Independent review of Donella and Ruby Knox's treatment set for May

Ruby Knox, left, with her mother Donella, the week before Ruby was killed.
SELINA POWELL/FAIRFAX NZ

Ruby Knox, left, with her mother Donella, the week before Ruby was killed.

A series of events which led to a mother killing her autistic daughter will be reviewed by the Nelson Marlborough District Health Board.

Blenheim woman Donella Knox admitted sedating and smothering her daughter Ruby in May last year, and has been sentenced to four years in prison.

Justice Joe Williams said at her sentencing in December she was isolated, exhausted and felt she had been let down by the medical fraternity.

Donella Knox and Ruby were turned away from the emergency department at Wairau Hospital in Blenheim.
DEREK FLYNN/FAIRFAX NZ

Donella Knox and Ruby were turned away from the emergency department at Wairau Hospital in Blenheim.

District health board chief medical officer Dr Nick Baker said an independent review into Donella and Ruby's treatment would be launched in May.

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"We anticipate that the review will examine our overall provision of health services for people with high and complex needs," Baker said.

Donella Knox is sentenced for murder at the High Court in Blenheim.
DEREK FLYNN/FAIRFAX NZ

Donella Knox is sentenced for murder at the High Court in Blenheim.

"We also anticipate that the review will validate the tireless efforts and expertise of multidisciplinary teams who cared for Ruby over the years."

Autism was one of the most challenging conditions to provide care and support for, Baker said.

"Nelson Marlborough Health, and New Zealand as a whole, has invested in services to support people with autism over the last 10 years. 

"These include the development of guidelines and care pathways, enhanced support services and the employment of an autism service co-ordinator."

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The health board's service provider Support Works was responsible for assessing people who needed respite care and how much they received.

After an assessment, the Ministry of Health contracted respite carers to provide that care.

The people receiving the care could choose which carer they preferred, which could be a professional respite carer or a family member.

Support Works service manager Simone Newsham said respite care had undergone significant changes since the Individualised Funding model was implemented by the ministry two years ago.

"This allows for much more flexible arrangements where respite funding can be used how the person or their legal guardian wishes," Newsham said.

Other respite options included residential homes set up to care for people with complex needs, and a combination of residential and in-home care called 'flexi-respite'.

The health board did not keep a record of how many people were receiving respite care in Marlborough, a spokeswoman said.

She would not comment on whether more respite carers were needed in Marlborough.

Baker offered his sympathies to the people who knew Knox and Ruby.

"These people include the large number of health and support staff across the many services and departments here, and in the community, who supported and cared for Ruby since early childhood."

People should be aware that the court processes, media coverage and other information provided by the public was only a small proportion of the issues involved with Ruby's case, Baker said.

"There are many unique factors about this tragic event that cannot be publicly disclosed under privacy law. We cannot overstate the challenges faced by those offering care and support for people with complex needs. Every case is different with unique sets of issues. 

"Ruby's disabilities did not lessen the highest value the law places on human life."

 - The Marlborough Express

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