JR West says non-punishment policy for errors improves safety

Asahi Shimbun

25-04-2025

The wreckage of a derailed train in Amagasaki, Hyogo Prefecture, on April 25, 2005 (Asahi Shimbun file photo)
West Japan Railway Co. (JR West) has drastically changed the way it handles errors committed by its train drivers, shifting from humiliation and punishment to human science and learning.
The non-punishment approach has improved safety on the company's lines, according to officials.
The changes were made following the disaster on the JR Takarazuka Line that killed 107 people in Amagasaki, Hyogo Prefecture, 20 years ago on April 25, 2005.
The driver of the express train, who was killed in the crash, was apparently desperate to avoid further disciplinary action for committing errors of the job.
In 2004, about a year before the derailment, the driver, who was 23 years old at the time, overshot the platform at a station in Kyoto Prefecture by about 100 meters.
He was berated by three supervisors, who told him such things as, 'You have failed as a member of society' and 'You must be taking the job of a driver lightly.'
He was given a warning and a reduction in his year-end allowance.
During his 13 days of internal retraining, he was ordered to write reports on 20 topics, including 'my conceit that I have recently become a full-fledged driver.'
On April 25 the following year, while driving on the JR Takarazuka Line, he stopped about 70 meters too far at Itami Station, forcing him to back up the train to the correct position.
According to a report by the transport ministry's railway accident investigation committee, the driver then used a phone in the train to ask a conductor to make a false report about the distance of the mistake.
In an apparent attempt to make up for lost time caused by his error, the driver accelerated the train, entered a sharp curve at an excessive speed and failed to brake properly.
The train derailed and slammed into an apartment building.
Multiple post-accident reports said JR West's strict demands for punctuality and its disciplinary actions against error-making drivers have 'conversely induced accidents.'
Shigeru Haga, professor emeritus of traffic psychology at Rikkyo University who advised JR West on human error issues, said the conventional view of mistakes is that they are caused by carelessness, and that punishment will prevent a recurrence.
He said this view still persists in Japanese society today.
However, around the 1960s, a new way of thinking about errors emerged in Europe and the United States.
It held that everyone makes mistakes, no matter how good they are. And it is crucial for safety and other reasons to report such errors without concealment.
JR West adopted this approach after the accident.
In addition to providing more practical training to drivers, the company has, in principle, not taken disciplinary measures for mistakes.
JR West said many employees were concerned that the non-punishment approach could lead to complacency.
In response, the company expanded the scope of errors that are not punishable in three stages: five months after the accident, in 2008, and in 2016.
Over that period, JR West checked to ensure that number of accidents and problems did not increase because of the change in policy.
Overruns, speeding and missed stops used to be subject to penalties, but now, in principle, they are not.
Unless the error was intentional or a result of negligence, drivers are not subject to disciplinary action, including for mistakes that result in accidents.
Reports of errors are compiled in a database, and safety measures are implemented where necessary.
For example, at stations where many mistakes have occurred, JR West sounds a warning announcement in the driver's room when approaching these stops.
JR West also conducts interviews with drivers who have overrun platforms and analyzes the causes and background that led to the error. Retraining can include having an instructor accompany the driver to check on brake operations.
Takeshi Urushihara, a top official of the company who is in charge of safety promotion, said the non-punishment approach has led to improvements.
'The decision not to take disciplinary action has increased the number of reports of errors that only the train driver knows about, and it is certain that safety measures have advanced,' Urushihara said.
However, he referred to an incident in 2017, when JR West ran a train with a cracked undercarriage.
'We failed to stop the train even though we were aware of the abnormality,' he said. 'There are still things that need to be done to ensure safety.'