Inquiry Search
Rec-ID | Code | Recommendation |
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REC317-4060 | 13 - Mapping and data quality | Australian, state and territory governments should create common information platforms and share technologies to enable collaboration in the production, analysis, access, and exchange of information, data and knowledge about climate and disaster risks. |
REC317-4105 | 13 - Mapping and data quality | Australian, state and territory governments should agree to: |
REC317-4067 | 39 - Disaster Risk Management | State and territory governments should have a structured process to regularly assess the capacity and capability requirements of fire and emergency services, in light of both current and future natural disaster risk. |
REC317-4094 | 8 - Communications and warnings | State and territory governments should expedite the development and implementation of the Australian Fire Danger Rating System. It should ensure that there is national consistency in the visual display of the AFDRS and action to be taken in response to each rating. |
REC317-4059 | 13 - Mapping and data quality | Australian, state and territory governments should prioritise the implementation of harmonised data governance and national data standards. |
REC317-4103 | 39 - Disaster Risk Management | Australian, state and territory governments should develop arrangements that facilitate greater inclusion of primary healthcare providers in disaster management, including: representation on relevant disaster committees and plans and providing training, education and other supports. |
REC317-4065 | 13 - Mapping and data quality | Australian, state and territory governments should continue to develop a greater capacity to collect and share standardised and comprehensive natural disaster impact data. |
REC317-4079 | 39 - Disaster Risk Management | Australian, state and territory governments, in consultation with local governments and the private sector, should review supply chain risks, and consider options to ensure supply of essential goods in times of natural disasters. |
REC317-4057 | 39 - Disaster Risk Management | The Australian Government should establish a standing entity that will enhance national natural disaster resilience and recovery, focused on long-term disaster risk reduction. |
REC317-4102 | 25 - Inquiry, audit, lessons management and after action review | Australian, state and territory governments should review Australian Medical Assistance Team capabilities and procedures and develop necessary training, exercising and other arrangements to build capacity for domestic deployments. |
REC317-4063 | 23 - Climate Change | Australian, state and territory governments should produce downscaled climate |
REC317-4132 | 26 - Research | The material published as part of this Royal Commission should remain available and accessible on a long-term basis for the benefit of individuals, communities, organisations, businesses and all levels of government. |
REC317-4077 | 26 - Research | Australian, state and territory governments should support ongoing research and evaluation into aerial firefighting. This research and evaluation should include: |
REC317-4099 | 8 - Communications and warnings | Australian, state and territory governments should continue to explore the feasibility of a national, all-hazard emergency warning app. |
REC317-4062 | 39 - Disaster Risk Management | The National Disaster Risk Information Services Capability should include tools and systems to support operational and strategic decision making, including integrated climate and disaster risk scenarios tailored to various needs of relevant industry sectors and end users. |
REC317-4109 | 13 - Mapping and data quality | Australian, state and territory governments should develop consistent processes for the classification, recording and sharing of fuel load data. |
REC317-4074 | 25 - Inquiry, audit, lessons management and after action review | The Australian Government should review the content of the Defence Assistance to the Civil Community manual to ensure consistency of language and application with a revised COMDISPLAN. |
REC317-4098 | 8 - Communications and warnings | The Australian Government should facilitate state and territory governments working together to develop minimum national standards of information to be included in bushfire warnings apps. |
REC317-4061 | 39 - Disaster Risk Management | Australian, state and territory governments should support the implementation of the National Disaster Risk Information Services Capability and aligned climate adaptation initiatives. |
REC317-4106 | 13 - Mapping and data quality | Australian, state and territory governments should ensure greater consistency and collaboration in the collation, storage, access and provision of data on the distribution and conservation status of Australian flora and fauna. |
REC317-4068 | 13 - Mapping and data quality | Australian, state and territory governments should establish a national register of fire and emergency services personnel, equipment and aerial assets. |
REC317-4096 | 8 - Communications and warnings | State and territory governments should urgently deliver and implement thevall-hazard Australian Warning System. |
Rec-ID | Code | Recommendation |
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REC314-3273 | 26 - Research | Collate data and research the impact of bushfires upon communities, firefighters and animals (both native and domestic) to identify appropriate medium and long-term welfare and support requirements. |
REC314-3271 | 8 - Communications and warnings | Better coordinate public information and warnings including evacuation plans and provide a single source of information about, the location and direction of fires, how and when to use Safer Places, Places of Last Resort, relief and recovery centres and directed evacuations. |
REC314-3270 | 17 - Assets and technology | Review the use of aviation assets including facilities to operate them given the increased pressure from extended fire seasons on northern and southern hemisphere resources. Review line scanning capability with a view to providing real time data to the IMTs on where fires are burning using aviation assets as an intelligence tool rather than just a fire suppression capability. |
Rec-ID | Code | Recommendation |
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REC302-2404 | 8 - Communications and warnings | Review the effectiveness of emergency public information arrangements, and give consideration to embedding an ABC Manager (not a journalist) into the RFS headquarters during emergencies to broadcast warnings to the community that can be pooled to commercial media outlets |
REC302-2402 | 17 - Assets and technology | Explore better options for call and dispatch, telecommunications and information sharing capability across the emergency management portfolio including the adoption of a multi-agency emergency management operations complex |
REC302-2398 | 17 - Assets and technology | As a matter of priority commence the roll out of AVL capability for the Rural Fire Service fleet, completing as much work as possible before the 2018/19 bushfire season, capitalising where necessary on current and future work undertaken with the NSW Government Radio Network to ensure both officer safety and situational awareness |
Rec-ID | Code | Recommendation |
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REC301-2392 | 39 - Disaster Risk Management | TFS should engage in discussions with government about the construction of purpose-built State Control Centre facilities for emergency management in Tasmania. |
REC301-2385 | 25 - Inquiry, audit, lessons management and after action review | TFS should initiate a policy review (seeking support from government as appropriate) to clearly identify what body or agency is responsible for planning, carrying out and enforcing fuel management on private property at a township level. If current arrangements are unclear or ineffective, TFS should request government to consider making this a statutory responsibility of TFS and provide any additional funding required to support this function. |
Rec-ID | Code | Recommendation |
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REC002-4012 | 38 - Agency/Department Reporting | Complete sets of daily-report books should be provided, and kept in the mine or office, to be overlooked by the Inspector during his periodical visits. |
REC002-4006 | 17 - Assets and technology | The Commisison would not insist upon a barometer being provided at each mine. Experience has proved that this is a tardy index to atmospheric conditions. Serious changes in the atmospheric pressure occur and are felt before they are indicated by a barometer. |
Rec-ID | Code | Recommendation |
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REC291-1243 | 8 - Communications and warnings | The Department of Fire and Emergency Services to investigate and adopt a system that will allow the public to opt in, monitor and receive, through a ‘push mechanism’, bushfire and other emergency warnings, maps and information using a wide variety of devices including personal hand held smart devices. |
REC291-1233 | 25 - Inquiry, audit, lessons management and after action review | The State Government to explore options for streamlining the functions and the independence of the State Emergency Management Committee Secretariat and the Office of Bushfire Risk Management with a view to including an inspectorate function, and appointing a person who is dedicated to that role. The purpose is to provide assurance and reporting, and to inquire into, monitor and report transparently on emergency management standards, preparedness, capability, service delivery and investment performance outcomes. Within two years of the establishment of this arrangement the State Government to review and assess whether it is meeting the desired outcomes. |
REC291-1249 | 25 - Inquiry, audit, lessons management and after action review | The Department of the Premier and Cabinet to conduct an independent review of the current arrangement for the management and distribution of the Emergency Services Levy. The review will have the specific purpose of: · seeking input from key entities including the Departments of Treasury, Finance, Fire and Emergency Services, Lands, and Parks and Wildlife, WA Local Government Association, and the Office of Bushfire Risk Management. · ensuring the arrangement has the flexibility and agility to deal with emerging bushfire risk priorities. · establishing a budget process that enables a shift in investment towards prevention, mitigation and building community resilience and capability. |
Rec-ID | Code | Recommendation |
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REC287-1188 | 25 - Inquiry, audit, lessons management and after action review | The Tasmanian fire agencies commission a review into the efectiveness of aerial firefghting in the 2016 fires, in order to better understand and to document for future reference the cost-efectiveness of specifc fire suppression strategies and tactics in different vegetation types. The Review should include a comparative analysis of fire suppression options whether aerial or ground-based. |
REC287-1185 | 25 - Inquiry, audit, lessons management and after action review | The Tasmanian fire agencies take steps at a national level to share learnings from the 2016 fires about the administration of interstate assistance and support the codifcation of the workings, structure and reporting lines of an Interstate and International Liaison Unit for future complex deployments within Australia and New Zealand. |
Rec-ID | Code | Recommendation |
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REC273-1134 | 8 - Communications and warnings | That future declarations be undertaken to ensure that the areas affected by the declaration are clear and concise. |
REC273-1140 | 8 - Communications and warnings | Review the current practise of issuing an ‘emergency alert’ telephone message or an emergency warning and/or watch and act alert to ensure that it is consistent, relevant and necessary. Prior to issuing an emergency alert message, consider state level involvement so that other agencies are made aware of message and intent. |
Rec-ID | Code | Recommendation |
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REC264-1081 | 26 - Research | The State should continue the long-term health study, and: • extend the study to at least 20 years; • appoint an independent board, which includes Latrobe Valley community representatives, to govern the study; and • direct that the independent board publish regular progress reports |
REC264-1076 | 13 - Mapping and data quality | The State equip itself to undertake rapid air quality monitoring in any location in Victoria, to: • collect all relevant data, including data on PM , carbon monoxide and ozone; and 2.5 • ensure this data is used to inform decision-making within 24 hours of the incident occurring. |
REC264-1089 | 8 - Communications and warnings | GDF Suez improve its crisis management communication strategy for the Hazelwood mine in line with international best practice. |
REC264-1072 | 25 - Inquiry, audit, lessons management and after action review | The State empower and require the Auditor-General or another appropriate agency, to: • oversee the implementation of these recommendations and the commitments made by the State and GDF Suez during this Inquiry; and • report publicly every year for the next three years on the progress made in implementing recommendations and commitments. |
REC264-1087 | 25 - Inquiry, audit, lessons management and after action review | GDF Suez: • practice and ensures that, by taking a risk management approach, it is suitable for fire prevention, mitigation and suppression in all parts of the Hazelwood mine; and review its ‘Mine Fire Service Policy and Code of Practice’ so that it refects industry best • work plan for the Hazelwood mine. incorporate the revised ‘Mine Fire Service Policy and Code of Practice’ into the approved |
REC264-1086 | 25 - Inquiry, audit, lessons management and after action review | GDF Suez: • consequences of fire in the worked out areas of the Hazelwood mine, and an assessment of the most effective fre protection for the exposed coal surfaces; conduct, assisted by an independent consultant, a risk assessment of the likelihood and • controls are in place to eliminate or reduce the risk of fre; and prepare an implementation plan that ensures the most effective and reasonably practicable • implement the plan |
REC264-1082 | 8 - Communications and warnings | The State review and revise its communication strategy, to: • needed for effective and rapid public communications during an emergency; and ensure all emergency response agencies have, or have access to, the capability and resources • ensure, where appropriate, that private operators of essential infrastructure are included in the coordination of public communications during an emergency concerning that infrastructure. |
Rec-ID | Code | Recommendation |
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REC258-2528 | 25 - Inquiry, audit, lessons management and after action review | The Australian Transport Safety Bureau investigates as many fatal accidents in the sport and recreational aviation sector as its resources will allow. |
REC258-2556 | 25 - Inquiry, audit, lessons management and after action review | The Civil Aviation Safety Authority structures all regulations not yet made with the three-tier approach, and subsequently reviews all other Civil Aviation Safety Regulation Parts (in consultation with industry) to determine if they should be remade using the three-tier structure. |
REC258-2552 | 25 - Inquiry, audit, lessons management and after action review | The Civil Aviation Safety Authority implements a system of using third-party commercial audits as a supplementary tool to its surveillance system. |
REC258-2551 | 25 - Inquiry, audit, lessons management and after action review | The Civil Aviation Safety Authority assures consistency of audits across all regions, and delivers audit reports within an agreed timeframe. |
REC258-2549 | 25 - Inquiry, audit, lessons management and after action review | The Civil Aviation Safety Authority provides full disclosure of audit findings at audit exit briefings in accordance with international best practice. |
REC258-2548 | 17 - Assets and technology | The Civil Aviation Safety Authority shares the risk assessment outputs of Sky Sentinel, its computerised risk assessment system, with the applicable authorisation holder. |
Rec-ID | Code | Recommendation |
---|---|---|
REC257-1546 | 25 - Inquiry, audit, lessons management and after action review | Defence undertake a review of its ability to respond to a fire within Marrangaroo Training Area, whether bushfire or structural. The underlying assumption should be that the only response available to fight a fire within Marrangaroo Training Area will be provided by Defence. Further, such response must occur while a fire is in its initial stages. A review must either acknowledge the risk of fire occurring in th future, or upgrade Defence's firefighting capability at Marrangaroo Training Area. |
REC257-1544 | 17 - Assets and technology | Defence should not procure any firefighting vehicle for Marrangaroo Training Area without first consulting relevant personnel within the Rural Fire Service on an appropriate type of vehicle, and obtaining training for the personnel proposed to use it. Alternatively, Defence should explore contracted firefighitng support during periods of live-fire on Marrangaroo Training Area. |
REC257-1542 | 17 - Assets and technology | Firefighitng capability at Marrangaroo Training Area be upgraded so that Australian Defence Force members are not placed in situations of unacceptable risk. Specifically, those participating in range practices must have access to a firefighting vehicle close by and easily deployed, and capable of throwing a large quantity of water an appreciable distance into areas adjacent to the ranges, should a fire occur. |
REC257-1541 | 17 - Assets and technology | A Stryker unit, or an upgraded firefighting unit, be present at the range sentry point, remain manned and ready to deploy during range activites, with its driver in direct radio contact with the Range Safety Officer. Upon the range being declared clear by the Safety Officer inspecting the range after a demolition serial, the firefighting unit must proceed forward to the range wile the periphery of the range continues to be inspected by the Safety Officer, and remain on the range until the Safety officer declares that the area is clear of fire or that it is otherwise appropriate for the fireghting unit to leave the range area. |
REC257-1539 | 25 - Inquiry, audit, lessons management and after action review | Defence Security Authority conduct an investigation into the whereabouts of items of anaccounted explosive ordnance issued to Defence Explosive Ordnance Training School Exercise Marrangaroo. |
REC257-1548 | 25 - Inquiry, audit, lessons management and after action review | The Regional Director-Defence Support-Northern NSW, make contact with Deputy Commissioner ~~~~~ Director of Operational Services Rural Fire Service, to arrange a headquarters driven bipartite review of the events of 16 October 2013 with a review to mitigation of future fire events generally, and with specific reference to: |
Rec-ID | Code | Recommendation |
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REC247-0849 | 26 - Research | That Tasmania Fire Service supports the relevant authorities to continue developing methodologies to forecast and simulate fire risk. |
REC247-0909 | 25 - Inquiry, audit, lessons management and after action review | That the plans for social recovery be reviewed, and plans and procedures are established ready for implementation. |
REC247-0866 | 26 - Research | That fire agencies continue to develop their predictive modelling capability for use in actively managing fires. |
REC247-0919 | 8 - Communications and warnings | That Tasmania Fire Service and Tasmania Police review their use of modern forms of communication with the community, including social media, and commit resources to fully use this capability where appropriate. |
REC247-0892 | 17 - Assets and technology | That a review be conducted of the resource capacity and capability to provide effective and efficient emergency operations, including approved improvements. |
REC247-0926 | 25 - Inquiry, audit, lessons management and after action review | That membership of the State Emergency Management Committee, and other processes to link in appropriate agencies and organisations to emergency management, be included in the recommended review of the emergency management arrangements. |
REC247-0905 | 8 - Communications and warnings | That the Government consider whether it should discuss options for greater mobile phone coverage and redundancy in areas of high risk in emergency situations where there are presently telecommunications limits. |
REC247-0860 | 13 - Mapping and data quality | That Tasmania Fire Service establishes suitable systems and practices for recording fire management objectives and tactics. |
REC247-0918 | 8 - Communications and warnings | That the State Emergency Management Committee makes arrangements to actively manage the use of social media in the community during an emergency, to avoid negative consequences for emergency operations. |
REC247-0880 | 17 - Assets and technology | That bushfire agencies develop, implement and maintain air operations procedures. |
REC247-0923 | 25 - Inquiry, audit, lessons management and after action review | That a process be established for the timely implementation of approved recommendations from the 2009 Victorian Bushfires Royal Commission. |
REC247-0903 | 25 - Inquiry, audit, lessons management and after action review | That the role of Red Cross in emergency management plans and procedures for the activation of Red Cross be reviewed. |
REC247-0855 | 17 - Assets and technology | That a structure and facilities be established for the State Controller or other person managing multi-agency response and recovery operations. |
REC247-0917 | 8 - Communications and warnings | That the State Emergency Management Committee makes timely decisions and resource commitments on the appropriate use of social media in emergency management. |
REC247-0879 | 17 - Assets and technology | That bushfire agencies develop procedures for the automatic activation of aircraft to fires at pre-determined trigger points on high fire risk days. |
REC247-0922 | 8 - Communications and warnings | That Tasmania Fire Service develops a research base from which to inform the design of communication campaigns for communities threatened by bushfire. |
REC247-0900 | 8 - Communications and warnings | That a public information plan be developed as a part of the State Special Emergency Plan–Recovery, for implementation in the immediate recovery phase. |
REC247-0951 | 25 - Inquiry, audit, lessons management and after action review | That an independent means of monitoring and reporting on the implementation of approved recommendations is established. |
REC247-0851 | 13 - Mapping and data quality | That if a sound business case is developed, the Emergency Information Management and Sharing Project be supported. |
REC247-0916 | 8 - Communications and warnings | That Tasmania Fire Service ensures that the priority on warning communities at risk of active bushfires is not confined to when bushfires are burning out of control. |
REC247-0878 | 17 - Assets and technology | That bushfire agencies evaluate the use and effectiveness of fixed wing water bombing aircraft. |
REC247-0921 | 26 - Research | That Tasmania Fire Service promotes a structured approach to research across Australia, to provide a shared understanding and the capacity to benchmark and judge performance. |
REC247-0894 | 17 - Assets and technology | That the police and other emergency service organisations discuss their resource issues for emergency operations with the Government. |
REC247-0941 | 25 - Inquiry, audit, lessons management and after action review | That the Strategic Fuel Management Plan includes measurable targets and they are actively monitored and reported on to the community. |
REC247-0850 | 13 - Mapping and data quality | That police and other emergency service agencies establish and maintain effective recording systems for emergency operations. |
REC247-0915 | 8 - Communications and warnings | That Tasmania Fire Service actively uses predictive modelling to design emergency communications for communities threatened by bushfire, unless there is a compelling reason for not doing so. |
REC247-0873 | 25 - Inquiry, audit, lessons management and after action review | If it is considered more information is required on action to suppress the fires in Dunalley and why fire operations did not continue, the Department of Justice should conduct an independent examination of this matter. |
REC247-0920 | 8 - Communications and warnings | That Tasmania Fire Service reviews its approach to communicating with communities threatened by bushfire and consider the matters referred to in this Report. |
REC247-0893 | 17 - Assets and technology | That further options to appropriately supplement the resources available for emergency management operations be examined. |
REC247-0927 | 25 - Inquiry, audit, lessons management and after action review | That an accountability process be established for managing improvement in the emergency management arrangements, including annual State of Readiness Reports by relevant departments and agencies and on the overall emergency management arrangements. |
Rec-ID | Code | Recommendation |
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REC223-0523 | 25 - Inquiry, audit, lessons management and after action review | The Government consider enacting legislation to facilitate the review of all future major incidents, including but not limited to fire, earthquake, storm and marine inundation, and the emergency response to them. |
REC223-0522 | 25 - Inquiry, audit, lessons management and after action review | The response operation to the Margaret River bushfire in November 2011 be the subject of a review with independent oversight. |
REC223-0517 | 26 - Research | The Department of Environment and Conservation be supported to conduct further research into the fuel management of coastal heath in the south west of Western Australia exploring alternatives to burning as well as best practice for burning. |
REC223-0516 | 25 - Inquiry, audit, lessons management and after action review | The Department of Environment and Conservation review its implementation of the findings of the Ferguson Review conducted in 2010. |
Rec-ID | Code | Recommendation |
---|---|---|
REC201-0249 | 17 - Assets and technology | FRS fire appliance allocation and training needs to be reviewed to enhance offensive bushfire capability within the metropolitan area. |
REC201-0250 | 8 - Communications and warnings | Initial StateAlert messages should provide timely broad advice to a wide audience authorised by the SDD, while subsequent messages may provide more detail. |
Rec-ID | Code | Recommendation |
---|---|---|
REC200-0392 | 25 - Inquiry, audit, lessons management and after action review | The State Government review implementation of the Special Inquiry’s Recommendations in two years. |
REC200-0358 | 13 - Mapping and data quality | The Fire and Emergency Services Authority, the Department of Environment and Conservation and local governments jointly develop a single, integrated system for fuel load assessment and management. The system should enable public access to allow members of the community to access information about the fuel load in a given locality. |
REC200-1698 | 39 - Disaster Risk Management | The Fire and Emergency Services Authority, the Department of Environment and Conservation and local governments jointly develop a single, integrated system for fuel load assessment and management. |
REC200-0370 | 8 - Communications and warnings | The Fire and Emergency Services Authority and the ABC commence a thorough review of emergency warning messages. This review should give consideration to: The content, structure and presentation of emergency warning messages Media access to the Incident Management Team and State Operations Centre. This review should be expanded to include other media organisations should they demonstrate a willingness and capacity to contribute. 20 |
REC200-1732 | 25 - Inquiry, audit, lessons management and after action review | The State Government review implementation of the Special Inquiry's recommendations in two years. |
REC200-0388 | 17 - Assets and technology | The Water Corporation immediately review the outstanding orders for hydrant repairs and develop strategies to reduce the backlog. |
REC200-0357 | 26 - Research | The Fire and Emergency Services Authority, the Department of Environment and Conservation and local governments closely monitor the research and development of alternative fuel reduction techniques to ensure that the most efficient and effective programs are adopted. |
REC200-1697 | 26 - Research | The Fire and Emergency Services Authority, the Department of Environment and Conservation and local governments closely monitor the research and development of alternative fuel reduction techniques to ensure that the most efficient and effective programs are adopted. |
REC200-0365 | 17 - Assets and technology | The Fire and Emergency Services Authority (FESA) review its program to decommission vehicles and ensure that when such vehicles are offered during an incident that FESA staff adhere to FESA’s own policy of ‘Use of Private Vehicles in Fires’. |
REC200-1722 | 39 - Disaster Risk Management | Emergency Management Western Australia and the State Emergency Management Committee amend WESTPLAN-BUSHFIRE to require State Emergency Coordination Group meetings to be held at the State Coordination Centre in West Leederville. |
REC200-0387 | 17 - Assets and technology | The State Government transfer responsibility for the installation, removal, maintenance of fire hydrants to the Water Corporation, in accordance with the Recommendations of the 2006 CDJSC Inquiry into Fire and Emergency Services Legislation. |
REC200-0355 | 13 - Mapping and data quality | The Western Australian Local Government Association explore the feasibility of local governments utilising aerial and satellite imagery to monitor firebreaks and fuel loads on private property. |
REC200-1690 | 8 - Communications and warnings | The Fire and Emergency Services Authority work in partnership with Main Roads Western Australia and local governments to develop and implement a comprehensive strategy for the use of mobile variable message boards to alert the community to the declaration of a total fire ban and what it means. |
REC200-0364 | 17 - Assets and technology | The Fire and Emergency Services Authority review its use of the Australian Interagency Incident Management System to ensure that the most appropriate resources (including aerial resources) are used to respond to an incident. If resources are rejected during an incident either through the decision making process or other grounds, the reason for the decision should be documented. |
REC200-1711 | 8 - Communications and warnings | FESA develop in partnership with other emergency service agencies develop a 'one source: one message' multi layered system similar to that recommended by the Victoria Bushfire royal Commission. |
REC200-0384 | 25 - Inquiry, audit, lessons management and after action review | Emergency Management Western Australia develop mechanisms to calculate the estimated total cost of a fire to the community. |
REC200-0352 | 13 - Mapping and data quality | The Fire and Emergency Services Authority and local governments ensure that the ability to: measure and map fuel loads maintain fuel load databases draw up prescriptions for, and oversee controlled burns are included as key competencies in any future recruitment of Chief Bushfire Control Officers and Community and Emergency Services Managers. |
REC200-1689 | 8 - Communications and warnings | The Fire and Emergency Services Authority consider alternative wording to Total Fire Ban that ensures people gain a more complete understanding of what actions are prohibited. |
REC200-0361 | 25 - Inquiry, audit, lessons management and after action review | The Fire and Emergency Services Authority convene a facilitated debriefing session between the families who remained behind to protect their properties, and the incident controllers. This session should include open discussion and explain the decisions of all parties – including how the incident controllers determined priorities, and why residents chose not follow their advice to evacuate. The learning outcomes should be promulgated across all agencies and incorporated in future level 3 incident controller training programs. |
REC200-1710 | 8 - Communications and warnings | The Fire and Emergency Services Authority and the ABC commence a thorough review of emergency warning messages. This review should give consideration to: |
REC200-0378 | 17 - Assets and technology | Western Power and the Water Corporation continue to work collaboratively to assess options to better protect the power supply to water pumping stations in bushfire prone areas. |
REC200-0359 | 13 - Mapping and data quality | The State Government ensure that the continued development of the Fire and Emergency Service Authority’s Integrated Bushfire Risk Management System is dependent on an independent comparative assessment of its functionality and cost effectiveness against the Spatial Support System used by the Department of Environment and Conservation. |
REC200-1701 | 25 - Inquiry, audit, lessons management and after action review | The Fire and Emergency Services Authority convene a facilitated debriefing session between the families who remained behind to protect their properties, and the incident controllers. |
REC200-0371 | 8 - Communications and warnings | FESA develop in partnership with other emergency service agencies a ‘one source: one message’ multi layered system similar to that recommended by the Victoria Bushfire royal Commission. |
Rec-ID | Code | Recommendation |
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REC183-0119 | 17 - Assets and technology | The development of a three year aerial firefighting strategy for W.A. would ensure optimal development of a joint air capability. |
REC183-0120 | 17 - Assets and technology | Maintaining the DEC fleet of tankers, bulldozers and low loaders is crucial to DEC’s fire management and control capability. |
Rec-ID | Code | Recommendation |
---|---|---|
REC182-0134 | 17 - Assets and technology | FESA reviews its air reconnaissance capability and determines if multiple multi-sensor air reconnaissance aircraft or unmanned aerial vehicles are required for managing concurrent and/or complex incidents. |
Rec-ID | Code | Recommendation |
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REC181-0187 | 13 - Mapping and data quality | The State identify a central point of responsibility for and expertise in mapping bushfire risk to: ■ review urgently the mapping criteria at present used by the Country Fire Authority to map the Wildfire Management Overlay, to ensure that the mapping used to determine building and planning controls is based on the best available science and takes account of all relevant aspects of bushfire risk; ■ map and designate Bushfire-prone Areas for the purposes of planning and building controls, in consultation with municipal councils and fire agencies; ■ finalise the alignment of site-assessment methods for planning and building purposes, taking into account bushfire risk to human safety as well as to property. |
REC181-0217 | 25 - Inquiry, audit, lessons management and after action review | The State consider the development of legislation for the conduct of inquiries in Victoria —in particular, the conduct of royal commissions. |
REC181-0171 | 17 - Assets and technology | The State, in conjunction with Emergency Management Australia and the Department of Defence, develop an agreement that allows Commonwealth aerial resources that are suitable for firefighting and support activities to be incorporated in preparedness plans and used on days of high fire risk. |
REC181-0216 | 25 - Inquiry, audit, lessons management and after action review | The State appoint an independent monitor or the Victorian Auditor-General to assess progress with implementing the Commission’s recommendations and report to the Parliament and the people of Victoria by 31 July 2012. |
REC181-0170 | 17 - Assets and technology | The Country Fire Authority and the Department of Sustainability and Environment amend their policies on aerial preparedness and standby arrangements, their dispatch protocols and the management of aircraft in order to do the following: ■ require that at locations that attract the risk assessment or preparedness level A on code red days all personnel needed for air operations must be on standby by 10.00 am; ■ establish a system that enables the dispatch of aircraft to fires in high-risk areas without requiring a request from an Incident Controller or the State Duty Officer. |
REC181-0215 | 26 - Research | The Commonwealth establish a national centre for bushfire research in collaboration with other Australian jurisdictions to support pure, applied and long-term research in the physical, biological and social sciences relevant to bushfires and to promote continuing research and scholarship in related disciplines. |
REC181-0166 | 13 - Mapping and data quality | The Country Fire Authority and the Department of Sustainability and Environment improve mapping support in the following ways: ■ DSE providing mapping data free of charge to emergency response agencies; ■ greatly increasing the CFA’s ‘write’ access to FireMap for incident management team staff; ■ establishing a joint DSE–CFA training program to ensure that mapping officers in level 2 and 3 incident management teams are fully trained in using FireMap, including in producing fire prediction maps; ■ requiring before the 2010–11 fire season that FireMap be used for joint incidents. |
REC181-0208 | 13 - Mapping and data quality | The Department of Sustainability and Environment significantly upgrade its program of long-term data collection to monitor and model the effects of its prescribed burning programs and of bushfires on biodiversity in Victoria. |
REC181-0193 | 13 - Mapping and data quality | The Department of Sustainability and Environment conduct biodiversity mapping identifying flora, fauna and any threatened species throughout Victoria and make the results publicly available. The format used should be compatible with that used for Bushfire-prone Area mapping. |
Rec-ID | Code | Recommendation |
---|---|---|
REC149-3145 | 25 - Inquiry, audit, lessons management and after action review | NOPSA should consider an audit regime that targets Greenfields operations at commencement of operations. |
REC149-3139 | 39 - Disaster Risk Management | The industry should develop in conjunction with the Regulator a process for addressing the need to maintain the risk profile of a facility moving into extended life operation at the same risk profile as when it was within design life. |
REC149-3138 | 38 - Agency/Department Reporting | The current KPI measures used by the Regulator and industry need to be reassessed and the performance indicators need to be related to the risk profiles of the industry. The industry needs to develop the indicators, which need to be agreed and measured by the industry in discussion with other stakeholders. The KPI's selected should be published in comparison with the worldwide offshore industry and with other industries. NOPSA should continue discussions with Australian Safety and Compensation Council (ASCC) with a view to adopting their goals. |
Rec-ID | Code | Recommendation |
---|---|---|
REC148-3182 | 25 - Inquiry, audit, lessons management and after action review | That Biosecurity Australia review that formal import risk analysis at least once every two years to take into account any relevant developments in scientific knowledge—specifically testing methods, vaccines, vaccination procedures and other matters that affect biosecurity. Reports on the reviews should be provided to the officer responsible for the importation of horses and should contain recommendations for any necessary changes to policies for importation. |
REC148-3154 | 25 - Inquiry, audit, lessons management and after action review | That the officer responsible for the importation of horses arrange for Biosecurity Australia or another qualified body to inspect and review the activities and events that occur from the time horses enter pre-export quarantine until the time they arrive at an airport in Australia, in order to identify any biosecurity risks and recommend any necessary changes to import conditions or other requirements. This inspection and review shall be performed without delay for each country or region from which horses are imported to Australia, and it should take account of my other recommendations and comments in this report. |
REC148-3181 | 39 - Disaster Risk Management | That Biosecurity Australia undertake and complete within 12 months a non-regulated but formal import risk analysis relating to the importation of horses from the countries and regions from which Australia currently permits such importation, and make such recommendations for any changes to policies for importation as are warranted by its risk analysis to the officer responsible for the importation of horses and the Executive Director of AQIS. |
REC148-3149 | 38 - Agency/Department Reporting | That there be established the position of Inspector General of Horse Importation, the duties of that position being: |
REC148-3178 | 38 - Agency/Department Reporting | That the officer responsible for the importation of horses prepare a report to the Executive Director of AQIS that: |
REC148-3175 | 25 - Inquiry, audit, lessons management and after action review | That the officer responsible for the importation of horses arrange for Biosecurity Australia to review, at least once every two years, the operating procedures to ensure that they adequately identify and manage the risk of entry and spread of equine influenza associated with the importation of horses into Australia. The outcome of each such review should be the subject of a written report and recommendations to the person responsible for the importation of horses and the Executive Director of AQIS. A determination should then be made as to whether any, and if so what, changes should be made to the operating procedures. |
REC148-3170 | 25 - Inquiry, audit, lessons management and after action review | That the officer responsible for the importation of horses arrange for Biosecurity Australia to conduct within six months, an inspection and review of the process of horse importation from the time horses arrive in Australia until the completion of their post-arrival quarantine in order to: |
REC148-3167 | 25 - Inquiry, audit, lessons management and after action review | That the facilities at Eastern Creek and Spotswood Quarantine Stations be reviewed by AQIS in consultation with experts in biosecurity and interested parties including state and territory governments, import agents, veterinarians, farriers, operators of private quarantine stations, and representatives of horse owners, horse racing organisations and equestrian organisations. There should in any event be constructed without delay, an adequate supply of hygienic, modern showering facilities and places of entry and exit to the stations and the horse sections of them that can be supervised and monitored continually. There should also be provided at those stations as soon as is practicable suitable means of electronic surveillance, including closed-circuit television; a secure place to store chemicals, drugs, instruments and equipment for use by people attending the quarantined horses, and a set of horse stalls and yards separate from the main stalls and yards to enable isolation of horses suffering from contagious or infectious diseases. These reviews should also consider the desirability of separate areas in quarantine stations to hold horses forming part of a single quarantine intake but that have been imported from different regions or have undergone pre-export quarantine in different places. The reviews should be carried out without delay, and the two quarantine stations should be upgraded in accordance with the recommendations of the reviews. |
Rec-ID | Code | Recommendation |
---|---|---|
REC132-3593 | 26 - Research | Analysing information from the joint CFA/DSE Post 2006 Wildfire Community Survey about public perceptions of information provision during January bushfires. Note implications for the VBIL and other information provision methods |
REC132-3590 | 8 - Communications and warnings | Investigate procedures for updating the Victoria Bushfire Information Line (VBIL) Integrated Voice Response recorded message system to allow recording of permanent bushfire safety, and incident-specific, messages, accessible when the VBIL is experiencing high call volumes during large and/or numerous significant incidents |
REC132-3594 | 8 - Communications and warnings | Need for scripting of messages by fire agency representatives when promoting VBIL services via radio, TV and newspapers. |
Rec-ID | Code | Recommendation |
---|---|---|
REC121-3712 | 38 - Agency/Department Reporting | RailCorp and ITSRR should co-operate with national programs for the collection, collation, trend analysis and dissemination of safety critical information. |
REC121-3775 | 38 - Agency/Department Reporting | The Minister for Transport Services must table in Parliament, each such quarterly report by ITSRR. |
REC121-3725 | 13 - Mapping and data quality | The data and information management system should be compatible with any data and information management system established by the ATSB for the designated interstate rail network, provided that the establishment of a compatible system does not reduce the amount or quality of the information obtained by ITSRR below the optimum levels which it needs to conduct trend analysis, and otherwise properly manage the safety of rail operations in New South Wales. |
REC121-3691 | 25 - Inquiry, audit, lessons management and after action review | The ITSRR should audit the RMC to ensure communications protocols are being followed. The sanction for non-compliance with communications protocols should be identical to that in the aviation industry and involve immediate removal from duty. Any RailCorp employee not following communications protocols should be required to undertake further training. If, following return to duties after such training, the officer continues to fail to comply with communications protocols, that officer is not to be employed in communications related work. |
REC121-3757 | 25 - Inquiry, audit, lessons management and after action review | RailCorp should conduct internal and external safety audits to evaluate the adequacy of its safety management system and to ensure that any risk control measures are effective. |
REC121-3710 | 39 - Disaster Risk Management | The ITSRR should have permanent access to the RailCorp intranet. |
REC121-3774 | 38 - Agency/Department Reporting | The ITSRR must provide a quarterly report to the Minister for Transport Services on the progress made by RailCorp in implementing these recommendations, including: |
REC121-3724 | 13 - Mapping and data quality | The ITSRR should establish a data and information management system, containing all data and information that it requires, to continually monitor the safety of the New South Wales rail system. |
REC121-3684 | 39 - Disaster Risk Management | The ITSRR should conduct its own risk assessment in relation to the risk of any such high consequence, low probability accident and, if necessary, direct RailCorp to conduct a further risk assessment to reduce the level of residual risk to a level ITSRR regards as acceptable. |
REC121-3753 | 25 - Inquiry, audit, lessons management and after action review | The RailCorp Board should establish independent external safety auditing processes to regularly audit and report to the Board on the implementation of an integrated safety management system by RailCorp and on safety performance generally. |
REC121-3700 | 39 - Disaster Risk Management | Maintenance plans on all trains should be revised annually. |
REC121-3768 | 25 - Inquiry, audit, lessons management and after action review | The ITSRR, when considering a re-application for accreditation, should conduct a field audit of the organisation to ensure that it is carrying on its activities in accordance with the basis upon which it seeks accreditation. |
REC121-3723 | 38 - Agency/Department Reporting | All ATSB accident investigation reports should be made public. |
REC121-3683 | 39 - Disaster Risk Management | RailCorp should undertake risk assessments of each of its activities as follows: |
REC121-3697 | 38 - Agency/Department Reporting | All train drivers’ defects reports should be entered by RailCorp into a computerised record and tracked to finalisation. |
REC121-3765 | 25 - Inquiry, audit, lessons management and after action review | The ITSRR should conduct field audits to satisfy itself that all accredited rail organisations conduct their activities in accordance with the safety management system on the basis of which each was accredited. |
REC121-3722 | 38 - Agency/Department Reporting | The ATSB should deliver any report of any such rail accident which it investigates to the Board of any rail organisation involved in the accident, ITSRR and the Minister for Transport Services. |
REC121-3656 | 17 - Assets and technology | Satellite telephones should be provided by RailCorp to all rail commanders at any emergency. |
REC121-3729 | 38 - Agency/Department Reporting | All reports of the Chief Investigator of OTSI should be delivered, upon completion and without being reviewed, to ITSRR and the Minister for Transport Services. |
REC121-3694 | 25 - Inquiry, audit, lessons management and after action review | The ITSRR should conduct random audits of accredited rail organisations for compliance with communications protocols. |
REC121-3713 | 25 - Inquiry, audit, lessons management and after action review | Recommendations one to seven of the final report of the Special Commission of Inquiry into the Glenbrook Rail Accident should be fully implemented, save that the random auditing referred to in recommendations five and seven should be carried out by ITSRR. |
REC121-3776 | 38 - Agency/Department Reporting | The Minister for Transport Services should retain, independently of ITSRR, safety auditors to provide a report to the Minister confirming or qualifying the contents of each such ITSRR quarterly report. |
REC121-3726 | 25 - Inquiry, audit, lessons management and after action review | The OTSI should continue to conduct rail accident investigations on behalf of ITSRR and report directly to the Chief Executive of ITSRR. |
REC121-3693 | 25 - Inquiry, audit, lessons management and after action review | ITSRR should ensure that, as a condition of accreditation, each of these recommendations is carried into effect and should audit against them to enforce compliance. |
REC121-3758 | 25 - Inquiry, audit, lessons management and after action review | Following completion of any external audit, a corrective action plan to remedy any identified safety deficiencies should be developed by RailCorp, implemented and followed up within the business groups affected, to ensure appropriate and timely completion of the action plan, by a formal examination of the effectiveness of the controls put in place. Senior management personnel should certify that the corrective action plan has been implemented and is effective. Senior management personnel should be accountable for any such certification. |
Rec-ID | Code | Recommendation |
---|---|---|
REC019-4153 | 17 - Assets and technology | No opportunity be lost by the Forests Department to improve the efficiency of their fire fighting gangs, radio and other equipment in the light of the latest practical and scientific developments. |
REC019-4151 | 26 - Research | The Forests Department carry out more research into both the technical and practical side of fire control as a necessary accompaniment to the expenditure of money on other forest works and that forest fire control officers be sent overseas at intervals to gain information regarding the latest developments in this work. |
REC019-4156 | 26 - Research | A fire control research advisory committee be formed to co-operate with the Forests Department in carrying out scientific research into fire control. |
Rec-ID | Code | Recommendation |
---|---|---|
REC016_3949 | 17 - Assets and technology | It is recommended that the A.R.P. dams or earth tanks be kept filled during possible danger periods. |
Rec-ID | Code | Recommendation |
---|---|---|
REC013_3977 | 8 - Communications and warnings | To arrange with settlers who live on hills or have a clear view, and are connected by telephone, to act as " look-outs ", and to communicate with the brigade in the case of fire. |
Rec-ID | Code | Recommendation |
---|---|---|
REC008-3985 | 17 - Assets and technology | The Commission recommends that conductors carrying currents at medium pressure should not be encased in wood in damp places. |
REC008-3989 | 17 - Assets and technology | The Commission recommends that there be continuous supervision of every chamber in which electrical machinery is worked by currents of medium pressure. |
REC008-3987 | 17 - Assets and technology | The Commission recommends that systematic tests be made and recorded of apparatus and circuits as a precaution against fire and so that any gradual deterioration of the system may be detected. |
REC008-3986 | 17 - Assets and technology | The Commission recommends that every precaution be taken to keep water off electrical machinery. |
Rec-ID | Code | Recommendation |
---|---|---|
REC004-3994 | 17 - Assets and technology | That the Railway Department, while gradually reducing the number of different types of locomotives, should steadily keep in view the adoption of English and American railway practice, by providing engines with larger boilers, fire boxers, and smoke-boxes, and with wide blast-pipes, in order to insure ample steaming power with a minimum of forced draught. |
REC004-3992 | 17 - Assets and technology | That the use of a spark-arrester and cinder-arrester by the Railway Department shall not constitute a defence to an action for damage caused by fire escaping from a locomotive, unless the Department proves that such spark-arrester and cinder-arrester were in a thoroughly efficient condition when the fire took place. |
REC004-3996 | 17 - Assets and technology | That the standard pattern of cinder arrester be affixed to the ash-pans in all locomotives during the summer months. |