Malachi Subecz: The lingering questions answered by the coronial inquest

• The inquest into Malachi Subecz’s death highlighted systemic failures in child protection and persistent institutional gaps.
• Jasmine Cotter explained her decision to leave Malachi with Michaela Barriball, who later murdered him.
• Oranga Tamariki apologised for its failures, acknowledging the need for significant changes in the child protection system.

Sitting in the witness box in a court in Auckland, the mother of murdered 5-year-old Malachi Subecz looked like a child.

Jasmine Cotter was tiny, with short, blonde hair. She wore a blazer, jeans and sneakers. She apologised repeatedly during her two-hour-long hearing.

“I am the type of person that avoids conflicts – a pushover,” she told the Coroners Court, explaining why she handed over her child to a woman who went on to kill him. “Unfortunately, in this case … that is exactly what I was.”

Malachi’s death in 2021 was a national scandal and has become one of the most pored-over child abuse cases in New Zealand.

There has been a high-profile murder trial, seven reviews by Government agencies and ongoing reviews that have highlighted persistent institutional gaps.

But questions still linger about the human side of the case. Some of these centre on Malachi’s mother. How did a teenage parent get caught up in a drug-importing ring? And why did she hand over her only child to a friend with no parenting experience instead of Malachi’s loving family?

Cotter’s public comments were, until now, limited to a statement issued from prison in 2022. She was known one-dimensionally as Malachi’s jailed mother.

Over two weeks of hearings, a more detailed picture of Cotter emerged: as a naive solo parent with a difficult upbringing who was eager to please those around her. Those traits helped explain some of the events that led to the loss of her son in November 2021.

Coroner Janet Anderson has been leading the inquest into Malachi's death. Photo / Jason Dorday

Cotter appeared on the first day of the coroner’s inquest, held in a large courtroom in Newmarket, just off Khyber Pass.

At age 4, she told the court, she witnessed her mother die while having a seizure. Her father was much older than her mother. He was depressed and on a pension. “We kids were neglected,” she said. She went into foster care at age 12 and later lived with relatives in Wellington.

Malachi Rein Subecz was born in September 2016 in Tokoroa, when Cotter was 19. She was determined to give him “the upbringing I never had”. She broke up with the father and, with a new partner, the family moved between Auckland, Wellington and Tauranga.

Working as a kiwifruit picker in Tauranga, Cotter met a woman named Michaela Barriball and they became friends. Cotter later moved in with Barriball’s aunt, and Malachi and Barriball grew close.

It was at this time that Cotter got caught up in a drug syndicate. Among the members of the group was a member of Barriball’s family.

Cotter told the court: “[My] co-offender had asked me to receive packages, and I also accompanied her on a trip to Christchurch. I was not told and did not know what was in these packages. I was not paid, nor did I receive anything in return for receiving them. These are not excuses - I fully acknowledge the offending.”

Criminal charges in 2022 came “out of the blue”, she said. Even though her role in the methamphetamine-importing syndicate was peripheral, a jail sentence was likely, and she began planning for someone to take over Malachi’s care.

Malachi’s biological family in the Wellington region knew him well, had similar-aged children and were keen to take him in.

Cotter was sentenced in the Tauranga District Court in June 2021 to three years’ jail. Malachi watched Cotter be taken away to the cells and left the courtroom with his new caregiver: Barriball. Malachi’s family – who found out about her guilty plea and care arrangements the same day – were blindsided.

A family photo of Malachi Subecz before his death in Tauranga in November 2021. His caregiver, Michaela Barriball, later pleaded guilty to murdering the 5-year-old.

Cotter’s decision to appoint Barriball as Malachi’s guardian is at the heart of the inquest into his death. She explained it in detail for the first time during the hearing last month.

She told the court she held no concerns about Barriball, who had known Malachi since he was a 1-year-old and was like his godmother. Barriball had no children of her own but spoke to Malachi with a high, sing-song voice like any parent did.

His daycare also told the inquest that Barriball appeared to be a caring guardian who engaged with Malachi and brought him full lunches and spare clothes.

Cotter wanted Malachi cared for, but kept close. She feared that if she gave him up to his family or his stepfather, she might never get him back when released from prison.

“I assumed that I would have a battle on my hands, more so than what I would with the caregiver,” she said.

Malachi’s father had never been involved in his life, but the boy had a deep relationship with his stepfather and called him “Dadda”. He and Cotter had split up, but he still lived in Tauranga and was regularly speaking to Cotter through social media.

Cotter admitted that she was so ashamed at her criminal charges she did not tell Malachi’s stepfather she was going to prison: “He thought I gapped it.”

Her partner only caught up on the situation in November, when Malachi had been hospitalised and Cotter was at his bedside in Starship children’s hospital with handcuffs on.

Cotter also knew that if Malachi was with his family in Wellington it would be harder for him to visit her at Auckland Region Women’s Correctional Facility. Barriball, who was in Tauranga, was much closer.

During the inquest, Detective Inspector Craig Rawlinson said Barriball had a number of motivations for having guardianship of Malachi, including welfare payments and state-supplied accommodation.

Detective Inspector Craig Rawlinson speaking at the coronial inquest in Auckland. Photo / Jason Dorday

She was in a relationship with an overstayer from India and believed that having a dependent child would help with his residency application.

Crucially, having custody of Malachi also gave her leverage over Cotter, who was a witness in the ongoing criminal prosecution involving a family member.

Cotter conceded to the court that she was a “people-pleaser” and was easily swayed. And Barriball, she found, could be highly persuasive, especially when “making a show” of being a capable parent.

“She could win an Oscar,” she said.

Barriball took Malachi to live at a house on a Te Puna farm owned by her father, Chris, where other similar-aged children lived. She and Malachi lived in a cabin at the back of the house, which had power but no running water.

Malachi’s family in the Wellington region immediately attempted to raise the alarm with Oranga Tamariki.

The children’s welfare agency’s response has already been heavily scrutinised in multiple reports. But the coroner’s inquest underlined the lengths Malachi’s cousin, Megan Cotter, went to in trying to get the state to intervene. In all, she made 10 reports of concern in the three days after discovering who had taken over Malachi’s custody. Other family members also contacted Oranga Tamariki.

Jasmine Cotter confirmed to Oranga Tamariki that she was happy for Barriball to be caring for Malachi. She made this decision with the mistaken belief that Oranga Tamariki had visited Barriball and Malachi at the Te Puna property where they were living. She had requested this, but it never happened.

“I thought that no news was good news, but now I know they didn’t do their job properly,” she said.

She also never knew about a photograph of Malachi at this time. Megan Cotter had acquired the photo from Barriball and believed that it showed bruising around his eye.

Social workers at Oranga Tamariki’s Te Āhuru Mōwai site in Tauranga assessed the photo but closed the report of concern without any further action. Knowing about this photo would have made “a massive difference” to her feelings about Barriball, Jasmine Cotter told the court.

In late September 2021, Malachi turned up at his preschool, Abbey’s Daycare Centre in Tauranga, with injuries on his face, including a black eye. Barriball told staff he had fallen off his bike, but when staff asked if this had happened, he said “no”. As staff inspected him, he added that Barriball would be angry with him. Staff took photographs of the injuries, but despite having a child protection policy, they did not alert the Ministry of Education, NZ Police or Oranga Tamariki.

Those decisions haunted the centre’s manager, and she cried throughout her appearance before the coroner. A complaint to the Teaching Council, which was not upheld, directly blamed her for Malachi’s death. The daycare was closed by the Ministry of Education after failing to meet the conditions of its licence.

The daycare’s failure to alert Oranga Tamariki “broke my soul”, Jasmine Cotter told the court.

What was occurring in Malachi’s home at this point has been detailed in countless media reports, a court case and government agency reviews.

Barriball beat Malachi at their home and threw him against walls. She severely burned him in a 73C shower and held his head underwater in the bath. She locked him outside when he soiled his underwear. She did not feed him for long periods.

Text messages read to the inquest showed that near the end of Malachi’s life, Barriball knew she was out of her depth as a parent and was worried she would seriously harm or kill him.

“What should I do to keep myself calm?” she pleaded to her partner. “Give me solutions.”

Asked in court why Barriball never gave Malachi to Megan Cotter once she became overwhelmed, Jasmine Cotter was scathing.

“Moolah,” she said. “Money.”

The stresses for Barriball kept adding up. She lost her welfare payments after the Ministry of Social Development discovered she was in a de facto relationship.

She was due to attend a Family Court hearing at which Malachi’s custody would be decided – his family had applied to take over his care. It was delayed because Barriball said she was sick and did not have internet access – later found to be lies.

On the day she fatally attacked Malachi, she had been rejected by several landlords in her attempts to find new accommodation.

Jasmine Cotter said she realised in hindsight that Malachi had been trying to alert her to his abuse. She became especially concerned in her last phone call with him sometime in October 2021.

“In the [final] part of the phone call, Malachi sounded very, very, very sad,” she said, crying in the witness box.

“He said, ‘Mum, I’m a strong boy, aren’t I?’ And I told him I’d see him when I get out.

“I had a feeling that something was wrong because he would only say those types of things when he was sad.”

On November 1, 2021, Barriball carried Malachi into the main house in Te Puna. He was unconscious and having seizures. An ambulance was called, and she told healthcare workers he had fallen over while getting ready for school. He was taken to Tauranga Hospital, then airlifted to Starship children’s hospital in Auckland. His eyes were dilated, indicating a traumatic brain injury.

“To be frank, he showed evidence of a sustained period of cruelty … and arguably torture, up to his death,” said Dr Patrick Kelly, the on-call paediatrician and a national expert in child protection.

Ten days later, Malachi’s life support was switched off. Barriball was convicted of murder in June 2022 and is serving a life sentence.

Michaela Barriball's minimum sentence of 17 years in jail was one of the longest sentences ever given for a woman in New Zealand. Photo / Andrew Warner

In many ways, Malachi’s case was exceptional. He was caught up in a complicated custodial tussle that was complicated by a criminal drug case.

But a theme that developed during the hearings was that the circumstances leading to his death were routine.

“It is of fundamental importance that the coroner appreciates that this behaviour by Oranga Tamariki was not an anomaly,” Kelly said.

“I would go so far as to say it was business as usual. There is a similar, embedded, business-as-usual culture in police. If those practices continue, other cases like Malachi will continue.”

Paediatrician Dr Patrick Kelly appeared at the coronial inquest.

Kelly saw an almost identical case two months after Malachi’s. Over a nine-month period, 16 children were admitted to Starship with child-abuse injuries. Six of them died.

Kelly, a paediatrician for 30 years, has given evidence in high-profile trials including the 2007 murder of Nia Glassie. Over two hours, he told the coroner he had seen it all before, and little had changed.

“Did you get all that down?” one of the lawyers said to the press bench when Kelly completed his evidence.

His observations about gaps in the child protection system were backed by an independent monitoring report published last year. That report found that while Oranga Tamariki had made all the changes recommended by an internal review, those changes had yet to make a significant difference on the frontline.

The lack of progress was blamed on many things, but the main criticism was that the changes were simply not prioritised.

Oranga Tamariki’s chief social worker, Nicolette Dickson, acknowledged that there was much more work to do. The child protection system was complicated, and changes needed to be carefully thought out if they were to have a lasting impact, she said at the inquest.

“I have accepted that more change must happen … and that not all changes have been made. It will take a long time to make it enduring.”

She also cautioned against further upheaval of the child protection system at a time when it was still trying to bed in the latest round of reforms. The organisation had finite resources, she said. Reports of concern rose 35% in the year to March, to 95,000.

Resourcing was a key theme at the Oranga Tamariki site that handled the complaints in Malachi’s case. Staff spoke of “unbearable” workloads and “praying” that the phone would not ring on after-hours shifts. Reports of concern were meant to be assessed by experienced social workers, but the first report received for Malachi was assessed by a social worker who had just started in the role – because of a backlog of cases.

Among the recommendations in a review by Dame Karen Poutasi in 2022 were mandatory reporting of child abuse and vetting the carers of children whose parents have been jailed.

Successive Governments have resisted mandatory reporting out of concern that it could lead to over-surveillance, deter people from making reports of concern, and increase the risk of racial prejudice. Officials have noted what has happened in Australian states, which reported initial promise in mandatory reporting but now said they were “drowning” in reports.

Automatic vetting of caregivers by Oranga Tamariki also carries a list of potential risks, including state over-reach and discrimination.

The Government has received advice on further changes and is expected to make announcements this year.

Oranga Tamariki has apologised to Jasmine Cotter and her extended family, though some of the family said it did not feel sincere. The organisation also contributed to a dinosaur-themed playground in Porirua, in honour of Malachi, who loved dinosaurs.

“I know it’s out there that he was the boy who loved dinosaurs,” Jasmine Cotter told the inquest. “But to me, he was much more than that.

“He was the type of person who could pick up when something was wrong, and he was that comforting person when you were feeling down.

“There was just a lot more to him than his death … He loved building Legos, … giving me the right parts and correcting me if I got those parts wrong. He was just a very, very, very special kid to me and to all those who knew and loved him.”

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