Conclusion?
Geoffersincornwall - thank you for the insight into how the UK HEMS model was born. Interesting to read where/how it all began!
I guess the conclusion that can be drawn is that in the UK, cost effectiveness is not really an issue. As the operations are charitably funded, and the public at large are happy to donate without any proven benefit (as might be defined by a health economist), it doesn't really mater what the statistical data may or may not demonstrate. Perceived benefit, which is hard to quantify, drives the UK HEMS market. This typifies the problem of quantitative versus qualitative data inherent to all types of health research.
From my experience, "life saving" is rare but does occur; "life changing" (i.e mitigating morbidity) is more common; "easing of suffering" (i.e shorter on-scene time/easier egress) is a near daily occurrence. What price you put on each of these 'commodities' is largely subjective. For the injured individual, it is often priceless, hence the ongoing public support for UK HEMS.
Of course, for other countries that seek government support or utilise private insurance payments, cost effectiveness is (for better or worse) the crux of the matter...
You only have to look at the UK's Police ASUs to see how proven worth is likely to drive future funding. Again, quantifying benefit is largely subjective and attracts a variety of opinions. Should the public decide to start charitable collections for their local police helicopter, cost effectiveness would become irrelevant, as it would appear to be for HEMS.
Simon