Angel Flights restrictions, things need to change.https://minister.infrastructure.gov.au/brown

[Ian]

Regional areas are pretty poorly serviced by the medical services and Angel Flight in Australia has been a community response to meet some of the needs of people who need healthcare. The problem is very real with concept such as "Burdern of Disease", From the AIHW comes this statement

Quote

In 2018, after adjusting for age, the total burden of disease and injury in Australia increased with increasing remoteness. Major cities experienced the least burden per population, while Remote and very remote areas experienced the most. The rate of disease burden in Remote and very remote areas was 1.4 times as high as that for Major cities.

A few of the aviation governance bodies haven't particularly taken a shine to the service and have effectively been trying to reduce it's scope of operations.

However rather than trying to restrict these operations this type of ground roots aviation should be encouraged and expanded in scope. There is a simple calculus associated with the availability of healthcare and morbidity and death. Investigations by the ATSB into accidents related to Angel Flight appeared to be almost a vendetta against the concept and the organisation, however this completely misses the point that thousands of premature deaths and extended suffering are occurring because of a lack of access to medical facilities in a reasonable and convenient manner.

A couple of questions for the group who may be understand the background and context of the current state of affairs.

• Why is there the degree of antipathy to the concept of Angel Flight from CASA and ATSB.
• Is it possible to garner greater support in regional areas by getting local GA to other local organisations like Lion/Rotary etc.
• What  percentage of you have written to your local member to get this fixed. The current Minister for CASA is Catherine King
• Given that there's an increasing number of amateur built aircraft, wouldn't it make sense to include these in fleet of vehicles if the end users are happy to accept the risks. People are grown up and can read and accept a risk assessment.

 

Basically it's and issue of equity and cost, and by any measure the current status quo is failing.

I'd encourage you to reach out to these ministers and shake the tree

https://minister.infrastructure.gov.au/c-king/contact

https://minister.infrastructure.gov.au/mcbain/contact

https://minister.infrastructure.gov.au/brown

 

Offer to take them up for a flight to an airport with a twice a week service and explain how hard it is to get an MRI if you have kids, or have dependents or are a carer.

 

 

[Bruce Tuncks]

I reckon they stand to gain money if they are a rival flight organization.

As for CASA, they are responsible only for flying accidents, They have zero interest in improving the quality of life. As for the medical specialists, they are dreadful.

Yes we need to change things, and your posting Ian is a good start.

 

As an observation, the latest angel flight disaster at Mt Gambier was caused by the pilot having too much awe for the medical specialists. He should have postponed the flight till the weather was better, but he clearly did not think he had this option.

[Thruster88]

The requirements for pilots to fly for angel flight missions are not onerous.   They can be found here https://www.angelflight.org.au/support-us/pilots there is nothing stopping any pilot that meets the  requirements flying for angel flight. The aircraft just has to be certified and have a valid maintenance release. I own an experimental and it is brilliant, however I can see why they don't allow experimental.

[turboplanner]

4 hours ago, Ian said:

Regional areas are pretty poorly serviced by the medical services and Angel Flight in Australia has been a community response to meet some of the needs of people who need healthcare. The problem is very real with concept such as "Burdern of Disease", From the AIHW comes this statement

A few of the aviation governance bodies haven't particularly taken a shine to the service and have effectively been trying to reduce it's scope of operations.

However rather than trying to restrict these operations this type of ground roots aviation should be encouraged and expanded in scope. There is a simple calculus associated with the availability of healthcare and morbidity and death. Investigations by the ATSB into accidents related to Angel Flight appeared to be almost a vendetta against the concept and the organisation, however this completely misses the point that thousands of premature deaths and extended suffering are occurring because of a lack of access to medical facilities in a reasonable and convenient manner.

A couple of questions for the group who may be understand the background and context of the current state of affairs.

• Why is there the degree of antipathy to the concept of Angel Flight from CASA and ATSB.
• Is it possible to garner greater support in regional areas by getting local GA to other local organisations like Lion/Rotary etc.
• What  percentage of you have written to your local member to get this fixed. The current Minister for CASA is Catherine King
• Given that there's an increasing number of amateur built aircraft, wouldn't it make sense to include these in fleet of vehicles if the end users are happy to accept the risks. People are grown up and can read and accept a risk assessment.

 

Basically it's and issue of equity and cost, and by any measure the current status quo is failing.

I'd encourage you to reach out to these ministers and shake the tree

https://minister.infrastructure.gov.au/c-king/contact

https://minister.infrastructure.gov.au/mcbain/contact

https://minister.infrastructure.gov.au/brown

 

Offer to take them up for a flight to an airport with a twice a week service and explain how hard it is to get an MRI if you have kids, or have dependents or are a carer.

 

 

Funny how it's big Oil that shuts down cheap fuel, big auto that puts prices up, big pharma that makes us sick, and now Big Governance that puts Angel Flight down.

 

I can give you another answer; I've read the ATSB (and yes I see BigATSB have a vendetta against Angel Flight); read the accident reports.

[onetrack]

The basic fact remains that all RA-Aus aircraft are a maximum of a pilot and one passenger. I would imagine it is more the exception than the rule, that only one person needing medical treatment is carried when a flight is planned - these people often need a parent or a carer with them.

It's unfair to expect a pilot of an RA aircraft to take care of a person with medical problems if something develops during an angel flight.

If lightweight aircraft were the answer, the RFDS would have some in their fleet.

Even the medical/rescue/crash choppers are heavy, for the simple reason they need to be able to carry medics and patients, as well as the pilot.

 

Edited September 8, 2022 by onetrack

[Flying Binghi]

Well intentioned, though…

 

I’m guessing when somebody wants to travel re medical issues they wants to get there by a set time.

 

A pilot aborting due WX or unserviceability is fair enuf, though the ‘patient’ may be a little unwell and stressing and noting they could have driven there the day before.

 

A few aborts and suddenly all pilots get a bad reputation. 

 

Imagine if the sick pax throws a fit or dies during the flight - Pilot liable ?

 

As I say, well intentioned, though probably best kept clear of.

 

 

[Ian]

1 hour ago, onetrack said:

If lightweight aircraft were the answer, the RFDS would have some in their fleet.

Even the medical/rescue/crash choppers are heavy, for the simple reason they need to be able to carry medics and patients, as well as the pilot.

Horses for courses Angel Flight doesn't replace emergency services, it complements them.

Sometime people just need to travel for a scans such as an MRI or a specialist appointment and for that role sport aircraft might fit the bill. They don't need hand holding on the flight, they just need to get to and from the appointment in a day. When a carer is needed larger aircraft are needed however the key point is its not a one size fits all scenario.

Comparing the requirements for emergency response vehicles to general transport is a bit out of the ballpark. It's like comparing an emergency response vehicle such as an ambulance or fire-engine to an uber or taxi. 

It is not that the requirements are particularly onerous, it is the general undertone that as a service Angel Flights or anything similar should be banned. Rather than the current adversarial ham fisted approach, a set of guidelines aimed at educating both the pilots and the passengers assisting with a risk based approach could have been taken.

2 hours ago, Thruster88 said:

I own an experimental and it is brilliant, however I can see why they don't allow experimental.

https://www.kitplanes.com/homebuilt-accidents-comparing-the-rates/ analysis indicates that the accident rates of experimental aircraft while higher than certified isn't enormously higher.

I'm not sure that it's quite as cut and dried and a more nuanced approach could be more productive. The average age of the certified fleet is over 40 years and often their instrumentation reflects that age. For example the plane at the centre of the ATSB investation was a 1980s era certified aircraft. If the plane were equipped with autopilot and more modern instrumentation it may have ended differently. Certainly being able to press a button to fly straight and level after becoming disoriented might have facilitated a better outcome.

Designs such as the RV series built to a standard design have accident rates similar to the certified aircraft.

 

The big picture outcome is to facilitate better healthcare. If you live in outer regional or beyond your life expectancy is between 2.8 and 13.9 years lower. This is 10% of the countries population which means that between 1096 and 5646 lives are being lost every year in aggregate premature deaths.  26000000*.1*2.7/(80*80) or 26000000*.1*13.9/(80*80). The assumption is that the average age is 80 years, dividing by 80 again gives an annual result.

 

Compared to the risks posed by experimental vs certified aircraft is like being concerned about the air temperature on impact velocity when you're skydiving without a parachute.

 

Something which would be nice to see are more major hospitals built next to airports so there is no a commute for those needing treatment.

 

 

[Ian]

15 minutes ago, Flying Binghi said:

A pilot aborting due WX or unserviceability is fair enuf, though the ‘patient’ may be a little unwell and stressing and noting they could have driven there the day before.

 

A few aborts and suddenly all pilots get a bad reputation. 

 

Imagine if the sick pax throws a fit or dies during the flight - Pilot liable ?

Angel Flight is a charitable service that operates successfully already and people are dealing with these issues already. It's a volunteer service which covers fuel costs etc.

Do you help an old lady across the road or walk away because of the fear of liability. It's your choice.

Personally I also think that it should be the choice of the passenger as to the aircraft and pilot they travel with.

[Flying Binghi]

18 minutes ago, Ian said:

Angel Flight is a charitable service that operates successfully already and people are dealing with these issues already. It's a volunteer service which covers fuel costs etc.

Do you help an old lady across the road or walk away because of the fear of liability. It's your choice.

Personally I also think that it should be the choice of the passenger as to the aircraft and pilot they travel with.

I don’t need to be wearing an Angel Flight cap when I help the old lady across the road.

 

If yer keen why not just put the word out to a few country Dr’s that your aircraft is available as a free taxi service..🙂

[Ian]

5 hours ago, Flying Binghi said:

If yer keen why not just put the word out to a few country Dr’s that your aircraft is available as a free taxi service.

If the Doctor covered the expenses, it would be reasonable but angel flight already has a good operating model

 

To help offset the pilots’ operating costs Angel Flight Australia subsidises fuel used on flights, negotiates the waiver of landing fees at many supporting airports around the country, and arranges the credit of any air navigation charges thanks to the support of Airservices Australia.

 

Angel flight specifically requires a referral from a health professional.

Also the scope of activities which are excludes are

What circumstances are not suitable for an Angel Flight?

• International requests.
• Unaccompanied minors.
• Nursing home relocations.
• Adults who are not able to enter or exit the aircraft unaided.
• Passengers requiring a rescue service or an air ambulance service, or who need monitoring by medical staff or medical equipment during the flight.
• Passengers who are not medically stable or whose medical condition is unsuitable for transport in a non-pressurised light aircraft.
• Passengers travelling for critical care (for example, an organ transplant) as flights can be delayed by the pilot or cancelled at short notice due to unsuitable weather conditions.

 

 

[walrus]

My experience is that most medical visits to capital cities are for tests or regular consultations with passengers having nil or marginal medical impairment. For example my wife is a breast cancer survivor and as part of her routine she has to visit: her oncologist, dietitian, surgeon and of course imaging and physiotherapist. 

 

‘’That translates to 1 - 2 visits a month with a six hour round trip which makes an overnight stay pretty much essential.

 

Even with kids to stay with, this is expensive, especially when you are stuck with unbreakable appointments on Friday and Monday as we are this weekend.

……..and we are the lucky ones. The value of Angel Flight to any one living more that 300km from a capital city is just stratospheric because specialist medical services are concentrated in the Capitals.

 

I can’t use the aircraft (45 minute trip)  because I don’t have access to controlled airspace and both Essendon and Moorabbin are expensive and unwelcoming - even if the weather was cooperative, but I’d like that option.

Edited September 8, 2022 by walrus

[RossK]

3 hours ago, walrus said:

 

 

I can’t use the aircraft (45 minute trip)  because I don’t have access to controlled airspace and both Essendon and Moorabbin are expensive and unwelcoming - even if the weather was cooperative, but I’d like that option.

If you're happy to land at Lilydale, I'll come pick you up and lend you a car for the weekend.

PM if interested.

[Ian]

4 hours ago, walrus said:

That translates to 1 - 2 visits a month with a six hour round trip which makes an overnight stay pretty much essential

This is one of the factors why, as soon as you leave the major metro centres that life expectancy declines significantly. The burden in time and financial expense of leveraging appropriate health services is too high.

From an image perspective I think that this has a lot to offer the aviation community and reinforces the public goods that maintaining a local airfield provides.

as opposed to something like leaded fuel 😉

[Bruce Tuncks]

I blame the specialists themselves and the govt which pays the bills for the situation. Specialists are the only trade where the existing practitioners can decide that they don't want any new entrants. Guess what? they all get millions a year.

[Ian]

1 hour ago, Bruce Tuncks said:

I blame the specialists themselves and the govt which pays the bills for the situation. Specialists are the only trade where the existing practitioners can decide that they don't want any new entrants. Guess what? they all get millions a year.

I agree there is a strong conflict of interest area the medical specialists area however that's not the whole story.

The real culprit has been the rise of industrial medicine and mega hospitals. The equipment and capabilities associated with a high grade hospital facility make it tempting financially to have fewer larger hospitals. However the side effect of this is that people away from capital cities no longer have access to these systems.

For example a high end MRI done in a capital city hospital may provide a significantly better scan than the low end systems available. A 3T scanner gets you to a resolution of about 1mm and there are now 14T MRIs. Your garden variety one is 1.5T with about 2.5mm resolution with few scan capabilites.

[Bruce Tuncks]

Yep Ian, and patient outcomes are highly dependent on how much in practise the specialist is. Apparently there is a hospital in the US which just does one type of operation. It holds a world record for good outcomes.

I wish I could find an answer to this...

[facthunter]

New technology is expensive and since about 80% of all the people live on the east coast that's where the bulk of the facilities are going to be.. It's just economics. A lot of older people move to where Hospitals are. IF you get ILL when on holidays the situation is the same. Thats where the RFDS come in. and air ambulance. IF you don't have Health insurance or pay for the ambulance the costs will astound you.. I had a high grade MRI yesterday and My mask was replaced twice. They also check your temperature. The Operator said they had a big backlog of Imaging to do. There's a lot worse Places than Melbourne to be. Nev

[Flying Binghi]

3 hours ago, Bruce Tuncks said:

I blame the specialists themselves and the govt which pays the bills for the situation. Specialists are the only trade where the existing practitioners can decide that they don't want any new entrants. Guess what? they all get millions a year.

Sounds like a conspiracy…..😉

[turboplanner]

1 hour ago, Flying Binghi said:

Sounds like a conspiracy…..😉

BigSpecialist Inc.

[Bruce Tuncks]

Conspiracy theories are generally crap, but apparently in this case, it is correct. In the US, the system extends to include GP's too. This is why we can't go there and start the Rec flying medical school, even if we restricted entry to straight "a" students. It is also why medical stuff is relatively unaffordable there.

So they get the benefits of extreme socialism as well as extreme capitalism....  wow.

[Thruster88]

18 hours ago, Ian said:

 

I'm not sure that it's quite as cut and dried and a more nuanced approach could be more productive. The average age of the certified fleet is over 40 years and often their instrumentation reflects that age. For example the plane at the centre of the ATSB investation was a 1980s era certified aircraft. If the plane were equipped with autopilot and more modern instrumentation it may have ended differently. Certainly being able to press a button to fly straight and level after becoming disoriented might have facilitated a better outcome.

In this discussion I am more interested in the pitot aspect than the medical.  If you are suggesting the answer to the mount Gambier crash that killed two innocent victims was for the non instrument rated pilot to press the blue button then you are just another muppet like that person flying the tb10 was.  Have you read the report and looked at the inbound track and weather at time of departure? 

[Ian]

1 hour ago, Thruster88 said:

In this discussion I am more interested in the pitot aspect than the medical.  If you are suggesting the answer to the mount Gambier crash that killed two innocent victims was for the non instrument rated pilot to press the blue button then you are just another muppet like that person flying the tb10 was.  Have you read the report and looked at the inbound track and weather at time of departure? 

No I'm not however the compounding effects of poor decisions may have been mitigated by better technologies. Yes multiple decisions which in hindsight were poor, however in the final instance assistive technologies may have helped. The pilot ultimate ended up in a situation beyond his abilities to manage. Expecting people to consistently make good decisions completely ignores the track record of flying accidents.

 

Seatbelts in modern cars don't mean that you should drive in a more reckless manner however they do save lives. Technology in RPL has demonstrated it's ability to reduce the accident rate by reducing pilot workload.

[Bruce Tuncks]

12 hours ago, Ian said:

Seatbelts in modern cars don't mean that you should drive in a more reckless manner however they do save lives. Technology in RPL has demonstrated it's ability to reduce the accident rate by reducing pilot workload.

While you are probably correct, there is a problem here. Car drivers tend to drive at what they perceive to be constant risk.  This is why annual inspections of cars don't save as many lives as you might expect. The owners of defective cars are only too well aware and drive accordingly.

[turboplanner]

14 hours ago, Ian said:

No I'm not however the compounding effects of poor decisions may have been mitigated by better technologies. Yes multiple decisions which in hindsight were poor, however in the final instance assistive technologies may have helped. The pilot ultimate ended up in a situation beyond his abilities to manage. Expecting people to consistently make good decisions completely ignores the track record of flying accidents.

 

Seatbelts in modern cars don't mean that you should drive in a more reckless manner however they do save lives. Technology in RPL has demonstrated it's ability to reduce the accident rate by reducing pilot workload.

Read the reports;Read the reports; see just exactly what the pilots did to unsuspecting patients.

Its nonsensical to assume a job normally done by a pilot (a) qualified on operations requiring a safe start and safe end on fixed time departure flights (b) qualified on the aircraft suitable for doing that (c) IFR qualified with currency based on weekly IFR flights, can be copied by an old fart escorting passengers to a base touring aircraft and phoning the patient's sister for Met (not referring to any of the flights).

 

As others have mentioned, these are not medivac flights, but a means of moving people from regional airports to the city or back for free.

 

There is an opportunity for a financial model using qualified IFR charter companies to move people faster with a combination of government subsidy and modest fare which would boost the operational hours of the companies giving them critical mass to start low fare feeder operations to the capital cities.

 

[Bruce Tuncks]

For many years, as a student, I drove an "unroadworthy" car. I never had an accident with them, but I sure was mindful that they would never pass an inspection.

The last was a mark 1 Zephyr. Apart from being full of rust, the wipers didn't work on accelerating or going uphill. You needed to momentarily lift your foot to get the vacuum to work and get a bit of wipe.

What I didn't know was that the rear axle was turning into a crystalline mess at the diff. One day it refused to reverse and I found the splined end to be in a thousand bits.