Introduction

After a recent spike in the number of flight safety related incidents in India involving runway excursions, the regulator resorted to suspending the flying license of crew without giving the specific reason or determining the root cause. The dialogue in today’s safety world is filled with praise for just culture with criticism for terms such as blame and punishment. So should safety focus solely on positive reinforcement and completely eliminate negative consequences? The answer is a resounding “no,” but with some much needed guidelines.

State Safety Programme is an integrated set of regulations and activities aimed at improving safety. It is a management system for the administration of safety by the State. States should establish a safety policy and safety objectives that reflect their commitment regarding safety and facilitate the promotion of a positive safety culture in the aviation community.

What is Safety?

Safety is the state in which the possibility of harm to persons or property damage is reduced to, and maintained at or below, an acceptable level through a continuing process of hazard identification and risk management

Indian DGCA’s State Safety Policy

DGCA will foster and assist stakeholders in developing comprehensive Safety Management Systems (SMS) and will develop preventive safety strategies for the aviation system in an environment of a “just culture”.

What is Just Culture?

It is an environment in which employees understand they will be treated justly and fairly on the basis of their actions rather than the outcome of those actions, in the case of positive, as well as negative safety events.

A Just Culture recognizes that systemic factors (not just individual actions) must be considered in the evaluation of safety performance and interpretation of human behaviour. A strong Just Culture in each aviation organization is perceived as the basis for a successful safety culture.

All employees must clearly understand and recognise that it is unacceptable to punish all errors and unsafe acts regardless of their origins and circumstances while it is equally unacceptable to give blanket immunity from sanctions to all actions that could, or did, contribute to organisational accidents. A prerequisite for engineering a just culture is an agreed set of principles for drawing the line between acceptable and unacceptable actions.

Deterrent Action and objectives

The major objectives of deterrent action are:
i) to protect the individual and the public from possible harm;
ii) to encourage future compliance; and
iii) to deter others from contravening legislative provisions.

Suspension of license

Suspension is the harshest form of deterrent. People who consciously and wilfully choose to operate outside the rules or procedures and thereby put the lives of members of the public including the passengers or property at risk should be prosecuted and removed from the industry. DGCA Enforcement manual extract.

Can Punishment Improve Safety?

Punishment is designed to stop, not start, behaviors. Punishment is not a tool to start anything except avoidance behaviors and malicious compliance. There appears to be an assumption that if you stop a certain undesirable behavior, the desired behavior automatically will take its place. That usually is not the case. Stopping and starting behaviors require different tools, and there is seldom a one-size-fits-all solution.

What is meant by ‘Wilful, conscious and repeated”?

Willful – Crew who are trying to do their jobs and are serious about safety still make inadvertent mistakes. Punishing these mistakes is tantamount to punishing the good intentions and efforts to be safe as well. Honest mistakes should result in coaching, not punishment. On the other hand, if a crew makes a conscious choice to violate a rule or override a safety device, punishment might be the right tool to stop that behavior. It is not always easy to determine if the act was willful or simply an oversight or lapse, but it always is important to try to do so. Often, the attitude and past performance of the employee is a good indicator of the willingness to violate safety rules.

Conscious – In the case of conscious violations, it is not difficult to determine if the act was willful. Conscious violations include those done immediately after being instructed to do otherwise, as a way to demonstrate defiance to supervisors or coworkers. The indicators of such behaviors often continue in the aftermath when the involved person persists in resisting both cooperation and instruction. Workers who openly defy authority and guidelines for safety are the prime candidates for punishment and supervisors carefully should document the situations and prescribed consequences. This documentation and communication should be aimed at sending the message that a repeat offense will result in even more severe penalties and will not be overlooked or tolerated.

Repeated – Repeat offenders often fall into the willful or conscious categories as well. But even if they don’t, they still may be candidates for punishment. Organizations should not tolerate repeat offensives in safety, both for the sake of the worker and the organization. Even innocent mistakes, if repeated often enough, can turn into personal and organizational disasters. Workers who simply cannot master doing the job safely, and organizations that allow them to be unsafe, expose themselves to great risks that are not good sense or good business. Punishment may be the right tool to stop the risks and protect the parties involved. Remember that punishment can be administered with concern as well as with strictness and warning.

mindFly analysis

While punishment may be the easiest form of deterrent action which can be used by the state, it is imperative that the fabric of trust and fairness are not damaged in the process. Malcolm Gladwell has written about the principle of legitimacy in his recent book, David and Goliath.

“When people in authority want the rest of us to behave, it matters – first and foremost – how they behave.

This is called the “principle of legitimacy,” and legitimacy is based on three things.  First of all, the people who are asked to obey authority have to feel like they have a voice  – that if they speak up, they will be heard.  Second, the law has to be predictable.  There has to be a reasonable expectation that the rules tomorrow are going to be roughly the same as the rules today.  And third, the authority has to be fair.  It can’t treat one group differently from another.”

Therefore, before the regulator acts in order to be seen as an effective regulator and keeper of safety, they need to build the trust and establish a safety culture which is not just pathological but moves towards attaining a generative safety culture. The state safety procedures manual and the enforcement manual detail the background and the procedure to be adopted after an incident and the extent to which action can be taken in all fairness to uphold the tenets of safety and enforce regulations. The rights of the crew to request for a review of the order of suspension of license and appeal to a higher authority are given in the enforcement manual. Its just for awareness that I am writing the blog so that certain key concepts are highlighted and used in the true sense.