It seems to me the key words, and the common thread in the recent spate of HEMS accidents are “pilot workload.” The majority of HEMS flights are conducted in conditions where the workload is easily manageable by a single pilot in a VFR-only machine. The economy of such operations is indisputable. The trouble can come when a situation arises for which that single pilot is not equipped or prepared, or the VFR-only machine is not capable. The workload can increase insidiously, and depending on the skill of the pilot, may exceed his abilities. At that point a successful conclusion to the flight may be solely a matter of luck.
Many HEMS operators in the U.S. base their operation on the premise that they simply won’t operate in situations where the workload is high. The unfortunate reality is that the line of demarcation is impossible to clearly define. Inevitably, someone will blunder across it, either through poor judgement or due to inadequacies in the information available for making their decision. Most of the time it results in no more than a bit of a scare and a good “there I was” story for the next safety meeting. The lesson is soon forgotten.
The major airlines conduct all their flights under instrument flight rules regardless of the actual conditions. Thus, when they do encounter weather it’s a “non-event.” Apparently, they’ve found that preparing for the worst pays off in a business sense – it allows them to run on schedule (much of the time) and it has contributed significantly to the low accident rate.
Not to compare HEMS with airline flying by any means, but the same philosophy of preparing for the worst would seem to make a lot of sense. If you want airline-like reliability in transporting medical patients it requires a higher level of equipment, training, and crew composition than the minimum the government currently mandates.
There are any number of fine aircraft and a variety of supplemental equipment available which could permit safe operation in all but the most severe conditions. The advantage of a second pilot is obvious. It all goes toward keeping the workload manageable all the time. The problem, of course, is that it’s expensive to go that route.
The solution to the disproportional accident rate doesn’t lie with a magic bullet – a piece of equipment, increased inadvertent IMC training, etc. It lies with a far-reaching change in operating philosophy. It lies with creating an environment predisposed to the successful completion of every flight that is accepted.
So, the question is, are we ready to change the regulations to enable a “high-end” operator to compete in what has become a market driven, in most cases, solely by economics. Honestly, I think the answer is no. One has to look no further than the horrific accident rate of automobiles in this country. There are any number of simple and obvious measures that could be taken to reduce the carnage, but perish the thought of depriving someone (either by regulation or by making driving unaffordable) of what has become essentially their right to drive when, where, and for however long they please.
-Stan-