The independent review of the Moncton shootings last year in which three RCMP officers were gunned down paints a picture of chaos: poorly equipped and trained officers, communication breakdowns and the lack of a co-ordinated plan.
The review, conducted by retired assistant commissioner Alphonse MacNeil, was released Friday morning and contains 64 recommendations, all of which the RCMP says it has accepted.
Mr. MacNeil's review showed that the shooter, Justin Bourque – who is now serving a life sentence without parole for 75 years – was at a total advantage as he was armed with semi-automatic weapons while the officers were carrying pistols. Initially, only one officer thought to bring a long gun to the incident.
"The tactical advantages are overwhelming in favour of Bourque," according to the review.
Mr. Bourque killed constables Dave Ross, Fabrice Gévaudan and Doug Larche. Constables Eric Dubois and Darlene Goguen were injured.
Friday's report is 180 pages long, but nine pages were redacted to protect officers' safety, Mr. MacNeil says.
It was not meant to lay blame – rather it is to analyze the response to the incident. But it is damning.
"We must learn from this tragedy," RCMP deputy commissioner Janice Armstrong said in a statement. "It is our duty to make sure all RCMP employees on the front lines are as prepared as possible to meet the threats we face every day."
The force's Staff Relations Representative Program, an elected body for more than 22,000 RCMP members and which participated in the probe, thanked Mr. MacNeil for the "timely and comprehensive review" and said the SRR "strongly" supports the recommendations.
"Our hope is that it will help to guide improvement in our Force, and create a more comprehensive individual and collective awareness amongst members of the challenges involved in policing," national executives Abe Townsend and Doug Anthony wrote in an internal email to members.
The review noted that none of the first officers to respond to the incident wore hard body armour to the scene. Hard body armour would not have saved the officers' lives, the report notes, but there was a "problem" with the amount of protective equipment at the Moncton station.
"The review team learned through interviews that one member opted to go without HBA so that her colleague, who had children, could have the protection of HBA. Members should never be in the position of having to decide who gets to wear HBA."
There were also concerns over the availability of proper weapons, including the carbine. Many officers interviewed for the report said that "had the patrol carbine been available it would have made a positive difference in this incident," the review found.
"The patrol carbines would have given a more effective lethal force option and could possibly have influenced members' risk assessments, tactical approach and confidence levels," Mr. MacNeil wrote. "This firearm was approved specifically to address this type of call."
At the time of the shootings, two officers were being trained on carbines. Now there are 120 who have been trained.
Training was inadequate for frontline supervisors, the review found. "Nobody established a command presence. …members were acting on their own accord without a unified tactical plan," according to the report. "Order could have been established if a supervisor had obtained a situational update and requested members report their positions."
As the officers were trying to find Mr. Bourque there was "nobody at a supervisory level" with an overall view of the situation on the ground. "Members were taking heroic and commendable action as individuals and in small teams, however, they were not co-ordinated with a common plan and action."
The report highlighted communication problems, noting that police were not speaking in plain language, but in "10 codes" that proved to be confusing.
Information was being communicated across police radios, but some officers were on different frequencies. Moreover, one of the key officers at the incident had lost his radio and did not have a cellphone. He was with one of the constables who had been gunned down – but couldn't communicate that.
With reports from Kathryn Blaze Carlson and The Canadian Press