Some recently available material in the Wellington City Council archives explains to some extent how this happened.
After the initial shock of hearing the Union Steam Ship Company (USS) inter-island ferry Wahine had struck Barrett Reef and was holed and without power, there were reassuring messages from the ship that it was holding to its anchors and drifting into the harbour.
The Wharf Police log recorded at 9.28am that Harbour Board pilot Captain Keith Mitchell's assessment was that "Wahine had her head into the wind with two anchors out, and was quite safe and not likely to come ashore''.
But as the Court of Inquiry found, the harbourmaster, Captain R E Suckling, and the ship's owners knew certain basic facts.
Wahine was without engines, holed, beset by violent wind and seas and dependent for its safety on its anchors and cable.
If they failed, disaster could be anticipated, and then a rescue fleet, provided it could operate in the conditions, would be needed.
After Wahine cleared Point Dorset, inside the harbour heads, Capt Suckling ordered Capt Mitchell to bring rescue equipment back to base so it would be in a central position if needed.
Capt Mitchell had advised that if Wahine's cables snapped there was a chance it would go ashore on the eastern side of the harbour.
Though USS staff were aware of that possibility, some internal memos, now available at the archives, reveal the confusion that reigned at the company's headquarters in Wellington, only a few kilometres from the stricken ship.
The company's radio room could monitor traffic but because of a fault, could not talk to the ship.
Assistant chief marine superintendent J. F. Collins reported: "My overriding impression of this disastrous day has been that channels of communication were completely inadequate.
"In nearly all the maritime accidents we have been involved with hitherto, communication has been direct with the master.
"I mention that on this occasion I have not seen one official message from the Wahine.
"In fairness to the master, he would be entitled to assume that all messages via Beacon Hill [the board's signal station overlooking the harbour entrance] would be relayed to this office.''
He added that one of the company's captains, P. H. Pallin, also reported there was no communication direct from Wahine's master in command, Captain Gordon Robertson.
"And in view of difficult communications confusing the issue, no instructions were passed to the master direct from this office.''
The company did try to communicate with Capt Robertson through the harbourmaster's office.
It asked the office to pass on two questions: what is the present situation, and what is the immediate prospect? The office refused to relay the message, without any reason given.
One bit of news about midday helped confirm for some of the staff the feeling that all was still well with Wahine.
The company received a message through Wellington Radio that said "distress finished''.
In his memo, branch manager C. D. Stevens said "we all felt confident there was little to worry about until the vessel berthed''.
"I have since learnt from Captain Robertson that no such message was sent from Wahine.''
But he recalled an inquiry from Wellington Radio, asking whether the "distress working'' Channel 16 should be discontinued so that ordinary traffic with all shipping could be resumed.
"Whereupon Captain Robertson agreed he would confine his advices to the VHS through Beacon Hill. It is obvious now, what Wellington Radio meant by 'distress finished' but it certainly misled us all.
"In fact, I went out before 1pm for a cup of tea. On my return about 1.20pm... I discovered Wahine was in real trouble and that rescue operations were being arranged.
"Wahine had become silent at this stage... if anything was lacking on our part, it arose because information was not passed on.
"For example, Captain Robertson has advised me he had undertaken to report at 20 minute intervals. We heard nothing of these.''
It is not clear whether the captain did not report as promised or whether the harbourmaster's office did not relay the messages.
For USS general manager Alan Waugh, the first occasion of apprehension for passenger safety came with the news at 12.45pm that the ship was definitely losing ground with the water, and then at 12.55pm with mention that the vessel was slowly settling with a draft of 7m to 8m.
At 1.17pm came the news that Wahine was launching starboard lifeboats, with the intention of putting passengers ashore at Worser Bay on the city side of the harbour.
The communication confusion also extended to the harbourmaster's office.
It received a request at 12.30pm from Wahine for pumps "if and when we get to Point Halswell, fear losing ground with water,'' but Capt Suckling told the preliminary inquiry "up until 1.25pm I did not receive any information indicatingWahine's abandonment was imminent''.
Yet it is clear from evidence produced at the Court of Inquiry that deputy harbourmaster Bill Galloway, who had managed to get aboard Wahine in the morning, noticed just before 12.45pm that the ship's position was deteriorating rapidly.
He radioed the harbour board's tug Tapuhi on the VHF and declared time was running out. Why action was not taken on this message by the harbourmaster's office is unknown.
Capt Suckling was unable to give evidence at the inquiry because of an undisclosed illness. The harbourmaster's office's communication with the police was also a disaster.
According to the police log the harbourmaster informed the police that assistance was required at all beaches on both sides of the channel, but this was only as a result of the police contacting him personally on a direct phone.
The log says: "There is general agreement that not at any time until 1.45pm was there any suggestion from either the Harbourmaster or Marine Department that Wahine was `holed' or taking water".
The court found that more could have been done ashore to ensure a suitable rescue fleet was as near to Wahine as possible when she capsized.
It added that it considered that while primary responsibility in this respect may have rested upon the harbourmaster, the desirability of such a step should have been realised and advocated by Wahine's owners.
The court emphasised that the harbourmaster was unable to attend the inquiry for health reasons and might have taken some steps which could not be known to the court.
Discussing the allegations against the harbour board, the court declared the actual charge appeared to be based on an alleged failure to take precautions against an event, a wreck on the eastern shore, which in fact did not take place.
For that reason the charge was not considered to be established.
However, a question of real significance to be considered was whether at some time before abandonment steps could have been taken to see that as many rescue vessels as possible would be close to the ship in case of sudden disaster.
The court said that had suitable rescue vessels been close to the ferry, when the decision to abandon ship was made, passengers ultimately carried to the eastern shore might have been intercepted while still reasonably close to Wahine.
"It is a reasonable inference that had this been possible the loss of life would have been reduced.''
- Jim Hartley was working for the New Zealand Press Association in 1968 and co-authored, with Max Lambert, The Wahine Disaster, the following year.
- Where initials appear, that is due to full names being unavailable.
