LBSCR Times
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And the person concerned got treated exactly the same as any other member of staff involved in such an incident!
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Southern DOO: ASLEF members vote 79.1% for revised deal
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And the person concerned got treated exactly the same as any other member of staff involved in such an incident!
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tsr
Established Member
I've not heard of it happening. Doesn't mean it isn't. I should imagine if any managers trained on Avantix machines were working trains in the morning peak from stations such as Brighton and East Grinstead, then they would have been wise to take them, to avoid complaints and generate the maximum of whatever revenue there is.
A number will have done, but it's taken extremely seriously. Retraining has happened as a result of lesser incidents...
Are you REALLY trying to normalise an incident like that?
No. Its a really serious incident. The last thing you check before giving the ready to start, is the signal. The most important bit of route knowledge we have is starter signals. I know where every starter signal is on my routes. I know that Ipswich platforms 1 and 4 are very easy to cross read with 2 and 3 respectively so pay extra attention. I also know that Wymondham down is approach controlled and despite its appearance is not a starter and you do give RTS against the red. For example.
Any SASPAD is investigated and dealt with as if it were a SPAD, even worse if it results in a SPAD.
Really??
Simply highlights that 2 person operation is less safe than DOO as errors such as these can happen.
What? If a guard does their job properly then the drivers attention is focused on the signal, and not a bank of CCTV screens. How is a driver concentrating on CCTV screens instead of the signal possibly safer than having a guard?
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No, what it highlights is two things. Firstly rushing managers through to strike break is dangerous as you have effectively untrained staff (5 days vs 5-6 months for the full course) in safety critical roles. Secondly how errors can be made and lumping more and more work on one solitary person is going to up that risk.
Call me a sceptic, but even bad news is good news for the right spin doctor, and given the right amount of massaging; stats could be produced to support the argument that the guard role itself constitutes a risk no longer viable.
I fear in years to come the same stats will be used to argue the drivers role is a risk too far.
Tetchytyke
Veteran Member
If a guard SASPADs the driver will notice and not move.
If a driver SASPADs there will be a SPAD.
Two sets of eyes are better than one.
I do hope so.
tsr
Established Member
DOO: Driver dispatches on a red and is also likely to take power afterwards due to the sole person involved (them) believing they have authority to move. No second person looking for any errors. SPAD. Subsequent consequences of SPAD, whatever they may be (tea no biscuits/derailment/vehicle struck on LC/death).
Guard operation: Guard dispatches on a red. Driver is a second person to check interlock and signal. Driver may notice signal if guard has not. Therefore 2 versus 1 human(s) checking signal. Chance of error much lower. SPAD thus less likely. Not impossible, but less likely.
How does it prove its less safe when there was another guy there also using his judgement too?
The only thing it could even be suggested to prove is that having a non experienced manager who only had a crash course is about as safe as DOO...
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Deepgreen
Established Member
OK, I have removed my headphones and await the important Chichester announcement!
Humans are fallible, the more humans that are involved in any process the more chance of error. (This is the reason we have signalling systems)
2 humans in a process doubles the chance of error one could argue.
Difficult to argue by unions if this same debate played out in the press as is being suggested, the science of human factors risk management is complicated and the point I'm making is that I don't think this is an area that the unions would want to shout about.
2 humans in a process doubles the chance of error one could argue.
Difficult to argue by unions if this same debate played out in the press as is being suggested, the science of human factors risk management is complicated and the point I'm making is that I don't think this is an area that the unions would want to shout about.
I think your logic is faulty.
If two people have to agree to "go" then the chance of failure has not doubled.
If two people have to agree to "go" and both have to check the signal, then the chance of failure has halved.
It's only if the two people are in a chain, one decides and then relays the decision, which is the only data point the second uses in his decision to go, has the risk increased.
Define failure. In this case the train was cancelled, that is a system failure. It is a safe failure but it is still failure. Yes the chance of an unsafe action may be reduced but that isn't the only mode of failure. I assume that there are further protections, such as TPWS that would have ensured the safety of the system had the driver actually applied power.
Consider, if there is one person and their chance of failure is P then that is also the chance of failure. If there are two people both with a chance of failure of P then the total chance is the chance that the first person will fail added to the chance that they won't fail but the second person will. I.e. adding the second person makes failure more likely not less.
The same thing happened in the aviation industry with ETOPS. It was realised that as engines became more reliable then having 4 engines rather than two for ocean crossings increased the chance of the flight being cancelled rather than decreased it. And there was no increase in safety for having the 4 engines (the engines also being more powerful). Hence you can now fly to the USA on 767, 777 & A330s rather than 747 & A340s.
In this case, although it could be said the management-guard failed in exercising duties competently, the system worked correctly to prevent an actual failure.
A failure would have occurred had the train proceeded.
If the train was then cancelled because a competent staff member was not available (as the management-guard clearly was not competent) then this isn't a failure of the system, the system worked correctly as intended.
ETOPS is a very different kettle of fish, and a debate not suited for this forum. However I do understand there are a lot of requirements that need to be met for 2 engine flights to be allowed.
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You may be right about my logic, I am not qualified in this area so leave to experts. Just suggesting that any incident such as those described, are probably left for operational risk experts, rather than being played out in the media.
The train was cancelled, from a passenger point of view that was a failure. The failure was safe but it was a failure none the less. I can't judge whether the guard was competent but I would have to see the incidence rate of this type of failure on a normal day compared to a strike day. To take a narrow view of what is failure to mean "something unsafe happened" isn't going to help improve the whole system from the passenger's point of view.
I would also say that a single incident like this does not mean the guard is incompetent, it merely means that they have failed in their duty and their competence should be reviewed. I do not want to brand all guards who have made this mistake as incompetent as that is unreasonable and unfair. Were anyone to suggest such a thing, if this hadn't been a manager, then I think they would be rightly pilloried on this forum. To do so because it is a manager is quite unfair.
But yes it is entirely reasonable to assume that a manager is more likely to make a mistake when doing someone else's job than the person who normally does it.
How on earth you managed to get ETOPs into a discussion on DOO is beyond me. But ETOPs is all to do with costs to the airline industry, and not every twin engine jet aircraft is ETOPs certified. It is a very complicated subject.
Anyway it has nothing to do with DOO.
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So lets get this straight.
You want to increase the chance of a catastrophic failure because the ever so slightly increased chance of a minor failure (delay or cancellation because the staff member has to be temporarily removed from service pending investigation/retaining/etc) is undesirable?
You must be an accountant.
Would TPWS have halted the train in the overlap of the signal? If so then there would not have been a catastrophic failure.
"Project Fear" seems to be alive and well in the rail industry. If I am an accountant then you are a politician.
Wow! TPWS is the last line of defence. If there is a TPWS brake demand on a train the reason has to be investigated and action taken against the driver if he/she has done something wrong. Not every signal is fitted with TPWS, and ideally it should never be needed.
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It might have. It might not have. Its not been unknown for that to be bypassed (I'm looking at you WCRC).
Major incidents rarely occur when just one thing goes wrong. What happens is you get a whole series of things goes wrong.
No, but since you brought up aviation, I am a glider pilot. Safety culture is beaten into me.
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ungreat
Member
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Indeed.
Got to say wasn't surprised......sneaks off to quietly grin...
--- old post above --- --- new post below ---
...is this what the Southern Manager said "acting"as Guard on being relieved of duty
!!
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We don't know yet. Wait and see what the ITT comes out with which is due in the very near future I would expect.
bb21
Emeritus Moderator
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That is one of the biggest fallacies through the misuse of statistics.
You are talking about the probability of failure by Person 1 (say P1) or failure by Person 2 (say P2) resulting in a failure, which has no relevance to this incident at Chichester. What you need to be looking at is P1 and P2 resulting in a failure in service. (The probability of TPWS failure is irrelevant in this case, as it does not depend on either Person 1 or Person 2s behaviour, and works independently whatever that probability is, assuming that it has not been tampered with.
So in the simplest form, you need to be looking at P1 (which would be less than 1, ie. always failing) multiplied by P2 (which is also less than 1), therefore the simplest form of mathematical theory would no doubt show that the probability of failure with two people present would be unquestionably lower than with only one person present.
What complicates matters here is that this simplest form assumes that the behaviour of Person 1 and Person 2 are independent, ie. the probability of failure by Person 1 is not affected by the behaviour of Person 2, and vice versa. Of course no matter how much we train ourselves and maintain our discipline, this is rarely the case with human behaviour, so in this case what we need to do is look at the probability of failure by Person 2 conditional on the event of failure by Person 1 (call it Q), and multiply P1 by this conditional probability Q. We only need to consider this case as with train dispatch, the actions are sequential, ie. Person 1 (guard) giving two on the buzzer before Person 2 (driver) performing final checks and applying power.
There are a lot of theories out there which argue that Q is much closer to 1 than P2 is, which is quite understandable. What is not clear is the relationship between P1 x Q (ie. two-person dispatch) and P2 (ie. driver only dispatch), which is part of the reason why this topic always attracts lots of discussion and no conclusive statistical proof either way.
In any case this is still a simplified model, but forms pretty much the fundamental structure of modelling such risks. The difficulty for any practitioner is to come up with accurate figures for these measures.
This does not mean some of your other arguments are wrong, just that I cannot let this go unchallenged as it is one of the biggest mistakes people make in the application of probability, and arguments based on this logic would be null and void. In fact, I quite agree that this isolated incident does not show the inherent danger of anything by itself, although I think most people can agree that someone with only 5 days' training is likely to be less experienced than someone with 6 months' training. I am unable to say whether that makes them more prone to mistakes, although the timing of this incident is really rather unfortunate.
Stagecoach have previously bid unsuccessfully for franchises that operate DOO. Had they had won these bids I think their attitude might have been somewhat different
cjmillsnun
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By that logic we should remove co-pilots. The idea of two sets of eye making something less safe is ridiculous.
--- old post above --- --- new post below ---
GSM-R has been introduced widely. It is the replacement for NRN and CSR. That said like any GSM type network (and indeed any radio network) there are dead spots.
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