Warning: Aboriginal and Torres Strait Islander people are advised that this statement contains references to an Aboriginal person who has passed away.

The passing of Veronica Nelson was a tragedy, and our thoughts continue to be with her family and friends through this difficult time.

I know that these findings will bring to the fore the ongoing pain for those who loved her.

All passings in custody have impacts on family members, friends, other prisoners and staff.

We take the care and wellbeing of all those in custody extremely seriously. However it is clear that we must do better.

I acknowledge the findings and recommendations, and thank the Coroner – and all those who have contributed to the inquest – for their commitment to reform. I, alongside Corrections Victoria and the Department, strongly share this commitment.

We will carefully consider all recommendations directed at the Department of Justice and Community Safety and Corrections Victoria.

We know that providing prisoners with the healthcare and the support they need to successfully transition back into the community is essential to help break the cycle of offending.

The Department of Justice and Community Safety is working closely with health service providers to ensure we’re providing a system that is responsive to the needs of Aboriginal people in prison and offenders to better support them and provide culturally appropriate care.

We have started to deliver on these reforms, including a new primary healthcare model, with better support for Aboriginal people in prison, as well as providing cultural safety training for our health service provider staff.

From 1 July 2023, public health providers Dhelkaya (Castlemaine) and Western Health will take over primary healthcare services for the women’s prison system, offering greater support and health services from a network of community and specialist providers.

But there is much more work to be done.

While nothing can bring Veronica back, we will continue to work with the Victorian Government, and all our partners, to reflect on these findings and to make our system safer, particularly for Aboriginal people in custody.