Saturday, 9 December 2017

Suggestions to the Committee to review SPAD penalties- AILRSA


The Convenor,

Executive Director (E and R),

Safety (A and R) Branch, Railway Board,New Delhi.

Sub: Views and suggestions of AILRSA before the committee to review the norms of punishments in SPAD cases.

Ref: No. ERB-I/2017/23/79 Dated 23.11.2017

Respected Sir,

This Union wishes to submit its views on the subject in the following few lines.

a. The Railway Safety Review Committee (RSRC 1998) chaired by Hon’ble Justice H R Khanna recommended that ‘extreme punishment of removal from service or compulsory retirement should not be imposed upon the Loco Pilots who passed the signal at Danger and not caused any accident.’

b. 14 General Managers of Indian Railways on a query from Railway Board vide its letter No. 99/Safety (A and R) dated 06/12/2012, made their suggestions on the norms of punishment on SPAD. Most of the Railways suggested that the extreme punishment has to be reviewed and the quantum of punishment to be decided according to the distance overshot the signal and not caused any accident.

c. The Task Force committee on safety 2016, recommended vide para 24.6.1 of its report that;

"SPAD should be classified according to the distance of overshooting. Cases of SPAD should be dealt differently upon whether LP, after committing SPAD ,has stopped within the signal overlap or crossed the overlap. This should also decide the penalty imposed on the erring crew".

d. Report of Commissioner of Railway Safety, Southern circle on side collision of Train no: 12623 dated 28.10.2016, in para 7.11 to 7.12 gives more light to SPAD incidents and desired approach. We quote some of the points enumerated by CRS.

Para 7.11 Points to ponder.

Para 7.11.1 Why things go wrong with normal people doing normal job under a normal situation is an issue that needs to be deeply pondered.

Para 7.11.2 People in safety critical jobs are generally motivated to stay alive to keep alive their passengers. It has to be assumed that nobody comes to do a bad job more so when he himself remains the first victim.

Para 7.11.3 Saying what the employee failed to do or should have done does not explain “why they did what they did”?

To understand failure, one must first understand his reaction to the failure. “Signal Passed at Danger” incidents are conveniently concluded as human failure. There is a strong bias towards holding the crew responsible prima facie.

Railways need to focus on its reaction to employees failures. Disciplinary actions are obviously not the right tool.

Para 7.11.4 Systems and process that depend on perfect human performance are inherently flawed.

Para 7.11.5 Rather than being main instigated, the front line staff tend to be inheriting the system defect created by poor decision, incorrect installation, unusual operation, faulty procedure and bad managerial decision. 

This part is only adding final garnish to a lethal brew already been long in cooking.

Para 7.11.6 The system is designed often in a complicated way such that it is difficult to anticipate all possible safety infringements and risk.

System sometimes also is made more complicated under hostile working condition to deceive the safety net through the hidden path to disaster.

Para 7.11.7 Railways, after accident reacting, often indicate that it had still to reach a level of maturity. Searching the culprit, presenting solution that consists of punishment for the apparent culprit and increased regimentation for other Practitioners/employees, lead to the belief that as if cause was residing inside the employee. Erroneous actions or assessments are symptoms/consequences and not the cause. These are context conditioned.

Enhancing error tolerance, error detection and error recovery together can only produce safety not the employee’s exile.

Para 7.11.8 Employees are Railway’s greatest assets, Highlighting their failure to a point of vengeance is perhaps an unethical act. They are the people who save hundreds of accidents and also loose the most if something unusual happens.

Railway administration shall do a lot good by resisting their temptation to highlight individual failure, while remain always non-committal and elusive of system or process failure.

Para 7.11.9 What happened before will happen again. There is nothing new in this world –Teachings of Bible.

It is often said that there is no new rail accident. The same old events repeats with new set of people and place. So true for accident caused due to SPAD.

Para 7.11.10 Truth of ‘SPAD INCIDENCES’ is never revealed/considered. Most investigation stops at accusing the crew.

Railways have legislated ‘Zero tolerance’ to SPAD incidences in its safety doctrine. The primary remedial measures prescribed against SPAD are removal/dismissal of train crew from service.

Despite such stringent approach incidences of SPAD are happening with equal impunity.

There is apparently no explanation to this paradox. 

Perhaps as death penalty is no guarantee against repetition of grave crime, similarly above recourse for SPAD is no guarantee for its non-occurrence. The reality remains that cause for SPAD is never truthfully analysed. The fact that SPAD is not a cause but a consequence needs to be appreciated.

To drive home the truth mentioned above, and to ensure effective learning from every incidence, a new approach to SPAD analysis using internationally acclaimed mode i.e MODEL FOR ASSESSING & REDUCING SPAD(MARS) is mentioned here briefly for benefit of the Railway Management involved in formulating prevention.

Purpose of any investigation is future prevention. With this objective, the following deliberations are made as a supplementary to the inquiry report.

Para 7.12 Some Truths of SPAD

1. SPAD is a “Random Human Error”(RHE).

Every human error leading to rail transport accident is in that way a ‘random human error’ then how SPAD is different?

2. SPAD is unique in the manner that it is both mental and physical at the same time and defies all logic. It is an unusual event so close to an usual event..

3. Crew passes millions of signals and also stops at millions of ‘Red signals’ safely every day and day after day and year after year rather very routinely, uneventfully unnoticed.

The fear of brutal punishments for SPAD has also caused stress as per the findings of High Power Committee Para Page No.62 in Studies/Research carried out on the stress levels of Railway Loco Pilot by Shri. Dr. S.K.Agarwal, CMD/ NER/ Gorakhpur.

Further in Para HPC observes,

“The Committee finds that, in many cases, even if the circumstances and other reasons for such infringements may point to the system deficiency or even when there is no consequential/adverse effect/damage, the prescribed minimum punishment has to be administered upon the Engine crew. This fear keeps lurking in the minds of the Running Staff all the time and over a period of time; it increases their stress level considerably which is not good for the system. "

Such staff when commit a mistake on account of error in judgement should not have punished so inhumanly. "No LP will pass the signal at danger intentionally"; that should be the outlook. Sympathetic approach is needed in their cases. 

The Parliamentary Standing Committee in para 11 of its report observed as follows. "What is more alarming is that at present there is no technological support available to the Loco Pilot and he has to depend only vigilant watch on the signal and control the train accordingly". While admitting this fact, the Hon' Chairman, Railway Board said before the Committee that" at present Loco Pilots are encountering a signal at every minute", and further the Chairman, Railway Board admit before the committee that "no technological support available to Loco Pilot".This justifies the due consideration to be shown to Loco Pilots while committing unintentional mistake like SPAD, that caused no accident.

Though foreign Railways have many safe guards and technologically upgraded locomotives to avoid SPAD automatically and systems like ETCS level 2, they are not awarding stringent punishment for SPAD. The Hon'ble Justice H R Khanna committee quoted best practices in foreign Railways. The Federal law in USA stipulates that a driver who passes signal at danger twice within a span of 24 months is removed from the driving function. In Britain, the future terms of duties of drivers involved in SPAD is decided not only on the known facts of the SPAD but also the past record of the individual including previous incidents in which the driver was involved

In the light of the above, we submit that no Loco Pilot will pass signal at danger intentionally. It can be termed as 'error in judgement'. In almost all cases the crew themselves detect their mistake and stop the train, though passed the signal by few meters. In many cases they pass the signal by few meters ranging from 2 meters to 150 meters, without causing any accident, but mechanically imposed with a punishment of Removal from service/compulsory retirement. In Southern Railway, one ALP has been awarded with a punishment of reduction to the initial pay in the scale for 21 years that too with recurring effect; on an appeal preferred against removal from service. In another case on appeal against removal, the appellate authority awarded a punishment of 14 stage reduction in pay for 5 years with recurring effect, including a reduction in rank. In both these cases the train stopped within the signal overlap. In another case, the MU/ LE has passed the signal by hardly 9 meters, the LP was awarded with a punishment of 10 stage reduction in pay for 5 years with recurring effect, added with a reduction in rank. Yet in another case the train passed the signal for 4 meters, the LP was awarded with compulsory retirement with 10% reduction in his pension for life. All these cases quoted are from one zone of the Railway. If we go on listing such inhuman punishments to the crew and thereby the mental trauma, suicides, heightened stress level etc in whole of the Indian Railways, that will run to pages.

It may be noted that the Railway Board order dated back to 1968, prescribed the norms of punishments. For any punishment other than Removal/Dismissal/Compulsory retirement, prescribed a limit of 3 stage reduction in pay or one or two stage reduction for 3 years as the maximum. But in the case of Loco Running Staff Disciplinary/Appellate authorities are imposing punishments without any limit as detailed above. Discretionary power without any guidelines given to Disciplinary and Appellate authority has caused havoc on staff. A limit should be prescribed in awarding punishments and disposal of appeal.

The Loco Pilots/ Assistant Loco Pilots are working in stressful circumstances. They are supposed to work upto 12 hours from signing 'on' to 'off' as if they are classified as essentially intermittent workers under the HOER, though they are classified as 'continuous.’ When all the workers in Government sector or in informal sector are mandatorily allowed with a weekly rest ranging from 40 hours to 54 hours, the Running staff are allowed with 22/30 hours weekly rest. When all the Railway staff are working for one night, the Loco Running Staff are mandatorily asked to work 3 to 4 consecutive night duties. When all staff are allowed with 16 hours rest daily after a spell of 8/10 hours duty, the Loco Running Staff are given with 8 hours rest after working 8 to 12 hours duty in the name of outstation rest. These entire unfavorable working environments cause undue stress, excess fatigue, and sleep deprivation in their whole life. Added to that 20% of sanctioned posts are kept vacant, this also force existing staff to over work, forego rest and leave thereby accumulating stress and fatigue. 

A directive has been issued by the Railway Board vide Letter No.99/Safety (A &R)/ 6/1 Dated 21.08.2012 that the ALP also be given the equal punishment as of the Loco pilot on SPAD cases on the ground that the ALP is provided with emergency brake valve. In this connection we submit that equal punishment to ALP seems too harsh and out of proposition. The ALP is not as skilled, trained and experienced like the LP. The LP is trained to drive the train and he got high skill in controlling the train by experience. Whereas the ALP is not trained to drive, control and stop a train exactly as of a LP. The ALP has no chance to get expertise in driving skill, thus lacks the technique to control or stop the train fully assessing the braking distance required for stopping the train at the foot of the signal. His duty is to call out the aspect of the signals and assist the LP. The ALP cannot judge the skill of LP and neither he could ascertain whether the LP will stop the train at the foot of the signal or not, till the last movement. The ALP will realize that the train will not stop short of the signal when the train passed the last point where the braking has to be started by the LP. Any application of emergency valve by the ALP after that point will not stop the train at the foot of the signal. In practice what the ALP could do is to reduce the distance the train passes the signal. This is the position. Therefore giving equal punishment for every SPAD to ALP is not correct.

In fine this Association concludes our views and suggestions to the committee as follows. We also request to finalize the recommendations of the committee, duly considering the recommendations of the expert committees viz the RSRC 1998, High Power Committee 2013, deposition of the CRB before Parliamentary Standing Committee on Railways 2016, the observations of the CRS/Southern Circle 2016 and the Task Force Committee 2017.

1. SPAD enquiries must be conducted in a holistic manner and the present syndrome of “who went wrong “requires a radical change to “what went wrong to find system failure also for corrective actions.

2. The strong recommendation of RSRC 1998 and many other committees thereafter that “SPAD, at the very least not having any consequences should be removed from the RB order on minimum penalty. 

3. In the case of SPAD with contributory factors like brake failure, system deficiency etc,Loco Pilots should not be taken up under DAR.

4. SPAD must be classified according to the distance overshoot and the gravity (consequence) and the penalty may commensurate with the consequence.

5. SPAD within the adequate distance (Block Overlap/Signal Overlap), the distance provided to ensure safety, should not be treated as a punishable offence.

6. For SPADs without consequences, counseling and retraining may be the corrective step as in advanced Railways, harsh penalties may not be imposed.

7. In the cases where SPAD is within the emergency braking distance of train, from the signal passed at danger, ALP should not be taken under DAR.

Thanking you, Sir

Ernakulam                                                                                                       Yours faithfully


                                                                                                                             (L. MONY)

                                                                                                               Central President, AILRSA

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