PTT, Dave Unwin
Some medicals are supposed to be getting simpler... aren’t they?
They say that ‘the road to hell is paved with good intentions’, and this seems to be the only plausible explanation for the latest medical mistake foisted on the long-suffering GA community by the CAA.
Coincidentally, when the story broke I was enjoying a few days soaring in the Black Mountains, and was thus able to have a sit down with my main medicine man, Dr Peter Saundby. We all know how opaque, oblique and unnecessarily complicated the aviation laws and rules often are, and one of the joys of discussing aeromedicine with Peter is that he clearly understands the subject; as the BGA’S medical advisor for many years he’s written some of it!
Although not as young as he once was (but then who is?) his mind is still as sharp as a scalpel, and with just a few succinct sentences he left me in no doubt that the proposals contained in Civil Aviation Publication (CAP) 1397 and promulgated in the latest revision to the Air Navigation Order (ANO) are fundamentally flawed. Indeed, I’m quite sure that all they have really achieved is to raise significantly the blood pressure of more than a few aviators!
If you’ve not yet seen it, the provisions of EASA Air Operations Annex VII, also known as PART-NCO and contained within the revised ANO (wake up at the back, this is important!), allow for a new type of ‘Self-declaration Medical’ which supersedes the old NPPL Medical Declaration.
Now, at first glance this didn’t seem unreasonable – according to ANO 2016 Article 163 all you have to do is fill in an online form stating that you honestly believe you meet the standards required for a DVLA Group 1 driving licence, and you can then fly up to three passengers in an aircraft weighing up to 5,700kg (i.e. quite big) and even at night or in IMC if suitably rated, within the UK. Sounds good eh? However, dig a little deeper and there is actually a substantial list of ‘disqualifying medical conditions’ that has caused quite a lot of heartburn within the sport pilot community!
I have neither the space nor, frankly, the enthusiasm to detail all the ‘disqualifying medical conditions’ but the one that seems to have caused the most palpitations amongst sporting aviators is ‘any surgery or medical treatment’. Although not as inclusive as it may initially seem, it does appear rather nebulous (perhaps ‘poorly worded’ might be kinder) and also open to interpretation. And of course, if you feel that your circumstances do fall within the remit of the ‘disqualifying medical conditions’ then it’s off to see an AME and try to get an LAPL medical. Some of the pilots I spoke to at the LAA Rally were really quite upset about the whole thing, while others felt that the actual wording of the guidance notes on the CAA website, the declaration form, and ANO Section 163 varied, and a couple told me that the web site didn’t even work properly. Some took the view that if you honestly believe you can meet the standards required for a DVLA Group 1 driving licence then simply proceed on the assumption that the ‘disqualifying medical conditions’ don’t disqualify you, and fill in the form. With my considerable legal experience (well, I did get an ‘O’ level in Law) I can’t help but wonder how well this approach would stand up in a coroner’s court, particularly if third parties were involved.
And it’s managing third party risk that is most important. For some time lawmakers in the US have advocated the doctrine of informed consent, but it seems to me that in some respects this is fundamentally flawed, because potential passengers simply cannot possess sufficient aeronautical knowledge to adequately allow them to assess the risk.
In his capacity as the BGA’S medical advisor, Peter has long advocated that passengers and inexperienced pupils (essentially anyone who could not reasonably be expected to land the glider if their instructor became incapacitated) need a level of protection. Few would argue with this assertion; it simply seems logical.
Now consider the CAA’S approach. As I understand it, the CAA’S thinking (derived from EASA policy) is that an instructor should hold the qualifications to which their pupil aspires. While this is clearly logical with regard to aeronautical qualifications and skill (how can you assess a student’s ability to fly a non-precision approach on one engine if you can’t?) it is specious when applied to medical certification. Why should an examiner conducting an ATPL skills test hold a Class 1 medical certificate? The incapacity risk is zero. Conversely, an air sports instructor responsible for an ab initio pupil clearly does need a higher level of medical fitness, as the incapacity risk is something that has to be taken into account.
Further flaws with the proposals contained in CAP 1397 are that not only are they too complicated for some pilots with a history of certain diagnoses, but there is no clear direction as to what standards or limitations AMES should apply. The experience of the BGA over fifty years is that the private driving licence is an adequate standard for solo flight or with another pilot, and the BGA has not suffered third party casualties by accepting a driving licence or equivalent as evidence of fitness. Does the CAA not trust the DVLA? However, when inexperienced persons are carried as either a passenger or pupil, higher medical standards should be met by the instructor, as the BGA’S policy has always been to match medical oversight against third party risk.
My diagnosis is that this system seems to be both pragmatic in principle and practical in application, something that the proposals in CAP 1397 clearly aren’t.
A long list of ‘disqualifying medical conditions’... The proposals in CAP 1397 are too complicated for some pilots...