Defence minister apologises for SAS test march deaths

http://www.theguardian.com/uk-news/2015/jul/15/defence-minister-apologises-sas-test-march-deaths

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A defence minister has apologised for a catalogue of failings that contributed to the deaths of three SAS candidates who died after suffering heat illness during a mountain test march in soaring temperatures.

Penny Mordaunt said the Ministry of Defence would study concerns raised by a coroner following the men’s inquest about how the exercise on the Brecon Beacons, south Wales, was planned and executed and how the failed rescue operation was organised.

Health and Safety Executive officials will now look at the evidence that emerged during the inquest to establish if any criminal proceedings ought to be instigated.

In a written ministerial statement, Mordaunt said once the civil investigations were complete the MoD would initiate its own service inquiry, to see where further lessons could be identified and improvements made. She said the Royal Military Police would also consider whether any non-criminal service offences appeared to have been committed.

Birmingham and Solihull coroner Louise Hunt was highly critical of how the march that led to the deaths of Corporal James Dunsby and Lance Corporals Craig Roberts and Edward Maher was run.

She said there was a “catalogue of very serious mistakes made by many people” and “systematic failings” and neglect contributed to the deaths.

Related: SAS inquest: coroner highlights 'catalogue of very serious mistakes'

Delivering a narrative conclusion, Hunt said those in charge had failed to undertake proper risk assessments before the 16-mile march or to begin a “dynamic risk assessment” once men began to drop. She said there was no adequate medical or evacuation plan.

There was a “general lack of understanding of heat illness”, the coroner said and a “failure to appreciate that candidates would push themselves to their limit and have an “overwhelming desire to succeed – do or die”.

She said chances to stop the march were missed when other men suffered heat illness earlier in the day. The first case of heat illness was at 12.14pm, almost two hours before the first of the three who died – Maher – collapsed.

Hunt pointed to an MoD document called JSP539 that says an exercise should be called off if just one person suffers heat illness. She said 13 soldiers who had given evidence said they had no knowledge of the document.

The coroner also said the reservists – part-time soldiers – did not do build-up marches and so were not as acclimatised as their regular counterparts. The coroner said there was a “culture of following what had gone before without giving any consideration to specific risks” and a “complacent attitude to risks”.

She was particularly scathing about a GPS tracking device the men carried and that – in theory – should have alerted directing staff that the three men had stopped. In fact the men lay suffering for up to two and a half hours before help got to them.

Mordaunt, the minister of state for armed forces, said: “I would like to apologise on behalf of the MoD and the armed forces for the deaths of Corporal Dunsby, Lance Corporal Roberts and Lance Corporal Maher. We would also like to offer our sincere condolences to their families and friends who have shown great dignity during what has been a very difficult period. We accept the failings identified by the coroner and are truly sorry.”

She said changes had already been made to the way this exercise and similar exercises were conducted. “These changes include improvements to the preparatory training that reserves undertake,” she said, “and a thorough review of the risk assessment process to ensure that all those involved have been trained in the effective management of risks.

“A new tracker system has been implemented to improve monitoring of individual candidates and to enable two-way communications between directing staff and candidates. We are looking at how this can be further improved. We continually review our code of practice for the prevention and initial medical treatment of climatic injuries in the armed forces in order to minimise the risk of such tragic events. We will continue to work hard to ensure the code of practice is understood and followed.”

On Wednesday the coroner said she was still not convinced the MoD had got to grips with coping with the potential for heat illness and said she was still worried that the trackers did not do the job.

Mordaunt said: “Over the next few days the coroner will issue her report to prevent future deaths to the MoD. We will treat her recommendations with the utmost seriousness. We will ensure everything possible is being done to reduce the risk to personnel who undertake these types of exercise and to try to prevent a reoccurrence of these terrible events.”

Reservists will play an increasingly important role in the British armed forces as the size of the regular forces is reduced.

The minister said: “The reserves continue to form an important part of military capability, whether on operations or at home. We will continue to ensure that the reserves have the necessary training, skills and fitness levels to do the tasks required of them.”

She continued: “It will always be necessary to train and test our military personnel to the highest possible level so that they can meet the challenges to national security that we face both in the UK and overseas.

“Achieving this end does involve individuals having to push themselves and take some risk. However, as an organisation we must ensure that this is balanced with the need to ensure these risks are effectively mitigated. In this case, we did not do this and we accept full responsibility for these tragic deaths.

“We are determined to learn the lessons. I am the minister who will be responsible for taking any corrective action forward. I will be writing to the families personally and will make myself available to meet them if they wish, and to facilitate any requests they might have.”