PTT, Dave Un­win

Pilot - - CONTENTS -

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...

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