The Senate committee inquiry into the accident report issued by the ATSB into the Pel-Air Careflight crash in 2009, which will conduct a further public hearing tomorrow Friday, is all about the fairness, integrity and honesty of the air accident investigator and CASA, the aviation safety regulator.
The jet concerned was small. The issues are large. They have the most serious implications for Australia’s compliance with international standards for investigating and reporting air safety incidents or crashes.
On 18 November 2009 a tiny Westwind corporate jet was ditched in the sea near Norfolk Island immediately before it would have exhausted its fuel reserves after repeated attempts to land in poor visibility at the mid point of a flight from Apia to Melbourne.
All on board survived. There were two pilots, a patient, her partner, a nurse and a doctor.
The entire blame for the accident was officially visited on the captain of the flight, Dominic James, for not correctly fuelling the jet.
However the core issues before the Senate committee concern matters that were excluded from the ATSB’s final report in arriving at its published conclusion that the causes of the crash were the actions and omissions of the pilot in command.
On the evidence to date the ATSB failed:
- to take account of a special CASA audit of Pel-Air which found at that the time of the crash Pel-Air was in multiple and gravely serious breaches of Australian air safety regulations.
- to take note of an absence of appropriate fuel loading and in-flight management policies for its Westwind pilots,
- to reference the extent to which the operator and CASA conducted and acted on the oversight of pilot standards in the Pel-Air Westwind fleet and provided definitive and unambiguous operational instructions, and
- to reference and investigate the consequences of the Westwind lacking the precision equipment which would permit it to continue to fly through controlled international airspace at its most fuel efficient altitudes if ordered to vacate those levels to safely avoid more modern aircraft such as scheduled airlines.
- (Which happened to the crashed Westwind on the night of the accident, when ordered out of RVSM or reduced separation vertical minima altitudes, significantly affecting the jet’s capability to carry out its mission even under benign wind conditions.)
These are matters which have already caused extensive discussion in public in the committee room. The two authorities, the ATSB and CASA, have urged the correctness of blaming Captain James for everything that went wrong that night.
The parties to the contrary view have argued that the exclusion of critical matters that go to the credibility and performance of CASA have compromised the public interest in fair, credible and detailed consideration of all of the factors that led to an inadequately supervised and instructed pilot flying an inappropriately equipped jet through airspace through which he was eventually expelled from by air traffic control prior to crashing near Norfolk Island in deteriorating weather conditions.
In the evidence so far heard and variously contested or corroborated according to the submissions by the interested parties it is alleged that the regulator CASA prevailed on the ATSB, the supposedly independent investigator, to change its mind about the seriousness of the issues or concerns it had about the conduct of the flight and other matters.
As a result it is claimed that the documented views reached by the ATSB early last year that were critical of the operator, Pel-Air, which is a wholly owned subsidiary of REX or Regional Express were changed and the final report delayed from early last year, to 31 August.
The inquiry has now reached a stage where anyone attempting to report on or acquaint themselves with the proceedings from scratch would find themselves in a maze of technical, ethical and legal issues, all of them being argued in their minutiae rather than broad detail.
Which means that the proceedings, which may end in a Senate report late next month, will not tomorrow easily lend themselves to sensible coverage for those who have not already done a great deal of reading of the Hansard or followed the public proceedings by video-cast and read the public submissions, which are definitely NOT THE FULL STORY.
Much of the testimony and examination tomorrow seems likely to be re-examinations of previous testimony, and answers to question taken on notice.
The ATSB and CASA can be expected to continue to argue that the pilot was bad, and the contrary voices will no doubt continue to argue or imply that these bodies are dishonest, incompetent or procedurally corrupted.
Even if nobody gives a damn about whether Captain James has been set up to deflect all criticism from Pel-Air and CASA or not, this is ultimately a matter as to whether or not the ATSB and CASA can be trusted to properly investigate something much bigger than an accident in which six people escaped with their lives against all odds.
It is about whether CASA is capable of diligently and fairly pursuing operations that expose the public to unacceptable risks in failing to comply with air safety laws.
It is even about whether the safety regulator is capable of making sensible and safe aircraft fueling rules for flights between tiny specks of land in the vastness of the oceans.
It is ultimately about Australia, and the rule of the law and the protection of individuals from the abuse of due process.