Creamy top post! 
Although the 2010 version of the MOU was covered on here way back when..
..it is worth a brief revisit. Coroner Barnes kicked it off in the ‘Inquest into the Aircraft Crash at Lockhart River’ report
:
Steps were then taken in early 2000 to address those concerns by requiring Transair to appoint a maintenance controller, safety manager and re-organise the structure of Transair’s organisation. I have highlighted earlier the considerable delay that occurred before these organisational deficiencies were addressed and the suboptimal manner in which some key positions were filled. CASA sought to “keep the pressure on” so to speak, by refusing to at first accept the nominee for deputy chief pilot. It was not so assiduous with the equally important role of safety manager.
Thereafter, CASA conducted various scheduled audits and ramp checks in accordance with its Surveillance Procedures Manual. None of the audits identified any problems associated with the duration or quality of endorsement training, frequency of proficiency checks or whether appropriately authorised pilots were conducting such checks.
It may be suggested that having regard to the concerns that CASA raised with Transair in 2000 concerning the work load of the Chief Pilot as the head of the check and training organisation of Transair, inadequacy of Transair’s “systems of corporate management control and communications” and the need for “a comprehensive safety system within the organisation”, CASA should have been minded to ensure that Transair was strictly complying with its own operations manual and had an effective program of recurrent training in place.
The extent of CASA’s assessment of Transair is well documented and highlights a number of inconsistencies between CASA’s oversight of Transair and its regulatory policies and surveillance guidelines. It seems CASA’s surveillance did not detect that some of the line and base checks had been undertaken by pilots not approved to do this, and that training stipulated in Transair’s operations manual had not been delivered. It is also apparent that audits of other operations run by Transair, notably the Big Sky Express, did not detect breaches of various aspects of the AOC. Nor did there seem to be much continuity of effort from one audit to the next, and some audits were done with very few resources (often only one inspector) and very little time spent.
CASA’s task was made more difficult by its inability to develop an adequate risk assessment tool for targeting its audit and surveillance activities. When the agency switched to systems auditing in about 2000 an advance that apparently marks it as a leader in aviation safety and warranting commendation it attempted to apply a safety trend indicator system that failed and was abandoned . Because systems auditing was so new, the guidance the agency could give to its inspectors was minimal.
Further, I accept the ATSB’s conclusion that even if CASA had fully met its own requirements, there is insufficient evidence to conclude that it would have detected and corrected the fundamental problems with Transair’s operations.
Another area of concern relates to CASA’s processes for assessing risks associated with applications by air operators to vary their AOC to add new routes. Such applications required CASA field officers to apply the guidelines and provisions of a particular manual of air operator’s certification. In the case of Transair this involved considering the operator’s request, in 2001, to add Bamaga as its first mainland Australia regular public transport route (from Cairns), and subsequently in 2004 to seek the addition of Lockhart River.
In neither case did CASA require the operator to conduct a comprehensive or structured risk assessment of the proposed change. In particular, no such assessment was required in relation to Transair’s operating procedures, pilot experience or level of training, the rostering practices of Transair in relation to pilots who would be flying the routes involved and the pilot resources available to Transair. In short, it was not part of CASA’s processes to require Transair to undertake a formal risk assessment or make out a safety case for the inclusion of Lockhart River as a new port although it did require Transair to revise performance charts.
I find that senior CASA management failed to provide sufficient guidance to its staff to enable them to fully and effectively evaluate risk management issues associated with Transair’s application to add Lockhart River to its air operator’s certificate as an interim port on the Cairns – Bamaga route. That guidance may have been as straight forward as requiring Transair to engage an independent specialist to conduct an assessment of, and provide a report on, all safety issues that were pertinent to the operation proposed. http://www.courts.qld.gov.au/__data/assets/pdf_file/0003/86682/cif-lockhart-river-aircrash-20070817.pdf
Then Coroner Barnes put his concerns to a recommendation…
Recommendation 4 – Ministerial assessment of interagency relations
Accordingly I recommend that the Federal Minister for Transport, consider engaging an external consultant to assess whether high level intervention is warranted.
….what followed was the Miller review and the rest (as we now know) is history. Reading the above makes you think that there must have been a lot of Chinese whispers for the 2010 version of the MOU to end up the way it did and for Dr Aleck to interpret it the way he did i.e. for the benefit of Fort Fumble.
Noticed that PAIN has made a comment on one of Phelan’s articles which is worth a read, see
‘here’. Wonder how many recipients to that letter??
Doin a Kelpie…