Decision Making / 2 / 2.2 / 2.2.6

2.2.6 Chief Of Army’s Report To The Minister For Defence

The concept map for the Chief of Army’s Report to the Minister for Defence is at Figure 2-5. Rather than depicting the views of the Board of Inquiry alone, this map contains the Chief of Army’s perspective, reflecting his somewhat broader remit. Figure 2-5 provides greater insight, introduces a number of related issues, and provides different emphasis. Chief of Army is entitled, by virtue of his position, to add emphasis without reference back to members of the Board. However, the balance achieved by addition of such emphasis needs to be critically reviewed rather than simply accepted on face value.

By way of comparison between this and the earlier map, see Concept No 4, high pilot separation rates, in Figure 2-4. In the earlier map this is shown as leading to erosion of experience base within 5 Avn Regt, but there is little other information about the problem. Further, it should be noted that this Figure 2-5, in particular, depicts on a single sheet of paper, months of detailed investigation and deliberation; close scrutiny is demanded. When the whole map has been read and understood, the overall structure should be viewed by standing back from the detail. See Figure 2-6.

One way of enabling this consideration is to view the map as numbers linked by arrows and lines, without any text. This facilitates thinking about:

• concepts connected in causal loops, such as 22 → 23 → 25 → 27 → 22, 22 → 24 → 25 → 27 → 22, and 22 → 24 → 26 → 22;
• nodes where several arrows enter or leave, such as 4, 33, 22, 14, shown in bold, with nine, six, six and six linking arrows or lines respectively; and
• concepts connected in loops involving a mix of causal and connotative links, where the latter are considered as bi-directional causal links following direction of the loop at least some of the time, such as 4 → 3 → 13 -- 2 → 4 and 4 -- 30 → 31 -- 4.

Figure 2-4 and Figure 2-5 complement each other. When read together and compared, and structure is considered, as in Figure 2-6, these maps provide insights into where efforts might have been directed to avoid tragedy. Just how this might have been done before the accident, thereby averting tragedy, is explained below. It is important to recognise that Figure 2-5 depicts a perspective different to the Board’s Executive Summary and brings in other concepts considered important by Chief of Army. This does not conflict materially with any findings of the Board of Inquiry, but stresses Chief of Army’s concerns and reflects his responsibilities to the Minister. This is Chief of Army's personal view. Vickers, (1970); Checkland, (1990); Vennix, (1996); Coyle, (1997); Eden and Ackermann, (1998a); and others have noted the significance of differing perspectives. In human systems, there can be many valid perspectives of the same problem. The consequences of the need to accommodate a variety of perspectives can be quite profound in the management of risks, since there is likely to be disagreement about the nature and significance of risks.