 with both trends seeing a climb in figures annually, making it an uphill battle to clear backlogs.

Despite the record high in finalisations, The DOJ’s annual report shows that as of June 30, 2020, the backlog stands at 497 cases, 39 more than in comparison to the same time last year.

When Ms Xamon asked if the government anticipated an increase in backlog cases next year, Ms Ellery said that the government expects the backlog to decrease as long as the finalisation of cases is greater than the number of case lodgements; a comment which holds true of any year.
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