Single-engine IFR is not prohibited in the US, but it is very rare for commercial operations. BH206s are not approved for IFR because they have only one electrical power source. There have been a few approved, with stability augmentation and spare generators, but it's uncommon. I don't know of any approved for commercial operations, which are different from private or corporate use. The US Army does operate 206s IFR, but it is not subject to FAA oversight. Nor is any other government entity.
EMS helicopter operations are becoming rather highly regulated in the US, but this flight was not an EMS operation. It was a straight Part 135 charter. Criticizing the Mayo Clinic for operating an older aircraft is just silly, because they didn't own it, they just chartered a helicopter on short notice. They took what they could get at the time, and almost certainly had no idea how old the airframe was. And the airframe age makes no difference at all. That's a complete red herring.
Allowing or not allowing night flights in single-pilot, single-engine helicopters is a decision that has to be made through a cost/benefit analysis. How many lives are likely to be saved over the long run, and how many lost? In England, probably not many will be saved, because the distances are so short. The entire island would almost fit into the area in Texas that I routinely cover. Here, an ambulance would take hours to cover the distance to a trauma center over rural roads, while a helicopter can do it in well under an hour. However, there is no way to break even, much less make a profit, using twin-engine two-pilot helicopters. And profit is the overriding issue, make no mistake about that. The federal government will not be involved in providing EMS services. So the choices are to allow HEMS flights in smaller, cheaper-to-operate aircraft, or to go back to the early 20th century and run ambulances hundreds of miles to get trauma, cardiac, and stroke victims to a hospital that can provide the necessary care. Local hospitals are fine for minor illnesses and sprains, but they simply can't handle much else. That's not ideal IMO, but I'm not in charge of the system. In short, as I've said before, those on the eastern side of the pond are simply ignorant of the way things work here, and why, and their babblings will continue to be ignored here. We already fought two wars to be rid of English rule, and aren't about to give in to it now.
