An inquiry into the deadliest Channel crossing on record has found the Dover coastguard was placed in an “intolerable position” by chronic staff shortages on the night 30 people died.
The independent investigation concluded that “systemic failures, missed opportunities” at HM Coastguard directly contributed to the failure to rescue those on board a crowded inflatable dinghy.
The sunk dinghy off Calais; at least 28 died when it capsized overnight on November 23 and 24 2021. Picture: Local lifeboat crew
The tragedy occurred overnight on November 23 and 24 2021, leaving just two survivors who were discovered in French waters almost 12 hours after the first calls for help.
Led by Sir Ross Cranston, the inquiry identified 27 men, women and children among the dead, with four people still missing.
It said some victims could have been saved had the response not been undermined by inadequate staffing.
It found HM Coastguard made a “number of flawed decisions” for the rescue search operation into the incident known as “Charlie”, which led to it being ended early on November 24 because of what was described as “failures in record keeping”.
Emergency services in France following the incident in 2021. Picture: UKNIP
There was also a “widely held belief” within the coastguard that callers from small boats “exaggerated their level of distress”, the report said.
“If the search had continued throughout that day, some of the deaths would have been avoided,” it added.
“These members of HM Coastguard were placed in an intolerable position because of chronic staff shortages at Dover and other deficiencies. These were known about for some time, but no effective action had been taken.
“This represents a significant, systemic failure on the part of government.”
The inquiry also highlighted the use of an overcrowded and unsuitable inflatable boat, supplied by people smugglers, and a failure by the French Navy vessel Flamant – the closest ship – to respond to a mayday call.
That failure is now the subject of a criminal investigation in France.
Chairman of the inquiry, Sir Ross Cranston. Picture: PA
Sir Ross said small boat crossings “must end”, adding that preventing further loss of life was imperative.
Evidence heard during four weeks of hearings last year showed the boat became swamped about three hours after leaving the French coast, with multiple distress calls made – several by a 16-year-old Kurdish boy who died alongside his mother and sisters.
One victim is believed to have died just half an hour before rescue.
One of the two survivors of the tragedy, Issa Mohamed Omar, gave evidence during the hearings, describing how he kept moving to survive the cold water.
“In the morning I would say about 10 people were still alive,” he said.
“It’s a harrowing experience and I just don’t want to remember.
“It’s a harrowing experience and I just don’t want to remember…”
“All night I was holding to what remained of the boat, in the morning I could hear people screaming, it’s something I cannot forget in my mind.”
Cold water expert Professor Michael Tipton concluded that while some of those on board may have drowned immediately, it is likely the majority of victims died over a long period, by sunrise at 7am and between sunrise and the rescue in the afternoon the next day, the report said.
During inquiry hearings last year, many families of the dead and missing paid tribute to their loved ones throughout proceedings.
Rasul Farkha Hussein had said he hopes the inquiry will find his missing son, Pshtiwan Rasul Farkha Hussein, and that he is certain he is alive somewhere.
“He was in cold water surrounded by dead people for so long it may be the case that he has lost his mind and does not know that he should call his parents,” he said.
The family of Pshtiwan Rasul Farkha Hussein believe he may still be alive. Picture: PA/Duncan Lewis Solicitors
“If someone finds him and he contacts us, our lives would be saved and filled with joy.”
While the inquiry noted improvements since 2021, it made 18 recommendations covering small boat rescues, mass casualty incidents and wider structural issues in maritime search and rescue.
Former Home Office official Dan O’Mahoney said enhanced aerial surveillance capable of operating in poor weather is now in place and believes “the outcome would have been different” if the incident happened today.