Risk register · entry
Q1 · PredictableGrenfell Tower fire
The cladding failed its fire tests. The Inquiry found the testing was manipulated, and a tower was wrapped in it anyway.
Documented, foreseeable risks that were ignored anyway. The failure is attention, not information.
Why this quadrant
Grenfell sits in Q1 because the hazard was documented, repeatedly, in the hands of the people responsible, and acted on by none of them. A parliamentary select committee warned in December 1999 that it should not take a fatal fire before the risks of external cladding systems were addressed; a large-scale test in 2001 showed aluminium composite panels with unmodified polyethylene cores burned violently and the department did not even publish the result; between 2012 and 2017 the department received numerous further warnings and knew by February 2016 that such panels were routinely being used on high-rise buildings in breach of the functional requirement. The Inquiry's own framing is a failure to act on information already available, which is the definition of Q1: the failure was attention, not knowledge.
The record
- 72 people died as a result of the fire at Grenfell Tower on 14 June 2017, 18 of them children.certain
- A large-scale test in 2001 involving aluminium composite panels with unmodified polyethylene cores showed they 'burned violently'; the government failed to publish the result, to establish how widely such panels were in use, or to warn the industry.certain
- In December 1999 the Environment and Transport Select Committee warned the department that it should not take a serious fire in which people were killed before steps were taken to minimise the risks posed by some external cladding systems; the Inquiry found the department failed to heed it.certain
- In May 2014, with the complicity of the BRE, Celotex tested a BS 8414 system containing RS5000 into which it had inserted two sets of fire-resistant magnesium oxide boards in critical positions to ensure a pass, then obtained a BRE test report that omitted any reference to those boards, rendering it materially incomplete and misleading.certain
- From early 2005 Arconic held test data showing that Reynobond 55 PE in cassette form performed much worse in fire than in riveted form; it withheld that data from the BBA and caused the BBA certificate to make statements Arconic knew to be false and misleading.certain
Sources
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