We have enough techology with GPS and TAWS and the like to come up with a compromise between hard IFR (airways, clearances, etc.) and VFR.
All the helicopters flying at night have attitude indicators and the appropriate navigation aids - why not adopt a semi-IFR approach - dedicated routes to get you close to the necessary scene - for scene calls, and dedicated routes from hospital to hospital. All this outside of built-up areas (which would be clearly defined).
An IFR attitude brings a whole different way of thinking - one that has proven to be extremely safe for airlines, corporate aircraft and the like. Why are we not putting something like this forward voluntarily...???