JOINT COMMITTEE ON TRANSPORT debate -
Wednesday, 22 Sep 2010

Collapse of Malahide Viaduct: Discussion

Vice Chairman

The next item on the agenda is a discussion with the railway accident investigation unit and the Railway Safety Commission of the findings made in the report on the investigation into the collapse of the viaduct in Malahide. Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House or an official by name or in such a way as to make him or her identifiable.

By virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of the evidence they give this committee. If they are directed by the committee to cease giving evidence in relation to a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. Witnesses are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise nor make charges against any person, persons or entity by name or in such a way as to make him, her or it identifiable. That is the gospel. I welcome Mr. David Murton, chief investigator, and Ms Jill Cregan, lead investigator, from the railway accident investigation unit, Mr. Gerald Beesley, commissioner, Ms Mary Molloy, principal inspector, Mr. Antony Byrne, principal inspector, Mr. Donal Casey, principal inspector, and Caitríona Keenahan from the Railway Safety Commission. I propose a short presentation followed by questions and answers.

Mr. David Murton

I thank the Chairman and members of the committee for the invitation to appear before the committee and make this presentation. The railway accident investigation unit is a functionally independent investigation unit within the Railway Safety Commission. The unit is based in South Frederick Street, Dublin. The purpose of an investigation by the railway accident investigation unit is to improve railway safety by establishing, in so far as possible, the cause or causes of an accident or incident with a view to making safety recommendations for the avoidance of accidents in the future, or otherwise for the improvement of railway safety. It is not the purpose of an investigation to attribute blame or liability. The railway accident investigation unit's investigations are carried out in accordance with the Railway Safety Act and the European railway safety directive.

On 21 August 2009, as an larnród Éireann passenger service travelling from Balbriggan to Pearse passed over the Malahide viaduct, the driver witnessed a section of the viaduct beginning to collapse into Broadmeadow Estuary. The driver reported this to the controlling signalman who immediately set all relevant signals to danger, ensuring no trains travelled over the viaduct. Within minutes of the report of the incident by the driver, pier 4 of the Malahide viaduct had collapsed into the Broadmeadow Estuary. Once notified of the collapse of the viaduct, the railway accident investigation unit on-call investigator mobilised to the site to establish the severity of the incident. On site the scale of the collapse was immediately apparent and the railway accident investigation unit initiated a formal investigation.

All parties involved co-operated fully with the railway accident investigation unit investigation in an open and helpful manner. The railway accident investigation unit report was published on 16 August 2010. As a result of the findings of the investigation, the railway accident investigation unit made 15 safety recommendations. Thirteen of these have been made to larnród Éireann, one safety recommendation has been made to the Railway Safety Commission and one joint recommendation has been made to larnród Éireann and the Railway Safety Commission.

In accordance with the railway safety directive, the railway accident investigation unit recommendations are addressed to the safety authority, the Railway Safety Commission. The Railway Safety Commission takes the necessary measures to ensure the safety recommendations issued by the railway accident investigation unit are duly taken into consideration and acted upon.

Mr. Gerald Beesley

I welcome the opportunity to present this briefing. As a result of the near disaster at Malahide, the landscape for railway safety in Ireland has changed. Coincidentally, a more stringent railway safety management regime, which will take effect in January 2011, has been prescribed under the European railway safety directive.

At the time of the incident at Malahide, larnród Eireann was required to conduct its railway activities in accordance with its safety case, for which a safety certificate was issued by the Railway Safety Commission in 2007. The validity of that safety certificate is due to expire at the introduction of the new regulations and larnród Éireann is in the process of preparing a submission for re-certification.

The European railway safety directive came into full force in 2008 when the Railway Safety Act 2005 was amended to take account of European railway safety regulations. Under these regulations, railway infrastructure managers and railway operators are required to establish their safety management systems in conformity with the relevant European common safety method. Scrutiny of safety management systems will be carried out by the commission using the new common safety methods, with a supervisory regime appropriate to the specific safety management system. Our supervision will focus on an undertaking's adherence to the standards, methods and controls prescribed in its safety management system. Any substandard practices, asset defects, competency shortfalls or system control failures that are revealed by inspections and audits carried out by the commission will be vigorously pursued to determine the primary and underlying causes of non-compliance. This is a more rigorous process than heretofore and it ensures a common standard and approach to railway safety throughout the European Union. It imposes greater demands on the Railway Safety Commission, especially in regard to capacity for supervising existing railway activities.

The commission must continue to execute all other tasks with which it is charged under the Railway Safety Act. The approval of new works includes several major railway infrastructure projects, and two of these contain works the likes of which have never been seen in Ireland, namely, the DART interconnector and metro north, both of which involve lengthy underground tunnels.

Involvement of the commission in the workings of the European Railway Agency and of its technical sub-committees is fundamental to our role in drafting regulations and guidelines on specific aspects of railway safety. It is also important to ensure Ireland's interests are articulated in the various fora and are recognised by the European Railway Agency in its submissions to the European Commission.

The major issue of concern in the recent past has been the collapse of the viaduct on the northern main line at Malahide. To determine where there might have been failures of safety management within larnród Éireann prior to the collapse of the viaduct, the Railway Safety Commission undertook a compliance audit. It was found that larnród Éireann failed to comply in four specific areas. Some 16 recommendations were made by the commission to larnród Éireann and larnród Éireann was requested to provide an improvement plan and has done so. The commission is closely monitoring its implementation.

Regarding scour, we have additionally tracked progress on underwater inspections at 105 other structures and our inspectors have accompanied larnród Éireann engineers to a number of sites. Regarding recommendations contained in the report published by the railway accident investigation unit, the Railway Safety Commission has taken steps to address recommendation No. 14 and arrangements are in hand with larnród Éireann to jointly address recommendation No. 15.

The Railway Safety Commission will continue to ensure all relevant undertakings comply with railway safety legislation. This will be achieved through the acceptance and supervision of robust safety management systems and by fostering and encouraging railway safety. I emphasise that, where the safety of our railways is concerned, none of us can be complacent. We must strive constantly for improvements in safety performance and apply the necessary resources to achieve that objective.

Deputy Simon Coveney

This is a comprehensive report and gives those of us not educated in the ways of railways an insight into what happened and why. That is very useful. There are 15 recommendations and I want to get an indication of how many have been implemented already, what number are being implemented and the timeframe for the implementation of all 15 recommendations. The Railway Safety Commission stated that recommendations 14 and 15 of the report are being implemented. I would like more detail on that because the recommendations are quite clear on what is expected from the Railway Safety Commission. Whatever about Iarnród Éireann, its obvious responsibility to implement the other 13 recommendations and its involvement in the 14th because of it being asked to work with the Railway Safety Commission on that, the public needs to know that the commission is prioritising the quick implementation of recommendations 14 and 15.

The Railway Safety Commission states that its aim is for a robust railway safety management system. For my own clarity, in terms of the commission's practical role in railway safety, does it investigate problems after they occur or does it inspect track and trains regularly or randomly? How intensive is the commission's oversight of the safety of Iarnród Éireann's operations? Is it like how Ryanair or Aer Lingus are monitored by the aviation safety bodies whereby persons take flights to observe and inspect different practices or does the commission respond to complaints in the event of problems or accidents? I want a proactive Railway Safety Commission that deliberately and randomly inspects and, at times and as appropriate, interrupts operations so that we all can know Iarnród Éireann is being monitored to ensure the safety of the travelling public. It was a miracle that what happened in Malahide was not a tragic accident with much loss of life. If it had not been for the train driver in particular, it would have been a very different outcome. Those are my initial questions.

Deputy Joe Costello

I thank everyone for coming along — the railway accident investigation unit for presenting a clear and comprehensive report to the committee, which certainly is very much appreciated, and the Railway Safety Commission for its fine contribution.

It was a miracle no one was killed on 21 August last year. Given that there were warnings from the public and that the warning that came from the driver was only dealt with after the bridge had collapsed, we certainly are lucky not to be dealing with tragic fatalities. We cannot emphasise strongly enough the importance of the matter with which we are dealing.

The report and its recommendations reveal a litany of failings of supervision, standards and personnel. That is what is before us — a litany of failings over an extended period. Senior supervisory staff were responsible for inspections, but these did not take place, and for maintaining standards, but this never happened. It is incomprehensible that there was an inadequate level of supervision and inspection. There is a question mark over the line of responsibility. According to the figures, there are 6,000 critical areas, 1,926 underbridges, 780 viaducts and thousands of miles of track that must be inspected. It is a major job. Clearly, this should have been a central part of Iarnród Éireann's operation and of the safety commission's enforcement role.

It is strange that over all these years and despite the warnings such as the complaints in 2006 and 2007, the standards were not improved, the engineering staff were not trained to the appropriate level, no training procedures were put in place and the inspections did not take place. We were waiting for an accident like this to happen. That is very serious. Virtually all the recommendations deal with standards and inspections.

Who was responsible? We are talking about a major operation — the running of the railway system. Iarnród Éireann is responsible for this and for carrying out inspections. Clearly, it did not train its staff properly. It did not put timescales in place to ensure inspections took place. It did not pay attention to warnings, even formal ones, on scouring in this instance.

What was the safety commission doing? It has responsibility for enforcing safety standards and ensuring their implementation. It is not as though Iarnród Éireann operates in a vacuum. It operates in the context of the overall supervision of the safety commission.

I am surprised there is only one full recommendation for the safety commission. I would have thought all 15 recommendations would have been the responsibility of the commission as well as of Iarnród Éireann and that the commission would have had a responsibility for ensuring their enforcement with Iarnród Éireann. Perhaps that will happen in practice, but if one does not state specifically in the document that the safety commission must have a timescale for Iarnród Éireann to implement training, improve standards, carry out inspections, check on personnel and go through the track in the railway system, we are not doing our duty to those being carried and there will not be confidence in the system.

What is the Minister's role in all of this? Presumably there is an annual report. Perhaps they would speak about that. What sort of annual reports on this matter have been forthcoming from Iarnród Éireann and the Railway Safety Commission? Does the safety commission report regularly to the Minister on the safety of the railway system and has he responded in that respect? I am still unclear on that line of responsibility. Who ultimately is responsible for it? Quis custodiet ipsos custodes? Who guards the guards? Who will ensure all the recommendations are implemented and operating?

The European Railway Agency is now in place. This body relates to the Commission, will bring elements of policy to the European Union and, I presume, will have a wider role as well. That is supposed to mean stricter supervision of the system. How is that working out? This agency only came into place in 2008, before the accident took place, but should now be operating across the board. Are new structures being put in place arising from the tighter regime under the European Railway Agency? If so, what changes have taken place and how will that work out in the future? I want clarity to ensure the recommendations will be implemented and to find out the role of the Railway Safety Commission in ensuring Iarnród Éireann fulfils its duty. Who is responsible for reporting on these matters to the Minister in order that we link all of the lines of responsibility?

Deputy Trevor Sargent

I thank Mr. Murton, Mr. Beesley and their colleagues from the Railway Safety Commission for being here and making their presentation.

I live in Balbriggan and have regularly used the train service since 1983 since which time Pier 4 was, no doubt, deteriorating. I was very lucky, as were many others, not to be travelling on the day in question. In fact, the train would have been much heavier had the incident occurred in mid-September or October. It happened during a holiday period. I am very glad I was not the straw that might have broken the camel's back. The expression, "There but for the grace of God," has been used.

It is good to see the report which is very detailed. As with many detailed reports, it is important not to lose the salient points. I welcome the fact that the recommendations laid out are explicit. Not coming from a technical background but sharing an obvious interest with my constituents and those of Deputy Kennedy in north County Dublin, I need to hear a number of answers. I have five brief questions.

That inspections were carried out three days before the incident is disquieting. In 1997 a report stated Pier 4 was too light for the job. It sounds as though the alarm bell should have been ringing very loudly. What is the nature of an inspection? Is there a check-list to be complied with scientifically set out for it to be considered an inspection in the true sense of the word? That needs to be clarified. Does the Railway Safety Commission sign off on how thorough it has to be for it to be called an inspection?

I understand there is a question of maintenance ceasing around 1996. Does such a ceasing have to be allowed for? Is there a procedure for saying we no longer need maintenance if the state of affairs is satisfactory? How can such a decision be arrived at? Is there a belt and braces approach to taking a decision to cease maintenance?

It seems Iarnród Éireann is stating the Railway Safety Commission closed a recommendation for flood or scour management. I am not sure about this and would like to hear the delegates' response. I wonder why Iarnród Éireann would state it. Obviously, the commission is in the best position to answer that question.

The illustration included in the presentation is useful. It is a case of a picture painting a thousand words. There could not be a better indication of just how serious the whole matter was and is, given that we are still learning lessons. The flow of water in the Broadmeadow estuary, in the perception of those closest to it such as Malahide scouts, was evidently getting faster and changing. Given the hydrological nature of what was happening, this could have been to do with the structure. However, there has also been heavier rainfall and there is a need for climate change proofing. Much of the national railway infrastructure is coastal and often subject to erosion. Apart from north County Dublin, I am thinking of south County Dublin, simply from my own experience of travelling on the railways. Delegates say engineers are not trained appropriately. It would not be appropriate to continue with the current training programme because changes are taking place. Will the Railway Safety Commission have a role to play in certifying the level of training needed to deal with the changing nature of inspections?

My fourth point is one about which we should be positive, if we can be. Earlier today the Ceann Comhairle hosted a national bravery awards ceremony. It is important to recognise and not forget the driver who had the necessary presence of mind to do what he did and prevent serious fatalities. Has there been a recommendation that the driver be a recipient of one of these awards? That would be appropriate.

I know the need for adequate resources will be cited. Do the delegates agree that there is a need for sufficient cultural as well as financial resources? They have mentioned the loss of corporate memory and how important that is. We hear about this in the discussions about decentralisation and there is much to be discussed in that regard. However, in a matter of life and death the loss of corporate memory cannot be tolerated and must be provided for. While we are talking about resources — we need to have them — we should also make sure resources that may not be financial are in place. Is the Railway Safety Commission following through on this? I thank it commission for the report.

Deputy Michael Kennedy

I welcome both groups and thank them for their comprehensive reports. It is a miracle that no one was injured or killed. We must pay tribute to the train driver for his quick action and equally to the Malahide sea scouts who were keeping their eyes open in the days prior to the incident. It is a particular problem that they were not listened to or that their report was not acted upon.

The current regulation calls for the production of a three-year safety report. Should that period be reduced, perhaps to 12 or 24 months?

The Railway Safety Commission clearly lays the blame on Iarnród Éireann for many oversights and lack of action. Does the commission consider itself culpable in any way? In 1997 the rock armour was identified as being too light for the job. While one accepts Iarnród Éireann has direct responsibility, does the commission not acknowledge that someone in its organisation overlooked this? I make the same point about the maintenance regime for the discharge of stones along the viaduct. A report presented in 1996 — 13 years before the incident — mentioned this factor. Should someone in the commission have been aware of this and followed up on it, rather than waiting until an accident happened for everyone to become very concerned? In addition, the report mentioned that a total of 105 underwater inspections were carried out on all the other bridges and that Railway Safety Commission, RSC, inspectors accompanied Iarnród Éireann on some of those trips. Given that the commission is the body with overall responsibility, would it not have been appropriate for the commission to have sent out an inspector to satisfy itself that all the aforementioned bridges nationwide were safe, rather than accepting the word of Iarnród Éireann? Mr. Beesley noted that a management control system is being implemented. Can he provide a date on which it will be ready and in force?

Finally, I revert to the investigation. Thank God there were no fatalities or injuries on that day. Had there been, what suggestions and recommendations would the commission be making in respect of emergency services? Had five or six train carriages entered the water in the Malahide estuary, resulting in people being injured or perhaps killed, how would the emergency services have been mobilised to gain access to the water? This is a relevant question because one must learn from experiences and I seek the witnesses' response in this regard.

Vice Chairman

We now will hand over to the witnesses. Who wishes to respond first?

Mr. David Murton

Perhaps I will address the questions that are more relevant to the accident investigation unit. As for recommendations, in accordance with the railway safety directive the safety authority manages our recommendations. Consequently it is the responsibility of the Railway Safety Commission. We make recommendations that the Railway Safety Commission then takes on board and manages. As for some of the timescales, these are normally set by the commission. In recommendation No. 15, we mentioned that the action plan should have timescales. However, whatever recommendations are set up by the commission normally are timebound.

Mr. Gerald Beesley

I will take the questions more or less in the sequence in which they came. However, in answering a particular question, there may be some crossover.

Vice Chairman

Of course. I also have one or two questions I will ask at the conclusion.

Mr. Gerald Beesley

Perhaps the best point at which to start is with a little history on how the RSC came into being, how the role we have today sits on us, how the new European legislation will come into force and what that will mean. Traditionally, railways were self-regulated and the role of the railway inspecting officer at the board of trade, as it was in the old days, primarily was to inspect new infrastructural works to approve them as being safe to open for railway operations, as well as to investigate serious accidents and make recommendations. The history of railway safety was built up on the basis of the findings of those accidents being incorporated into new regulations and procedures and, in certain instances, into new railway Acts of Parliament. For example, I refer to the Regulation of Railways Act 1889, enacted after the Armagh accident here in Ireland, when a Sunday school train went out of control and many people were killed. The recommendations of that inquiry mandated that railways were obliged to introduce safe working systems in respect of brakes, signalling and so on.

That is the way things were until 1996 and it was not until 2006 that the Railway Safety Commission was formed under the Railway Safety Act 2005. One might ask what happened between 1996 and 2005. There was an interim arrangement in which we gravitated from being a railway inspectorate in the old sense to becoming the Railway Safety Commission. During that process and time, we carried on the traditional roles of inspecting new works and investigating accidents through the railway accident investigation unit, which was set up as a separate unit that was separated from our functions but administered under a common administration. However, one important additional feature came onto the shoulders of the Railway Safety Commission in its formative years, namely, the approval of new rolling stock in addition to the approval of infrastructural works. As the Railway Safety Commission started to grow in its early years, the predominance of activities pertained to the approval of new works, driven in particular by the Transport 21 initiatives. Members are aware that many old railway lines have been reopened, the Luas has been built in Dublin and so on. Consequently there was tremendous emphasis on new works. Our first inspector with the capacity to deal with inspecting railway activities was only appointed in 2008 — and then on the basis of 50% availability. Thereafter, three more inspectors were recruited in 2009 and they have been carrying out inspections since they got their feet under the table approximately halfway through 2009.

Deputy Simon Coveney

How do they choose what they inspect?

Mr. Gerald Beesley

If I may, I will come round to that point.

The position is that the safety case under which Iarnród Éireann works at present was put together during that interim arrangement and there was no requirement in the 2005 Act for a supervisory regime. However, Statutory Instrument No. 61 of 2008 translates into legislation in Ireland the European railway safety regulations. These mandate that railway undertakings, be they infrastructure managers or train operators, must have in place appropriate safety management systems. Such safety management systems must be scrutinised by the Railway Safety Commission and falling out of that process comes the regime of supervision that will supervise those safety management systems. The aforementioned safety management systems include everything from the standards, methods, procedures and staff competence, that is, everything that has been raised by members today. This supervision regime follows from that.

That new regime by European directive comes into force in January 2011. At present, we are working with Iarnród Éireann on the development and approval process for its safety management systems and, at the same time, we are constructing the supervision regimes that will accompany them. Had Ireland a multiplicity of railway organisations, we would have a multiplicity of safety management systems. They may be unique to the different operations a company has. In the case of Iarnród Éireann, it carries out two functions as defined under the Act. One is as infrastructure manager, which comprises the management and provision of railway infrastructure. The second part of its function is as a train operator, that is, running railway services over that infrastructure. These two components of safety management will be put in place.

To take this a stage further, it is important to realise that management of railway safety differs from regulation of railway safety. The management of railway safety is a function that must and is appropriate to remain with the duty holder, namely, Iarnród Éireann in this case. Supervision is a process that always goes across the direction of the railway. In other words, the railway is a commercial undertaking that has a business to run. It must transport passengers from A to B. While it must have primary regard to safety, in weaving a cloth that is robust for safety we come across at a 90° angle to that commercial direction. We slice through it in our supervision regime and look into how it is implementing its safety management. The new regime that will be put in place asks whether the standards are correct, whether the correct standards are being applied and whether the competence is there to deliver. If we find deficiencies in the application of that regime, they will be vigorously pursued to find out the primary causes and the underlying causes. That is the way we are moving forward. It is fair to say that Malahide has been a wake-up call for everyone. We are very fortunate that the new legislation will be enacted at the same time and will give us the tools to ensure that these sort of things are mitigated to the lowest level of possibly ever happening again. That is where we stand at the moment. I hope this answers the major questions raised by Deputies Coveney, Costello and Sargent in regard to the safety management system aspect of railway safety regulation.

In regard to the timeframe for implementation which was Deputy Costello's first question, I will invite my colleague, principal inspector Mr. Byrne, to comment on how we are handling the recommendations from the RAIU, railway accident investigation unit.

Mr. Anthony Byrne

With regard to the recommendations, the committee may be aware that three separate investigations were undertaken. These were an investigation by Iarnród Éireann, the independent investigation carried out by the railway accident investigation unit and a separate compliance order undertaken by the Railway Safety Commission. These are three separate reports. Each of these reports contain a number of recommendations. The Iarnród Éireann report contains approximately 20 recommendations developed by the company and in consultation with external consultants. The company will implement those recommendations. The Railway Safety Commission's compliance audit made 16 recommendations and identified four non-compliances. The railway accident investigation unit report made 15 recommendations. There are quite a number of recommendations to be considered overall.

There is a certain amount of overlap between the Railway Safety Commission recommendations and the railway accident investigation unit recommendations. The difference between the two sets of recommendations is that the railway accident investigation unit report investigated the cause and decided on no blame whereas the Railway Safety Commission compliance audit looks at blame to a certain extent as it investigates what failed, what was not done. There is still a certain amount of overlap between the two reports with 15 recommendations from the railway accident investigation unit and 16 from the Railway Safety Commission.

We have undertaken an exercise to overlay the two reports to see where the similarities occur. We are of the opinion that seven recommendations are the same. Following the compliance order report which was issued in March 2010 we have had two meetings with the assistant chief executive in charge of engineering in Iarnród Éireann in which the company made presentations and submitted documented evidence to prove it is taking X, Y and Z actions to remedy or to close a non-compliance or to close a recommendation.

Seven of the railway accident investigation unit recommendations are now complete; they are not closed but they are complete. What I mean by this is that evidence has been submitted to us. Where we have asked for new standards we will now review standards. We will examine them to determine whether they are satisfactory. If they are deemed to be satisfactory, a peer review process is in place and we will then close those recommendations.

Regarding the Railway Safety Commission compliance audit, of the 16 recommendations made and the four non-compliances, the four non-compliances have been addressed, 13 recommendations are complete and three are still in progress. The commission will meet on a quarterly basis or more frequently if required to obtain the evidence and to be confident that Iarnród Éireann is implementing the commission's recommendations. This is the status of the recommendations and I hope this answers Deputy Coveney's questions on that aspect.

Deputy Simon Coveney

Mr. Byrne dealt with the recommendations of two of the reports. He has not yet dealt with the railway accident investigation unit report.

Mr. Anthony Byrne

I said the railway accident investigation report made 15 recommendations. We have overlaid that report with our own compliance audit and we believe a total of seven recommendations are common to both. Seven of those recommendations are complete. With regard to the other eight recommendations, we will have a meeting next Thursday, 30 September 2010 with the assistant chief executive of Iarnród Éireann, the chief civil engineer and his senior management team, to review the company's implementation plan and the way forward. At the meeting we will agree time lines for implementation of those recommendations.

Deputy Michael Kennedy

Mr. Byrne referred to seven recommendations which he believed are complete. Surely they are complete and Mr. Byrne knows it because he checked it.

Mr. Anthony Byrne

What I mean by that term is that the company has submitted documented evidence to us and therefore Iarnród Éireann is of the opinion the recommendations are complete. The company has given us the evidence and we must now review that evidence to ensure we are satisfied.

Deputy Michael Kennedy

So Mr. Byrne and the commission will review the evidence to rubber-stamp each——

Mr. Anthony Byrne

Yes, absolutely. We will review them before they are closed. If we are not satisfied with a standard the company has submitted to us, we will say we are not satisfied and we will not close that recommendation.

Deputy Michael Kennedy

That is fine. I thought Mr. Byrne suggested that the commission had accepted the company's report and that would be the end of it.

Mr. Gerald Beesley

On a point of clarification, I will explain the distinction between "complete" and "close". The use of the word "complete" means that Iarnród Éireann has submitted back its presumed method of dealing with the problem. The commission will then review it, agree the timelines, but the issue will not be closed until all the actions are implemented. It therefore remains an open issue. We have this situation under control and that process is now all formally documented.

Deputy Joe Costello

There is a total of 51 recommendations between the three reports. I note there is some overlap but some of those recommendations require resources. For example, I note the failure to introduce an information asset management system. There is a bit of work to be done in that regard and it is a complex process. I note that Iarnród Éireann did not provide adequate resourcing of the engineers and training was not in place. What system has the commission put in place to ensure there is a full implementation of these recommendations, as distinct from drawing up plans as to what should be done?

Mr. Gerald Beesley

The Deputy is asking what other proactive steps are being taken by the Railway Safety Commission.

Deputy Joe Costello

Supervisory steps.

Mr. Gerald Beesley

Yes, but in a proactive sense. The one aspect we have seen in the report is the loss of corporate memory and the commission regards this as probably the most significant issue. Without the knowledge to do the job——

Vice Chairman

Will Mr. Beesley explain that comment in greater detail? We are listening to many examples of loss of memory. Will Mr. Beesley give the committee some indication as to where the loss of memory arose on this occasion?

Mr. Gerald Beesley

Like many specialised industries, the railway industry has a unique fund of knowledge that has been built up over its history. That knowledge is handed down by tradition through training people who are involved in the job and by their peers and their seniors. One of the key features emanating from the railway accident investigation unit report is this loss of corporate memory, in other words, the loss of the information available to do the job——

Vice Chairman

In other words, the records that should be there were not there. Is that the case?

Mr. Gerald Beesley

It may be a situation where it is not known where they are or whether they are accessible.

Vice Chairman

Does this mean the commission could not get the information it wanted?

Mr. Gerald Beesley

No, I think this is slightly different.

Vice Chairman

Will Mr. Beesely explain that statement?

Mr. Gerald Beesley

Within the Iarnród Éireann organisation there should be a certain fund of knowledge to carry out all engineering operating tasks on the railway. Traditionally this has been handed down and built up by experience. Such corporate knowledge is built up even from accident reports. It is a pyramid of knowledge. If for any organisational change reason or lack of a proper hand-over from an outgoing officer to an incoming officer, that information or the means of accessing it does not get handed on, then we have what is known as a loss of corporate memory. I raised this point in reply to a question from Deputy Costello and for which I thank him. My reason for raising this point is that we have taken steps in this regard. I will invite Ms Molloy to comment.

Ms Mary Molloy

When we read the report, one of the areas of most concern to us was that the records relating to the bridge and how the bridge was built existed within Iarnród Éireann some time ago, in the 1980s.

Consequently, we were concerned about the reason this information was not with the people who should have known about it from 1996 until the collapse of the viaduct. We are in the process of appointing experts on information control. These are people who will examine Iarnród Éireann and ascertain how information is managed in that company. This will pertain to informal information, such as how the information possessed by someone who has been working in the company for 30 years is passed on to someone who has just joined, as well as formal information, such as bridge records, because all these records existed in the 1980s. We are bringing in experts to examine and further probe this area.

Vice Chairman

Is Ms Molloy telling members that in this case, important information that was available in the 1980s regarding bridge construction and so on was not available to the commission when it carried out this inquiry?

Ms Mary Molloy

Eight generations of engineers managed to keep the bridge safe and then the ninth generation failed as the correct inspection and maintenance regime was not implemented. Because of this, we will examine this area in somewhat more detail.

Deputy Michael Kennedy

On this aspect of information, presumably retired people have gigabytes of information stored in the back of their brains that never was committed to paper. Will the commission identify such people, interview them and update its records with their knowledge of what they used to do in the 1980s, 1970s, 1960s or perhaps even earlier?

Ms Mary Molloy

The railway company must have a system to manage and control vital information.

Deputy Michael Kennedy

I accept that. However, I am talking about implementing something from now on.

Ms Mary Molloy

We will examine the railway company.

Deputy Michael Kennedy

There certainly are people who have retired or who may have gone to other companies. Will the Railway Safety Commission endeavour to pick their brains to get all the gigabytes of information they have stored in their memories on to its records and those of Iarnród Éireann?

Ms Mary Molloy

We will look at how Iarnród Éireann controls important and vital safety information. This would include how it goes about its maintenance and inspections because clearly——

Deputy Joe Costello

Does Iarnród Éireann have a library?

Vice Chairman

I call Deputy Sargent first and then will come back to the Deputy.

Deputy Trevor Sargent

Many members have questions, which is understandable, given the seriousness of what we are dealing with. For example, I know of one engineer from Iarnród Éireann who retired in the 1980s and who lives abroad. I am interested to ascertain whether he was debriefed fully and whether this could be done now, as well as looking to the future to see what can be done, because obviously a great deal of information needs to be reclaimed and investigated.

I did not receive replies. In general, I appreciate the points made by Mr. Beesley when it comes to looking at the entire picture. However, people need to know and to be reassured that what passed for an inspection in the past will no longer so do. Will there be something tangible to demonstrate the shift from what was inadequate then to a satisfactory level now? I do not know how an inspection works or whether a checklist is used but for example, when I have my car maintained a checklist in respect of each item, down to the smallest bulb on the dashboard, must be ticked before I am expected to believe it has been properly maintained. Does a similar level of detail exists when it comes to an inspection? While it may be tedious, long drawn-out and more difficult, people need to know.

Deputy Kennedy and I raised the issue of the 1997 report to the effect that the fourth pier was too light for the job. This is quite a damning indictment that apparently was left in abeyance. One must question whether this could ever happen again or what now is in place to prevent such an oversight in the future, given how serious the outcome was. I again raise an issue to which I do not believe members have yet got answers. I asked about future-proofing regarding changes related to weather patterns and water flows that are evident and are happening. I note that Professor John Sweeney from the NUI again spoke on the subject from a meteorological point of view on radio this morning. Have such issues been factored in clearly and specifically rather than in a general way?

I refer to the issue of engineers not being trained properly. Obviously, Iarnród Éireann must investigate and I believe a word other than "closure", should be used, such as "verification" because closure sounds as though one walks away and locks the door, whereas I am talking about verification, whereby one double-checks that everything is right. I am unsure whether the new requirements regarding the inspection regime and the training of engineers have yet taken hold or whether we remain in a kind of hopeful period of change. I travel on that line every day, as do many others, and many trains throughout the country go over viaducts and various structures of one sort or another dating from the 1840s. Consequently, it will be important to reassure to those who use all of those services that this episode has marked a watershed in every sense and that the new era has begun. Alternatively, is it about to begin or does a timeframe exist in which the Railway Safety Commission can state that it will have in place new procedures?

Vice Chairman

Mr. Beesley might answer those questions, after which I have a number of further queries. However, I first will bring in Deputies O'Dowd, Costello and Coveney. I ask members to be specific in their questions as we had earlier agreed to try to finish by approximately 5.30 p.m. However, this is a subject of huge importance and Mr. Beesley should first respond to Deputy Sargent.

Mr. Gerald Beesley

I hope my answers can give Deputy Sargent the comfort he seeks and I am not trying to avoid that. Let me take the points he raised about climate change proofing. It is very important and the forces of nature are well understood. In fact, we know that they have had a disastrous effect on railways in Ireland before now. Fortunately, we do not live in an aggressive environment with earthquakes and floods such as Pakistan but that nonetheless does not mean that Iarnród Éireann and its engineering risk assessment should not take those into account. This brings me to the fundamental of the Deputy's question on what actually is happening to make sure that standards and procedures are in place to deal with risk mitigation into the future. The point about the loss of corporate memory is that in such a situation, the standard could be adequate but unless the procedures are there to make sure that this standard is issued and that the person concerned is trained in how to implement that standard, one will have a gap in the process. As members can see, one must take it all the way from the method of doing it, through the competence of the individual who is doing the job, to the competence of his or her supervisor to sign off the job as being complete, to the competence of the management that organises the programme of work that prioritises all the work. All of this will be addressed in the new safety management system and the European legislation that comes into force mandates this to be operable in January 2011. Iarnród Éireann is at present working vigorously with us on that.

I make an additional point that is important in respect of providing some degree of comfort. The joint committee may elicit the point from Iarnród Éireann itself that it has made significant changes in the organisation of its civil engineering department and the manner in which the technical functions get down to the grassroots and the front-line troops. Heretofore, the technical standards and the backroom part of it essentially was a control function but it now is driven down into the divisions in order that it is at the right hand of those engaged in the production side of the work. There have been big changes and it would be appropriate to note that this is a matter for Iarnród Éireann itself.

Vice Chairman

Representatives of that company will appear before the joint committee.

Deputy Michael Kennedy

On the reason the Railway Safety Commission did not inspect the underwater sections of the bridges, does Mr. Beesley not think that given what happened in Malahide——

Mr. Gerald Beesley

The important thing is that we observe a number of these to see that, first, there is a procedure that is adequate and, second, that the procedure has been carried out properly. In this case specialist resources such as diving resources were required to get down to the foundations of the piers. We have done that through being out on-site with Iarnród Éireann. We carried out a number of inspections so that we could see that the procedures it is now adopting are robust. It is not our role to go around and count every bolt in every bridge.

Deputy Michael Kennedy

I accept that but a major accident was averted through the grace of God. Given where we have come from with corporate loss of memory and totally inadequate procedures and disregard for same, the Railway Safety Commission, RSC, is a new body with that responsibility. Does Mr. Beesley consider that as an organisation the RSC should be able to say that on 22 September 2010 it knows every bridge was safe and that one starts from here and can account for anything that happens after that on the basis that Iarnród Éireann's new practices will come into being?

Mr. Gerald Beesley

There are 105 bridges over water that have been inspected——

Deputy Michael Kennedy

By Iarnród Éireann.

Mr. Gerald Beesley

——in accordance with procedures that the Railway Safety Commission is satisfied are robust because we have also been out on inspections on a number of those sites.

Vice Chairman

Is Mr. Beesley saying the Railway Safety Commission double-inspected the sites?

Mr. Gerald Beesley

We were with Iarnród Éireann as the inspections were carried out.

Vice Chairman

Yes, but on a sample basis.

Mr. Gerald Beesley

Yes, on a sample basis.

Deputy Michael Kennedy

Does Mr. Beesley have a view on recommendations?

Mr. Gerald Beesley

Yes. I wish to add something to the previous point raised. Once we are satisfied that we have got it right in one area we must not over-concentrate because there are so many other areas out there that we have got to supervise in railway safety. We must apply our resources very carefully. We are satisfied that the procedures now in place are robust for the job in hand.

On the question of——

Vice Chairman

I wish to bring in Deputy O'Dowd next.

Deputy Michael Kennedy

Does Mr. Beesley have recommendations that he might pass on in the event of a future emergency?

Mr. Gerald Beesley

Could I bring in Ms Molloy to answer that one?

Ms Mary Molloy

On the emergency services and the running of trains, Iarnród Éireann meets frequently with the emergency services. Responsibility for the emergency services rests with them but they meet with Iarnród Éireann and they know the different types of trains there are. That is managed between Iarnród Éireann and the emergency services.

Deputy Michael Kennedy

In the light of this accident have there been meetings for all of the people involved so they can say what they need in terms of resources and how they would implement plans? If, for example, Deputy Sargent was on the train — I do not know how good a swimmer he is — he could probably only take one person in to shore with him in the event of the train ending up in the water. How would one get the fire brigade to put out a fire and get boats out?

Ms Mary Molloy

That is a difficult question to answer. Bridges are designed so that trains will be contained and not come off them.

Deputy Michael Kennedy

Does the RSC not think it appropriate for the emergency services to analyse the potential of what could have occurred at Malahide and say what they would do in the event of it happening elsewhere? If one is on the ground one can use tractors or JCBs to lift a train off the tracks but it is a different story when one is in the water.

Ms Mary Molloy

I do not know what the emergency services do for road traffic. There are lots of bridges over the Shannon, for example, and all around the country. I do not know how the emergency services would manage a disaster over water. I am aware that Iarnród Éireann meets with the emergency services and they hold table top exercises and real exercises.

Deputy Michael Kennedy

Perhaps we could invite them in for a future meeting.

Vice Chairman

Yes. We will move on. We are running into injury time. I call Deputy O'Dowd.

Deputy Trevor Sargent

I have been here longer.

Deputy Fergus O’Dowd

We are present to discuss injury and death. I respect the fact that Deputy Sargent has been present for some time. The meetings used to take place on Thursdays. I had made another appointment but I was keen to meet with the Railway Safety Commission.

Deputy Trevor Sargent

Apology accepted.

Deputy Fergus O’Dowd

The issues I wish to raise are clear. The first relates to transparency and accountability. On its website the Railway Safety Commission says it will be accountable and will fulfil the spirit of the Freedom of Information Act, notwithstanding the fact that it does not apply to it. One of the key issues relates to how it does that especially given that there is no accountability in terms of freedom of information. I was unsuccessful in trying to get information from the Railway Safety Commission. That is a matter of record between us. Is it not a fair point that the findings of the rail accident investigation unit were against the Railway Safety Commission in its operations?

Ms Mary Molloy

Only two recommendations were made to the Railway Safety Commission.

Deputy Fergus O’Dowd

The most important one was Iarnród Éireann informed the Railway Safety Commission that the scour plan had been put in place for the bridge or complex and that the Railway Safety Commission believed that was the case when it had not been done. How does one account for that? How can we accept anything the Railway Safety Commission says if it accepts assurances from Iarnród Éireann that are untrue which placed at risk everyone who was on the train or who travelled by train over that bridge during the year in question? The Railway Safety Commission's systems are appalling if it was told a lie about the work but the work had not been done. How can we believe the Railway Safety Commission in future?

Mr. Gerald Beesley

I will take that question and hand it to my principal inspector, Mr. Byrne, to answer.

Deputy Fergus O’Dowd

With respect, I was asking Mr. Beesley who is the chief of the Railway Safety Commission.

Mr. Gerald Beesley

All right, fine. The situation is a little more complex than just closing a recommendation. A total of 67 recommendations were made in the A. D. Little report of which 58 were closed.

Deputy Fergus O’Dowd

There was an earlier report about scour management on the bridge dating back to 1998.

Mr. Gerald Beesley

Each of the recommendations is broken down into the actionable areas that require to be dealt with. Any one recommendation may have a multiplicity of action areas. In the case of the particular item to which Deputy O'Dowd referred, there were three actions. The first was to review and revise the structural inspection standard. The second was the basis of the new standard to amend the training for engineers and roll out a new training programme for them. The third was to develop a scour flood management plan for the whole country. They were all elements of that——

Deputy Fergus O’Dowd

With respect, an earlier report, the IMRS report, specifically identified scour as an issue with the bridge in question. That was not for the whole country but that specific bridge. The Railway Safety Commission was told by Iarnród Éireann that it had done that when it had not. That is the key.

Mr. Gerald Beesley

If I may, I am coming to this step by step. First, the report to which Deputy O'Dowd referred was commissioned by the Department of Transport not by the Railway Safety Commission.

Deputy Fergus O’Dowd

That is correct. But the accident and investigation unit was part of the Department of Transport. The report is on the Internet. It relates to safety and the Railway Safety Commission. Mr. Beesley cannot say the report did not exist even though it might predate the setting up of the RSC.

Mr. Gerald Beesley

I explained earlier but I will repeat the history of the formation of the Railway Safety Commission. It gained its powers——

Deputy Fergus O’Dowd

With respect, I am not interested in that, I am interested in the safety issue. The bridge was dangerous. It was identified as having 60% inadequacy where zero is safe and 5% is the extreme limit to which one can safely go.

Mr. Gerald Beesley

Five per cent is best practice.

Deputy Fergus O’Dowd

Yes, exactly. It was potentially the second worst location in the country.

Mr. Gerald Beesley

That is correct. If I may now proceed to answer the Deputy's question——

Deputy Fergus O’Dowd

Yes, of course.

Mr. Gerald Beesley

——this particular recommendation was broken down into its three actionable parts. In regard to the revised standard for inspection, we got that. We saw the revised standard for inspection and were happy with it. We also saw the revised training materials and training plan and carried out spot check to determine whether engineers had been trained. They had been. We were advised that Irish Rail would undertake an assessment of all bridges. I refer not only to bridges over water because the structural inspection standard applies to all bridges. There are 700 such structures on the railway. We were also advised there would be an implementation plan based on the inspection process. There was evidence that the company was progressing with it but that it was not complete. However, on the basis that the company had considered various items along the path and given a verbal undertaking, the statement was accepted at the time.

Deputy Fergus O’Dowd

By whom?

Mr. Gerard Beesley

There was a weakness in that regard, but we would all be very good if we had the same level of foresight as of hindsight. It was referred to in recommendation No. 14 of the independent accident investigator. That matter has been remedied within the Railway Safety Commission in order that all closures are properly documented and dealt with.

Deputy Fergus O’Dowd

I may ask the Railway Accident Investigation Unit what it is stating. In 1998 the IRMS report identified the circumstances that would obtain if there were problems anywhere along the estuary. The safety inadequacy score was 60%. Therefore, a red light indicated a potential problem. There was a reference to there being no proper scour management system in place. The report refers specifically to the location in question. The Arthur D. Little reports and all of the others refer to this issue. Everybody who travelled on trains over the line was at risk after the Railway Accident Investigation Unit was told the job had been done. However, it had not been. There was no proper scour management system in place and, therefore, everybody was at risk. Is that true and a fair point? The unit commented on this aspect. What exactly did it find? Is what I am saying right or wrong?

Ms Jill Cregan

With regard to the IRMS report carried out in 1998, the Deputy is correct when he states the Malahide viaduct was assigned a safety inadequacy score of 40%.

Deputy Fergus O’Dowd

Sixty per cent. I may be wrong.

Ms Jill Cregan

It goes the other way. A score of 5% is considered to reflect best practice, while a score of 0% is considered safe. The Railway Accident Investigation Unit could not find any information on how the safety inadequacy score had been assigned to the Malahide viaduct. However, there were also safety inadequacy scores pertaining to the adjoining structures; therefore, that might have been an element.

Deputy Fergus O’Dowd

I accept that. There was a score of 60% for the whole lot and a score of 45% for the actual line. It is not as clear as it might be, but the same location is at issue.

Ms Jill Cregan

Yes.

Deputy Michael Kennedy

It was about eight times less safe than the norm if one takes 5% as the average.

Vice Chairman

When the delegates saw the figures which represented a high risk reading, did they not believe the first place they should have arrived was the viaduct at Malahide?

Mr. Gerald Beesley

With respect, because this predates my taking up——

Vice Chairman

This is memory loss again.

Mr. Gerald Beesley

No.

Vice Chairman

From where should the information have come? Why should somebody not have given it to Mr. Beesley?

Mr. Gerald Beesley

With due respect, the answer would be better coming from Ms Molloy because she is very well informed on what——

Deputy Fergus O’Dowd

My question is to the rail accident investigation unit, not Ms Molloy. It is a separate organisation within the structure. What exactly was its finding on this issue?

Ms Jill Cregan

Let me refer again to the IRMS report. The implementation review states that, in 2000, "It is noted that scour is the subject of one of the standards that IE's consultants [...] will be producing. This should address not just the assessment of vulnerability of a structure to scour and its routine examination but also how times of flood are dealt with". Our findings are that the consultants employed by Iarnród Éireann were not employed at a later date and, therefore, the standard in regard to scour was not produced. An assessment of the vulnerability of structures vulnerable to scour and the assignment of a routine examination were not carried out. There was no procedure to deal with times of flooding. There were several failings on Irish Rail's part. However, our recommendations have dealt with these issues.

Deputy Fergus O’Dowd

The Rail Accident Investigation Unit also made a finding against the Railway Safety Commission.

Ms Jill Cregan

With regard to the finding, the commission forwarded us a letter it had written to Irish Rail on 9 April 2006, in which it had documented that it considered a recommendation for a closure in regard to the development of the flood and scour management system. Consider the evidence produced by Irish Rail for the Railway Safety Commission. It forwarded information to the effect that it would include elements in its inspection standard documents. The reason the Railway Accident Investigation Unit did not consider that the recommendation was closed was that there was no information in Irish Rail's structural inspection standards on managing structures in times of flooding. There were no formal parameters defining flood incidents; therefore, we did not believe the recommendation should be closed.

Deputy Fergus O’Dowd

That is the key to it all. There were no proper scour management investigations on the site because the Railway Safety Commission believed something was done that had not been done.

Ms Jill Cregan

The recommendation was made to Irish Rail and it was up to it to meet the standard.

Deputy Fergus O’Dowd

However, it accepted it. It was told the investigation was carried but it had not been. That is the point I am making.

Ms Jill Cregan

Yes.

Deputy Fergus O’Dowd

It is not about the Railway Safety Commission. The Railway Accident Investigation Unit was told by Irish Rail that there were no issues in regard to scour management and that the breach was safe when, in fact, it was not. Ms Cregan's finding is that the commission should not have accepted that fact because it was not true.

Ms Jill Cregan

Yes.

Deputy Fergus O’Dowd

Therefore, bearing in mind that I do not doubt the integrity of anybody, how can we believe all bridges are safe? One should remember that hundreds of people, most of whom would have been from my constituency, could have died. That is why I am deeply worried about this and remain deeply concerned. While I accept the bridge is now safe, I am still not happy because I have a serious doubt about the credibility of Irish Rail. I have stated before that there ought to be prosecutions. Is the rail accident investigation unit considering prosecutions against Irish Rail as a company or against individuals as a result of the company's neglect of the duty of care to the public? I refer also to the failure to inform the Railway Safety Commission that the biggest threat in terms of scour had not been investigated properly by the company and that it did nothing about it. Is the railway accident investigation unit considering prosecuting Irish Rail?

Mr. Gerald Beesley

I understand exactly where the Deputy is coming from. With regard to the safety of bridges, the public needs to understand that, as a result of the incident at Malahide, not only was the bridge at Malahide inspected and subsequently reconstructed, 105 other bridges were also inspected to ensure the technical integrity of the underwater foundations of their piers. That is very important.

Deputy Fergus O’Dowd

That is 12 years after it should have happened.

Mr. Gerald Beesley

This concerns scour where the effect of water on the piers——

Deputy Joe Costello

That is one element that we have discovered to our chagrin.

Mr. Gerald Beesley

This is where the water impinges on the foundations and where underwater inspections are required to ascertain their condition. That is the most critical area.

Deputy Simon Coveney

Is Mr. Beesley satisfied there are no more scour issues with any of the viaducts?

Mr. Gerald Beesley

I am satisfied with the inspections carried out on the 105 over-water viaducts that have been inspected.

Vice Chairman

What about legal proceedings?

Mr. Gerald Beesley

On the question of enforcement by the Railway Safety Commission, enforcement is the stick in the carrot-and-stick process of encouraging and ensuring railway safety. It is not there as a punishment.

It is an escalating process that starts with issuing a request for an implementation plan to address an issue. It would then escalate to an enforcement order. The ultimate sanctions available to us cannot be applied without having gone through the various steps beforehand. They are used usually because there was a failure to address an issue along the way.

Deputy Fergus O’Dowd

Which there was and there was a finding against Mr. Beesley's organisation. It simply did not do its job. Irish Rail is getting away with murder.

Deputy Joe Costello

There is gross negligence all over the place.

Deputy Fergus O’Dowd

That is the truth of it.

Mr. Gerald Beesley

We are reviewing the railway accident investigation report. It has been in our hands for several weeks. We are considering whether it is feasible and in the public interest to pursue a course of action along the lines suggested by Deputies.

Deputy Michael Kennedy

I acknowledge the integrity of everyone before the committee. Before Mr. Beesley's organisation came into being, it was clear in 1996 and 1997 that there were breaches in rail safety. There were clear indications of problems. No one saw fit to do anything about it. Were any of Mr. Beesley's predecessors culpable in ignoring some information that came to them? Should they have sought the information? In 1998 International Risk Management Services, IRMS, assigned the viaduct a 60% security risk on a scale where 5% is best practice. The Malahide viaduct was, therefore, 12 times more dangerous.

Someone did not follow up on this. It is in the public interest for people to know train travel over viaducts is safe. I am also concerned for Deputies O'Dowd and Sargent when they travel by train on this viaduct.

Deputy Joe Costello

We have been operating in the same area for some time. It is clear the 1998 IRMS report should have been acted upon. It was a warning, as was the independent 1997 report that claimed the rock armour was too light, and should have been dealt with by the Railway Safety Commission. It is incredible that the inspection three days before the accident did not even notice the effect of the scouring. The quality of inspections carried out by Iarnród Éireann must have been totally inadequate.

The response to any suggestion from an independent source by the Railway Safety Commission was also inadequate. How could Iarnród Éireann lose all the information relating to the viaducts?

Across the board there is a level of responsibility as to what actions need to be taken. I believe in the need for a further report to go to the Minister for Transport on this matter and for it to then go to the Director of Public Prosecutions for a court action against gross negligence and dereliction of duty.

What structural systems will be put in place to ensure such an incident will not happen again? What happens to those who did not fulfil their duties properly must be dealt with in a separate process. The committee's first priority is to ensure all the recommendations made by the various bodies are implemented.

While it may be wonderful that 105 over-water viaducts have been inspected, there are 680 viaducts in total which may have deterioration problems. There are 1,902 under-bridges, any one of which may collapse. Have they all been inspected? Is there a system in place to ensure regular inspections?

It is essential that these recommendations, which have emerged from this accident, are implemented. It is not good enough to say, "It will be all okay on 1 January 2011 when the new EU legislation comes into place." Legislation is meaningless without enforcement. How will we know these recommendations will be enforced when previous recommendations have not even been implemented?

Deputy Simon Coveney

The efforts of the Railway Safety Commission to regulate safety on the railways preceding this incident failed. The relationship between Iarnród Éireann and the Railway Safety Commission was based on trust. It should not have been because the information coming from Iarnród Éireann was not correct. Mr. Beesley said that following the 1998 report, issues around engineering training were being dealt with by Iarnród Éireann. It is clear from the report published this summer, however, training issues were not. We need some reassurance that the Railway Safety Commission will take a much tougher line with Iarnród Éireann in asking hard questions and conducting robust inspections to ensure work is carried out to the standard it should be carried out. The Malahide viaduct collapse was a wake-up call for everybody. I am not that satisfied with the answers we have received today — that only seven of the 15 recommendations have been achieved and that the other eight will be discussed at a meeting next week.

Mr. Anthony Byrne

With all due respect, the report only came out on 16 August. We have only had sight of the recommendations.

Deputy Fergus O’Dowd

All of these issues were identified in the audit carried out in February.

Mr. Anthony Byrne

The audit was carried out in February. In the work we undertook we looked at compliance issues.

Deputy Fergus O’Dowd

Yes, but most of them were identified.

Mr. Anthony Byrne

We identified four areas in which there was non-compliance and made 16 recommendations, of which 13 are now complete. We have received and are reviewing evidence with a view to closure, if satisfied. As I stated, the RAU report was issued three to four weeks ago and seven of the recommendations overlapped our work.

Deputy Simon Coveney

Seven of the recommendations have been achieved

Mr. Anthony Byrne

Yes

Deputy Simon Coveney

What about the other eight recommendations?

Mr. Anthony Byrne

Work is in progress. We will close them until we are fully satisfied. We are having a meeting next week.

Deputy Michael Kennedy

Did the Railway Safety Commission consider it was adequately resourced for the future?

Vice Chairman

I accept that Mr. Byrne does not speak for Iarnród Éireann and that its representatives will appear before the joint committee again, but on a previous occasion it gave a robust defence of the safety measure in place, which were to the last letter of the law. In Mr. Byrne's opinion, given what he has found, is there any credibility attaching to an organisation which can spin the evidence? Was it reasonable for and sensible of Iarnrod Éireann to put up such a defence of the safety measures it had taken before the report came out? There is no magic about this question; the representatives of Iarnród Éireann were sitting where Mr. Byrne is sitting and both the chairman and the chief executive gave a robust defence of the safety measures in place. I ask all the delegates in their respective roles to comment on the evidence given by the chairman and the chief executive and whether they were living in cloud cuckoo land when they put up that defence.

Mr. Gerald Beesley

For the benefit of the committee as a whole, the situation is that Iarnród Éireann's safety performance is very good by European standards. We run a safe railway. It would have every right to say it has a safety management system that addresses a great many issues. However, what the Rail Accident Investigation unit has unearthed is that there was a fatal flaw in a particular part of the system. It has also unearthed other worrying features such as the loss of corporate memory which may have wider implications. That is why we in the Railway Safety Commission are concerned to address that issue. I cannot speak for how the representatives of Iarnród Éireann in terms of how they wish to spin their presentation on their safety procedures. All I can say is that looking at statistics Iarnrod Éireann is a good performer in terms of rail safety. There have not been collisions.

Deputy Fergus O’Dowd

We could have been looking at a scenario where there could have been 200 to 300 fatalities.

Mr. Gerald Beesley

Absolutely.

Deputy Fergus O’Dowd

The Railway Safety Commission did not insist on producing the goods on the scouring issue. That dates back to 1998 and is the core of the issue.

Mr. Gerald Beesley

Deputies O'Dowd and Kennedy raised the issue of predecessors. As I said, until 1997, the matter of rail safety was in the hands of one individual, the late Vincent Feighan who was the railway inspecting officer.

Deputy Fergus O’Dowd

I know that.

Mr. Gerald Beesley

His role was to investigate accidents and approve new works. There was no inspection or supervisory role at the time.

Deputy Fergus O’Dowd

I am aware of that.

Mr. Gerald Beesley

Following the passage of the Railway Safety Act 2005, the Railway Safety Commission was established, but the supervisory role was not mandated until Statutory Instrument 61 of 2008 was placed on the Statute Book.

Deputy Fergus O’Dowd

Is Mr. Beesley saying the Department of Transport had that role up to that point?

Mr. Gerald Beesley

As European legislation has been given effect in this country, the Railway Safety Commission has developed and grown. It is a young organisation. It has moved from having one inspector on inspection duties to four. To respond to Deputies Kennedy and Coveney, I am conducting a study of the issue internally and will be presenting my findings to the Department shortly.

Vice Chairman

I thank the delegates for their contributions. This issue is of major importance to every rail commuter across the country. As has been acknowledged, this is the place in which to ask all of the difficult questions. We have to hope that what the delegates have told us will work in the way we all want it to work.

The joint committee adjourned at 6.10 p.m. until Wednesday, 6 October 2010.