PPRuNe Forums - View Single Post - Senate Inquiry, Hearing Program 4th Nov 2011
Old 28th Feb 2013, 18:15
  #1247 (permalink)  
Up-into-the-air
 
Join Date: May 2010
Location: More than 300km from SY, Australia
Posts: 817
Likes: 0
Received 0 Likes on 0 Posts
atsb and answers to the Senators

Well Mr. Dolan, your answers leave much to be desired.

From your own paperwork:

ATSB Function:

The ATSB’s function is to improve safety and public confidence in the aviation, marine and rail modes of transport through excellence in:

 Independent investigation of transport accidents and other safety occurrences;
 Safety data recording, analysis and research;
 Fostering safety awareness, knowledge and action.

The ATSB is responsible for investigating accidents and other transport safety matters involving civil aviation, marine and rail operations in Australia that fall within Commonwealth jurisdiction, as well as participating in overseas investigations involving Australian registered aircraft and ships.

A primary concern is the safety of commercial transport, with particular regard to fare-paying passenger operations.
By any measure, you have not achieved these primary functions.

A search of the atsb site reminds us that the Norfolk ditching was reported on 30th August 2012, and needed to meet the ICAO principles at the time.

The "Chamber's report" by casa, which casa "conveniently" forgot under the MOU between casa and the atsb, to pass on to the atsb, identifies a number of areas, including, but not confined to:

CASA identified in an audit the following breaches:

CAR 5.04
CAR 50
CAR 78 and CAO 82.1
CAR215(2)
CAR 215(8)
CAR 215(9)
CAR220(1)
CAR 233(3)
CAR 233(1)
CAR 235(1) and (2)
CAR 253(4)
CASR 92.095
CAO 20.7.1B parts 4, 7 & 12
CAO 20.11 parts 11 & 12
CAO 40.0 para 5.1, resulting in noncompliance with CAR 215(2)
CAO 48 para 4
CAO 82.1 para 3.3
Act Section 28BE paragraph (1), (2), (3a), and (3b).
Yet on the 28th February 2013, atsb head Mr. Dolan says ".......it would not change what we said...."

When asked on 15th February 2013:

Senator FAWCETT: We are really running short of time. Can I just go to a different point. You have talked about the expertise and the robustness of your investigators.

Did the investigator in this case support the narrowing of the scope and the downgrading of that critical safety factor?

Mr Dolan: No, he remained of the view that it ought to be given more weight than it ended up being given in the report.

Senator FAWCETT: Was he required, at any stage, to change the evidence tables in the report to match the final recommendations that came out?

Mr Dolan: I suspect—and perhaps Mr Sangston can help me—that there was some reworking of the evidence tables to reflect the consideration that had been given. I am not sure how that was brought about. Is there anything you want to add, Mr Sangston?

Mr Sangston: That does occur and has occurred. In fact, there is a QA, a quality assurance, process in our processes to ensure that our findings are reflected in our investigation management system. The words that are in our final report agree with things in our investigation management system, because those things go up on the web and so on. So there is a process for quality assurance, yes.

Senator FAWCETT: I am making the assumption here that that would be about checking that, as you said at the start, Mr Dolan, any reports you put out are backed up by facts. Does it also cover the case where facts are left out because they do not fit with the recommendations that the organisation wants to make?

Mr Dolan: I am not aware of anything in this case where we suppressed or left out facts that did not support analysis. What we had was some vigorous disagreement within the organisation, including with one officer in particular, about the analysis and what the analysis arrived at.
Surely that tells us there has been a simple pressurisation placed on an investigator???

Maybe someone can tell us whether that is an offence under the TSI Act
Up-into-the-air is offline