Common Law Duty to Report to HM Coroner Ferry Walkway Collapse and Death of Child Patients Guys

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Dear Health and Safety Executive,

You brought a successful prosecution in the tragedy of the Thanet 1994 Ramsgate Ferry Walkway Collapse.

In 1995 a child patient in post op ICU died at Guys Hospital when the hospital Petbow (Thanet Kent) backup power system went rogue. Auto switching mains power off the hospital refusing override and then delayed stalling which left Guys with no power.

HSE contributed to the inquest inquiry. After the Misadventure verdict I found out that HSE had condoned the recording of the manufacturer as "MVA model 1.5". This is the power rating in Mega Volt Amps. On that basis Petbow Thanet escaped inquiry.

Jonathan Aitken MP involved in pointing out to HSE that the Guys Petbow system had failed in exactly the same rogue sequence in 1987.

HSE made inquiry then at Petbow about Guys and about the extensive history of failures of Petbow Rotor Shaft welds. Petbow admitted to the weld problem and failure to issue a product recall or warning.

The position taken by your senior investigator South East was that failures of generators on hospitals are not reportable under HSAW Act so though HSE got the Guys inquiry wrong it was never HSE duty to get it right.

Please disclose your case report. I am interested why HSE failed to report to HM Coroner under the Common Law duty to report facts to HM Coroner.

In 1988 when investigating industrial exposure to tetrachlorethylene at Petbow you were told by your consultant chemist he was sure a GMBU shop steward was lying in concert with a manager.

My next disclosure request is industrial exposure to PCBs at GEC Distribution Transformers at nearby Broadstairs An inquiry raised by GMBU convenor after developing disease at GEC 1977 and never working again. In that inquiry you would have been told about the leaking of PCB laden transformer oils due to sub standard tank welding and that GEC did a product recall.

And a diligent inquiry at Petbow 1988 and 1995/6 would or should have spotted that the same man who became a GMBU shop steward, who your chemist accused of lying, had worked previously at GEC. Hence spotting that sub standard welding and the employment of this man had coincided at both GEC and at Petbow.

I don't know if you were involved at Pfizer Development site later in 1990s. But they had a sub standard pipe and vessel weld problem which inspectors refused to sign off. Among the contractors were former Petbow production welders.

Pfizer took penalty clause money but dumbed down the contractual standard to commission the site.

On site some of those men detailed to site weld inspectors how production welds were sabotaged at Petbow. This was reported to Kent Police for action and onward report to HSE.

This history clearly needed line of inquiry referral into your ferry walk way collapse inquiry which was not all about flawed design but also about sub standard structural welding.

Indeed you had a common law duty to report this to HM Coroner.

So my disclosure requests are Please disclose whether or not the following investigations were properly cross referred

Guys child death 1995 follow up inquiry at Petbow including admission to 100s of weld failures in service

GEC industrial exposure to chemicals

Petbow industrial exposure to chemicals

Pfizer development site especially confession to prior weld sabotage

GEC product recall for defective welding.

Yours faithfully,

Richard Card

Health and Safety Executive

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Dear Health and Safety Executive,

I also have to point out that there was a custody death in Margate Police Station 1995. During the inquiry for Thanet HM Coroner (who stood down in case 1997/98) there was a clash between Coroners Officer and Police Complaints invigilator.

In that clash the charity "Inquest" and others learned that the Coroners officer had accused the supt invigilator of being in CID who stole evidence at both Deal terrorist bombing scene 1989 and Ferry Walkway collapse scene 1994. These facts were reported to John Morris Attorney General about 1997.

Yours faithfully,

Richard Card

Health and Safety Executive

Thank you for emailing the Health and Safety Executive. This is an automatic acknowledgement to tell you we have received your email.

Please note this email account is for the submitting of FOI requests via the 'whatdotheyknow' website only. For all other FOIs requests please refer to http://www.hse.gov.uk/foi/your-right-to-...

HSE publishes a comprehensive range of information and guidance on our website. You can find out what the health and safety law requires by searching under the relevant topic or industry section, and all of our publications are free to download. HSE does not operate a telephone helpline for general health and safety information. If you need to engage the services of a health and safety consultant, you may wish to visit the Occupational Safety and Health Consultants Register (OSHCR).

If your email is a request for advice, please visit http://www.hse.gov.uk/contact/informatio...

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Thank you for contacting the Health and Safety Executive.

Health and Safety Executive

1 Attachment

Dear Mr Card

Find attached a request relating to your enquiry.

Regards,
Catherine Parker

Health & Safety Executive
International House
Dover Place
Ashford
Kent
TN23 1HU

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Dear Health and Safety Executive,

You should have Petbow records as in the 1990s HSE had to investigate them and they admitted the history of rotor pack to shaft welds failures. You then had to admit your errors in the 1995 Guys Child Deaths inquest inquiry. Involved were your head of health interest and a senior investigator South East B R Sutton. IIRC

This I think was while Ferry Walkway Collapse was sub judice

Would you care to re-check thank you

Yours faithfully,

Richard Card

Health and Safety Executive

Thank you for emailing the Health and Safety Executive. This is an automatic acknowledgement to tell you we have received your email.

Please note this email account is for the submitting of FOI requests via the 'whatdotheyknow' website only. For all other FOIs requests please refer to http://www.hse.gov.uk/foi/your-right-to-...

HSE publishes a comprehensive range of information and guidance on our website. You can find out what the health and safety law requires by searching under the relevant topic or industry section, and all of our publications are free to download. HSE does not operate a telephone helpline for general health and safety information. If you need to engage the services of a health and safety consultant, you may wish to visit the Occupational Safety and Health Consultants Register (OSHCR).

If your email is a request for advice, please visit http://www.hse.gov.uk/contact/informatio...

If your email is about a concern, please visit http://www.hse.gov.uk/contact/complaints...

If you wish to report an incident, please visit http://www.hse.gov.uk/riddor/index.htm

Thank you for contacting the Health and Safety Executive.

Helen McGlown, Health and Safety Executive

1 Attachment

Dear Mr Card

 

Please see attached an acknowledgement of your internal review request.

 

Regards

 

Helen

 

 

Helen McGlown PC.foi | Information Management Unit | Freedom of
Information Unit Health & Safety Executive | 1.3. Redgrave Court, Merton
Road, Bootle L20 7HS |

 

 

 

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Helen McGlown, Health and Safety Executive

1 Attachment

Dear Mr Card

 

Please see the attached internal review response letter.

 

Regards

 

Helen

 

 

Helen McGlown PC.foi | Information Management Unit | Freedom of
Information Unit Health & Safety Executive | 1.3. Redgrave Court, Merton
Road, Bootle L20 7HS |

 

 

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