Aboriginal and Torres Strait Islander readers please note that this article mentions deceased persons.
Police officers responding to domestic violence call-outs in the remote central Australian town of Tennant Creek worked off an incomplete flowchart to make bail decisions, a coronial inquest into the deaths of four Aboriginal women killed by their intimate partners has heard.
Three Tennant Creek police officers involved in the case management of one of the deceased women, 34-year-old Kumanjayi Haywood, appeared in Alice Springs Local Court on Friday. They told the coroner their caseload was heavy, training was scarce, and decisions made in relation to domestic violence incidents relied on forms and bail flowcharts that were routinely misunderstood and incorrectly filled out.
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“There are likely many, many, many incorrect bail decisions over the last years in relation to breaches of domestic violence orders,” Northern Territory coroner Elisabeth Armitage told the inquest, adding that mistakes are likely not isolated to Tennant Creek given the number of constables that have moved on to other stations and “taken those learnings with them”.
“It’s likely that similar errors are being made across the Northern Territory.”
Both Constable Matthew Murphy and Constable Madaleine Garnsey, as well as Senior Constable (then acting sergeant) Gary Higgie told the inquest that despite experience filling out bail forms, they did not know there were two drop-down boxes relating to breach of domestic violence orders (DVOs) and past criminal history.
“This flowchart is printed off and posted on the wall in Tennant Creek and it was common practice to use this every time we were completing a bail form,” Garnsey told the inquest.
It was understood by officers that the second box titled “Serious Harm: Breach DVO” could only be triggered if someone was charged with both serious harm and had breached DVO. As a result, the decade-long history of serious violence between Kumanjayi Haywood and her partner Kumanjayi Dixon was overlooked.
This included a number of occasions when Dixon was jailed for lengthy periods because of violent assaults (notably an incident in 2017 when Haywood was stabbed 15 times in her leg), a breached DVO in Queensland, repeated breaches of non-contact orders in the six months leading up to Haywood’s death, a serious assault in September 2021 that hospitalised Haywood, and repeated threats to kill her.
There were also a number of other incidents against Haywood that were known to police but not reported, or alternatively reported but not formalised — a statement made one day but not signed the next — and therefore not captured in convicted offences. Many of these were logged on the police real-time online management information system (PROMIS). Over 21 years, police recorded 47 incidents between Haywood and Dixon, with 35 confirmed domestic and family violence (DFV) incidents.
Haywood died in November 2021 as a result of injuries sustained in a house fire lit by Dixon, three days after he was granted bail for breaching a domestic violence order.
The bail flowchart forms were first filled out by constables Murphy and Garnsey before being passed on to Higgie to make a final decision. All three landed on a “presumption for” (meaning bail is granted) by drawing on information from the courts (to ensure there were no other live convictions) and what they deemed “relevant criminal history”.
Higgie said that because the November 2021 breach of DVO was “no violence” and there was no evidence of a breached order in the past two years, bail was granted. Had PROMIS history and interstate offences been considered, Higgie acknowledged his decision would have been “against” — meaning bail denied.
Murphy told the inquest that these forms were often done in collaboration with other officers — constables like himself and superiors like Higgie — and no one ever picked up on the errors.
Higgie took responsibility for the oversight, telling the inquest that the constables’ error was his own: “I had a similar train of thought because I essentially gave that guidance to them. And that’s what I was taught from my senior partners.”
“Their oversight was my oversight,” he said.
In a statutory declaration provided to the inquest, he explained that in his capacity as acting sergeant at the time, he relied on the bail flowchart as a “quick guide into whether bail is for or against”.
“The bail flowchart is one of the only tools available to me at the time of making the decision to grant Mr Dixon bail. I had no formal development training with regards to providing higher duties including custody sergeant roles,” Higgie wrote, adding that in his seven-year career leading up to November 2021, he assumed the role of shift supervisor (which in Tennant Creek also performs the duties of custody sergeant) and officer in command a number of times, despite the absence of any training.
Both Murphy and Garnsey also told the inquest about a dearth of domestic violence and cultural awareness training despite domestic violence call-outs accounting for 80-90% of police workload in Tennant Creek. The training they did receive was online and largely related to understanding the domestic violence act. Garnsey said she recalled being shown a “graph” and a “circle” diagram relating to domestic violence.
Murphy, Garnsey and Higgie have all since left the Tennant Creek Station — Murphy to Katherine, and both Garnsey and Higgie to Darwin — and none were given further training or updated advice on how to correctly fill in bail flowchart forms upon arrival.
Murphy told the inquest that he observed no change in bail practice when he moved to Katherine — both stations were operating the same way.
It was not until last month, two and a half years after Ms Haywood’s death, that the officers were notified by Northern Territory police of the administrative error. Murphy told the inquest that he was given no reason from NT police for the delay and confirmed that no changes were made or announced until recently.
The police flowcharts at the centre of all decisions to grant bail have since been reformatted with two separate drop-down arrows, one for “Serious Harm” and another for “Breach DVO”. The new design is to help police ascertain whether an individual has prior guilt for a breached DVO (including in another jurisdiction) or prior guilt for a range of other offences.
The coroner drew attention to the visual resemblance of the old and new flowcharts, particularly in relation to colour choice. She suggested a “whole new set of colours” to ensure officers don’t accidentally pick up the wrong one.
“Someone at every single station is going to have to check that the new flowchart is put up on the wall and the old ones taken down and there aren’t old ones lying around in the bottom of drawers that people are going to pick out,” Northern Territory coroner Elisabeth Armitage said.
The coroner reiterated to all officers that the breakdown in communication and failure to draw on relevant information were indicative of a “general practice” and “widespread approach” in the Northern Territory police, rather than a reflection on the officers and their colleagues. She acknowledged that all of them were young and reliant on their superiors to learn and identify errors in their practice.
All officers expressed deep regret over their errors and extended condolences to the family of Ms Haywood.
If you or someone you know is affected by sexual assault or violence, call 1800RESPECT on 1800 737 732 or visit 1800RESPECT.org.au. In an emergency, call 000.