Brief account of events
Thursday 18th - Saturday 20th January 2007
2.1 At 11am or so on the 13th January 2007 the Napoli broadcast a distress signal and captain and crew abandoned ship soon after. By 1400 they had all been rescued by RN helicopter. Napoli drifted north, then 10 sea miles east before a tow was attached at 1700. Progress eastward (down-wind, the perceived safest direction given the visible vertical split forward of the engine room) was maintained or another 25 miles at an average 2 knots. (For greater detail see the Marine Accident Investigation Branch (MAIB) report of the incident). By now the partially flooded Napoli's draught had increased substantially, ruling out entry to all available inner harbours.
2.2 Attention in some detail has been paid to container ship construction, speed and handling at sea by MAIB in its report of its investigation into the foundering of the Napoli, largely confirmed by this Inquiry's advisers, and recommendations made to the International Association of Classification Societies (IACS), International Chamber of Shipping (ICA) and to Zodiac Maritime Agencies (who managed Napoli). We understand that the Classification Societies - who assisted the MAIB - and ICA are pursuing improvement in each of those areas and the few ships identified with the same or similar weaknesses have been attended to. Inevitably we strongly support such moves but:
2.3 WE FIND that we share the continuing concern at the pace of change in the modification of codes, and agree with the SoSREP that regulation update needs to catch and overtake he rate of container ship building and the accompanying rapid increase in their size (5.16.1 refers).
2.4 Meanwhile the SoSREP, who already thought that Napoli was highly likely to sink, discussed matters with his French counterpart (PrŽfet Maritime) and agreed the unwelcoming nature of the French coastal waters (rocks and tidal currents) up-Channel to beyond Cherbourg. They also agreed that if Napoli sank or wherever she was taken, if further damage or loss of fuel and cargo occurred, the English coast would receive the worst environmental effects. That being the case the SoSREP decided it was best that he kept control of events as long as he was able. He also consulted, among others, his Environmental Advisory Group (EAG) Chairman (at 1230) and the Falmouth Harbourmaster, Capt. Sansom. The former, having seen the ship's manifest, or at least a summary of it, advised that if the Napoli sank in deep water the potential for environmental disaster, and for it being of a longer term, was greater than an alternative in shallows. The latter, concerned about oil pollution particularly, offered Carrick Roads (but pointed out the difficulties and hazards for unloading there), Napoli's draught was already denying her entrance to Falmouth Harbour itself.
2.5 The EAG (whose Chairman, Julian Wardlaw, appeared before us), ascertained that some containers held hazardous substances and that Napoli's composite fuel load was near tankful (3800 tonnes). Captain Sansom explained to us the double jeopardy for a Harbourmaster who can be instructed by the SoSREP, under the National Contingency Plan (NCP), to take a casualty in but then is regarded as having invited it and thus responsible for any consequences. His Commission has to attempt recovery of costs from the ship's insurers. His Milford Haven counterpart had been charged by the Environment Agency (EA) under the Water Resources Act after the Sea Empress's oil polluted the Haven in 1996. Lord Donaldson recommended that that Act should be amended after that incident. So far no such action has been taken.
2.6 WE FIND that the NCP and the Water Resources Act should be amended to deal with the perverse position in which harbourmasters find themselves on acceptance of casualties (5.16.3 refers).
2.7 The decision was taken to attempt the Channel crossing which, under collision regulations, must be as near as possible at right-angles to the two main routes of the traffic separation scheme of this most densely used of waterways. At the same time, and the decisions are inter-linked, Portland emerged as the optimum destination for handling the disposal of fuel oil and cargo. The towed Napoli was turned northwards at 0615 on Friday 19th January.
2.8 At that time and in that position (48.45W, 49.20N) there was some 9 nautical miles difference between the distances to Falmouth and Portland respectively, over a potential journey of 90 miles. That to Falmouth would have been heading closely across the weather and waves throughout its time, the northward route before the wind, would gain the shelter of the Start Bay/Torbay coast within 50 odd miles with the wind backing behind it as time went on. It was nevertheless urged upon us that Falmouth would have been a better target, even that it was a 'reckless' decision to aim for Portland.
2.9 WE FIND that hindsight is a difficult aid in these circumstances and that the advice on which weather a id wave direction would create most stress on the Napoli's damaged hull is a matter for even expert conjecture. We have in the end heard no persuasive reason to dispute the decision taken.
2.10 By 2100 or thereabouts on Friday the 19th Napoli was sixteen miles east of Start Point having made some 7 knots throughout the last six hours, or three times her speed over the previous 24, and proceeding northwards sub-parallel with the coastline. About then the decision was taken to remain parallel with the coast in the relative shelter of Lyme Bay. Early on the 20th the salvors observed that Napoli was settling lower in the water and soon reported that she appeared to be sinking. The SoSREP decided that the risk of break-up was increasing (with potentially disastrous environmental con sequences), that she would not round Portland Bill safely, and that she should be beached on the soft sea bed off Branscombe to reduce all risks as far as possible. That is where she ended u p, somewhat less than a nautical mile offshore at 1148 (EAG) or 1243 (MCA), even 0900 (Multi Agency Debrief).
2.11 On that Saturday morning the choices for beaching were clearly limited and while the target - in the lee of Portland Bill and harbour - would have been well sheltered from prevailing winter weather, the same cannot be said of Branscombe. Witnesses have pointed out since that SW and SSW gales typified the late winter of 2008 there, when work on the hull was suspended.
2.12 WE FIND that the planned optimum target location for unloading and dismantling was in the end missed because the condition of the vessel suddenly worsened on the last leg, but the best of a bad job was then made and very luckily untypically calm weather followed for most of February, 2007 allowing critical work at sea to be completed.
2.13 WE ALSO FIND that, despite hearing two views to the contrary about the target, the outcome of the exercise thus far was achieved with maximum effectiveness and was as environmentally friendly as it could have been under the circumstances.
2.14 The list imparted by the and of the beaching caused the shedding of a number of containers and ten had arrived on the beach before ten o'clock that evening, nearly all in the dark, but located and recorded by the voluntary coastguard team in attendance (one of whom appeared before us).
2.15 Thus was the scene set for the drama to be played out on Branscombe beach which is probably the real cause for this Inquiry, and its handling our main consideration.
3 BRANSCOMBE BEACH, SATURDAY 20TH - WEDNESDAY 24th JANUARY
3.1 It became clear to us that the MCA or the SoSREP himself had communicated the potential beaching of the Napoli to local authorities before it actually happened. The County Councillor for the area and a representative of Devon County Council (DCC) press office (both of whom appeared before us) were in Sidmouth by 1130 on the 20th January, and a putative press centre was set up in the Sailing Club at that time. The police set up a 'Gold' control in the afternoon, and by then the beach had been 'taped off' by local police personnel and the boundary thus created manned by volunteer coastguards. As we have seen, containers were unshipped during and just after the grounding of the vessel, but only came ashore after dark that evening. The implication is that on t le beach then, all was under control.
3.2 Media reports of the beaching were made during the latter half of Saturday. Overnight Napoli was rocked by strong winds and 50 containers fell overboard. On the morning of the 21st local interest in the beached vessel by sightseers and in the material washed ashore by amateur salvors began and increased during the day exponentially. The Receiver of Wreck (another MCA officer) had been summoned and arrived late on Sunday morning. She advised people on the beach and eventually the police about the legal position, particularly that salvors had 28 days in which to declare their salvage to her. There was also a perceived need, by police and Highway Authority, to carry out traffic management but it proved ineffective until the 24th. By Sunday evening a jolly 'Whisky Galore!' story was the theme of further reporting of local salving, but it was that reporting that triggered a much more mendacious, national, and ultimately frightening interest in the prospect of illegal profit from the incident by Monday. Even the BBC reported a 'new' kind of beachcombing. Exactly when someone first broke into a closed container is not clear, but that is obviously when the beach became a 'crime scene', 28 day rule or not.
3.3 The National Contingency Plan (NCP) nowhere obliges the SoSREP to communicate with the police or local authorities - and is strangely silent about any role or function for the police. They are not even listed as members of the Shoreline Response Centre (SRC). This clearly confirms that the Napoli incident was unprecedented, that the SRC or a form of it is needed, oil pollution (and clear up) or not and the NCP now needs major revision.
3.4 The reference to 'salvors' in 3.2 above is because that is how the Receiver of Wreck (RoW) is bound to regard them until they fail to report to him or her their 'salvage' within 28 days of removing it. They are regarded as making items washed ashore safe (for their owners) until the RoW rules otherwise or the owner is identified. It appears to us that the literal 1egal advice of the RoW caused confusion in the minds of senior police officers, who at that time felt suddenly powerless to intervene just as, most unfortunately, the media stories drew plunderers from as far away as Manchester and Birmingham. Their arrival in Branscombe Parish, coupled with the sightseeing public, caused traffic management problems on the 22nd of enormous proportions, relative to those normally encountered on a Monday in the narrow twisting lanes of a coastal parish and its main village. They continued through the 23rd and into Wednesday the 24th. More importantly the personnel involved in the 'white van' invasion were such as to strike fear into the hearts of many of the residents (the elderly among them told us so) and even caused concern for the few professionals working there such as the headteacher of the primary school (who appeared before us). She had difficulty getting advice about potential vaporous hazard in the Napoli's containers and the likely problem of getting children to school. Although the Highway Authority has an operations centre staffed 24/7 and contractors on stand-by for emergencies, the implementation of an early traffic management scheme was hampered by the fact that at the weekend in question neither the Highway Authority team on rota nor the Police traffic officer, who was based in Plymouth, had particular local knowledge of the Branscombe road network. The unlucky weekend timing, its effect on staff availability, and cost implication: for managers was probably not confined to one agency or another.
3.5 We make our major recommendations about communications, command and control ashore in Section 5, but:
3.6 WE FIND that the NCP needs a major overhaul as a result of the 'Napoli experience' to make it inter alia capable of guiding the handover from sea to land, and thus from MCA to the landward authorities. (5.A refers).
3.7 WE FIND that the definitions involved in the whole shoreline salvage business should be carefully examined and where necessary refined. This is especially so with regard to the scale, or even potential scale, of the material (including vessels, ancillary equipment and cargo lost at sea) coming on to the intertidal zone. Police should be empowered to oversee, manage and intervene in amateur recovery of cargo or looting without waiting for MCA advice. (5.16.5 refers).
3.8 WE ALSO FIND that the Highway Authority and other relevant agencies should consider the weekend position in any routine planning and ensure that at least one officer with the best available local knowledge is on standby for each of the sectors of the coastal hinterland which may emerge from our proposals about contingency planning in Section 5. (5.10 refers).
3.9 As observed already it is not clear whether the earliest amateur 'recovery' of material was only from the beach or from containers which had broken open during their float ashore, on impact with the shingle or with each other. The first 'breaking and entering' of a container is not recorded, but that would have been the moment at which actual illegal activity, regardless of RoW rules, began. It had almost certainly happened by the end of Sunday, for the Fire and Rescue Service were called to put out fires in containers on Sunday, lit to keep looters warm! The maritime salvors had also by then reported that containers still on board were spilling their contents overboard and many 'lashings' were proving inadequate for holding deck cargo given the vessel's list. The EAG had known since the 18th that some containers had hazardous material inside (e.g. nitric acid, airbag inflators) and at least two of them were among those that were unshipped overnight on 20/21st January.
3.10 All this suggests that had communication between all parties been tight and comprehensive, the beach could have been properly closed to the public from late on Saturday for reasons of public safety and the prevention of crime, had the evidence for that been shared widely enough. It also seems to us that there are too many 'parties' (authorities, agencies, organisations, units, groups, centres, teams and now cells) with an apparent 'need to know', which bedevils communication if only in scale and risk of missing out one or more who may under present circumstances be critical (local authorities and land owners were certainly out of the loop on more than one occasion). Their scattered bases from Weymouth to Exeter (perhaps Southampton to Plymouth) exacerbated the problem. We shall return to the 'too many cooks' syndrome but for now:
3.11 WE FIND that communication of every detail of vessel condition and cargo, as it is revealed and whether its relevance is yet clear, should be sent from the MCA to the landward authorities and logged by them in the same spirit. (5.4.3 refers).
3.12 As it was, looting went on throughout the 22nd and the 23rd by which time worldwide TV had broadcast scenes of it in sufficient detail to allow distant individual viewers to recognise their own property in someone else's hands. Numbers of scavengers had increased overnight of the 22/23rd. Road closure barriers were unmanned and thus swept aside easily. Police presence was minimal, the Chairman of the Parish Council told us. A congested Branscombe was made worse by vehicles left on roadsides and in residents' driveways, with some not daring to challenge the drivers. Respect for property was negligible and not immune from the looting frenzy. Wheelbarrows and wheelie bins were appropriated for transporting beach loot; by the end of the incident garden ornaments and chain saws were among that loot. The onshore salvors (DRS) arrived and set up their compound at the top of the beach early on Tuesday, and that presaged a different 'ownership' of the salvage. Police command changed late on Tuesday, attitudes to 'salving' changed and decisions were promptly taken to close the beach, and police and coastguards were joined by private security men. The footpaths into Branscombe, especially from Beer were closed, as were some roads and a one way system was put in place
3.13 The maelstrom that invested Branscombe from Sunday to Tuesday night, with its traffic chaos, trespass and terrified elderly residents only points up the calm which returned on Wednesday 24th when someone got a grip on the landward situation. More than one witness wondered how much the fact that the onshore incident itself began at the beginning of a weekend, with consequent implications for manpower availability and cost, coloured decision making. Whatever, it is clear that had the decisions of late Tuesday and early Wednesday been taken on the previous Saturday or even on Sunday, Branscombe village would have been spared, much media attention might have advised of the beaching of the wreck but not the wreckage, and much public resource might have been saved.
3.14 WE FIND that the most important overall lessons to be learned from the whole Napoli landward experience involve:
a) having a single individual in total command, (5.A)
b) creating a much simplified incident/emergency organisational system, (5.A)
c) implementation of a) and b) above should involve providing a communication protocol that is readily understood and foolproof, (5.B)
d) planning for confronting the development of the worst case scenario, and ensuring that all contingency plans cascade down to, include and are understood by parish councils (5.C)
e) acting immediately even if much then done can be stood down quite soon after (5.A).
(WE CONSIDER THAT OVER-REACTION MUST NEVER BE A VALID CRITICISM IN THE FUTURE)
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