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Chief Commissioner's review

2012/13 was a busy year for the Commission, with a number of high profile inquiries occupying significant investigator and Commission time. Two particularly complex inquiries - into the Easy Rider fishing boat tragedy (12-201) and a mid-air collision near Feilding (10-008) were completed - along with a significant review of civil flying training safety in New Zealand (10-011). In all three cases, the Commission held hearings and invited interested persons to meet with them.

Other significant inquiries continued through the year included the grounding of the Rena (11-204) and the Carterton hot air balloon tragedy (12-001). In the case of the Rena, extensive engagement within international interests has prolonged the Commission’s inquiry. However, a draft final report for this inquiry was nearly completed for consultation by the end of the financial year.

Overall, good progress was achieved with inquiries during 2012/13 even though investigative capacity in the marine and air modes was constrained with three of a total of nine investigators still under training.

Alcohol and drug impairment continued to feature in occurrences in all transport modes considered by the Commission. This is deeply concerning. The Commission has made a number of recommendations in this area, recommending detection and deterrence measures such as the setting of impairment limits and the introduction of testing regimes. The Commission’s latest Historical Impact Review, commenced in 2012/13, also looks at fatigue and substance impairment.

Strategic highlights

The Commission introduced a new set of values based on the International Consortium for Court Excellence Framework. This framework has been adopted by a number of groups and organisations from Europe, Asia, Australia and the United States, and is imbedded within the Commission. This framework informs the Commission’s approach to conducting inquiries.

Stakeholder highlights

During 2012/13, inquiry participants and key stakeholders were invited to participate in an independently conducted formal survey about the Commission’s investigative and inquiry processes, and its approach to communications. This was the first survey of its kind. The Commission received positive feedback from survey participants who saw the Commission acting appropriately, and having a positive impact on transport safety. A general concern was raised about the length of time it takes the Commission to complete inquiries. This feedback has informed our thinking about how the Commission can improve its timeliness and keep stakeholders better informed.

Capability and capacity highlights

The Commission is committed to adopting a better public service approach to its business operations, and made good progress during 2012/13 to improve its investigative and corporate procedures and processes. A review of the Commission’s major accident manual and other investigative procedures was commenced, with particular focus on the Commission’s evidence collection protocols and evidence analysis framework. Work also began on developing an international strategy to help the Commission to determine when and how to assist other countries’ investigative efforts (beyond those with a direct New Zealand connection which is already provided for in international conventions).

Budgetary constraints, coupled with opportunities offered by new all-of-Government purchasing contracts, meant that the Commission’s management team invested considerable effort to realise operational and service efficiencies. Good savings were achieved in information and communications technology services enabling a long-standing research analyst position to be advertised at year-end.

Managing organisational risk

The Commission is facing two significant risks in the medium to long term; the impact of an ageing workforce, and budgetary pressures caused by:

Potential new direction

The Taskforce on Workplace Health and Safety was established in June 2012 to evaluate whether the workplace and safety system in New Zealand was fit for purpose, and to recommend practical strategies for reducing the high rate of workplace fatalities and serious injuries by 2020. It released its report in April 2013 with a recommendation that the Commission’s role and function be extended to allow the Commission to investigate some workplace health and safety accidents and incidents.

The Commission sees merit in this proposal, given it already has a legal framework and operational processes to conduct safety focused root-cause investigation and analysis which could cost effectively extend to other "modes". Agencies of similar scope to that proposed exist in other countries. We look forward to contributing to the policy process that will consider this recommendation.


John Marshall, QC
Chief Commissioner





It is a pleasure to introduce this annual report of the Transport Accident Investigation Commission for the financial year ended 30 June 2013.

  •  the impact of staff turnover and complex cases;
  •  the challenges of new technologies and increased data availability from more heavily computerised systems;
  •  the potential demands of a major accident or other expensive logistical or technical challenge.

The Commission is a fully funded Crown entity, and its statutory independence and quasi-judicial nature means that it cannot raise additional funds. Although it continues to look for opportunities to improve service and operational efficiencies and to make savings, the Commission will continue to face strong budgetary pressures.

It has been six years since the Commission last received an increase in operational funding. A funding review is now desirable. Commission management has begun exploring with the Ministry of Transport how this should occur during the current year.

Inquiry highlights