devil, I regret to disagree with several of your remarks on that post. Equipment and training matter, and amtter a lot.
When we are talking Twins I guess most of us have in mind that we are talking about having Perfomance I CAT A MTW helicopters. The kind of mchine that if properly operated would make the difference if you have one engine out.
Twins but CAT II are surely not the answer.
IFR currency (operational currency I would call it) should be a must for any HEMS pilot flying by night. And with special enphasis on procedures for inadverted entry into IMC conditions.
If you want SAFE HEMS by night, then think in CAT I perfomance helicopters fully IFR equiped, a crew of 2 fully qualified a current IFR pilots and an properly trained dispacher that knows how to read weather maps and know what icing conditions and its effect on helicopters are.
Then add NVG or a nice FLIR and then you will have a SAFER HEMS night program.
The above mentioned equipment and conditions would not guarantee a 100% accident free but it is the best we can have for now, provided of course that the operators/customers value more safety than profits.