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Two points arose on the evidence — (i) Whether the Daily Report Book was in form sufficient to satisfy the requirements of the statute and (ii) whether the "withdrawals" were in fact duly reported, and, in a manner to satisfy the statute.

As to (i). If the Daily Report Book is "kept for the purpose" and is arranged to receive the reports under General Rule 7, i.e., there is a space for entering them, I see nothing in the rule to prevent these reports from appearing in the same book as the daily reports made under General Rule 4.

In the present case, however, although the Daily Report Book was avowedly "kept for the purpose," there was no space set apart for entering such reports and it was not possible on reading an entry to say whether it was a report under General Rule 4 or General Rule 7.

This is illustrated by the following questions by Mr. Redmayne of Mr. Blair.

(Mr. BLAIR, 1460) — "May I ask, is that the withdrawal book? — That is the Daily Report Book."

"Is that the withdrawal book kept under General Rule 7? — Yes."

Mr. STEELE, THE MANAGER, INTERPOSING: "No, that is not withdrawals."

"Has that book been put in? — No."

Mr. STEELE: "Those men have not been withdrawn, you only enter in the withdrawal book where the men are withdrawn, there were no men in the place when the gas was reported.

"None of them? — No."

(Mr. REDMAYNE to Mr. BLAIR, 1465-1471) —"Have you a withdrawal book? — No."

"Then what I said is right, that this book (indicating the Daily Report Book) is the withdrawal book? — We don't withdraw any men."

"You never have withdrawn the men? — No, the men are " . . . .

"Am I to understand you have never withdrawn the men on account of gas found in these workings? — Not that I know of."

"All these occurrences of gas recorded here have been at places where men have been working, is that so? — Yes."

"All these cases are where men ere working? — Yes."

"And nobody has been withdrawn because of gas at this colliery? — So far as I know."

This evidence gives the impression that the principal officials did not know exactly what the reports indicate in reference to withdrawals. The last entry of gas, 30th March, 1910, was as follows :— "Examined the high North, alright excepting Thomas Gill and John Connor's place, stopped for gas — John Wilson." Then later under the same day "all right in No. 3, North, excepting the far brake standing with a fall of roof, the above places stopped for gas have now been started."

John Wilson clearly recalled the circumstances giving rise to this entry, and it was a clear case of men being withdrawn and sent to work elsewhere, the place being afterwards fenced and the next men not sent in. But the entry is equally consistent with the place having been fenced off as a result of the examination under General Rule 4 before the commencement of work, and with men never having been working there at all.

As to (ii). — The record of withdrawals. — Strictly interpreted all withdrawals were not recorded. Evidence was given to the effect that men have been "withdrawn" in the sense that they were required to leave their place for a few minutes until a show of gas was cleared, and such occasions were not reported, because it was not thought by the Deputies to be necessary.

As these occurrences, if at all frequent, may have some relation to the adequacy of the ventilation or indicate to the management either the care and attention or the want of it, as the case may be, of his Deputies, it seems to me desirable that such occasions should be reported.

Further, as to the manner in which entries of "withdrawals" were made, some discussion as to what was required, and particularly, as to whether it was obligatory to record the fact of the men being withdrawn. The words of the Act are, "and in every case shall make a true report of the condition of the mine or part."

The direction to withdraw men if at any time any part of the mine is found "dangerous" from any cause whatever, is a duty cast upon the person for the time being in charge of the mine or part thereof.

The next direction is that a competent person appointed for the purpose shall inspect the part so found dangerous, and shall make a true report of the condition of the mine or part.

The next direction is that a direction (except for certain purposes specified) shall not be re-admitted into the part so found dangerous until the same is "stated" by the person appointed not to be dangerous.

It is by no means clear that this last paragraph means that a workman is not to be re-admitted until the part so found dangerous is "reported in writing" to be safe.

A place may be "stated" to be safe orally to the workmen concerned, and as a matter of practice that is what would take place. In other words, although there must be two examinations, the one to inspect the part so found dangerous in order to make a report of the condition, and the other to determine that the part is no longer dangerous, there is no mention of two reports, and in fact the last direction is "every such report" shall be recorded in a book, &c. (the rule does not say "both these reports" or "such reports" shall be recorded in a book).

I consider that the Daily Report book, as used for reporting withdrawals, was not in a form sufficient to satisfy the Statute, and that the reports of the withdrawals therein were not made in a manner to satisfy the Statute, since a verbal explanation would be necessary to explain that they were reports of withdrawals under General Rule 7, and not reports under General Rule 4. Further, all withdrawals, strictly regarded, were not recorded. I must therefore report that General Rule 7 has not been complied with.

As to 5 and 6. — Practices of deputies ; men working in gas — A number of men came to give evidence that they had been sent to work in gas by the deputy, and that the deputy had chalked on a shovel, "gas," together with the date and his initials, and left it to warn them when they went to their working places. This allegation proved in part to be true, but no reliable evidence could be obtained from any of them as to the amount of gas they would find on such occasions, since they seemed to rely more upon their sense of smell than upon the ordinary lamp test for determining the presence of gas. The deputy in question, Robert McDonald, very frankly stated in answer to Mr. Redmayne (Q. 14347-8) that it had been his practice if he "found a small quantity of gas, say an ? or ¼ in. cap close in the forehead up to the top at the highest part of the working" to write "gas" on the shovel, and sign his initials with the date, "so as they would know that there was a portion of gas there." But he did not expect the men to go into their working until the day shift deputy had come and remedied the place, and he did not credit all the men had said about it. He did not put a fence across, because for such a small quantity he thought he could let the workings go on, but prevent the men going into that working until the deputy had come. If the instructions of the deputy that they should not go in or commence work had been made clear to the men, they, from their own account, flagrantly disobeyed them.

Certain witnesses made statements that on many occasions they had worked in gas. Their accounts of what occurred on these occasions appeared somewhat extreme. Some of the allegations were emphatically denied by the overmen and deputies, but there was some slight corroboration in one particular, and that is that men had been found to be working in gas by the deputies and had been "fetched out." This, of course might occur without anyone being to blame ; on the other hand, some of the witnesses gave evidence pointing to the fact that in cases where gas was present in a quantity to be thought dangerous, the men would nevertheless at times "just fettle on," "try and manage the shift out," or "take the risk in order to get the coal." (Steel, 8531-8532.) The witness significantly adding, "well, there is a lot of that."

I have no doubt that the evidence, when stripped of the personal colouring of the narrator, presented a true picture, based upon actual experience at some time or another (the witnesses to the facts, with very few exceptions, impressed one favourably for their class), but with all allowances properly made, the evidence only satisfactorily proved that the Special Rules applicable to the men themselves, viz., Special Rules 112, 113, 148, 151, 168* were, at times, knowingly disregarded by them and with impunity.

In reference to these "charges" by the men, I must refer to certain answers given by one of the delegates for the Wellington Pit, who had acted as local Inspector on seven occasions under the powers conferred by General Rule 38.

(MATHER, 10,255-10,258). — "Did you ask the men if they had anything to report when you went to their places in the course of your inspection? — No."

"That was the time to do it surely, was it not, when the official was there, and they could hear the complaint? — It was the time for them to make complaints while we were there."

"It was the time for you to ask them, was it not? — It comes rather awkward asking a man if he has a complaint to make. You would naturally expect to get it off him."

"There are two ways of looking at it. That may be your way. However, you never did it? — No, we have never done it. Certainly not."

(10,338-10,339). — It was remarked by the witness (without intending to make any charge) that "if one tried to get a complaint you might be checked" and "that he had once known an Inspector interfered with so far as that." But no complaints as to the occurrences of gas had ever been made by the men or by the delegates to the Inspector of Mines.

The last inspection under General Rule 38 took place so late as the 21st, 22nd, and 23rd March, 1910. I will only remark upon the before going facts that there does not appear to be that co-operation towards maintaining a high standard of efficiency in the common interest which one would like to see existing between workmen and employer in a difficult and dangerous industry.

I was not at all favourably impressed by the account given by the men of the inspection undertaken by them under General Rule 38, particularly with references to the examination for gas. This important matter was left entirely to the initiative and discretion of the under-manager who accompanied them, and not a single working place on the last inspection was tested and no evidence was therefore available on the points spoken to by the men.

As to 5. — It was stated by McDonald that in the part of the pit where he was (6th North) the practice of marking a shovel "gas" instead of fencing off the place, had been carried on before he came and that he just followed suit when he got on the job. Other deputies knew nothing of the practice and did not approve of it. Mr. Henry, when questioned as to the practice, said — "I did not know it existed until this morning." "He thought it was a foolish thing and he could not have done it," and "he did not consider it was good practice to have different methods of dealing with gas in different parts of the pit, particularly where the men cavil for their places and are sometimes under one set of deputies and sometimes under another." The fact that Mr. Henry did not know the common practice, apparently of long standing, in a part of his own pit in a matter of this kind seems odd.

My impressions of the under-manager were in every sense most favourable, but the nature of the evidence, viewed as a whole, forces me to the conclusion that he committed, or, found it necessary to commit, a larger measure of initiation and discretion to his overmen and deputies, excellent as these men appear to be, than was judicious, particularly where gas was trouble.

The most important part of the evidence and to this in my opinion particular attention should be drawn, was the proof of what I should call laxity in the matter of organization. To this are no doubt traceable :—

(1) The apparent absence of strict discipline in the mine.

(2) The apparent lack of any uniform line of action to be followed by each and every overman and deputy throughout the pit in cases where firedamp gave indications of its presence in the working places or elsewhere.

(3) The apparent wide discretion and responsibility given to, or assumed by, the overmen and deputies, particularly with reference to reporting gas.

(4) The keeping of reports in a manner not calculated to present to the management the real condition of the pit, in every part, ay any moment.

Conclusion.

Whilst recording, with such comments as I have deemed necessary, the matters in which I consider that there have been breaches of specific statutory duty, I do not think it was in any way established that there was any connection between the fact of the explosion and these departures from the rules.

In my opinion there is only one possible charge of negligence causing death which could be suggested. It is, that the insufficient watering of the mine (it being of a dry and dusty nature in the districts principally affected by the explosion) enabled the originating explosion to travel over and devastate a large area in the form of a coal dust explosion, and so brought about the deaths of men in parts of the mine well removed from the point of origin.

The evidence showed that some watering was done, but that the system was inadequate to prevent an explosion travelling over the mine. However, no statutory provisions have been made regulating the clearing of dust from roads or requiring the main travelling roads in the mine, generally, to be efficiently watered, or otherwise treated for the purpose of removing the danger arising from the presence of fine dry coal dust, nor has science yet determined what is right, or even the most effective, remedy to adopt under the varying circumstances found in daily practice. For these and other reasons, I am clearly of opinion that there is no case made out, or which could be made out, sufficiently strong to justify criminal proceedings.

I have the honour to be,

Sir,

Your obedient servant,

Samuel Pope.

The Right Hon. Winston Spencer Churchill, M.P.,

H.M. Principal Secretary of State

for the Home Department.

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* 112. — In addition to the examinations by the Deputy, or other person appointed for the purpose, each work person must satisfy himself of the safety of his own working place before commencing and whilst at work.

113. — Should anyone observe at any time diminution of the ordinary quantity of air, or inflammable gas, or dangerous symptoms in the roof or sides of any working place or travelling road, or an unusual quantity of water, or a door open or partially so or any other source of danger, he shall at once cease work, and report the same to his immediate superior.

148. — Any person observing gas, in his lamp shall carefully lower the flame and the lamp, and carefully and slowly remove the lamp, and leave the place at once, and immediately report the same to the Deputy.

151. — No official or workman must allow any gas to explode in his safety-lamp under any circumstances where it can be avoided. Where necessary to try for or examine for the presence of gas, the safety-lamp must not be raised higher than will allow the presence of gas to be detected.

168. — No person shall do anything to endanger his own or another person's life.