The price of safety

The price of safety

When a Pel-Air Westwind jet left Samoa bound for Melbourne on an air ambulance flight, no doubt the pilots and passengers expected a fairly routine, if long and tiring flight. What they flew into is a storm that threatens to engulf more than their own tea cup. Ian Cameron, ITIJ’s editor in chief, stirs the waters  

First published in ITIJ 108, January 2010

When a Pel-Air Westwind jet left Samoa bound for Melbourne on an air ambulance flight, no doubt the pilots and passengers expected a fairly routine, if long and tiring flight. What they flew into is a storm that threatens to engulf more than their own tea cup. Ian Cameron, ITIJ’s editor in chief, stirs the waters

On the evening of 18th November, the pilots of the Pel-Air aircraft, operating on behalf of Careflight International, made several abortive attempts to land on Norfolk Island, their designated re-fuelling stop, in poor and deteriorating visibility. Having failed to land the aircraft and with a critically low fuel level the pilot decided to ditch into the sea just off the Island’s coast (see ITIJ issue 107, December 2009, Air Ambulance in deep water). That the pilot managed to land the aircraft in the sea, in the dark and in rough weather is no doubt a testimony to his flying skills as a pilot. The subsequent rescue, however, owes more to luck (and the skills of the islanders) more than to any plan.

The pilot failed to issue a mayday call prior to ditching and they were only located by the sight of the light on one of the lifejackets. Norfolk Island is also notorious for rough seas, so much so that boats are rarely moored in the sea around the island; rather they are launched from land when weather permits. It is also renowned for frequent fog and poor visibility.

All the more surprising then, that the pilot took off with sufficient fuel only for his primary destination, and not enough to reach a secondary destination as mandated by the CASA – (the Civil Aviation Service of Australia), which basically says that if you’re making a journey to one airport, you should carry enough fuel to get to a secondary destination should you be unable to land at your primary destination for any reason (see Box 1, CASA regulations).

All the more surprising then, that the pilot took off with sufficient fuel only for his primary destination

John Sharp, the Pel-Air chairman and former Australian minister of transport, has admitted that there was ‘no plan B’ in place for that particular air ambulance repatriation. The pilot took off from Apia having checked that the weather at Norfolk Island was OK (at that time) and with sufficient fuel only for that journey, which is exactly what the regulation was designed to prevent.

So what exactly is the relevance of a supposedly one-off incident, off a small Pacific island, miles from anywhere, to insurers?

Abide by the rules

Quite simply, this has everything to do with travel insurance and anyone who is involved in the use of air ambulance services around the world. Pel- Air, like all commercial and private aircraft operators, has clear guidelines and rules to follow on any flights that they operate that are laid down to them, in this case by CASA.  And it is safe to say that virtually all of the world’s airspace is governed by similar authorities (The Federal Aviation Administration in the US , Civil Aviation Authority in the UK, LBA in Germany etc), all of which have (necessarily) similar rules and regulations governing  aircraft operations within their airspace.

If you take the example of the major scheduled commercial carriers, the application of these rules and regulations are very clear to see. It is unthinkable that a pilot of a major commercial airline such as American Airlines or Lufthansa could or would be able to take a decision to fly without sufficient fuel for a diversion to an alternative airport. Even if there was one rogue pilot who tried to do just that, the systems in place at the airlines, at the airports and the sheer numbers of people involved in the dispatch of such an aircraft, pretty much precludes that possibility.

For the smaller, privately chartered aircraft, which air ambulances predominantly are, the situation is totally different. For the most part, air ambulance organisations are relatively small. As such, the pilot and the company will have a greater degree of control over what happens with their aircraft, and it would be virtually impossible to provide continuous external independent monitoring for each flight.

This lack of monitoring therefore means that application of such rules and regulations can be open to abuse.

It is important to stress here that no-one is suggesting that all insurers or assistance companies are contracting air ambulances on an ad-hoc and price-driven basis. To the contrary, the vast majority have strict guides as to which companies they can use, and have conducted rigorous audits on their suppliers to ensure compliance with the most exacting of standards.  The same is true of the vast majority of air ambulance operators, who day in and day out provide a service that the industry can be proud of.

Pressure changes

The air ambulance market is a ruthlessly competitive market, however, and for a few insurance and assistance companies, price will be the prima facia motive for choosing one operator over another. As such, air ambulance operators are constantly being forced to look at ways to increase their competitive edge, and there is no doubt that if there is one company out there that is found to ‘cut corners’, then there will another 20 that will do it just to be able to match the first company.

For the most part, air ambulance organisations are relatively small. As such, the pilot and the company will have a greater degree of control over what happens with their aircraft

Ultimately, the responsibility for compliance, at least in operational matters such as fuelling, is with the pilot. However, it is perfectly understandable that a pilot might be prepared to ‘bend’ rules under pressure from a company that is keen to keep costs down. One only has to look at the number of unemployed pilots, particularly in the US, to realise that if you don’t do it, someone else might.

Should he or she therefore choose to ignore those regulations, unless things go horribly wrong, (as in the case of the Pel-Air pilot,) nobody will ever know.

And as more aircraft and operators continue to enter the market, the pressure to be competitive, get work and keep your aircraft flying can become greater. And you can therefore understand why an operator will take the risk of flying with sufficient fuel only for the primary destination if they thought there was no chance of a problem. Flying with extra fuel causes extra fuel burn from the weight of the fuel, which then results in extra costs to the operator. If your margins are that tight it may well be the only way to make a profit.

As long as anyone involved in the chartering of air ambulances is prepared to base the award of a contract or individual flight based primarily on the cheapest price, then incidents such as the Pel-Air crash are going to happen again and again. It is ridiculously short sighted to allow price alone to dictate the award of a contract on this basis.

It is essential that anyone involved in using air ambulances, be they insurers, assistance companies or another ancillary service connected to the industry, sit down to work out a table of what would be a reasonable price for an air ambulance operation, based on the variable factors of aircraft type, distance and medical crew etc., before offering any repatriation out for tender. Air ambulances must be able to make a reasonable profit. And insurers must know they are paying a fair price for services rendered.

With this system, you would have a least a degree transparency, and perhaps even a modicum of trust. But most importantly, there would be a chance we could help ensure that all air ambulances flew under the regulations that were design to avoid the avoidable, such as the Pel-Air incident.

The alternative to this is really unthinkable, but ultimately there will be more incidents, and the likelihood that the outcome will be as fortunate as the Pel-Air flight is slim to non-existent. No matter which company you are, big or small, you (or your PR people) try explaining to grieving relatives and the press why you chose the cheapest option.