Life as a human being has many pitfalls, largely as none of us fit the theoretic model of a human being set out in HSE best practice protocols. Our propensity for failure and lapse can drive risk levels from low to high in the blink of an eye. The blanket of health ‘n’ safety knitting, which has become so much woolier over the past ten years, is all that industry specialists can offer to address the accidents that result. But those efforts are, of course, futile as it’s impossible to predict what the next cock-up will be. It’s a vicious circle that’s becoming ever more distorted.
When 60-year-old Ernest Rodgerson passed through the access gate with his colleagues near Whitehall West Junction, about half a mile west of Leeds Station, on 2nd December 2009, he would not have expected his life to end less than two hours later. The fact that it did had little to do with rules or paperwork. His untimely demise was an accident - pure and simple. But that hasn’t prevented investigators attempting to further burden those who manage and implement safety arrangements with yet more ineffectual irrelevance.
Ernest Rodgerson (far left) undertaking the role of west-facing lookout at Whitehall West Junction. The site of work is just out of shot to the right.
Picture Source: RAIB Rail Accident Report (Crown Copyright)
The task on that day was to restore track level where the Shipley and Doncaster lines diverge - work that would take place in a red zone, with a warning system involving one site and two distant lookouts. Mr Rodgerson was assigned the role of west-facing distant lookout, but this was largely redundant as the site of work was on a line used, in normal circumstances, only by westbound traffic - any trains seen first by him passed on a line adjacent to the one on which his colleagues were lifting and packing. Over the hour and 22 minutes that followed the start of work, he did not issue a single warning.
The gang got down to business at around 0815. At 0918, the driver of a freight service sounded the horn as his train approached the workgroup and passed over the junction towards Shipley. Mr Rodgerson acknowledged and the train trundled harmlessly by. All other trains heading west through the site - and there were a fair number - had taken the diverging route for Doncaster.
At 0936, a four-car Class 333 pulled out of Platform 6 at Leeds Station. Driving it was a trainee with a supervisor sitting alongside. As the train curved to the right, the east-facing lookout, then the workgroup, and finally the west-facing lookout came into view. A warning was sounded which was acknowledged by the first lookout who waved his chequered flag. The workgroup also raised their arms and moved clear of the line.
As the train passed the site, it was travelling at 25mph. About 100 yards further on was Ernest Rodgerson who, according to the trainee, appeared no closer to the track than the workgroup did. But when his train was just 10 yards away, the driver remarked that the lookout seemed very near the line. A second later, having not moved throughout the train’s approach, he was struck and fell to the ground. An emergency brake application was made.
...the driver remarked that the lookout seemed very near the line.
The COSS phoned for an ambulance whilst another member of the gang called the signaller who blocked all lines. The unconscious lookout was attended to by his colleagues. Paramedics were delayed by the absence of a postcode for Whitehall West Junction - a detail they relied upon for their SatNav - but this did not affect the outcome.
(Unfortunately, RAIB did not see fit to provide a track layout diagram in its inquiry report so some uncertainty hangs over the above.)
Ernest Rodgerson was a well-liked and conscientious trackworker with 35 years railway experience under his belt. His judgement was not impaired by drugs or alcohol, fatigue or any distractions on site. Although the safe system had been inaccurately documented during the planning process, it was perfectly robust and compliant in practice. The site lookout, trainee driver and his supervisor all agreed that the casualty appeared to be standing clear of the line as the train approached, as the Rule Book demanded.
The inquiry found that Mr Rodgerson had moved from his safe position, possibly to keep warm, comfortable and alert on a cold winter’s morning. There were no physical features on site to draw his attention to this lapse. He may not have heard the approaching train over the ambient sounds generated by the work and the cityscape, or perhaps he assumed it was on a different line.
Whilst unquestionably tragic, this event was a function of misadventure. Even RAIB, which has a habit of fishing around for unconvincing underlying causes, was unable to find any in this case. But that hasn’t prevented it from issuing a recommendation with potentially onerous
implications -
Network Rail should consider ways to reduce the risk of lookouts moving dangerously close to trains and if appropriate make arrangements to physically identify a safe position by:
marking its limits on the ground
placing barriers at its limits
placing a rest in a safe position to allow the lookout to remain in comfort; or
other appropriate arrangements.
How comfortable is it appropriate for a lookout to be? Sufficient to make him sleepy? What form should ‘a rest’ take? A sofa perhaps? Where will the resources come from to plan and implement the erection of these barriers, in order to prevent such one-in-a-million occurrences? This germ of straw-clutching prattle is the kind that could only have evolved in the gut of an organisation that doesn’t have a railway to run.
Why not require lookouts to stand in the four-foot? Seriously. This would keep them on their toes - their life would depend upon it - and leave drivers in absolutely no doubt as to whether they were in a safe place or not, and an urgent warning would then be issued. Or, to deliver wider benefits, Network Rail could create a proper place for people to walk and stand in at trackside. They could call it ‘the cess’!
The salient point to emerge from this episode is that trackworkers must always keep their wits about them - day or night, green or red, on a busy line or a quiet one. But that too is a trite statement. How can you expect that of someone who has become institutionally conditioned to the risks of the railway through decades of exposure? This one should be filed under “one of those things” but the health ‘n’ safety flappers don’t have the courage to do that.
Finally I must say thanks but no thanks to First TransPennine for the service I received recently en route to Manchester Airport.
Thanks because they got me there in time despite having to turn back at Hebden Bridge (the Standedge route was closed for engineering works) due to flooding of the line at Walsden. No thanks because they insisted that everyone in the packed carriages got out at Hebden Bridge, with all their luggage, whilst the train used the emergency crossover to reach the other platform. This created a couple of safety problems.
Passengers packed the platform right up to its edge which resulted in much pushing and shoving when a loco-hauled train passed through the station at speed. The guard then shouted across the line for us all to get back on board, prompting something of a stampede down the ramp to the subway. Underfoot conditions were difficult due to the torrential rain that was falling.
I recognise that the crew was just following the rules but in doing so a train-load of passengers were exposed to unnecessary risks. Surely the crossover is either safe to use or it isn't, irrespective of whether the train is loaded or not.