Inquest into the death of Ursula Barwick, Gary Jones; Lionel Daveson, and Christof Meier

Case Number: 2016/190872; 2018/197922; 2018/382225; 2002/12305 and 2006/364681   

Date of Findings: 02 November 2021

Magistrate: Deputy State Coroner, Magistrate Derek Lee

Catchwords: Homicide/ Missing persons - Road safety and railway - Mental Health misadventure and suicide

Responses

Recommendations

To NSW Commissioner of Police and Chief Executive, NSW Health Pathology :

1. That a Memorandum of Understanding be prepared and executed that defines the roles and responsibilities of each member of the Missing Persons, Unidentified, Destitute Review Committee. 

To NSW Commissioner of Police:

1. That reviews of the Missing Persons Standard Operating Procedures (SOP) are to be conducted on a 12-monthly basis, with reference to any recommendation made following a coronial inquest in connection to missing persons over the previous 12 months. During the revision process, a draft of the proposed changes to the SOP is to be given to members of the Missing Persons, Unidentified, Destitute Review Committee so that their input can be provided and considered by the Commissioner of Police.
2. That:
   a) Key Performance Indicators for:
           i. the Missing Persons Registry; and
           ii. Police Area Commands in relation to missing persons investigations be reviewed within 12 months to evaluate whether any improvements or additions to the Key Performance Indicators are necessary or desirable; and
   b) The Missing Persons Registry Key Performance Indicators be integrated into the Compass/Vortex system as soon as practically possible.
3. That ongoing training be provided to Missing Person Coordinators which includes specific information in relation to the operation of DNA databases (including the NSW DNA database and the National Criminal Investigation DNA Database-Integrated Forensic Analysis) relevant to missing persons investigations. In particular, Missing Persons Coordinators should have training in:
   a) ensuring that the purpose of obtaining DNA reference samples from relatives of missing persons is clearly identified so as to allow for appropriate comparison searching to be performed by Forensic and Analytical Service (FASS), and against relevant state and national missing person indices;
   b) how to identify which family members are the most appropriate for the purpose of giving a DNA sample in the circumstances of a specific case; and
   c) how requests for comparison DNA searches addressed to FASS should be made and how the most appropriate indices for search purposes should be selected.
4. That consideration be given to engaging with the National DNA Program for Unidentified and Missing Persons in circumstances where the New South Wales Police Force consider that additional resources would assist in:
   a) progressing outstanding Unidentified Bodies and Human Remains and Long Term Missing Persons cases; and uploading substantive data to the National Missing Persons and Victim System in a timely manner.