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An accident, an investigation and a case for change

An accident, an investigation and a case for change. A rail safety campaign by the Australian Rail, Tram and Bus Industry Union (RTBU). Roger Jowett IRSC, Denver 2008. Background. Industry context: South Australia (SA) Prior to 1998 ANRC was vertically integrated.

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An accident, an investigation and a case for change

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  1. An accident, an investigation and a case for change A rail safety campaign by the Australian Rail, Tram and Bus Industry Union (RTBU) Roger Jowett IRSC, Denver 2008

  2. Background • Industry context: South Australia (SA) • Prior to 1998 ANRC was vertically integrated. • In 1998 ANRC is privatised and sold in “bundles” • Leigh Creek coal line: electricity industry production,distribution,generation • SA Rail Safety Act 1996 “light hand”

  3. RTBU Rail Safety Campaign • Australia wide review of rail safety in progress • RTBU argues for review of the SA Rail Safety Act following • Deaths, injuries, near misses • Incidents and life expired infrastructure • Rail companies investigate accidents

  4. Australian Rail Network

  5. Leigh Creek Line High rail vehicle accident site September 2004

  6. RTBU Safety Demands • Independent rail investigator-ATSB • Systemic issues • Role and responsibilities of the regulator • National review of operating practices • Train control procedures • Working alone in remote locations

  7. Hirail vehicle-post accident

  8. Accident site

  9. Accident Investigation Findings • Large number of contributory factors • 2 principal concerns • Why did the hirail vehicle derail? • The time taken to find the track inspector

  10. Investigation Report: safety actions to be taken • Safe working forms • The vehicle • Communications-contact lists • Location devices • Radio network control centres • Overdue track occupancies

  11. Code of Practice Developed • Code Management Company (RISSB) develops industry technical standards • Development group • Track managers/maintainers, rail regulators, vehicle manufacturers, rail operators, RTBU reps • First meeting March 2005 • Guideline completed February 2006 • Australian Code of Practice • Guideline for the safe operation of Road-Rail Vehicles

  12. Prosecution of Company • Charged under OHS law • Finding: “culpability of very high order” • Foreseeablity of risk serious injury/death • Several means to reduce or remove risks • Penalty of $US48,000 with 20% reduction for early plea and contrition • Another rail company fined $US24,000 in early 2008 for death of wagon maintainer

  13. Wider issues raised • Union studies of OHS fines found • Fines actually imposed showed little relation to legislative provisions • Value of life studies was variable • Fines and sentencing outcomes were inadequate • Deterrence ineffective • Pervasive undervaluing of workplace deaths

  14. Wider issues raised(cont) • Stronger framework required to improve safety outcomes • Corporate crimes involving money attract significant fines and jail sentences – apply similar principles? • Relate fines to company turnover? • Consider adoption of 2008 UK Corporate Manslaughter Legislation model?

  15. Australian Transport Ministers to examine single national regulator and separate investigator • Options for single investigator • Status quo –enhanced status quo and single National Investigator • 8 Governance principles

  16. Governance Issues • Principles • Independence • Witness protection and confidentiality • Transparency of public reporting • Confidential reporting • Current structures • 8 jurisdictions • 3 have dedicated investigator resources

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