I have been involved in rescue hoist work for over 9 years now. On a public use single engine Huey in the US. I crew the helicopters, run the hoist and ride the cable.
We were professionally trained and have a very high standard for pilots and crew. We train twice a month. We have a 90 day recurrency for all crew and pilots.
We use the best equipment available. We also do hoist rescues at night on NVG's.
Helicopter hoisting is inherently high risk. But we feel that by conducting regular training we can keep it in the high risk high frequency category. Meaning we keep our skills sharp. There is no place here for the "B" team.
We will do hoists in life threatening situations or when the risks to ground rescue personnel are too great. Others in this thread have mentioned the same thing.
We did one yesterday with a minor injury but by ground would have taken nearly a full day over difficult terrain. In fact one rescuer was injured just getting to the victim.
We have aborted numerous missions. Some we returned at first light. Others aborted for weather that never improved.
We have had some incidents. A fouled cable and a badly damaged helicopter. But no crew has been lost.
There have been fatalities in the US. Texas lost a hoist rescue tech last year. Las Vegas lost a rescue tech and within the last 2 weeks a firefighter fell to his death that was not tethered to the aircraft properly.