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#1 Posted : 16 July 2009 14:01:00(UTC)
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Posted By Arran Linton - Smith See: http://news.bbc.co.uk/1/...16_07_09_icl_inquiry.pdf
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#2 Posted : 17 July 2009 11:09:00(UTC)
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Posted By Fornhelper The findings of this report make very interesting reading and highlight not only the failures in the management of H&S at the plant (which is as clear a case of negligence as I have seen) but also the failure of the HSE to enforce its own recommendations. I hate to be cynical but I am pretty certain that had the organisation involved been a local authority or other public body then no doubt the HSE would have been issuing prohibition notices and implementing prosecution procedures long before the lack of action by both parties lead to the horrific loss of life at this workplace. It appears to me that the private sector seem to get an 'easy ride' when it comes to enforcement action either by the HSE or Fire Authorities. I would also add that I am disappointed that this thread, which relates to one of the worst industrial accidents in the UK in many years has attracted so little interest or comment from a website visited by H & S professionals across the UK. It is a little disheartening to note that the posting has attracted only around 100 views and no responses whilst a posting made at the same time entitled " H&S - Royal Society for the Extremely Stupid" has had 2,300+ viewings and attracted more than 50 comments. What impression does this give of our profession to anyone 'looking in'? Regards FH
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#3 Posted : 17 July 2009 11:15:00(UTC)
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Posted By martinw I didn't comment or post anything, as other than what you said, what else is there to add? I could express how I feel about the HSE action/inaction but that is a common feeling, I believe; and I could express how horrific it must have been for all involved. To what end? I have to be honest but I had forgotten all about it; I suppose that my only thoughts are those of sadness for all involved, and I felt no useful purpose in sharing that with people who I do not know.
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#4 Posted : 17 July 2009 13:25:00(UTC)
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Posted By peter gotch In addition to the 190 page report there is a short summary at http://www.theiclinquiry.org/ p
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#5 Posted : 17 July 2009 16:16:00(UTC)
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Posted By Pete48 FH, perhaps some of us are still studying the very long and comprehensive report rather than rushing into print here? As you say it is a complex accident with some significant lessons to learn I am sure. Give us a break, some of us have lives despite the myth. Boris did not require anymore than minute to read his blog
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#6 Posted : 17 July 2009 16:48:00(UTC)
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Posted By Pete48 Well I have just read quickly through the summary at the link provided by PG (thanks). FH, I cannot see how you arrived at much of your comment from my quick read of that summary. A quick and blunt assessment would say that the inquiry has confirmed that the regulation of the use of LPG is a mess. That to me is of far more importance than simply "blaming" one key player, the HSE, and suggesting that the private sector is somehow allowed more leeway (?). Presumably as the HSE is a public body you are not showing more leeway to the commercial interests. The report clearly states that the primary responsibility rests with the party who creates the risk, the site user. The other point about this is that much of the failure was put into place up to 40 years ago and when applying that to today we need to take care about applying todays judgements to history. I sincerely hope that the relevant parties will be able to build something positive from this tragedy. Yes there is clear evidence of failure but I would suggest that there are still many other similar situations (in fact the report says as much) and as the report outlines in the recommended plans getting some improvements is the priority. I guess the proof will be whether all those unsafe installations that exist out there today will get sorted and who is going to foot the bill both for the works but also the enforcement resource.
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#7 Posted : 18 July 2009 14:34:00(UTC)
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Posted By Al.. First, I commend the full report to all safety practitioners. It provides a detailed account of the circumstances over many years which led up to the tragedy and it can help us better understand how accidents like this can happen. Reading it is worthwhile CPD. Second, it is worth considering how many of us visiting the factory in a professional capacity would have picked up the buried pipe as a major problem to be addressed. This issue was not one which was regarded as a priority risk in the UK. It was not on our “radar”! The ambiguity in many people’s minds as to who has responsibility for an LPG installation downstream of the tank is at the root of it and this was not just confined to the ICL site. It is clear from the inquiry report that the uncertainty persists today in many small to medium organisations. It is interesting to read that a safety consultant who quoted for providing a safety advisory service to the company (but whose quote was not accepted) acknowledged to the inquiry that he would have assumed that the underground pipework was the responsibility of the tank supplier and he would not have included in his risk assessment for the factory. Lord Gill concluded that the current LPG safety regime in the UK is inadequate and he highlighted nine aspects of the current arrangements which give rise to significant risks. He recommended an action plan to address these matters. Jim Murphy, the Scottish Secretary speaking for the UK Government, said, the Government “fully accepts those recommendations, and will provide a full response to the report in January…..our main aim must be to see the introduction of a safety regime around LPG systems which is transparent, workable and enforceable." Lord Gill was critical of the HSE’s response following the tragedy with, five years on, no coherent action plan to deal with underground metallic pipework and the risk of a recurrence. He ascribes this inaction and the apparent lack of a sense of urgency on the part of the HSE to its assessment that the risk of a recurrence is remote. Mrs Sandra Caldwell from the HSE said as much in her evidence to the inquiry. Her comments on page 127 of the report are worth reading. And this, for me, gets us to the nub of the matter. Lord Gill’s remit required him to look only at the circumstances leading up to the tragedy and to make recommendations in the light of lessons learned. The HSE meanwhile looks at the risks of a recurrence of this type of incident in the context of the overall risks of gas-related incidents, the Government’s appetite for more health and safety regulation and the resources given to the HSE by Government to do its work. It would have been surprising if Lord Gill had concluded, as the HSE appeared to have done, that this was a tragedy but that in the overall context of things, the risk of this type of accident happening again remains low. He would have been accused of a whitewash. The Scottish Secretary has now asked the chair of the Health and Safety Executive to “report to Government within eight weeks, both to address the allegations of their serious failings in how they responded, and also to look at ways of strengthening the safety around liquid petroleum gas here and throughout the UK." It is always easy to be wise after the event. Public opinion now requires that something be done and time and effort will now be put into making sure that something is done. There will be a beefed up safety regime for LPG and everyone will feel more comfortable, and perhaps safer, as a result. But will it have been a proportionate response to the real risk? Who knows?... but I think that public opinion will not allow that debate.
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#8 Posted : 19 July 2009 18:20:00(UTC)
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Posted By Phillip The risk assessment was carried out by an undergraduate - surely knowledge & experience is a prerequisite for competence. The advice of the HSE expert was ignored - why was this allowed. The company thought hiring professionals was too expensive Surely it's time that HSE practitioners must be registered and employed by all site's that have the potential to cause major injury
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#9 Posted : 20 July 2009 13:17:00(UTC)
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Posted By Jim Tassell (2) Al Thanks for a considered initial reading of the report - you must have had a very slack Friday (or like PG and I you work in Glasgow and as it's Fair Friday...!) I think that the initial response from government needs to be carefully considered. It does seem to have aspects of knee-jerk about it, just as we are seeing for tower cranes. If your memory goes back far enough, isn't this starting to resemble the mish-mash of risk-specific legislation that we had under the Factories Act pre 1974? You know, the ones that Robens reckoned would only take five years to repeal! There is another discussion strand running today on the history of the HSW Act and I think history has some important, perhaps profound, lessons for the legislators. Robens' views are still valid today... aren't they? And does anyone recall what a Kier is and why they once had their own regulations? (Answers on some grey cloth to...)
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#10 Posted : 20 July 2009 14:18:00(UTC)
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Posted By Peter Zunda "And does anyone recall what a Kier is and why they once had their own regulations? (Answers on some grey cloth to...)" Didn't need the clue at the end, brought up in a mill town so knew that a bleaching vat was known as a kier and saw one once, not in use though, so would summise regs were to do with their use ?
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#11 Posted : 20 July 2009 18:33:00(UTC)
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Posted By Jim Tassell (2) Peter spot on! At least they aren't totally forgotten bits of kit. They were (are?) giant pressure cookers for bleaching cotton. The main risk was falling in as the lips were set low down for easy hand loading. And yes, my grandfather started work aged 12 as a kier boy loading and unloading them. Jim
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#12 Posted : 01 September 2009 21:26:00(UTC)
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Posted By Al.. Well, the HSE has replied to Lord Gill’s criticisms in a letter from the Chair to the Secretary of State for Work and Pensions. http://www.hse.gov.uk/gas/lpg/letter.htm It is a response which I find more interesting for what it does not say rather than for what it does. It acknowledges that Lord Gill’s account of matters leading up to the incident is “fair and accurate” and that failings by the HSE were contributory factors. However the HSE’s letter goes on to explain that this happened long ago and that major improvements have since been made to the way the HSE is run and all this was done on the HSE’s own initiative without any prompting from public inquiries and the like. Lord Gill was also critical of the HSE actions since the incident. The HSE counters this by explaining that it has been very busy indeed undertaking what is complex work and not wanting to rush it but get it right. The HSE also points out that it has gone beyond what Lord Gill recommended in his report by including domestic premises in the pipe work improvement programme. The HSE’s response is in fact a polite but complete rebuttal of the criticisms in the inquiry report of its actions post-incident. The HSE does not like being criticised. Then there is the strange, and slightly unexpected, bit in the HSE’s response. Lord Gill said: “This case [i.e. the ICL case] has demonstrated the weakness of the risk assessment process. The regulations merely oblige the employer to carry out an assessment. They do not provide any safeguard that will ensure that the assessment is properly carried out by a competent person; or that it is subject to any form of independent expert audit. I do not doubt that the risk assessments at Grovepark Mills were carried out conscientiously, but this case demonstrates that formal compliance with MHSWR and DSEAR gives no assurance of safety.” He went on to say: “This is a public inquiry and not a law reform project. I do not feel that it is appropriate that from the evidence of one case I should extrapolate any general principles for the amendment of the existing regulations. However, I recommend that the Ministers should consider whether the existing regulations on risk assessment could be made more effective, perhaps by the addition of some form of independent safety audit.” The HSE has responded to this by including a couple of questions in the preliminary consultation on the recommendations of the Gill report: 1 What are your views on the introduction of some form of independent safety audit: (a) for LPG? (b) more generally? 2 What do you think are the practical implications of introducing an independent safety audit: (a) for LPG? (b) more generally? http://consultations.hse...278629.1/pdf/-/cd224.pdf I find this bizarre. For LPG – yes consult on that. But to ask such a fundamental question “more generally” hidden away in what most will regard as a consultation document on LPG safety is extraordinary. Is this an attempt to kick it into touch or some other tactic?
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