Railtrack revealed today that an advance warning system will be commissioned at York's notorious blackspot railway signal by the end of the summer - as a public inquiry report into the Paddington crash accused the company of institutional paralysis.

Lord Cullen's report into the tragedy, in which 31 people died, said there was a "lamentable failure" on Railtrack's part to respond to two earlier instances of signals passed at danger before the October 1999 accident.

It was a Thames Trains service passing through a red light and crashing into a London-bound Great Western express that caused the accident at Ladbroke Grove, west London.

Lord Cullen's report said the fact that Railtrack had many groups dealing with similar issues led to confusion.

The report was also critical of Thames Trains, whose driver Michael

Hodder, 31, was killed in the crash.

It said the removal by Thames of all their in-carriage emergency hammers before the crash compromised the safety of passengers.

In York, a signal on the East Coast line north of the station has long been a cause of concern, with nine trains passing through on red in nine years - the most recently in June last year.

Now Railtrack has revealed that work to install Train Protection Warning System at signal Y304 is under way and the system is expected to be commissioned by the end of the summer.

Under TPWS, sensors are placed on the track in the approach to the signal, and if a train is going too fast, the brakes will automatically be slammed on.

But even when the system has been commissioned, it will not come into use until 2003, when GNER trains have all been adapted to use it, testing has been carried out and drivers have been educated.

A GNER spokesman said trains were in the process of being adapted to the system.

Railtrack said there had not been another instance of a signal being passed at red since last June.

Today's report on the Paddington crash said there was "a lack of appreciation within Railtrack that deficiencies in the infrastructure could play a significant part in SPADs (signals passed at danger)".

Lord Cullen said there had been concern that SPADs occurred at twice the industry rate on Thames Trains services and although there had been an improvement in this respect during the period June 1996 to June 1998 "more could and should have been done to organise driver training and management in a systematic manner".

The report added that there was an "obvious lacuna (gap)" in procedures in that the Thames driver instructor did not recognise it as part of his job to teach knowledge of the route in and out of Paddington station.

Lord Cullen concluded that the training of Mr Hodder, who had only just qualified as a driver, was not adequate and that he probably believed that he had "a proceed aspect" at the signal he passed at red - signal 109.

This signal had been passed at danger on a number of occasions before.

Lord Cullen said: "The fact that he (Mr Hodder) had not been instructed that signal 109 was a multi-SPAD signal increased the risk of his making, and not correcting, a mistake as to the aspect shown by that signal."

Updated: 11:00 Tuesday, June 19, 2001