Contrary to the hopes of most French helicopter EMS operators, French doctors have issued a motion calling for the soon-to-be-mandatory second flight crewmember to be a trained paramedic. New rules at the European level will mandate such a second crewmember, for some operations, beginning in October next year.

The additional cost of a second pilot would be prohibitive for hospitals, in the opinion of the French Association of HEMS doctor-users (AFHSH). The association therefore proposes training a paramedic for those missions when a “second pair of eyes” is needed in the front seats, Nicolas Letellier, president of the AFHSH, told AIN. The new rule will apply when a helicopter carries a patient from an unprepared site to a hospital in day VFR conditions. The person seated next to the pilot would be tasked only with helping him “see and avoid” in the landing phase, under the AFHSH’s proposal.

Rarely, such flights are operated at night. On those occasions, once the patient is on board, the paramedic would occupy the left seat for the entire flight. The doctor would be alone with the patient, but Letellier does not see this as a problem, thanks to the medical equipment on board and the short duration of the flight–usually no more than 10 or 15 minutes.

Except in some hilly areas of the country, most HEMS flights in France are urgent transfers from one hospital to another, in day or night VFR. Such operations will remain single-pilot. France is the only European country where HEMS operations are flown with a single pilot (without any other crewmember), but “we have recorded zero accidents since 1997,” Letellier notes. Under the current regulation, the operator would train the paramedic under a program approved by the national civil aviation authority.

The idea of having to pay a second crewmember has long been unpalatable for French hospitals, as they would receive no more money to cover the cost of the addition, the Ministry of Health maintains.

While the majority of French operators are understood to be reluctant to see a paramedic–instead of a second pilot–assisting the pilot, at least one supports the idea. Frédéric Goig, CEO of Inaer France (Avincis group), favors the idea. “Let’s use somebody already on board, instead of adding 180 pounds,” he told AIN. He also emphasized the importance of technology, such as night-vision goggles and autopilots, and expressed the opinion that the helicopter industry is lagging behind the rest of air transport in terms of safety and IFR equipment.