What happens to coroners’ recommendations for improving public health and safety? Organisational responses under a mandatory response regime in
Victoria, Australia is the self explanatory title of a new paper coming mostly from Melbourne University School of Population and Global Health.

More than 150 recipient organisations were asked about coroners’ recommendations. Only one third of the recommendations were implemented by the organisations to which they were directed, though for the balance, some had already taken action.

The authors’ conclusions include:

Rejected recommendations raise questions about the quality of the recommendations, the reasonableness of the organisation’s response, or both. Supplanted recommendations focus attention on the adequacy of consultation between coroners and affected organisations and the length of time it takes for recommendations to be issued.

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