Having read all the preceding posts, in which most people seem to be in violent agreement that this "organisational" failing was both systematic and preventable, I have not seen anything about the final link of the chain before the crew strapped in and took off - the Authorisation. It certainly used to be a function of the Authorising Oficer to ensure the crew and the task were successfully mapped to the aircraft fit/role and the flying conditions, but in this case the experience and currency of the pilot seem somewhat at odds with the sortie - MSD specifically.
This is in no way intended to cast aspersions about the final Auth, just to indicate that those organisational failings led to low hours and experience levels combined with a taxing role fit and weight, being viewed as a normal occurrence within the unit. Alarm bells that may have rung only a few years ago were silenced by repeated exposure to institutionalised shortcomings in training and currency and as a result the Authorisation, the last safecheck in the system, was effectively negated.