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A mistaken identity


I was recently asked whether engineers ever really learnt from their mistakes. Examples were quote such as the stillclosed Millennium bridge, the spate of recent train crashes, constant excavations in the same stretches of city roads and the fact that most public infrastructure is delivered late and over budget.

Faced with this barrage of hard evidence my answer was still resolutely yes. The wobbling footbridge was pushing innovation to the limit, I replied, the rail industry problems could have been prevented had engineers been allowed more direct involvement in decision making and new techniques are starting to make road excavations less likely.

I also pointed out that many big public projects like the Jubilee Line Extension, which finished £1.5bn over budget, were set unrealistic budgets for political reasons - and lessons learned here mean the Channel Tunnel Rail Link will be different.

But I felt uneasy. NCE reports on many engineering problems each year - do we really learn as much as we could?

Well, according to three reports this week, I was right to feel uneasy.

First, the Cullen Report pointed out a catalogue of failings by engineers involved in the inspection, repair and maintenance of track and signals outside Paddington Station leading to the Ladbroke Grove train crash. Significantly, warning after warning about signal visibility went unheeded. And apparently improvements works are still outstanding in the area.

Second is our own report this week about the near disaster when a vehicle almost careered off an East Coast Main Line overbridge. This was just days after NCE highlighted this and 12 other potentially dangerous ECML crossings; and three months after 10 people died when a landrover came off the M62 at Selby into the path of an ECML express.

To cap it all, the thirteenth bienniel report of the Standing Committee on Structural Safety (SCOSS) warned that the potential lack of specific learning and training to cope with the increasing demands of innovation and new, more efficient, ways of working could start to affect structural safety (see news).

My disappointment was complete. All three reports, in varying degrees, highlight the civil engineering profession's blatant failure to learn from past mistakes, driving a coach and horses through my earlier debate.

Fortunately SCOSS also includes some salvation, albeit hidden in its final two conclusions. The first commends a little seen document produced by the late Edmund Hambly and published 10 years ago by what is now the Royal Academy of Engineering. And quite why Hambly's Draft Guidelines for Warning of Preventable Disasters has never been adopted by the ICE or IStructE is a mystery to me. It should have been.

Second is SCOSS's proposal and consultation on the need for a confidential reporting scheme to highlight structural safety problems. NCE worked to pilot such a scheme in 1998 - then known as CROSS - and it is yet to see the light of day. For me, against the backdrop of the revelations detailed above, its reemergence now is vital.

So while I still believe that engineers do work hard to learn from errors, I also believe we need to be more sophisticated about how we do it. How is the big question. Get a copy of SCOSS's report and pass on your views - I know I will.

Antony Oliver is editor of NCE

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