alot of EMS types hang their butts out to do the right thing
And this is exactly the problem. EMS is not Dustoff, it’s a transportation service, but attitudes in the cockpit too often do not reflect this fact.
When every pilot approaches every EMS flight with the attitude that he/she is just going out to pick up some KFC for whoever pays the bills, but that whoever pays the bills does not want to run any risk, including bad publicity, then the accident rate will decline. Operators, regulators, med crew can all do their part but any pilot who’s spring-loaded to the can-do position is a hazard in EMS operations.
Tools like NVGs can be great improvements to safety; alternatively they can be great ways to set up accidents. The only difference between the two is the pilot’s attitude: “A great way to do what I’ve always done at night but more safely” vs. “Now I can fly like it’s daylight and in conditions that would have kept me grounded before”.
Regulators can indeed greatly improve EMS safety by creating an environment that reduces and may even eliminate these attitudes, but in a manner that I feel is contrary to the American tradition of private enterprise. At the moment practically anyone with a helicopter can become an EMS operator. All that’s required is to attain Part 135 certification, then it’s between you and your (medical) clients. So there is a huge variety in standards and also the phenomenon of “chopper shopping” by health care providers. As an example, an ex-colleague of mine was killed in an EMS crash, night VFR, good visibility and ceiling but with patches of fog and/or low cloud. Would he have accepted the flight if he’d known that
pilots at three other operations had already declined to go ?
The way to avoid situations like this is a system like the Coast Guard contract in the UK. The authorities set a national standard for EMS operations, including aircraft, flight (and med) crews, training and maintenance; the authorities contract one operator and one only for each geographical area; and the authorities establish an ops center that assigns flights. Private enterprise reigns during the contract bidding stage, once the contract is awarded everyone toes the line and outsiders are kept out until the next round of bidding.
What do you think, would such a system ever be acceptable in the USA?