Annual Review 2007


The ATSB has come a long way since its creation on 1 July 1999. Legislation, training and IT systems have all been upgraded. The ATSB has an increasingly national and international reputation for independent safety material. This is reflected in the almost 800,000 new visitors to the ATSB website which also had more than 30 million 'hits' in 200607, and in multiple articles in such publications as the prestigious US-based Flight Safety Foundations AeroSafety World.

During 2006 - 07, the ATSB finalised its complex investigation into Australian civil aviation's worst accident since 1968, the 15-fatality aircraft accident near Lockhart River, Queensland on 7 May 2005. The 500-page final report released on 4 April 2007 identifies important safety issues to enhance future aviation safety relating to the crew, the operator, regulatory oversight and instrument approach chart design. Three ATSB factual reports, a research report and ten safety recommendations were released during the course of the almost two-year investigation. A further ten safety recommendations were issued with the final report, which also utilised an enhanced ATSB investigation and analysis methodology. Among other coronial inquests, the ATSB assisted with the inquest into the Lockhart River accident by the Queensland State Coroner which included a month of hearings on Thursday Island and in Brisbane. The Coroner reported on 17 August 2007.

During the year the Bureau released 80 final aviation investigation reports, 19 aviation safety recommendations, 10 aviation safety research reports and five research grant reports. The ATSB also cooperated with the Indonesian National Transportation Safety Committee (NTSC) in the investigation of the Garuda Airlines Boeing 737-400 accident at Yogyakarta Airport on 7 March 2007 in which 21 died, including five Australians, and 12 were seriously injured. ATSB assistance included an on-site team comprising a Deputy Director and two senior investigators, flight recorder analysis in Canberra, and the drafting of preliminary and final reports.

In April 2007 the Bureau introduced a new Safety Investigation Information Management System (SIIMS) aviation database which will be extended to rail and marine in 2007-08. SIIMS was developed using the $6.1 million committed by the Australian Government in the May 2004 Budget, and was within time and budget.

In marine, the ATSB released 14 investigation reports, issued 38 safety recommendations and continued an education campaign on commercial fishing vessel safety. International success included ATSB coordination and facilitation of recent amendments to the Code for Investigation of Marine Casualties and Incidents as a member of the IMO Flag State Implementation Subcommittee. The ATSB also assisted with the inquest into the loss of the Immigration vessel Malu Sara with five fatalities in the Torres Strait.

The ATSBs rail safety investigation team released nine final reports and 39 safety recommendations under the Transport Safety Investigation Act 2003 (TSI) which included a number of level crossing accidents. In June 2007, the ATSB published jurisdiction regulators rail safety occurrence data in eight key categories covering the period January 2001 to December 2006. Further improvements in rail safety data are being sought through a process coordinated by the National Transport Commission.

The ATSB is continuing its commitment to training its investigators through accredited Diploma of Transport Safety Investigation. In 200607, 12 staff completed the TSI Diploma with 13 progressing through the required coursework and mentoring.

In March 2007 I completed my term as Chairman of the International Transportation Safety Association (ITSA), which includes major independent transport safety investigation bodies from around the world. ITSA has been revitalised and has grown to include the UK, Japan and Norway. France and South Korea are potential new members.

The ATSB continued to support Ministers with road safety advice and coordinated with other jurisdictions to develop the National Road Safety Action Plan for 2007 and 2008, which was approved by Ministers of the Australian Transport Council. While the challenges in road safety are immense, progress is being made in jurisdictions and through other stakeholders. It has been my privilege to chair the National Road Safety Strategy Panel since 1999 and work with such dedicated officers as ATSB General Manager Joe Motha and Team Leader John Goldsworthy and senior staff including Chris Brooks.

In 2006-07 the ATSB released 25 road safety research and statistical publications including a report on transport injuries amongst Indigenous people. The Bureau also helped organise an Indigenous road safety forum in October 2006. Work continued in preparation for the major novice driver research trial in New South Wales and Victoria which the Australian Government is supporting. Partners are scheduled to finalise the curriculum and conduct pilot testing before the end of 2007.

All of the achievements made in 2006-07 and on an ongoing basis are the result of the dedication of ATSB professional officers. For this untiring service, I salute them all. Most have made major personal sacrifices to make a difference for future transport safety. I particularly recognise my direct report colleagues: Peter Foley, Kerryn Macaulay, Joe Motha, Alan Stray and Julian Walsh. The investigator-in-charge of the Lockhart River investigation, Greg Madden and his team also deserve special praise.

Type: Annual Report
Publication date: 31 October 2007
ISBN: 1 921092 26 9
ISSN: 1444-4798
Last update 07 April 2014
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