Bolger's comments on Cave Creek
Mostly academic now, but there's a short stint of talk from Jim Bolger on the Cave Creek Tragedy, from about 1h:05m:30s onwards. http://www.radionz.co.nz/programmes/the-9th-floor/story/201840999/the-negotiator-jim-bolger One claim I'd never heard previously was that Denis Marshall, then Minister of Conservation, offered to resign immediately after the accident. Bolger told him not to, and now believes that was a mistake. He also trotted out the same line of regret about having to take symbolic responsibility for actions which he and the Minister couldn't possibly have known about. I doubt anyone would expect a Minister to be micro-managing things like nails versus bolts, yet DOC was later shown to have been a critically under-resourced and dysfunctional agency at the time, and that because of this it was likely that something like Cave Creek would have happened sooner or later. I still don't see how a Minister cannot be allocated serious responsibility for not knowing and dealing with an agency in such a dysfunctional state.
@TH Thanks for clarifying the 'getting rid of skilled engineers' aspect.
Regarding Cave Creek, I understand there was a cantilever weight supplied that wasn't used on the platform. My brother-in-law, Roy Arbon, outed the use of nails instead of bolts when he was being interviewed by Tsehai Tiffen for the news. He was one of the SAR volunteers attending the collapse. Unfortunately Roy is currently in jail awaiting sentencing for importing 6kg of cocaine into Australia. The victim of a scam. If anyone on tramper.co.nz knows him, we have a give-a-little page set up to assist with legal costs for his defence.
Just reading up about your brother in law. What a sad situation. Poor fulla has been preyed on because he is lonely. Man the Internet can be an evil place.
Too many people call "underfunding". I suppose calling DoC underfunded is the politically correct thing to do right now (despite DoC itself making the strongest claims it is not underfunded at all). But building a platform to specs has nothing to do with underfunding. Please read the commission of enquiry's report. For example the guy approving the plans, didn't complain about funding, but: "... he lacked any expertise in this area, he was unable to recognise that a specialist was required [to have a look at the platform plans]". I.e. we call that incompetent, and not recognising you are. More money doesn't help here.
Who are you addressing, Berend? I can't see anyone in this thread who's outright blamed the accident on under-funding. I agree with the incompetence label, but it also comes down to whether you blame the person for not knowing what they were meant to be doing, or the agency for putting the person in that position and, explicitly or implicitly, demanding results which go well beyond the resources and skills which the person's capable of. On the funding and general resourcing aspects, though, Judge Noble did write in the Commission of Inquiry's report: "A lack of money was not the cause of the Cave Creek collapse. None of the department’s witnesses suggested it was. Neither do I. But in my view, the inadequacy or otherwise of funding is highly relevant to this inquiry in providing a background against which the evidence and submissions can be judged." - section 1, page 43. "The position at the Punakaiki Field Centre well illustrated the under-resourcing/under-staffing dilemma. It is clear from the evidence that the prevailing culture was one of seeking to do more with less and of working long hours in order to cope with changing priorities—shifting the goal posts, as one witness put it." - section 1, page 50. "Society always likes to feel it is progressing, but there are lessons for society in all of this. No government organisation can do its job without adequate resourcing. In my opinion, it is up to governments to ensure that departments charged with carrying out statutory functions for the benefit of the community are provided with sufficient resources to enable them to do so. Here, the evidence is clear that the Department of Conservation lacked and continues to lack those resources. For future safety that must change." - section 2, page 93. @PhilipW, thanks for that reference to the Guy Salmon report on DOC's establishment. I'm only half way thorough, but hadn't seen that one before.
izogi, yes I know Judge Noble felt the need to write "underfunding" but he does not provide us with a single instance where underfunding had anything to do with the collapse, and it doesn't feature in his causes. DoC may have been underfunded, but that was irrelevant. The collapse was the inevitable result of a department that had no interest in following the law or having any kind of process in place that would have prevented cases like this. Money would not have changed anything there, and Noble never makes the case it is (irrelevant references to underfunding are the only weird feature of this excellent report). Key phrase: "I do not intend to denigrate or reflect in any way upon the veracity of any individual but, unhappily, I was left with the impression that these very capable people from the top levels of the department's hierarchy simply did not seem to appreciate the concept of accountability in personal terms as it applies, for example, to the private sector. Knowing one is accountable requires consciously acting in a manner that takes account of all known potential pitfalls. It requires one consciously to adopt a risk analysis and risk management approach. This concept scarcely needs explanation in the private sector, where being accountable may mean loss of wages, a job, a business or profits, or damages, or some other form of financial disadvantage. But in this part of the New Zealand public sector I am left with the uneasy impression that the understanding of accountability is blurred." But we are very fortunate the DoC appears to be a very different entity now. PS: obviously to improve, DoC had to be adequately funded, so in that sense I think Judge Noble's statements helped.
As a result of cave creek, DOC introduced a comprehensive asset management system, which includes engineering sign off, inspections, work scheduling etc. This has soaked up massive amounts of DOCs $$. So it could be argued, that DOCs underfunding prevented implementing a asset mgt process that met "industry: standards. But the reality is, some managers didn't know what they didn't know. Never gave it any thought. And didn't realize field staff totally unqualified were making decisions about asset construction, and upkeep. The judges points about lack of understanding about accountability are interesting. Nothing to do with lack of funding
Could it be a reasonable to say that the fact that those at the top of DOC didn't seem to understand the concept of accountability, according to the COI, means they needn't have been held accountable? That's the part of this that I still struggle to understand. I can understand the concept of people at the low levels being instructed to do stuff without being given the necessary skills, but I can't understand how someone at the top levels couldn't comprehend that it's necessary to ensure your staff are appropriately skilled for the jobs you're requiring of them. Sure, the Building Act was fairly new, but it's not as if there was a complete void of building standards and regulations before it existed. A separate review by the SSC in 1995 noted that DOC didn't know where its money was going or how much things were costing, and this in turn basically crippled its ability to ask for extra money if it were needed. An extrapolation of that could be that it probably also had no clue about what its staff were doing in their regional silos. *Surely* this is the type of thing that those at the top should either be keeping under control, or if that's not possible then being vocal to their Minister that the agency's incapable of carrying out its mandate. But they weren't, or the Minister and Cabinet did nothing, and 7 years after its creation DOC was still a disorganised shambles. I guess this all contributes to the conclusion of "systematic failure", but is it really not possible to assign fault to any person or people for allowing the system to fail so catastrophically?
@izogi "I guess this all contributes to the conclusion of "systematic failure", but is it really not possible to assign fault to any person or people for allowing the system to fail so catastrophically?" should have been able to make those responsible, accountable Its starts at the top, the DG appointed Directors and those people appointed technical staff responsible for planning and policy etc of operations. The DG went, but the Directors didnt The DOC head office had more than its share of highly paid staff, as did the regional offices, have technical staff that issues like standards and planning was their job
did the forestry service ever build major viewing platforms? did they have any major structural failings in their structures? my impression is the forestry service were making more stock standard structures than DOC ended up making, large cantilevered viewing platforms are something that seem to me more out of the ordinary in the parks in recent times... it was a specialist structure without a tried and tested design done by DOC beforehand. perhaps staff were complacent because normally they would be making structures they were more familiar with and knew how to construct with minimal issues? and they were caught out when DOC moved more into more specialist structures for tourists over and above standard hut and bridge designs... we've all seen huts and bridges that are identical or very generic designs used throughout the country and have been built repeatedly by staff who are more likely to become well versed in their construction or at least have someone supervising who is well versed in their construction, rather than being handed a specialist design they have never have to build before and that will have major safety issues if the design isnt followed carefully. I'm not justifying or excusing the failure of the platform, just raising it as one factor that could have contributed to the building of a faulty structure...
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