Minself, I am sure the winching kit doesn't cost a lot to purchase and fit, but if you think that the training costs in terms of maintaining a safe and professional capability are cheap then you haven't done much winching.
My point about the 24 hour cover was that AAs should look first at providing that before they start strapping on winches as the benefit of night AA cover must be higher than being able to winch.
As to the patient - I am 100% with you that whatever is best for them is what should happen - unfortunately that is not what is happening at the moment.
I was at Wattisham recently when we attended an RTA and the patient was worked on for 25 minutes en route to Cambridge by 3 paramedics and a technician - not likely in an air ambulance!
You have me at a disadvantage as I do not know what ORCON is or why the RAF should need to sign up to it. I do know that we regularly fly paramedics from various NHS trusts so that they can see our capabilities and pass the information on to their controllers.
3D - the AA used to come all the way from Exeter to land on Saunton Sands, so I know exactly what you mean.
This is not a dig at AAs as they do sterling and valuable work - I just think that crossing over into winching ops is a step in the wrong direction.