Spanish Rail Crash

[jjb1970]

There was a fashionable idea a few years ago called the car crash school of management which advocated pushing people harder and harder and that you'd know when they were pushed too hard as they'd crash. A bit like with a submarine you'll never really know how deep it can dive unless you take it to crush depth. I always found the idea to be appalling.

The other extreme was a guy I worked with who was taking four to five times longer than anybody else to do the same job and cried wolf about bullying and risking safety when he faced questions about why he was so slow. He was doing safety critical work, as he was doing design calculations for the propulsion system of ships. I could do a full set of calculations in 7 - 12 hours which was average, he was taking 30 - 60 hours for the same jobs and claiming any pressure at all to speed up was showing a flagrant disregard for safety. To be honest in a situation like that I think it is fair to ask questions about pace, he was dismissed in the ends on capability grounds.

[Glorious NSE]

This is not an equivalent example.  Although I know very little about running a railway I do know that trains operate to diagrams/timetables so once a realistic and achievable time is set for a route the driver cannot/should not try to beat it, if anything the train 'may' be late.......but not early!

I would disagree there, railway history across the world has featured multiple accidents caused by misplaced pride by crews in not being late. Even relatively recently Japan has suffered a multiple fatality derailment (not so different to this one) caused by the driver having undue pressure placed on him to be punctual, regardless of safety.

[Jeff Smith]

I would disagree there, railway history across the world has featured multiple accidents caused by misplaced pride by crews in not being late. Even relatively recently Japan has suffered a multiple fatality derailment (not so different to this one) caused by the driver having undue pressure placed on him to be punctual, regardless of safety.

Yes I hadn't thought of that aspect.....

[pete_mcfarlane]

This being the most notorious British example: https://en.wikipedia.org/wiki/Salisbury_rail_crash

[martin_wynne]

I would disagree there, railway history across the world has featured multiple accidents caused by misplaced pride by crews in not being late. Even relatively recently Japan has suffered a multiple fatality derailment (not so different to this one) caused by the driver having undue pressure placed on him to be punctual, regardless of safety.

 

See: http://www.bbc.co.uk/programmes/b03yfwk3

 

There is a 3-minute clip from the programme here:

 

http://www.bbc.co.uk/programmes/p01v1qhn

 

Martin.

[bbishop]

This being the most notorious British example: https://en.wikipedia.org/wiki/Salisbury_rail_crash

Pete,

 

Sorry, I don't agree.  LSWR Management certainly wanted to beat the opposition into London and one way as to reduce the locomotive changes from two to one, resulting in the Boat Train not stopping in Salisbury.  Before 1904, there wasn't a speed limit at Salisbury and Drummond stopped the inaugural run to warn the driver about running slowly through Salisbury.  Thereafter a speed limit of 30mph was set, and Drummond would "interview" drivers who arrived too early at Waterloo.  However, a culture seems to have arisen amongst the drivers to exceed the speed limit.

 

The South Western Circle published a Monograph entitled Salisbury 1906 by Norman Pattenden.  The causes of the accident are excessive speed and the fact that the L12 locomotive had a higher centre of gravity than the usual T9.  Norman moots that Driver Robins may have fallen into a micro-sleep at the crucial moment.   The SWC will republish the Monograph next year.

 

Bill

[The Stationmaster]

I would disagree there, railway history across the world has featured multiple accidents caused by misplaced pride by crews in not being late. Even relatively recently Japan has suffered a multiple fatality derailment (not so different to this one) caused by the driver having undue pressure placed on him to be punctual, regardless of safety.

But perhaps not so much the case in Britain.  The vast majority of high speed derailments and collisions in Britain have been the result of errors (some of which remained unsolved of course) with very few down to specific excessively fast running in order to make up time or uphold some form of prestige.

[Tigermoth]

Doesn't the law of averages come into this as well, sometime, somehow, someone is going to make a mistake.

[The Stationmaster]

....doesn't the law of averages come into this as well........sometime, somehow, someone is going to make a mistake.....

I don't think it even needs to be the law of averages, more the law of s*d in many cases.

 

But that is the whole point of why the better part of two centuries have - in Britain at least - been spent devising new equipment, new materials, and different procedures and Rules & Regulations in an effort (generally highly successful) to avid the opportunities of the laws of averages or s*d having any impact.  I doubt if anything quite as diverse as a railway can, at least at normal economical cost, be made absolutely 100% foolproof but Britain's come pretty close to that, although in some instances there is still nothing to prevent a Driver making a fatal mistake.

[wombatofludham]

Sixty years ago there was a high speed derailment at Sutton Coldfield caused when a diverted York to Bristol express, driven by a conductor driver familiar with the route, inexplicably took the sharp curve through the station at about twice the speed restriction. The loco, a Black 5 overturned causing the coaches to pile up behind it and into the station structures. Some of the coaches were wooden bodied which virtually disintegrated. Although running about half an hour late due to other diversions and slowings, there was no indication that the driver was attempting to make up time. According to the inspector's report, the driver was regarded as a conscientious driver familiar with the route who had a reputation for "driving hard" but wasn't regarded as a problem. The report did identify a number of systemic issues including an impossibly tight timing over the line, the lack of speed restriction signs and a lack of speedometer on the loco, plus some cultural issues such as the reluctance of guards to apply their emergency brake when the guard realised the train was travelling too fast, and the fact the rostered train driver wasn't on the footplate whilst the conductor driver was in control, contrary to the rule book. There was also criticism of the management attitude which seemed to be too reliant on driver route knowledge and adherence to the rules as a safeguard against mistakes and not applying simple aids, such as speed restriction signs, to help drivers in their task

 

Although the technology and situations are very different, there are some parallels to the Spanish crash. A driver who was familiar with the route and train took the curve at double the design speed. The damage and loss of life were made worse by the train derailing in a confined space into masonry. Driver aids, in this case ATP, which could have prevented the crash, were not fitted, the management seemingly being content to rely on drivers route knowledge and strict adherence to the rules.

 

I think what it goes to show is that despite the march of technology and the years of development of "tombstone technology" to overcome as far as reasonably practical the factors which lead to disasters, the human element can and will always lead to mistakes. There is a world of difference between Sutton in 1955 and Spain's high speed network, but fundamentally the root causes have some parallels.

[Jeff Smith]

How did drivers operate without speedometers?

[wombatofludham]

Don't know, I assume by sound and feel, and route familiarity, which is how they drove in the dark or murk of course. It's a tribute to the concentration and dedication of loco crews in the past that there were so few accidents given the lack of any real driver aids at the time.

 

[Edit] I've only had one experience of driving a train, on a Llangollen DMU driver experience day, but I was surprised just how easily I was able to judge the speed, albeit the Llangollen line never went above 25mph and it was a DMU in daylight. Nevertheless, the rail joint sound was a real subconscious clue, so I daresay with all the years of working as a fireman before becoming a driver a steam loco driver would soon develop a sixth sense about speed and location

[Titan]

Almost all track of the time was 60 foot jointed. The rhythm of the joints running under the loco would give an audible indication of speed, and the speed restrictions were a little conservative just in case drivers estimations were a bit out, but I would expect most to be able to get within +/- 10mph at worst. 

[Tigermoth]

It's not easy to do anything about a thought distraction which could happen to anyone .

[The Stationmaster]

How did drivers operate without speedometers?

Easy - feel.  Don't forget that in steam days there were a lot more things to register in terms of road knowledge, the simplest being evenly spaced (mostly) telegraph poles and rail joints plus they could actually see where they were rather than gaze at a green lineside jungle.  Experience built up over the years and learning how to run to time through experience meant it all gradually sank into their mind  No doubt some speed restrictions were always treated a bit liberally while others were perhaps taken over-cautiously and of course more than few Drivers had reputations for hard running or being 'miners' friends'.

 

One old axiom I was told of many years ago was that you didn't know a road thoroughly until you could go over it at any time of day or night, and  (theoretically of course) with yours eyes shut and still know exactly where you were.  In some places you knew where you were by smell as well as feel and sound was also an important factor. All very different from sitting in an enclosed air condition cab of a modern traction unit where a lot of those sensory indications just don't exist - apart from the atrocious continuous green tunnels everywhere.  But then nowadays the signals are, generally easier to see and are - in some places at least - nice and evenly spaced.

[Pacific231G]

This is not an equivalent example.  Although I know very little about running a railway I do know that trains operate to diagrams/timetables so once a realistic and achievable time is set for a route the driver cannot/should not try to beat it, if anything the train 'may' be late.......but not early!

Hi Jeff

But if there's pressure to not be late when conditions make keeping to time unusually difficult then there will be a tendency to cut corners to make up time.

I wasn't though really seeing the delivery company example as directly equivalent but more exemplifying that there are pressures that a management intent on cost cutting (and probably themselves under pressure to do so)  can impose while still being able to hide behind a set of rules. That pressure could end up with a driver taking out a train with a technical fault, being afraid to go sick when not really fit fr work (and that might apply to an S&T technician as well) or, as in a number of past disasters, being under pressure to take out an overloaded (or underbraked) train. As another example, think of the signalman or station master having to decide whether to call out fogmen, which cost the railway company money, not when thick fog descended when the decision was obvious but when conditions were marginal.

 

Any "safety" regime that relies on human beings to not make mistakes or to always make good decisions is a disaster looking for somewhere to happen.  Generally speaking the railways have been good at learning from mistakes by examining them in depth. "lessons will be learnt" actually means something when it comes to railways which is why I find the apparent attitude of simply blaming the driver so inexplicable in the Spanish example.

[roythebus]

I'm probably one of the last generation of drivers who has driven trains without speedometers, the 4SUB and Waterloo & City stock, though the later was fitted with them in later years. The SUBs were driven by "feel" and experience as Mike says. You simply KNEW what your speed was. Series position on the deadman would be about 20, parallel was over 20! Going down the bank towards Horsham was about 75 and a bit if you had a good one! No AWS on the SUBs either.

[Dagworth]

Yep, drive by the seat of your pants. You knew how fast you were going without a speedo in front of you.

 

Andi

[jjb1970]

I'm not advocating removing speedometers here or a return to the safety systems of an earlier era but it is very easy to underappreciate the capabilities and potential of a well trained, competent human being. I'm no train driver but I found in my own line of work there were certain things I could do just as well by touch and feel as by using expensive measuring instruments (such as feeling surface finish of machined components or listening to bearings rather than using accelerometers). That said, humans do make mistakes and safety systems should be resilient to human failings.

[jcm@gwr]

Experience, and 'the feel' for things, counts for a lot.

 

My mate (and best man) was a technician in the RAF.

If they couldn't find a fault on a circuit board within a set time, it got sent out to a 'civvie' dept. 

 

He went round their facility once, and was amazed by what he saw.

The girls had 'Avo' fingers, they would lick their fingers,and quickly tap them across a 'live' board.

The level of tingle would tell them the voltages, they were 98% accurate and could check out a

board in a fraction of the time the RAF technicians could!

[wombatofludham]

Experience, and 'the feel' for things, counts for a lot.

 

My mate (and best man) was a technician in the RAF.

If they couldn't find a fault on a circuit board within a set time, it got sent out to a 'civvie' dept. 

 

He went round their facility once, and was amazed by what he saw.

The girls had 'Avo' fingers, they would lick their fingers,and quickly tap them across a 'live' board.

The level of tingle would tell them the voltages, they were 98% accurate and could check out a

board in a fraction of the time the RAF technicians could!

Going off route a bit but that does remind me of an electrician who, amazingly, is still alive, who used to check the (presumably non-lethal voltage) live wire by the "spit and finger" method. The level of profanity resulting from the manual live wire test usually was an accurate measure of the level of voltage.

[jcm@gwr]

I'll have to take your word for that operation,

'cos I dare not google 'spit & finger' method!

[wombatofludham]

I'll have to take your word for that operation,

'cos I dare not google 'spit & finger' method!

Probably counts as foreplay in parts of the Black Country.

[roythebus]

It reminds me when I was a guard on the District Line in the early 1970's, a blind man would board the train at Mile End and go to Barking. I used to chat to him and it turns out his work was as quality controller in a factory. his fingers were far more sensitive than a sighted person and he could find faults in whatever product that most others could not.

 

Drive trains by the seat of the pants, that's what was taught the the blokes in my driver training class at Waterloo, using those exact words. I fell sorry in a way for the Spanish driver who has been made the scapegoat form management failings in this matter. I hope he's in the union and they get someone very good to represent him.