Inquiry Search
Rec-ID | Code | Recommendation |
---|---|---|
REC321-4202 | 10 - Infrastructure | We recommend that DELWP investigates incentives and advises government on options to accelerate burying and insulating the remaining high-voltage bare-wire powerlines in the 33 highest risk areas. |
REC321-4201 | 10 - Infrastructure | We recommend that DELWP improves the Powerline Bushfire Safety Program's transparency by publicly reporting on activities, costs and risk-reduction outcomes. |
REC321-4207 | 25 - Inquiry, audit, lessons management and after action review | We recommend that DELWP reviews its target for the number of fuel hazard assessments conducted and ensures that this measure is evidence based, accurately reflects regional performance, and that the department monitors and reports on each region’s performance against it. |
Rec-ID | Code | Recommendation |
---|---|---|
REC318-4181 | 25 - Inquiry, audit, lessons management and after action review | The Inspector-General for Emergency Management recommends that Emergency Management Victoria – in collaboration with the emergency management sector and as part of the emergency management planning reforms: |
REC318-4178 | 25 - Inquiry, audit, lessons management and after action review | The Inspector-General for Emergency Management recommends that the Department of Environment, Land, Water and Planning (or the single entity referenced in Recommendation 4) – in collaboration with the Country Fire Authority and local government – undertake a review of the current residual risk target to ensure that it remains contemporary in terms of its designated percentage value. The review should: |
REC318-4171 | 25 - Inquiry, audit, lessons management and after action review | The Inspector-General for Emergency Management recommends that the State review (and where necessary amend) legislation including but not limited to the Country Fire Authority Act 1958, Forest Act 1958 and Local Government Act 2020 to: |
REC318-4182 | 25 - Inquiry, audit, lessons management and after action review | The Inspector-General for Emergency Management recommends that Emergency Management Victoria – in partnership with agencies engaged in state, regional and incident control centres: |
Rec-ID | Code | Recommendation |
---|---|---|
REC314-3266 | 14 - Incident Mgt Teams | Engage with the Australian Defence Force (ADF) once or twice a year to understand the capabilities that could potentially be deployed. Educate IMTs about how to deploy ADF assistance effectively and develop a streamlined ‘call out’ procedure. |
REC314-3265 | 14 - Incident Mgt Teams | Prepare to ‘scale up’ capability during major bushfire events with senior representatives (including BoM staff) in the SEC 24/7, ensure adequate facilities for IMTs, base camps (e.g. Humanihuts) and recovery centres. Consider the resource implications of providing firefighters to interstate operations. |
REC314-3272 | 10 - Infrastructure | Clarify business continuity and restoration of critical infrastructure in the planning and response phases to facilitate water replenishment, fireground remediation and access to businesses (including farming properties). |
REC314-3262 | 10 - Infrastructure | Invest in upgrading and integrating ICT platforms to eliminate manual data transfers, and ensure IT and radio communication interoperability across the agencies, together with a dedicated focus on the development of a coordinated risk intelligence capability to provide all stakeholders with a common operating picture and rapid damage assessments. |
Rec-ID | Code | Recommendation |
---|---|---|
REC313-2508 | 25 - Inquiry, audit, lessons management and after action review | Regularly reviewing these plans to ensure that they reflect the current operating environment. |
Rec-ID | Code | Recommendation |
---|---|---|
REC299-1344 | 25 - Inquiry, audit, lessons management and after action review | That a review of the cross‑tenure approach be undertaken to determine its effectiveness and to address issues that arise in fire prevention on private and public land. |
REC299-1343 | 25 - Inquiry, audit, lessons management and after action review | That the Government conduct a review of fire prevention |
Rec-ID | Code | Recommendation |
---|---|---|
REC296-1354 | 10 - Infrastructure | Monthly and annual maintenance servicing needs to be scheduled for the generator to DPTI or CHSA schedule requirements. |
REC296-1359 | 10 - Infrastructure | Renegotiate the maintenance contract at the end of the current contract and have DPTI through AGFMA take on the maintenance contract. |
REC296-1353 | 10 - Infrastructure | Regular annual testing at 100% on a load bank needs to be scheduled into a maintenance schedule. |
REC296-1358 | 10 - Infrastructure | If the existing generator is capable of providing the current essential power requirements then the generator needs a major inspection and overhaul all items that may need to be replaced due to age and condition. This includes checking compression, oil pressure, coolant pumping and all other critical components and may actually require providing a temporary generator while the Hospital generator receives a major inspection and possible re build. A ball park figure to do this would be $50,000.00 plus cranage and transport to Detroit workshop probably another $10,000.00 then a temporary generator would need to be hired and installed which could run into $10’s of thousands of dollars depending on how long the engine was out of service. For the money that would be spent checking and rebuilding the existing engine it would be recommended to replace the generator with a new generator. |
REC296-1363 | 10 - Infrastructure | Due to the age of the generator, reliability and reparability risk due to age and the apparent under capacity of the generator it is recommend to replace the generator with a new generator and associated control system designed for the current load requirements and allowance for some future expansion. |
REC296-1352 | 10 - Infrastructure | A monthly testing regime needs to be developed that will allow the generator to be tested at full essential load capacity and to ensure that 4 hour monthly testing can be done every month. |
REC296-1357 | 10 - Infrastructure | Monthly test results need to be accurately recorded. |
REC296-1362 | 10 - Infrastructure | Carry out a detailed audit of the current Hospital essential loads to determine the current load requirements of the Hospital. |
REC296-1351 | 10 - Infrastructure | From the above assessment determine the existing generator load requirements and provide a new generator to meet those loads. |
REC296-1356 | 10 - Infrastructure | Accurate records need to be provided as to what is done for each service. |
REC296-1361 | 10 - Infrastructure | Prepare and carry out a testing regime and testing strategy and ensure testing of the generator is done every month for 4 hours over that month and under full Hospital load with test result recorded every 15 minutes. |
REC296-1350 | 10 - Infrastructure | Remove any loads that do not need to be on essential power. |
REC296-1355 | 10 - Infrastructure | Replacement of all original pipes and hoses not yet done. |
REC296-1360 | 10 - Infrastructure | Carry out regular load bank testing on the generator with a load bank large enough to fully load the generator to 110% which will clean out the engine and also identify whether the generator is capable of providing full load for a sustained length of time. |
REC296-1349 | 10 - Infrastructure | Conduct an assessment of the current essential loads and determine if there are loads that should not be on essential power. |
Rec-ID | Code | Recommendation |
---|---|---|
REC295-1305 | 18 - Access to fire ground | That the annexure to the State Emergency Management Plan, ‘Traffic management during emergencies’, be updated to include: responsibilities and processes for road closures; and, Department of Planning, Transport and Infrastructure requirements in regards to provision of road closure information, notification of changes in road closure status and publishing of that information. |
REC295-1302 | 28 - Personal responsibility | That the State Emergency Service together with the Local Government Association and Country Fire Service establish a plan for coordinated provision of sandbags to the public, including options for what is provided, where and when, and the process for effective communication of availability to the public. |
REC295-1327 | 25 - Inquiry, audit, lessons management and after action review | Establish a lessons management capability across the SA emergency management sector to collect, analyse and track lessons identified during debriefs and reviews following events and other sources such as interstate and oversees reviews and inquiries. |
REC295-1286 | 10 - Infrastructure | That the Attorney General’s Department consult with local government regarding potential for them to provide logistical support associated with backup power supply to SA Government Radio Network towers in the event of an emergency. |
REC295-1317 | 25 - Inquiry, audit, lessons management and after action review | Review representation in the State Emergency Centre including: a) determining if there is a more suitable functional support group e.g. the Procurement Functional Support Group, to replace the Logistics Functional Support Group, and if so, Chief Procurement Officer, DPC, has responsibility for the management of this role within the State Emergency Centre. b) That when the State Crisis Centre is not operating from a physical location, a State Crisis Centre liaison officer is attached to the State Emergency Centre. |
REC295-1279 | 10 - Infrastructure | Install UPS on traffic lights on main Central Business District (CBD) and arterial roads to allow an effective movement of traffic during a loss of power. |
REC295-1315 | 25 - Inquiry, audit, lessons management and after action review | That a review of the role and effectiveness of the State Emergency Management Committee (SEMC) including: the legislative functions; membership including the chair; roles and responsibilities; and, SEMC Advisory Groups be undertaken. |
REC295-1297 | 25 - Inquiry, audit, lessons management and after action review | Engage an independent business analyst to review the current call, receipt and dispatch process for emergency services i.e. the Metropolitan Fire Service, Country Fire Service and State Emergency Service, from the initial call for assistance through to response of emergency service resources, including the allocation and coordination of multiple taskings. |
REC295-1285 | 7 - Inter-agency communication | Identify, document and communicate contingency arrangements and procedures for emergency services in the event SA Government Radio Network paging is turned off to conserve power, or other loss of paging capacity. |
REC295-1326 | 14 - Incident Mgt Teams | Establish a State-wide resourcing capability to support incident management teams, regional coordination centres, zone emergency centres, relief centres, recovery centres and State control centres. some of the features of such a capability should include: a) multi-agency, cross-government, State-wide pool of incident management and emergency management personnel building on the State incident management team concept currently facilitated by the Country Fire Service, and expanded to include all hazards, multiagency teams with a roster that provides year-round coverage b) a system that enables staff and volunteers from any agency to identify their availability for upcoming shifts c) a rostering system that enables one or more incident management teams, staging areas, regional coordination centres, State control centres and relief centres to develop, maintain and distribute rosters and structure charts in a more coordinated manner d) identifying areas of expertise for key incident and emergency management functions (e.g. public information, alerts and warning, media liaison, logistics and resource management) that would benefit from a coordinated and resource pooling approach and take steps to implement (consider the Mapping Functional Support Group model as a potential service delivery model). |
REC295-1276 | 25 - Inquiry, audit, lessons management and after action review | That SA Health undertake a review of their emergency management arrangements. Health State Controllers should be consulted during this review and arrangements should be consistent throughout the department and across the State and compatible with State emergency management arrangements and information systems |
REC295-1328 | 25 - Inquiry, audit, lessons management and after action review | Update the SEMP Part 3, Annex F ‘Debriefs’ to provide more guidance regarding the types of debriefs, when they are required to be undertaken and at what level and guidance for undertaking and recording debriefs, and implementing lessons identified. |
REC295-1283 | 7 - Inter-agency communication | Consider bringing other agencies onto the SA Government Radio Network, in particular, Department of Education and Child Development and local government, to support more effective coordination and provide a reliable communications contingency during emergencies. |
Rec-ID | Code | Recommendation |
---|---|---|
REC284-1371 | 10 - Infrastructure | Generator dual redundant starter systems should be considered. |
REC284-1365 | 10 - Infrastructure | The electrical master plan for the site should be updated to include planning for the scheduled replacement or refurbishment of those parts of the infrastructure that have not been renewed in the last 10 years. This planning to consider other upgrades or plans for the FMC overall. |
REC284-1370 | 10 - Infrastructure | Review control system for the main generator normal/essential changeover system and ensure that it has effective backup/manual or redundant operations, and suitable testing facilities. The Essential board that supplies the main generator power to Blocks A, B, C (except theatres), D, E (except certain critical engineering plant) (MD-1-4P-10E), is a potential single point of failure of a significant portion of the emergency power system and as part of the Master Plan update should be considered as a priority. |
REC284-1369 | 10 - Infrastructure | Review all generator locations for arrangements for temporary generator installation, including design of modifications as required for electrical connections and spatial requirements at installation locations, to be documented in an emergency procedure. |
REC284-1374 | 10 - Infrastructure | Provide walls around critical electrical infrastructure within the main plant area to provide security and protection from catastrophic water system failures. |
REC284-1368 | 10 - Infrastructure | Improvements to installation to be implemented as follows: - Lighting within the generator enclosure and immediately adjacent to be emergency battery-backed type. - Improvements to the spatial layout within the main generator enclosure should be investigated, including allowance for the control panel door to open 180o (only 90o currently); moving the fuel pumps to a more accessible location, and ensuring clear access to the day tank for manual filling if required. - Improvements to communications facilities between critical areas, including fixed phone line connections between the main control room, main generator control panel in the P (energy) Building, and the generator enclosure, and allowing link to offsite specialist advice. - Where generator maintenance requires operations outdoors (not applicable to main generator, but applicable to others), a shelter over the relevant area should be provided to allow safe work during wet or hot weather. - Written emergency procedures to be prepared covering credible failure scenarios with step by step checklists and recommended actions. |
REC284-1373 | 10 - Infrastructure | Review generator installations details as noted in report and implement physical improvements where possible. |
REC284-1367 | 10 - Infrastructure | Add to generator test procedure a checklist at the end of testing which includes checking that all systems are back to normal positions and includes a requirement to leave the day tank full where there is a bulk tank/day tank arrangement. |
REC284-1372 | 10 - Infrastructure | As part of the electrical master plan update recommended above, a complete and consistent set of single line diagrams describing the electrical distribution network be prepared. Relevant diagrams to be laminated and displayed in the main substations. Labelling to all main electrical equipment be reviewed and updated in accordance with the final documents. |
REC284-1366 | 10 - Infrastructure | A detailed review of the fuel control and BMS systems (for all generators) be carried out and actions taken to: 1) Ensure that the fuel alarm system is operational and properly calibrated, and ensure that the alarms are connected to the BMS. 2) Ensure that the BMS transmits these alarms effectively to the maintenance staff. 3) If this review demonstrates risk of fuel control systems not adequately reporting alarms, consider an independent day tank level switch to be installed in each generator fuel tank, directly connected to the BMS. 4) Consider the feasibility of adding a “fuel system not in auto” or “fuel system fault/fail safe watchdog” or “pre-alarm identifying that the generator is about to shut down without intervention” feature to current systems – subject to details of each individual generator system. |
Rec-ID | Code | Recommendation |
---|---|---|
REC274-1408 | 7 - Inter-agency communication | That the Department of Health & Human Services uses Emergency Services Telecommunications Authority Computer Aided Dispatch data to report ambulance emergency response time performance. |
Rec-ID | Code | Recommendation |
---|---|---|
REC273-1139 | 14 - Incident Mgt Teams | SACFS appoint the Regional Controller and/or Coordinator as the IC for any Level 3 incident occurring within their Region to provide better continuity and improved coordination. The position of the regional controller and/or coordinator could then be backfilled by a suitably qualified individual as required. |
REC273-1144 | 7 - Inter-agency communication | That SACFS consider a review to develop an effective interagency messaging system and agency resource management system. |
REC273-1138 | 14 - Incident Mgt Teams | Review the communication and request procedures within SACFS to ensure that the most effective chain of command and line of communications are established between the Incident Management Team, region and state. |
REC273-1142 | 18 - Access to fire ground | That SACFS consider the Traffic Management Procedures and guiding principles adopted in Tasmania as a model that could be implemented within SA. |
REC273-1135 | 14 - Incident Mgt Teams | That SACFS conduct a review of SIMT with a view to increasing the number of teams from four to six, aligning them with each of the six regions within SA. |
Rec-ID | Code | Recommendation |
---|---|---|
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 |
REC264-1072 | 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. |
REC264-1085 | 10 - Infrastructure | GDF Suez establish enhanced back-up power supply arrangements that do not depend wholly on mains power, to: • ensure that the Emergency Command Centre can continue to operate if mains power is lost; and • ensure that the reticulated fre services water system can operate with minimal disruption if mains power is lost. |
Rec-ID | Code | Recommendation |
---|---|---|
REC262-1485 | 7 - Inter-agency communication | That Victoria Police implements the recommendations relating to protective services officers in the Service Demand and Dispatcher Capacity Analysis dated September 2013 and: |
REC262-1490 | 10 - Infrastructure | That the Emergency Services Telecommunications Authority critically reviews: |
REC262-1484 | 7 - Inter-agency communication | That Ambulance Victoria: |
REC262-1489 | 10 - Infrastructure | That the Emergency Services Telecommunications Authority reclassifies its State Emergency Communications Centres as critical national infrastructure. |
REC262-1483 | 7 - Inter-agency communication | That the Emergency Services Telecommunications Authority includes Victoria State Emergency Service vehicle capability details in the Computer Aided Dispatch database. |
REC262-1491 | 7 - Inter-agency communication | That Emergency Management Victoria expedites the expansion of the Rural Mobile Radio network to all emergency services organisations. |
REC262-1487 | 7 - Inter-agency communication | That the Emergency Services Telecommunications Authority, assisted by the Inspector-General for Emergency Management and responder agencies, improves the process for changing call-taking and dispatch procedures by comprehensively appraising the costs, benefits and operational impacts of these changes and agreeing a plan for their implementation with all affected agencies. |
REC262-1486 | 7 - Inter-agency communication | That Emergency Management Victoria novates the head contract for the StateNet Mobile Radio network to the Emergency Services Telecommunications Authority. |
Rec-ID | Code | Recommendation |
---|---|---|
REC250-0796 | 25 - Inquiry, audit, lessons management and after action review | The Department of Premier and Cabinet should lead: x the development of an evaluation framework, based on work undertaken to date by the Department of Human Services, to be used in assessing the impact of relief and recovery programs in the recent floods and in future disaster events x an evaluation of the impact of relief and recovery programs in the recent floods, using this framework. |
REC250-0790 | 25 - Inquiry, audit, lessons management and after action review | The Department of Justice should review the current model for rapid impact assessment to improve the quality of the information collected. |
Rec-ID | Code | Recommendation |
---|---|---|
REC244-2620 | 25 - Inquiry, audit, lessons management and after action review | Review employment conditions under the F&ES Act to align with those under the Public Sector Act unless there is a compelling reason to the contrary. |
REC244-2617 | 25 - Inquiry, audit, lessons management and after action review | When judging major incidents in the future, consideration be given to Eburn and Dover’s proposal to establish processes with a statutory basis that sufficiently balance the community’s interests in ensuring that true lessons, including lessons of error or neglect, are identified, whilst also protecting members of the emergency services. Processes need to be developed for emergency services such as those used in aviation and medicine, to facilitate open and honest disclosure of errors. |
REC244-2601 | 25 - Inquiry, audit, lessons management and after action review | That an independent review of the operational and geographic boundaries of the ESOs be conducted recognising the limitations of the current governance structures to adequately address such issues. Such a review needs to be performed periodically, but not less than every 8 years. |
REC244-2600 | 25 - Inquiry, audit, lessons management and after action review | An external audit of shared services performed by SAFECOM and services now provided by the three ESOs which have the potential to be shared, be undertaken to determine the most efficient and cost effective way such services can be delivered to the sector. The three ESO Chiefs need to have input into this process. |
REC244-2631 | 25 - Inquiry, audit, lessons management and after action review | Review Section 134 to ensure that it is not a deterrent to a group of farm fire units operating at an incident. |
Rec-ID | Code | Recommendation |
---|---|---|
REC242-2643 | 25 - Inquiry, audit, lessons management and after action review | That the Government consult broadly upon and review impediments to volunteering in the community and establish a taskforce to assist in removing barriers to volunteering, particularly with respect to: |
Rec-ID | Code | Recommendation |
---|---|---|
REC217-1840 | 25 - Inquiry, audit, lessons management and after action review | The state government implement the Victorian Floods Review recommendation 8, to review the flood gauging network. As part of the review, consideration should also be given to the use of portable telemetered river gauges, and to the replacement of manual gauges with telemetered gauges over time and where appropriate. |
Rec-ID | Code | Recommendation |
---|---|---|
REC216-2867 | 14 - Incident Mgt Teams | Agency incident management preparedness: refining IT tools to process the intelligence. |
REC216-2866 | 14 - Incident Mgt Teams | Agency incident management preparedness: provide clarity and certainty in specific roles and responsibilities for each agency. |
REC216-2868 | 14 - Incident Mgt Teams | Agency incident management preparedness: a more comprehensive approach to planning, including the number of personnel, their training and better use of on-the-ground intelligence in the affected areas that enables immediate and strategic decision-making to be concurrent processes. |
Rec-ID | Code | Recommendation |
---|---|---|
REC215-1871 | 14 - Incident Mgt Teams | Fire services can improve outcomes by developing a checklist for use by incident controllers |
REC215-1879 | 25 - Inquiry, audit, lessons management and after action review | Regulators can help to achieve improved outcomes by auditing compliance with the BPEM guidelines on a regular basis |
Rec-ID | Code | Recommendation |
---|---|---|
REC199-0407 | 25 - Inquiry, audit, lessons management and after action review | the state: • undertake a strategic review to identify areas at risk from flash or riverine flooding. Shortcomings in the flood gauging networks identified in the review should then be the focus of remedial action • seek to address as a priority any notable gaps in the total flood warning system as apparent in the 2010–11 floods (including south west Victoria, Wimmera and north central region) by enhancing mapping, gauging and education programs; and • seek a commitment from the Bureau of Meteorology to ensure any new gauges installed are utilised to enhance flood prediction capability and coverage. |
REC199-0446 | 7 - Inter-agency communication | the state commit to securing effective multi-agency interoperable communications as a high level priority and that all future communications projects and upgrades incorporate compliance provisions mandating interoperability requirements. |
REC199-0401 | 25 - Inquiry, audit, lessons management and after action review | the state task the Emergency Services Commissioner with the responsibility to establish an effective audit regime of the total flood warning system. |
REC199-0482 | 25 - Inquiry, audit, lessons management and after action review | the state task the Emergency Services Commissioner with the responsibility to develop and undertake the regular audit of emergency management plans at all levels. |
REC199-0418 | 7 - Inter-agency communication | the state develop an efficient process to ensure that, during flood events, temporary construction of flood mitigation works, such as levees, is controlled so as not to unacceptably impact on flood intelligence. |
REC199-0413 | 14 - Incident Mgt Teams | the state clarify the role of intelligence cell staff (for example, hydrologists and/or Catchment Management Authority) who are utilised in Incident Control Centres during flood events |
REC199-0450 | 25 - Inquiry, audit, lessons management and after action review | the state ensure that appropriate record management processes are developed and implemented and that these processes also provide record accountability for multi-agency operations. Agency processes should be standardised to the fullest extent possible |
REC199-0458 | 7 - Inter-agency communication | the state ensure: • a common, functional and accessible system be introduced to enable effective Municipal Emergency Coordination Centre and Incident Control Centre communications • a regime of regular Municipal Emergency Coordination Centre exercising is introduced with oversight by an appropriate independent body. Such exercising should include testing of systems utilised for Incident Control Centre and Municipal Emergency Coordination Centre communications • those required to perform Emergency Management Liaison Officer roles have undertaken appropriate training; and • resource requesting arrangements are clarified and documented so that control and coordination functions do not overlap. |
REC199-0445 | 25 - Inquiry, audit, lessons management and after action review | the state develop and implement operational performance standards for each state agency involved in emergency management response and recovery and that: • each agency be assessed by the Emergency Services Commissioner periodically against these performance standards for both capability and capacity; and • where performance against these standards for either capability or capacity cannot be demonstrated by any agency – appropriate advice is communicated to the relevant Minister, departmental/agency head and State Emergency Response Coordinator; and – an action plan is developed and implemented to address the relevant capability or capacity deficiency in both the short and longer term. |
REC199-0449 | 7 - Inter-agency communication | the state ensure that interoperable information management practices are developed and implemented by emergency management agencies. Common systems should be utilised to the fullest extent possible. |
REC199-0428 | 25 - Inquiry, audit, lessons management and after action review | the state clarify which agency is responsible for collecting post-flood extent and related data. This should include: • the development of guidelines to ensure consistent standards are applied to post-flood data collection; and • an appropriate process to ensure funding availability for such activities. |
REC199-0447 | 7 - Inter-agency communication | the state ensure that common and interoperable resource management systems are developed and implemented by emergency management agencies. Common systems should be utilised to the fullest extent possible. |
Rec-ID | Code | Recommendation |
---|---|---|
REC198-2905 | 14 - Incident Mgt Teams | The Fire Services Commissioner ensures that there is a single standard for the tabards worn by the IMT on the fireground and in control centres to ensure consistency and aid interoperability. |
REC198-2902 | 14 - Incident Mgt Teams | The Fire Services Commissioner clarifies the role of regional controller for major fires and incidents other than bushfire. |
Rec-ID | Code | Recommendation |
---|---|---|
REC197-1733 | 25 - Inquiry, audit, lessons management and after action review | That a review of the Country Fire Authority Act 1958 and the Country Fire Authority Regulations 2004 be undertaken. |
Rec-ID | Code | Recommendation |
---|---|---|
REC195-0315 | 14 - Incident Mgt Teams | The Fire Services, as part of the regular review of Incident Management Teams – Readiness Arrangements, reassess current resource sustainability and identify opportunities for a more flexible application. |
REC195-0335 | 10 - Infrastructure | Energy Safe Victoria ensures that the standards for vegetation clearance around power lines consider the impact of fire on electrical infrastructure and the risk of loss of electricity supply to the community. |
REC195-0322 | 7 - Inter-agency communication | The Fire Services investigate the reported technical communication issues for this fire |
REC195-0323 | 14 - Incident Mgt Teams | Incident Controllers ensure that Emergency Management Teams consider, provide advice, and manage the broader consequences of actions, such as reopening roads, the resumption of public transport and school buses, and the welfare of those impacted by traffic management points. |
REC195-0321 | 7 - Inter-agency communication | The Fire Services move towards a common and more disciplined approach to fireground communications. |
REC195-0317 | 14 - Incident Mgt Teams | The Fire Services ensure that an incident action plan (summary) is developed in accordance with the Standard Operating Procedure J3.03. |
REC195-0319 | 7 - Inter-agency communication | The Fire Services introduce systems, procedures and operational training that promote information sharing and consistent situational awareness at every level, including to and from the fireground. This should include agencies such as police members on duty at roadblocks |
REC195-0316 | 14 - Incident Mgt Teams | The Fire Services continue to develop fire behaviour analysis and predictive science capability by ensuring the Fire Behaviour Analysis Team is appropriately resourced with accredited staff and available to provide services to the IMT. |
Rec-ID | Code | Recommendation |
---|---|---|
REC181-0177 | 10 - Infrastructure | The State amend the Regulations under Victoria’s Electricity Safety Act 1998 and otherwise take such steps as may be required to give effect to the following: ■ the progressive replacement of all SWER (single-wire earth return) power lines in Victoria with aerial bundled cable, underground cabling or other technology that delivers greatly reduced bushfire risk. The replacement program should be completed in the areas of highest bushfire risk within 10 years and should continue in areas of lower bushfire risk as the lines reach the end of their engineering lives; ■ the progressive replacement of all 22-kilovolt distribution feeders with aerial bundled cable, underground cabling or other technology that delivers greatly reduced bushfire risk as the feeders reach the end of their engineering lives. Priority should be given to distribution feeders in the areas of highest bushfire risk. |
REC181-0173 | 7 - Inter-agency communication | The Country Fire Authority review and improve its communications strategy as a matter of priority and develop a program for identifying and responding to black spots in radio coverage. |
REC181-0182 | 10 - Infrastructure | The State (through Energy Safe Victoria) require distribution businesses to do the following: ■ disable the reclose function on the automatic circuit reclosers on all SWER lines for the six weeks of greatest risk in every fire season; ■ adjust the reclose function on the automatic circuit reclosers on all 22-kilovolt feeders on all total fire ban days to permit only one reclose attempt before lockout. |
REC181-0168 | 14 - Incident Mgt Teams | The Country Fire Authority and the Department of Sustainability and Environment amend their procedures to require that a suitably experienced, qualified and competent person be appointed as Incident Controller, regardless of the control agency for the fire. |
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. |
REC181-0180 | 10 - Infrastructure | The State amend the regulatory framework for electricity safety to require that distribution businesses adopt, as part of their management plans, measures to reduce the risks posed by hazard trees—that is, trees that are outside the clearance zone but that could come into contact with an electric power line having regard to foreseeable local conditions. |
REC181-0184 | 10 - Infrastructure | The State amend the regulatory framework for electricity safety to strengthen Energy Safe Victoria’s mandate in relation to the prevention and mitigation of electricity-caused bushfires and to require it to fulfil that mandate. |
REC181-0167 | 14 - Incident Mgt Teams | The Country Fire Authority and the Department of Sustainability and Environment establish before the 2010–11 fire season: ■ a uniform, objective and transparent process based on the current DSE approach for the accreditation of level 3 Incident Controllers; ■ a performance review system for level 3 Incident Controllers; ■ a traineeship program for progression from level 2 to level 3 incident management team positions. |
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. |
REC181-0179 | 10 - Infrastructure | The State (through Energy Safe Victoria) require distribution businesses to review and modify their current practices, standards and procedures for the training and auditing of asset inspectors to ensure that registered training organisations provide adequate theoretical and practical training for asset inspectors. |
REC181-0165 | 14 - Incident Mgt Teams | The Country Fire Authority and the Department of Sustainability and Environment: ■ amend their procedures to require that an incident action plan summary be completed within the first four hours of an incident being reported and be provided to the State Control Centre and, where established, to the relevant Area of Operations Control Centre; ■ adopt DSE’s incident action plan summary as the template to be used by all incident management teams and ensure that the template is included in the online IMT Tool Box; ■ provide regular training to IMT staff, highlighting the importance of information and reinforcing the support available from specialists within the State Control Centre. |
REC181-0178 | 10 - Infrastructure | The State (through Energy Safe Victoria) require distribution businesses to change their asset inspection standards and procedures to require that all SWER lines and all 22-kilovolt feeders in areas of high bushfire risk are inspected at least every three years. |
REC181-0169 | 18 - Access to fire ground | The Country Fire Authority provide to all CFA volunteers an identification card or similar to facilitate their passage through roadblocks established in accordance with the 2009 Guidelines for the Operation of Traffic Management Points during Wildfires. |
REC181-0183 | 10 - Infrastructure | The State (through Energy Safe Victoria) require distribution businesses to do the following: ■ fit spreaders to any lines with a history of clashing or the potential to do so; ■ fit or retrofit all spans that are more than 300 metres long with vibration dampers as soon as is reasonably practicable. |
REC181-0159 | 14 - Incident Mgt Teams | The Country Fire Authority and the Department of Sustainability and Environment prescribe and audit the minimum number and nature of level 3 joint training exercises in which incident management team staff (including volunteers) are required to participate. |
Rec-ID | Code | Recommendation |
---|---|---|
REC158-3452 | 25 - Inquiry, audit, lessons management and after action review | That the nominated marine safety authority undertakes a further assessment to determine the recommendations from this Review that may also be applicable to State waters outside commercial port waters. |
Rec-ID | Code | Recommendation |
---|---|---|
REC156-3494 | 10 - Infrastructure | Energy Safe Victoria finalise the development of the passport system to improve interstate mutual aid arrangements allowing operator access to qualified interstate power restoration personnel. |
REC156-3487 | 10 - Infrastructure | Electricity distribution businesses develop and implement alternative arrangements for monitoring fallen powerlines. |
REC156-3516 | 28 - Personal responsibility | All Victorians should: |
REC156-3500 | 10 - Infrastructure | The Emergency Services Telecommunications Authority, in partnership with Telstra, consider technological solutions to streamline the handover process for Triple Zero calls. |
Rec-ID | Code | Recommendation |
---|---|---|
REC155-3466 | 25 - Inquiry, audit, lessons management and after action review | A comprehensive review of the effectiveness of the increased prescribed burning target in meeting ecological and bushfire suppression needs should be conducted every three years. |
Rec-ID | Code | Recommendation |
---|---|---|
REC153-1799 | 14 - Incident Mgt Teams | That the South Australian Country Fire Service establish preplanned Level 2 Incident Management Teams in each Region for deployment to Level 2 incidents. |
REC153-1791 | 14 - Incident Mgt Teams | That the Minister for Emergency Services and the Chief Officer of the South Australian Country Fire Service consider the creation of a position within an Incident Management Team of a Landowner Liaison Officer the duties and responsibilities of whom is to establish contact with and liaise with the owner and/or occupiers of rural land on which a fire is situated. |
Rec-ID | Code | Recommendation |
---|---|---|
REC125-3898 | 25 - Inquiry, audit, lessons management and after action review | That agencies develop a detailed improvement plan and commit resources to its implementation. |
Rec-ID | Code | Recommendation |
---|---|---|
REC123-3877 | 25 - Inquiry, audit, lessons management and after action review | All agencies review formal and informal incident notification processes to ensure they support the earliest possible reporting of emergencies to all stakeholders involved in the Airport Emergency Plan and in so doing, ensure early access to specialist advice and support. |
Rec-ID | Code | Recommendation |
---|---|---|
REC112-3919 | 25 - Inquiry, audit, lessons management and after action review | That the model for state funding be reviewed to ensure that DPI can confidently build and maintain a core level of diagnostic expertise and research capability. |
REC112-3912 | 25 - Inquiry, audit, lessons management and after action review | That DPI, as part of the development of the Victorian plant biosecurity strategy, undertake a strategic review of its plant health planning framework so that: • corporate and business unit plans at all levels of the department align to each other and to government policy so that staff have a coherent frame of reference to guide their work • performance indicators are developed, used, reported against and evaluated regularly • all plans (including service agreements with other parts of DPI) are communicated to staff and implemented in their day-to-day activities and responsibilities. |
REC112-3907 | 25 - Inquiry, audit, lessons management and after action review | That Department of Primary Industries (DPI), in partnership with the Department of Sustainability and Environment, reviews all legislation relating to plant biosecurity with a view to streamlining the legislative framework. |
REC112-3932 | 25 - Inquiry, audit, lessons management and after action review | That DPI conducts and documents debriefs after all incursions, and adopts any improvements that are identified through debriefs. |
REC112-3922 | 25 - Inquiry, audit, lessons management and after action review | That DPI maintains ISO 9000 accreditation for at least one laboratory and seeks NATA accreditation for key diagnostic tests. This should be done in combination with Plant Health Australia’s laboratory accreditation project. |
Rec-ID | Code | Recommendation |
---|---|---|
REC104-2282 | 25 - Inquiry, audit, lessons management and after action review | That quality control or performance assessments are routinely completed post fire season, to ensure that contractors who have not performed to an agreed standard are not re-engaged for the consequential rehabilitation works. |
REC104-2258 | 14 - Incident Mgt Teams | That, wherever possible, Incident Management Team members from DSE, CFA and MFESB who are likely to be deployed together to manage fire, should train and exercise together. |
REC104-2333 | 25 - Inquiry, audit, lessons management and after action review | That in doing so, this Review must consult with the agencies mentioned above, and others such as VICSES and the Departments of Human Services and Primary Industries. |
REC104-2272 | 14 - Incident Mgt Teams | That personnel assigned the roles of Division Commander, Sector Commander and Strike Team Leader on the fire ground are actively encouraged to provide input into the selection of strategies and tactics. |
REC104-2281 | 25 - Inquiry, audit, lessons management and after action review | That DSE and CFA work cooperatively to review the management and application of bulldozers in fire suppression operations to ensure that they are used effectively, appropriately and are adequately supervised. |
REC104-2274 | 7 - Inter-agency communication | That when Incident Management Teams implement significant changes to objectives and strategies, these are effectively communicated to firefighters, fire ground supervisors and affected communities, and are incorporated into the broader organisational planning. |
REC104-2332 | 25 - Inquiry, audit, lessons management and after action review | That the Review of emergency operations centres by the Departments of Premier and Cabinet and Treasury and Finance and the Office of the Emergency Services Commissioner: |
REC104-2271 | 14 - Incident Mgt Teams | That DSE and CFA ensure that agreed strategy and tactics, and the rationale, be communicated to personnel involved in the fire fight and be included in briefings for fire line personnel. |
REC104-2280 | 14 - Incident Mgt Teams | That DSE and CFA ensure that: |
REC104-2277 | 25 - Inquiry, audit, lessons management and after action review | That DSE and CFA review methods of gathering and processing fire information to ensure all methods are pursued to greatest effect. |
REC104-2293 | 25 - Inquiry, audit, lessons management and after action review | That aviation contractors be required to submit a copy of their annual independent regulatory compliance audit prepared for Civil Aviation Safety Authority to the State Aircraft Unit. |
REC104-2269 | 14 - Incident Mgt Teams | That the fire agencies ensure that Incident Action Plans developed by Incident Management Teams are consistent with, and built on, the agreed Fire Control Priorities. |
REC104-2279 | 14 - Incident Mgt Teams | That operational briefings in multi-agency fires should, wherever possible, be joint briefings of all agencies involved. |
REC104-2228 | 25 - Inquiry, audit, lessons management and after action review | That the Government identifies an appropriate body, or bodies, to undertake the audit of the Municipal Fire Management Plans. |
REC104-2292 | 25 - Inquiry, audit, lessons management and after action review | That a systematic performance audit of State Aircraft Fleet contractors be conducted jointly by agency and SAU personnel. |
REC104-2267 | 14 - Incident Mgt Teams | That DSE and CFA develop an agreed process for the effective transfer of control from one Incident Control Centre to another, including processes for communicating this change to fire ground supervisors and local communities. |
REC104-2275 | 14 - Incident Mgt Teams | That the ‘Incident Objectives’ established for any response should reflect the endorsed Statewide ‘Fire Control Priorities’, and the relevant Municipal Fire Management Plan. |
REC104-2197 | 25 - Inquiry, audit, lessons management and after action review | That a review of the fuel management zones be implemented with a view to reducing the number of zones so as to focus clearly on (i) asset protection (especially at the Public/Private land interface), and (ii) ecological burns. |
REC104-2284 | 25 - Inquiry, audit, lessons management and after action review | That DSE and CFA review the management of personnel deployed ensuring that: |
REC104-2291 | 28 - Personal responsibility | That after each fire season, measures of the effectiveness of aerial firefighting be collated, analysed and used for the assessment of the State Aircraft Fleet composition and the adequacy of Training and Accreditation programs. |
REC104-2223 | 10 - Infrastructure | That Government review legislation for utilities operating within the State to ensure their involvement in regional fire preparedness and mitigation planning. |
REC104-2262 | 14 - Incident Mgt Teams | That the practice of appointing Deputy Planning Officer, Deputy Operations Officer and Deputy Logistics Officer in an Incident Management Team be abandoned. This recommendation acknowledges the benefits of retaining a Deputy Incident Controller from the support agency (in accordance with section 4.2.6 of the Emergency Management Manual Victoria), to ensure that the command structure of that agency is preserved. |
REC104-2273 | 14 - Incident Mgt Teams | That personnel assigned the roles of Division Commander, Sector Commander and Strike Team Leader be given flexibility to alter tactics to take advantage of changed conditions on the fire ground. |
Rec-ID | Code | Recommendation |
---|---|---|
REC061-3423 | 25 - Inquiry, audit, lessons management and after action review | The Committee recommends that the Metropolitan Fire Brigades Board be reviewed five years from the tabling of this report in Parliament. |
REC061-3258 | 25 - Inquiry, audit, lessons management and after action review | The Committee recommends that the Metropolitan Fire Brigades Board be reviewed five years from the tabling of this report in Parliament. |
Rec-ID | Code | Recommendation |
---|---|---|
REC016_3951 | 10 - Infrastructure | It is recommended that the State Electricity Commission adopt a policy of conciliation and good will towards its closer neighbours. It is not suggested that its policy has been essentially otherwise. In future that policy can best be assured of success by time conferring of material benefit upon its neighbours at some monetary cost to the Commission. It is suggested, with conviction, that it would prove to be of great advantage to time Commission if it were to take an active part in the clearing and bettering of its neighbours’ scrub and timber country at time cost of the Commission. The settler whose land is fully cleared and in production, or who knows that his land will be cleared for him, has no incentive to burn illegally or carelessly. If this suggestion should he adopted, it would be necessary that it should be carried out in all cases in accordance with the settler’s convenience, that he himself should take an active part in the operations, and that he should be left, not with a financial obligation, but with a definite material advantage. |
REC016_3944 | 10 - Infrastructure | It is recommended that the water pressure be improved so that a greater volume and jet may be available for the suppression of fires on the faces and also for the purpose of wetting the berms more widely and thoroughly when necessary. It is suggested that there should be variable control of the pressure so that production need not be adversely affected in times of normal danger. |
REC016_3943 | 10 - Infrastructure | It is recommended that a more constant, running revision of the main and sprinkler system be maintained in future so that the service which it is intended to convey shall be closely and efficiently available to all parts of the berms and faces. It is emphasized that the reticulation system in the berms is fixed and stationary, whereas the faces are continually receding as their surfaces are scraped away by the dredges. |
Rec-ID | Code | Recommendation |
---|---|---|
REC004-3999 | 10 - Infrastructure | That, in view of the fact that along many of the lines, between the road-bed and the fences, there are numbers of dry inflammable stumps, which, when they catch fire, are very difficult to extinguish, and that the surface of the ground surrounding these stumps is usually chipped by the permanent-way men every summer, thus causing considerable expense without removing the risk of fire, the Railway Department should remove this source of danger, by grabbing them out and burning them as early as may be found practicable. |