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AVMAD PMO continues to defy logic on bollocks Class 5 medical - Clinton McKenzie in reply?? - 

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Via Oz Flying:

Unpacking the Class 5 Medical
20 February 2024


CASA Principal Medical Officer Kate Manderson spoke exclusively with Australian Flying about what the new Class 5 self-declared medical standard means for aviation and aviators.

A Class 5 medical has been on the GA wish list for several years, but despite Recreational Aviation Australia (RAAus) and several overseas jurisdictions operating on self-declared medical standards, CASA still refused to budge. The only concession was the Basic Class 2, which was only a shadow of what the GA community really wanted.

But the tide began to change with the Class 5 listed on CASA's GA Workplan. It seemed to the GA community that CASA was beginning to flex under the weight of evidence in support of a self-declared medical standard. So what have been the driving motivators that prompted CASA to yield to industry demands?

"What we're trying to do is make it so that more pilots can get a medical certificate more easily, and not making it so that they have to jump through the hoops that are needed for higher-risk flying," PMO Kate Manderson told Australian Flying.

"It's about responding to the industry's requests, but it's also about focusing CASA's attention where it should be, which is higher-risk operations like commercial aviation or ATC, rather than spending too much of our time on people who are low-risk.

"It doesn't do much for our safety system to be spending a lot of time on the private pilot who's flying from A to B on a Sunday afternoon."

That attitude has been informed and reinforced by the experience of RAAus; then CEO Matt Bouttell was on the Technical Working Group (TWG) that placed Class 5 recommendations in front of CASA. RAAus supported Class 5 even though it stood to benefit them none.

"One of the things the group looked at was whether RAAus experienced any safety issues that could have contributed to medical conditions as a result of not having a doctor assess a pilot," Manderson said.

"If an RAAus aircraft had a safety incident like an airspace incursion or flight into terrain, it wasn't because the pilot hadn't seen a doctor; it wasn't a medical certification issue. It wasn't because they had a seizure, their blood sugar was low or they had a heart attack, so we considered a lot of that data and information."

CASA has admitted that they are operating without a lot of data on medical incidents, partly because the Australian Transport Safety Bureau (ATSB) collects no data on the medical class of a pilot involved, and partly because PPLs tend not to report incidents when they disqualified themselves from flying due to a medical issue.

Manderson has called on the GA community to start reporting medical incapacitation to give them measures to evaluate the effectiveness of Class 5

"To be clear, we're not going on a witch hunt for the pilot," Manderson stressed. "We don't want their ARN; we don't want to know exactly who they are, we just want to know if they were Class 1 or 2, BC2, RAMPC or Class 5.

Those restrictions

CASA has imposed controversial and unpopular restrictions on pilots operating under Class 5. Among the no-goes are aerobatics, formation flying, a 2000-kg MTOW limit, a 10,000-foot ceiling and IFR. According to Manderson, the issue is down to whether or not a pilot is capable of self-assessing their medical fitness for these flight activities.

"We are basing the aerobatics exclusion on science and physiology of g tolerance," she points out. "We've got quite a few decades of data on g tolerance, which goes back to centrifuge experiments done internationally.

"That tells us how g tolerance and spatial orientation are affected by certain medication and medical conditions. We know that these reduce g tolerance, which means you are more likely to have an incident or accident.

"We've looked at whether or not these things can be self-assessed, but you can't self-assess cardiac function, blood pressure response or cardiac rhythm response.

"If it's not self-assessable, then it can't be part of a self-declaration."

Formation flying was included in the bans because pilots can't assess their own vision, which ignores that fact that both the GFA and RAAus pilots have been forming-up for years without a demand to have their vision checked.

"The assessment was that with formation flying, it is not possible to self-assess the way the visual and orientation system works." Manderson said. "We acknowledge that RAAus and the Gliding Federation of Australia have plenty of experience flying formation safely.

"But for formation flying to be safe, the pilot needs to have good peripheral vision, visual acuity and depth perception. These are all things that you can't self-assess, and you can't self-assess the diseases that cause problems as well."

The RAAus experience has a habit of contradicting the CASA position, but as a Part 149 Approved Self-administering Aviation Organisation (ASAO) they are free to administer as they like. CASA, however, operates under a risk framework into which Class 5 needs to fit to be implemented.

"We also looked at what size aircraft, number of passengers and where a Class 5 pilot would be able to fly," Manderson said. "This is a multi-layered complex system. One of the TWG members identified that we're adding layers of risk on top of layers of risk.

"Is there a point where we have to stop adding layers? CASA has a bunch of risk management layers that RAAus doesn't have.

"The TWG would have preferred to have had a higher altitude limit of 12,500 feet. But the 10,000 feet limit just comes back to human physiology.
"We’ve taken into account the human physiology and science that comes from many decades of science that determined that 10,000 feet is the point at which even a very healthy human can't maintain their oxygen saturation at reasonable levels."

And as for the 2000-kg MTOW limit ...

"Everyone was pretty happy with the 2000 kg limit," Manderson points out. "There was one dissenting voice, but everyone else was quite satisfied with 2000 kg.

"A lot of work was done by one of the TWG members to actually reference the Australian Civil Register to find out how many aircraft were covered by 2000 kg, and I think it came to 73%.

"Aircraft above that are getting into the multi engine aircraft, complex rotary wing and high-capacity, high-performance aircraft that ought not to be flown on a Class 5."

Exemptions, or lack thereof

Some pilots and aircraft will fall just outside the limits set for self-declared medicals. Why is it safe to fly a 2000-kg MTOW aircraft on a Class 5, but not one with an MTOW of 2010 kg? Surely under those circumstances CASA could provide exemptions? Apparently not.

"We won't be granting exemptions because we wanted to keep it simple," Manderson stated firmly. "The idea is that a large proportion of pilots flying compliant aircraft would be happy to become Class 5. Anyone who wants an exemption can get a Class 2.

"And the other thing is that exemptions would be getting away from the whole point, which is not having to jump through the CASA hoops, which the industry was quite adamant about; they don't want to have to go to a doctor or DAME or get specialist reports.

"If I'm going to give you an exemption, it's going to be based on you giving me evidence to do a risk assessment, which means all the things you didn't want to do."

Surprisingly, CASA is happy for Class 5 pilots to operate in controlled airspace, a volte-face on a vigorously defended position that to do so is unsafe. It is an attitude that has kept RAAus pilots out of CTA for decades. Now CASA admits the safety argument no longer stacks up, and in a huge reversal now considers it more dangerous for self-declared pilots to be excluded from CTA than admitted to CTA.

Kate Manderson: "We unpacked a lot of the assumptions around not allowing self-declared medical pilots into CTA, particularly the assumption that having a medical certificate means you are safer in controlled airspace than you would be outside CTA.

"We talked about how being in CTA might actually make it safer for someone who hasn’t got a medical certificate because now we have a way of making sure that that aircraft doesn’t come near anyone.

"Outside CTA, there’s no-one checking. Inside CTA there are other mechanisms that can be relied on to maintain separation and keep people safe.
"It was thought that having control over the aircraft in CTA was safer than keeping all Class 5s in uncontrolled airspace where we can’t see them."

Applications for Class 5 medicals opened on 9 February, with pilots needing to qualify by completing an on-line course and exam, and verifying that any of a long list of disqualifying conditions don't apply to them. 

So Class 5 is not a free-for-all medical standard, but it is workable for most people in the GA community and is a rare present from a gift horse that has a historical reputation of delivering nothing at all.

Via the UP:

Clinton McKenzie

I’m still recovering from the giddy-spin caused by contemplating the implications of the factual errors and the illogicality of the puff piece about Class 5 in the latest Australian Flying. (Does CASA pay for advertising in Australian Flying?) The text within quotation marks in the article is attributed to the Principle Medical Officer of CASA:

"It doesn't do much for our safety system to be spending a lot of time on the private pilot who's flying from A to B on a Sunday afternoon."

That attitude has been informed and reinforced by the experience of RAAus; then CEO Matt Bouttell was on the Technical Working Group (TWG) that placed Class 5 recommendations in front of CASA. RAAus supported Class 5 even though it stood to benefit them none.

Say what? I think the tortured sentence asserts that Class 5 is of no benefit to RAAus.

Doesn’t the implemented Class 5 protect RAAus’s commercial interests in fact? If an equivalent of UK PMD had been implemented in Australia - as it should have been - a whole fleet of more capable aircraft would have become available to the many RAAus members who could satisfy UK PMD requirements. UK PMD has higher MTOW and higher POB limits than apply for RAAus, and self-certification. With a POB 2 limit, I reckon many potential Class 5 applicants are likely to skip the rigmarole and stay Class 2 or go RAAus.

"One of the things the group looked at was whether RAAus experienced any safety issues that could have contributed to medical conditions as a result of not having a doctor assess a pilot," Manderson said.

"If an RAAus aircraft had a safety incident like an airspace incursion or flight into terrain, it wasn't because the pilot hadn't seen a doctor; it wasn't a medical certification issue. It wasn't because they had a seizure, their blood sugar was low or they had a heart attack, so we considered a lot of that data and information."

This is Alice In Wonderland stuff.

Who’s investigating the medical circumstances of pilots involved in RAAus incidents? Not ATSB. Not CASA. Where is this “data and information” published? If it comes from coronial inquiries – coroners are now the metaphorical ‘last man standing’ on investigation of RAAus fatalities – coroners inquire into ‘traditional GA’ fatalities as well.

But, this, in the very next paragraph:

CASA has admitted that they are operating without a lot of data on medical incidents, partly because the Australian Transport Safety Bureau (ATSB) collects no data on the medical class of a pilot involved, and partly because PPLs tend not to report incidents when they disqualified themselves from flying due to a medical issue.

Manderson has called on the GA community to start reporting medical incapacitation to give them measures to evaluate the effectiveness of Class 5.

So CASA’s admits it is “operating without a lot of data on medical incidents”, but considered “a lot of data and information” about RAAus incidents was sufficient to come to the conclusion that RAAus airspace incursions or controlled flights into terrain incidents were not because "the pilot hadn't seen a doctor; it wasn't a medical certification issue. It wasn't because they had a seizure, their blood sugar was low or they had a heart attack.”

I don’t know what this is intended to mean: “PPLs tend not to report incidents when they disqualified themselves from flying due to a medical issue.” Does that mean not reporting incidents in which they are involved after the pilot disqualified themselves from flying due to a medical issue? How can a pilot be involved in a reportable incident if they aren’t flying?

I suspect it is intended to mean that PPLs tend not to report to CASA circumstances in which pilots have disqualified themselves due to a medical issue. I’ll post the regulation on the matter below, but the ‘bottom line’ is that the holder of a class 2 medical certificate is not obliged to "report" a medical issue to CASA unless, among other things, the issue “continues for longer than 30 days”.

And where is the call for the RAAus ‘community’ to start reporting medical incapacitation to CASA to give CASA measures to evaluate the “effectiveness” of the RAAus arrangements? I know: absence of evidence of incapacitation due to medical issues in the RAAus community is treated by CASA as evidence of absence, but the absence of evidence of incapacitation due to medical issues in the GA community is not treated by CASA as evidence of absence. This is typical ‘cherry picking’ by AvMed.

The assertion that: “the Australian Transport Safety Bureau (ATSB) collects no data on the medical class of a pilot involved” is just bullsh*t. Plain and simple. You can google this stuff. I plucked one ATSB report that has a whole section headed: “Medical and pathological information”:

The instructor held a class 1 aviation medical certificate…

The student held a Class 1 aviation medical certificate …

The examiner held a class 2 aviation medical certificate …

The controller held a Class 3 medical certificate…

The autopsy of the examiner … identified a level of ischaemic heart disease capable of causing death in isolation from other factors, but there was no evidence of an acute cardiac event having occurred at the time of the incident.

No other significant medical issues were identified in any of the remaining pilots. Further, the toxicology results did not identify any substance that could have impaired the pilots’ performance or that were not noted in their aviation medical records.

The PMO seems seriously to be suggesting that CASA has lots of data and information about of RAAus incidents, sufficient for CASA to draw conclusions about the causes of those incidents at least so far as medical issues are concerned, notwithstanding that the ATSB and CASA leave RAAus and coroners to investigate those incidents, but CASA doesn’t have sufficient data to draw the same conclusion in relation to the people who hold certificates issued by CASA over many decades and whose incidents are actually investigated by ATSB occasionally.

On "reporting" of medical issues, here’s what the law says:

67.265(4) If:

(a) the holder of a class 2 or class 3 medical certificate and a licence:

(i) knows that he or she has a medically significant condition; and

(ii) is reckless as to whether the condition has been disclosed to CASA; and

(b) the condition continues for longer than 30 days; and

© the condition has the result that his or her ability to do an act authorised by the licence is impaired;

he or she must tell CASA or a DAME about the condition as soon as practicable after the end of the 30 days.

The first thing to note about that regulation is the “and” at the end of each paragraph. The criteria are cumulative. That means the obligation to report under that regulation does not arise unless all of the criterial are satisfied, and one of those criteria is the continuation of the condition for more than 30 days.

Further, whilst it is true that the definition of “medically significant condition” is Orwellian – it literally includes the words “no matter how minor” - the condition must result in the certificate or licence holder being impaired in his or ability to do an act that’s authorised. Not “might” result, not “could” result and not “probably” result. The words are “has the result”.

The next reg says:

(5) If the holder of a medical certificate and a licence:

(a) knows that he or she has a medically significant condition; and

(b) is reckless as to whether the condition has been disclosed to CASA; and

© the condition has the result that his or her ability to do an act authorised by the licence is impaired;

he or she must not do the act until a DAME certifies that the holder can safely do such acts.

Again, an “and” at the end of each paragraph and the condition must be such that it “has the result” of impairing the holder’s ability to do an act that’s authorised. And note: It’s not an obligation to report anything to CASA. It’s an obligation not to do the specified act until a DAME says the holder is safe to do it. (No doubt DAMEs are under an obligation to ‘tell all’ to CASA. That might partly explain pilots' reticence to raise issues, lest they get back CASA. And on that subject...)

To be clear, we're not going on a witch hunt for the pilot," Manderson stressed. "We don't want their ARN; we don't want to know exactly who they are, we just want to know if they were Class 1 or 2, BC2, RAMPC or Class 5.

Unfortunately, CASA ‘has form’ in saying one thing but doing another. The circumstances in which CVD pilots now find themselves, after 2 years of CASA not doing what it said it was going to do about the OCVA, is a typical example. All on Manderson's watch.

MTF...P2