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Herald of free enterprise

The Sheen Inquiry concluded that the ferry capsized because it set sail with its bow doors open, a disaster it famously described as being "infected with the disease of sloppiness" from the board of directors down to the junior staff.

On the evening of 6 March 1987, the Townsend Thoresen ferry Herald of Free Enterprise capsized just minutes after leaving the Belgian port of Zeebrugge. The vessel was a "roll-on, roll-off" (Ro-Ro) ferry, designed for rapid loading. Because the bow doors had been left wide open, water flooded the car deck almost immediately, destroying the ship's stability and causing it to settle on a sandbar in less than 90 seconds.


The inquiry, chaired by Mr Justice Sheen, was a devastating critique of the company, Townsend Thoresen (a subsidiary of P&O). The immediate cause was identified as the failure of the assistant bosun to close the doors because he was asleep in his cabin. However, the inquiry looked far beyond the individual error. It found that the ship’s officers were under immense pressure to maintain strict "turnaround" times, often starting the engines before the doors were closed to save minutes.


Justice Sheen’s report used famously scathing language, stating that "from top to bottom the body corporate was infected with the disease of sloppiness." He highlighted that the company’s directors had ignored repeated requests from captains to install "bridge indicator lights" that would show whether the doors were closed. The board had dismissed these requests as unnecessary expenses.


The inquiry’s findings were so severe that they led to a landmark attempt to prosecute the company and five individuals for corporate manslaughter. While the 1990 trial eventually collapsed, the "Sheen Report" fundamentally changed international maritime law. It shifted the focus of safety from the "man on the spot" to the "corporate entity," eventually leading to the International Safety Management (ISM) Code, which mandates that shipping companies must have a documented safety management system and a designated person ashore responsible for safety.

Key numbers at a glance

50

Recommendations

4

Months to complete

Cost in millions      (if known)

193

Deaths (direct)

Recommendations

Recommendation Category

Summary of Advice

Current Status

Bridge Indicators

Mandatory lights on the bridge to show the status of all loading doors.

Implemented (International maritime requirement).

CCTV Monitoring

Installation of cameras to monitor the car deck and bow doors.

Implemented (Standard on all Ro-Ro vessels).

Draft Monitoring

Systems to accurately measure a ship's draft and stability before sailing.

Implemented (Digital sensors now mandatory).

Emergency Lighting

Improved escape lighting and "life-saving appliances" for capsized vessels.

Implemented (SOLAS regulations updated).

Corporate Duty

Legal requirement for companies to have a "Designated Person" for safety.

Implemented (Via the ISM Code).


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