But Helinut the doctors will still be annually appraised to a national standard, regulated by the GMC, and the standards believed appropriate will have to be met by all as otherwise the courts will intervene if someone complains.
And a parallel system goes for nurses, physio etc etc
In e 1960s kidney transplantation was run along the same lines as HEMS with everyone doing their own thing and money raised from charities. The doctors realised it was poor and pressure was put on the NHS to fund a proper service.
I am sincerely grateful to all those who raise money but if you needed a heart operation you would not be best pleased for me to tell you I was waiting for the charity to do a tombola and I didn't use an anaesthetist because my unit used porters.
You only have to realise there is effectively no real controlled medical audit of HEMS after 25 years save a couple of rather negative studies.
The fault lies as much with my fellow doctors who seem more concerned they might have their flights or power base restricted rather than pushing for NHS funding and a proper helicopter healthcare system integrated into trauma care