Meetings, but what's the stats?
After all the FAA and industry complains about HEMS having a higher standard accident rate than GA, and there's demand to fix the problem... But like sas said, and I have to agree- where are the inspectors? No, we don't like them there- I'm not the main guy at our operation, but pretty near for purposes of responsibility; and I can objectively say that there are times we need to tighten up a bit.
If the FAA is serious, then they need to spend some time with several operators in the highest risk sections- several that operate different ways (with NVG, without, single/dual pilot). And agreed- taking a VFR ride in the day is supposed to evaluate someone who routinely performs at night or under NVGs either overwater or into/out of confined areas? That's something the military types have been doing for years- evaluating people in the most demanding flight environment.
Ask ourselves this- Why is it that USFS determined the need to card pilots for operations, and operating in HEMS requires nothing other than meeting the FARs? I know we dislike oversight- me included, but the implied statement is that by not carding or any other requirements- it's not as difficult or risky.
Just like I've told the guys that have worked for me- it doesn't take anything other than a couple minutes walking onto the hangar floor to see what kind of maintenance is going on and where the problems lay- the key here is being there and finding out for yourself. Spot on- paperwork and auditing is only 1/8th to 1/4 of it.