Criminal action raised as possibility against ATSB chief investigator in Pel-Air inquiry as experts shred credibility of air safety authority

A former deputy CEO of CASA, Mick Quinn, raised the possibility of criminal prosecutions against the chief investigator responsible for its the ATSB’s final report into the Pel-Air ditching off Norfolk Island in 2009 during today’s Senate inquiry into Air Accident Investigations.

In answer to questions from Senator Nick Xenophon, Quinn said a comparison of draft final reports into the accident that were circulated much earlier in the year, with omissions and factual errors made in the actual final report into the crash released at the end on 30 August suggested to him that offences had been committed under the Transport Safety Information Act.

“My view is that this report doesn’t reflect the facts, some aspects (for which) there can be no other reason why the chief investigator has released this report other than matters that are an offence under the act,” he said.

Quinn did not elaborate further in the public hearing, and it is not known what else may have been said during a subsequent closed hearing, in what is the third time the committee went into camera during today’s proceedings.

He followed independent aviation safety analyst, Bryan Aherne, in giving testimony to the committee, which first heard from the pilot of the ditched Westwind corporate jet, Dominic James, as reported here.

Aherne and Quinn made detailed criticisms of the fairness and accuracy of the report issued by the ATSB, which the committee is due to hear from later today.

Quinn told the committee he was assisting James in technical aspects of the inquiry into the crash.

In answer to similar lines of questioning from Senators Heffernan, Fawcett and Sterle, Quinn said he couldn’t remember a single instance where an air operator or airline which had a serious crash in which a jet aircraft was destroyed had “gotten off so lightly” as Pel-Air.

“They got off completely” Quinn said.

When questioned about the fact that the Chief Pilot of Pel-Air, who had been responsible for some of the serious irregularities or safety failings of the operator found in a CASA audit after the crash had subsequently been recruited to an air safety enforcement role by the air safety regulator, Quinn avoided being drawn into any detailed commentary as to the propriety of that happening, or whether it had any effect on the ATSB report.

Quinn said “That Pel-Air was let off on this is completely astonishing”

He added “Not on my watch.”

Quinn said that there was an emergency audit meeting between CASA and Pel-Air on 7 December 2009 called by the operator after it grounded its remaining fleet of Westwind jets, which were mainly used in military and air ambulance charters.  The accident happened on 18 November 2009.

He said that if Pel-Air hadn’t grounded its fleet CASA would have, adding when further questioned by Senator Xenophon that Pel-Air’s continued operations of the type at that stage would have constituted an imminent threat to public safety. [The same grounds that led to CASA grounding Tiger Airways last July].

The 7 December 2009 meeting was referred to in the earlier draft of the final ATSB report yet expunged from the final report. Quinn said he believed as detailed explanation as to how and why this had happened was essential to air safety in Australia. He joined Aherne (and James) in calling for the ATSB final report to be withdrawn.

He said that for the air safety investigator to take 1015 days to produced a factually flawed report that made Australia the laughing stock of international air safety authorities was totally unacceptable.

The report failed to meet any of the ICAO (International Civil Aviation Organisation) annex 13 guidelines on safety reports, and emphasised that it was the only ATSB report to be comprehensively lacking in these respects.

“It says nothing about human factors analysis ….  even though the ATSB is a world leader in human factors in air safety,” Quinn said.

It makes no safety recommendations. Quinn was at a loss to nominate any other ATSB report that made no mention of human or organisational factors contributing to the accident.  It contained no references to the organisational failures that had been identified in considerable detail in the CASA audit into its Pel-Air Westwind operations, which was conducted soon after the crash.

It did find performance errors by the pilot yet makes no reference to errors by management of Pel-Air or in its  procedures, he said.

Quinn described a letter from CASA suspending the licence of the pilot Dominic James as bizarre in its language.  James’s pilot licence was later restored, after a legal challenge to its cancelled in the  Administrative Appeals Tribunal was withdrawn.

When asked by Senator Xenophon what he thought should be done,  Quinn said “My view is accident report needs to be withdrawn. There should be some sort of formal inquiry as to why we reached this position needs to be conducted.”

He said that after that inquiry a fresh accident report should be produced, including one which applied to lessons learned from the accident to the broader flying community, since that was the ATSB’s role, which it had uniquely avoided carrying out in the case of Pel-Air.

Quinn said Dominic James’s check to line and later endorsements to become a Westwind captain appeared to have been done by two Pel-Air officers who weren’t registered with CASA.

He said this might mean that while James was a competent pilot, he may not have been a legal pilot, a situation which could have he said serious implications for the operator and its insurer.

Earlier, independent air safety consultant Bryan Aherne told the committee that the ATSB final report into the Pel-Air ditching in 2009 contains significant and deliberate omissions.

He drew the committee’s attention to significant changes that occurred between earlier drafts of the ATSB final report and the one that was published at the end of August, and said that any aviation analyst reading all of these reports would conclude that information critical to the safety of the Australian public had been deliberately withheld.

Aherne said it was apparent that CASA never intended an adverse safety audit of Pel-Air’s operations that it conducted after the crash be released.

He said the ATSB had made critical and deliberate omissions of matters of importance to the travelling public in its final report that were not reflected in the earlier drafts of that report.

“The ATSB should not treat the travelling public with contempt or regard them as stupid,” he said.

Aherne said the Pel-Air flight was conducted without defined performance figures relevant to the purpose for which the Westwind was being used. It was equipped with safety equipment that didn’t work, and which a crew which had not been trained in its use first had to attempt to use it while under water.

He said that the Westwind was incapable of doing the air ambulance work it set out to do in its charter role taking into account the real world factors in place including its unsuitability for flying in reduced vertical separation minima or RVSM air space.

Aherne said that the ATSB final report was “completely devoid of regulatory or organizational or human factors issues and  analysis. I find it quite incredible.”

He said “I don’t remember any other ATSB report that did not go to human factors and organisational issues.

There will be further reports later today