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Malahide Viaduct Report Published
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so name the person responsible for not keeping up the knowledge and training?
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The RAIU as policy does not name staff involved. That is consistent with transport accident investigation worldwide.
Book stops with the chief civil engineer. The chief civil engineer in charge in 2009 has left the company for reasons unrelated to Malahide. The chief inspector of the Rail Safety Commission retired, unexpectedly this March. |
ok, grumble, so who was the responsible manager/person who didn't act on this report in 1997, if that person doens't want to take responsibility, then surely the company can have some legal action taken on it for neglect, could there not be some penalty on the IR, so international theres mark on them about this.
you didn't get to respond about the bridge checks tranparency, i presume they just put out a press release about checking the all the bridges but not details? |
I don't have the name of the chief civil engineer in 1997. Legally the RSC can take Irish Rail to court and the fines are significant.
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The engineer sent out wasn't familiar with the viaduct, and assumed it was on piled foundations. Only 2 out of 104 bridges over water with piers in the water are not carried on foundations. Two are carried on gravity piers on weirs |
Scapegoating Eileen Wilcock (announced as CCE designate in Dec 2007) lets way too many people off the hook. Unfortunately, short of a public inquiry overriding her legal settlement, we'll probably never know what she did or didn't do, and if she tried to do stuff how much support she received.
If this was a LUAS collapse John Lynch would have been calling for heads by now. Most importantly - there is little significant difference between this bridge and a road viaduct given that everything from the concrete beams up behaved as designed - how many NRA/county council bridges over tidal bodies are built on such foundations? What is their inspection regime? Who's keeping track to make sure it's happening and recorded properly? |
A couple of highlights that struck me as somewhat interesting regarding lack of action taken on an inspection in 1997.
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Then on page 82, you don't know whether to laugh or cry
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Prosecuting IE and fining them heavily will just leave them even more strapped for cash and may lead to closures and service reductions. Prosecuting and disciplining individuals (or even firing them) would be more appropriate.
But this is the Irish public sector, where the only thing you can be fired for is what in academic life is called "gross moral turpitude", so dream on! |
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The RSC can take a prosecution against a named individual or a corporate entity. They should but a bit like the calls to sack half the senior staff it won't achieve anything and would make matters worse.
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Yes, I'm being slightly tongue in cheek but the acceptable outcome isn't the publication of the RIAU/RSC reports and then... nothing. These people take on a very important job and they failed to do it. |
Today FM Last Word Matt Cooper 17:15 16/8/2010
http://www.railusers.ie/podcasts/aud...d_Malahide.mp3 |
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If you went and sacked the entire senior layer of engineers, the RSC would withdraw Irish Rail's safety case and the entire network would be closed down until new staff were found, trained (pretty hard if you sacked the only people who knew the 'system') and the safety case submitted. Not to mention the high court battle as the staff took unfair dismissal proceedings (and would win). There is a serious question of engineering competence and professionalism. Regardless of the 'system' in place a good engineer will ask questions and continue to ask until answers are found. We saw what happened to the last chief civil engineer when she stood her ground. The critical report was 1997 presumably before the Knockcroghery accident of November 8th that year. Was it deliberately buried? Surely there were at least 2 copies. Its clear sometime around 1996-1998 something serious went wrong inside Irish Rail. Back then a lot was wrong and the safety assessments suggested multiple passenger fatalities annually. The Malahide report might be shocking, the safety reports back then made for terrifying reading. Is the network safer now than at any time in the past - yes, that is the most important concern. Now clearly the bulk of this improvement has been through new track, new trains and signaling there is much to be done in the procedures and supporting systems. If you look back at every major past accident, they either couldn't happen today or if they did chances are everyone would walk away with at most cuts and bruises. |
I had a quick skim back thorugh the Cahir Viaduct Collapse Report - yes I know it is a very different structure, but it is interesting to compare the recommendations in this against the Malahide report.
There are some recommendation that appear to have been completely implemented (for example one regarding communciation with the signalman), some which only apply to the type of viaduct and wagons at Cahir, but there are a couple relating to asset management that appear to have been implemented but not done properly. See Recommendation 8 Quote:
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So it would seem to me that several recommendations of an accident report that doesn't go back to the dawn of time haven't actually been implemented. This raises the point that if you are going to have expensive investigations and reports and then ignore the results, why bother having them in the first place. I don't think particularly that heads need to roll particularly given the fact that loss of corporate memory was pointed out as a contributory factor in the Malahide collapse, but there needs to be some visible evidence of some action being taken. |
There is a new document management system in place.
There are 6000 odd structures in the Dublin division alone, oldest 1833, newest 2010. There is a clear failure to address concerns from pervious accidents. The review of the investments made and the somewhat random management and expenditure is interesting http://www.transport.ie/upload/general/11293-1.pdf |
The RSC report has some interesting add-ons to the RAIU report - search for "coastal defence". Those who commute from Greystones and points south should think about the implications of that part of the report.
One weird thing, the RAIU refers to IE's IAMS but says it's not being used whereas the RSC reckons IE should buy a Document Management System :confused: |
if the previous chief civil engineers did try to do something about this bridge should we not try to find that out, and if they were prevented then the corporate person who prevented them should be named or fired if still at IR, and if they didn't do something about should that not be noted.
the problem in Ireland is the lack accountabilty, vague talk of systematic failures, "its all in the past", or sentiment shouldn't get in the way of accoutablilty, look at the way fas, you can't trust people who previosuly mismanaged even if there are new syste, in place, sack em and pay them to consult if you have to don't let them continue to mismanage the entire system. I see you say elsewhere its hard to find who runs IR, could you find the rest of the names the report spends most of the time talking about the a derelict barge, not about the chain of responsibilty for inspections and repair from 1997 till 2010, what does the RSC report really tell us? love barry kenny yesterday saying of the 1997 inspection report "we know it was deinfilty lost" |
I agree with Mark that clearing out the senior engineers would achieve little and would just end up further undermining the safety regime.
However, there is no reason whatsoever why the board couldn't be cleared out as a means of achieving some level of responsibility. If this had happened in France - I single them out as they seem to be particularly keen on corporate responsibility, the board would be in court on charges. I am not suggesting that anybody did anything illegal in this case but the fact remains that it is difficult to describe an event that occured and was predicted by reports that were ignored as anything other than negligence. I'll leave the question open as to what you would describe a predicatable event which you failed to stop where people were killed? It was only pure and simple luck that people weren't killed here and the same goes for the Cahir collapse. Yes, the driver was well trained and responded appropriately to the collapse but he was very lucky. If an Enterprise with 400 passengers had gone barrelling over it at 70mph, what would the likely outcome be? It seems to me that at this stage Irish Rail have used up all of their luck. |
I firmly believe that the entire of CIE holding company should be shutdown. Irish Rail already have a board so its a another level of bureaucracy.
There is a question of engineering competence and that may be a matter for Engineers Ireland as regardless of the systems failures inside Irish Rail questions must be asked of the engineers involved. Engineers should regardless of circumstance ensure safety is the first concern |
I used to work for a small firm of Quantity Surveyors. When my boss's father (who was also a QS) died, we did a certain amount of clearing out of the office. While a QS will always keep a bill of quantities, there is little obligation to keep drawings and certainly not beyond the statute of limitations (6-12 years depending on the circumstances). There were drawings there from 50 years before, when the father would have been starting out on his own. The drawings were passed to the RIAI Archive (which is admittedly under resourced, but at least it’s there).
Indeed, my boss rescued a few drawings of buildings from an institutional client who had disposed of the buildings and was going to throw out the drawings. He framed them and hung them on the office wall. While relatively simple drawings, they were thorough, done at a time when such drawing was a real craft. While every last detail (paint colour, type of door panels, sanitary ware) may not have been present, one A2 sheet was enough to build the building and anyone familiar with construction would have been able to rebuild it in a relatively authentic style. Those drawings were 120 years old (and possibly worth a pretty penny). Any discussion I've ever had with an (structural / civil / building services) engineer has always pointed to them having the drawings from the previous construction / alteration of the building. I see no reason why it should be any way else with civil engineers. While the drawing and reality may vary somewhat (builders are notorious for not keeping their excavations and therefore foundations rectangular :)), the vast bulk of the relevant information should be there. Now, I can understand if someone was introduced to a system whereby documents weren't kept or weren't kept systematically, that they may not be diligent in the future about keeping such things. However, that’s a valid excuse for someone who's 18 and doesn't know any better, not a qualified or senior engineer. I bet Barry Kenny (not particularly wishing to pick on him, others are responsible here) has a record of every press / media mention of Irish Rail since he started his job - and before that. |
https://www.irishrail.ie/news_centre/news.asp?action=view&news_id=871
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How I wish the guy who wrote that had gone nuts and written it in plain English.
"Due to having a falling out with our CCE, she's going to be the scapegoat which means our appointment of a new one looks like we're doing something" "The IE Dictionary is being reviewed with the definition of Standards being changed from "conditions that are nice to have if we can be bothered" to "conditions that we will do our best to make it look like we're following, subject to inadequate funding and diversion of resources to new lines from nowhereville to ballygobogland". "We have fancy new safety, training and assessment schemes in place but the most important one is that people have been told that if you hand in inspection forms with only 2 or 3 boxes filled out, and them not even adequately specified, your ass will be fired ^H^H^H^H^H severely told off but since we don't want a strike that will be the end of it." |
Shockingly similar in many respects
http://www.raib.gov.uk/cms_resources...10_Feltham.pdf It even references the Malahide Viaduct collapse as a similar event |
That's England so obviously it's privatisation's fault.
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Nope, Continuity Irish Rail.
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