Transport Committee on April 13th, 2010

[Wendy Tadros]

Let me just add something, if you don't mind, sir.

One of the things we look at every day at the board is whether to make a recommendation on a particular issue. The threshold or the test that we use is whether it's been found in a number of investigations as causal and it is a pervasive problem, a pervasive risk in the industry. So we look at work rest. We look at crews in all modes: air, rail, aviation, and pipeline. We have found it as a contributing factor, but we have not found in our investigations.... The data, the evidence we have does not suggest—from the information we have—that it's a pervasive problem in Canada.

[Mario Laframboise, Bloc, Argenteuil—Papineau—Mirabel, QC]

Ms. Tadros, following the CBC report, some pilots said they were aware of pressures by business owners in the industry to extend schedules, to alter logbooks and to be able to face the competition.

It was journalists who told me that, whereas it should have been the Transportation Safety Board of Canada and Transport Canada. Why do we need journalists to do your job? That's my problem. If people alter logbooks simply to please the boss, we have a problem in the industry. You're telling me that wasn't important and that you didn't go any further? That's what you're telling me?

[Wendy Tadros]

No, that's not what I'm saying.

We have to look at the evidence that we have before us. I would very much welcome that Transport Canada is going to do a study on work duty times of pilots, on fatigue, on circadian rhythms, because I think they need to do that. It's an important safety issue. However, what I'm telling you is that if you look over the last 20 years at all of the aviation investigations, we don't have evidence that it was a causal factor in a number of investigations. It's not popping out in our investigations. Our job is to investigate from a scientific perspective, and we have to be mindful of the evidence that we uncover, sir.

[Mario Laframboise, Bloc, Argenteuil—Papineau—Mirabel, QC]

However, Ms. Tadros, an analysis will be done by the Transport Canada people. There will be a meeting in June, and that won't be because of the recommendations you'll have made. The Transport Canada people have told us it will probably be because of the CBC report.

As a member of Parliament, I wonder what's being done, and that leads me to safety management systems. I was on the committee when it was said that it was senseless for private businesses to be able to control safety management systems through an organization.

It's been said, and it's been repeated, and today you see it, because there has been an accident, that the procedure should probably be changed. Transport Canada will resume control over inspections. This makes no sense, Ms. Tadros. And yet, a few years ago, we members on the committee questioned this entire system and no one listened to us. We members aren't important. What do you think of the role of this committee?

[Wendy Tadros]

I think your role is very important. You may well have safety issues in the system that Transport Canada needs to monitor that don't pop up in individual accidents. They still need to keep a strong hand on them.

[The Chair, Conservative, Merv Tweed]

Mr. Bevington.

[Dennis Bevington, NDP, Western Arctic, NT]

Thank you, Mr. Chair.

Thank you, witnesses, for appearing here today.

I just want to continue on that briefly. If what you say is correct, that you have good regulations that are not being followed, then why haven't you identified this to Transport Canada as an oversight issue? Why haven't you identified it as something for which Transport Canada is responsible to ensure compliance? Where are your reports saying that the oversight is not adequate from Transport Canada to deal with operators who are not following regulations?

[Wendy Tadros]

You're speaking specifically about fatigue.

[Dennis Bevington, NDP, Western Arctic, NT]

Yes.

[Wendy Tadros]

Mark.

[Mark Clitsome]

In our reports, when we identify fatigue as a contributing factor, it is identified. It is in the factual section. We identify what the regulations are, what the pilot exceeded, and what caused him to be fatigued. Whether it was a loss of sleep or whether it was a circadian rhythm issue, we identify that in the report. We analyze it and make some findings, and those findings go to Transport Canada. We would identify that the pilot was fatigued, and they--

[Dennis Bevington, NDP, Western Arctic, NT]

Well, where are your recommendations to ensure that Transport Canada is doing proper oversight to ensure that these regulations are being followed? We've seen evidence that they aren't, and you've just said yourself that the regulations are adequate but they're not being followed. What does that suggest to you, that oversight is required to ensure that regulations are being followed?

We had evidence presented to us on some of the policies. Do you actually work with Transport Canada on their policy development? Is that something the Transportation Safety Board would be engaged in?

[Wendy Tadros]

No, sir. We're an independent body. We're not part of Transport Canada. I would suggest to you that we would be in a conflict of interest if we worked with them on their policy. What we do is tell them--

[Dennis Bevington, NDP, Western Arctic, NT]

But you don't recommend on their policies. You don't look at the policies that they create and say those policies fit with your nine watchlist items. You don't examine that.

I'm reading a policy document that we got at the last meeting, showing quite clearly the problems that come from surveillance. Transport Canada has now identified that it wants more surveillance within the safety management system. Were you aware of that? Were you aware that this is moving forward?

[Wendy Tadros]

We keep a general scan on what's going on in the transportation industry, including in government. In every investigation we do, we will look at the role of the regulator. If we find that it played a role in the accident, we report on that to the Canadian public.

[Dennis Bevington, NDP, Western Arctic, NT]

Within the policy document, they don't give particulars about how they do random audits. This is a concern I have. If you're going to do oversight, I don't think ten weeks' notice for an audit of a company, to go on the ground and look at the company, is adequate. That just doesn't work. I'd like your comments on that. That's what appears to be in the policy document, that we're going to do surveillance with ten weeks' prior notice.

[Wendy Tadros]

I'm not going to comment on a policy document out of Transport Canada, because I don't think that is the role of the Transportation Safety Board. But what I would tell you is that if that policy were germane to a particular safety issue that came up in an investigation, we would look at that policy and at the practices of the regulator and we would comment on whether the oversight was adequate.

[Dennis Bevington, NDP, Western Arctic, NT]

Now I'd like to go on to another issue.

With the crash of Sikorsky S-92 off the coast of Newfoundland, there was prior understanding of the nature of the mechanical problem that led to that crash. That's my understanding of it.

Transport Canada now has voluntary compliance on actions taken, rather than simply shutting the aircraft down until the problem that is clearly identified is fixed. Do you agree with that policy?

[Wendy Tadros]

Do you want to speak to what we learned in the....

[Mark Clitsome]

I'm not exactly sure I understand your question about voluntary compliance.

[Dennis Bevington, NDP, Western Arctic, NT]

That was the evidence presented to us at the last meeting, that Transport Canada now has a policy where, if they identify clearly what is a mechanical problem and the company identifies that to Transport Canada, they don't have an enforcement action; they simply allow voluntary work be done to correct the problem. Is that your understanding of what the situation is?

[Mark Clitsome]

In the Sikorsky S-92 accident of Cougar Helicopters, we determined there were some studs on the oil filter housing that had cracked and fatigued and caused the oil pressure loss. We were informed of a similar situation in Australia prior to that. We work with the FAA and Sikorsky. They came out with a service bulletin that would allow the companies a certain period of time to go in and correct that problem. That's the service bulletin policy that Transport Canada has with--

[Dennis Bevington, NDP, Western Arctic, NT]

That service bulletin policy, though, was not adequate in this case, because the Sikorsky crashed.

[Mark Clitsome]

As it turns out, the service bulletin was given an extension of one year or 1,200 hours of flying time for the helicopter. In this particular case, the bolts were not changed on the Cougar helicopter.

[Dennis Bevington, NDP, Western Arctic, NT]

Do you see this particular policy of Transport Canada as a wise one?