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Private Pilot Licence medical certification requirements __________________________________________________________________

Consultation Document April 2017

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Contents

Providing Your Feedback .................................................................................. 3

Executive Summary ........................................................................................... 5

Status quo and problem .................................................................................... 5 Background ....................................................................................................................................... 5

New Zealand’s PPL sector .................................................................................................... 5 Class 2 medical certification .................................................................................................. 6 International developments ................................................................................................... 7 Occurrences involving medical issues in the private flying sector .................................. 8

What is the problem? ...................................................................................................................... 8 Risk in the PPL sector ............................................................................................................ 9 Standard of medical fitness ................................................................................................... 9 Cost of a PPL .......................................................................................................................... 9

Objective .......................................................................................................... 10

Options ............................................................................................................. 10 Retain the status quo ..................................................................................................................... 10 Develop an alternative CAA standard ........................................................................................ 10 Adopt the commercial driver licence medical certificate (with passenger

endorsement) ...................................................................................................................... 11 Private driver licence medical standard ...................................................................................... 12 Self-declaration ............................................................................................................................... 12

Conclusion ....................................................................................................... 13

Next steps ........................................................................................................ 13

Feedback Form ................................................................................................ 24

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Providing Your Feedback The Civil Aviation Authority (CAA) is seeking your feedback on the potential for the development of alternative medical certification requirements for the Private Pilot Licence (PPL).

In particular, we would like your views on the following questions:

1) What is your view on the current PPL medical certification standards? 2) What is your view on adopting an alternative CAA medical standard? 3) What is your view on adopting the commercial driver licence medical standard? 4) What is your view on adopting the private driver licence medical standard? 5) What is your view on a self-declaration system? 6) What medical conditions, if any, do you think should prevent a pilot from flying on a reduced

medical standard and why? 7) Are there any other systems you think the CAA should be considering? What are they and

why? 8) The new United Kingdom Private Pilot Licence (UK PPL) restricts pilots to three passengers,

and the new FAA private licence with a BasicMed restricts pilots to five passengers. What number of passengers do you think pilots flying on a lower standard of medical certification should be restricted to, if any, and why?

9) The new UK PPL restricts pilots to non-EASA1 aircraft of no greater than 5,700 kg Maximum Certified Take-off Weight (MCTOW). The new Federal Aviation Administration (FAA) BasicMed restricts pilots to aircraft authorised to carry up to six seats and with an MCTOW of no greater than 6,000 pounds (approximately 2,721.5 kg). What do you think is an appropriate size of aircraft for private pilots flying on a reduced medical standard, and why?

10) Given the nature of the risk posed by PPL holders may be mitigated to some extent by the prevalence of single engine aircraft in the private and recreational sector, should a PPL with any reduced standard of medical certification be limited to the operation of single engine aircraft? If not, why?

11) Do you think private pilots flying on a reduced standard of medical certification should have restrictions placed on the altitude at which they can fly? If so, why, and what do you think the restrictions should be?

12) Do you think private pilots flying on a reduced standard of medical certification should be able to fly IFR operations? If so, why?

13) Do you think private pilots flying on a reduced standard of medical certification should be able to fly at night? If so, why?

14) Should private pilots operating on a reduced standard of medical certification be able to perform aerobatics? If so, why, and what, if any, other restrictions do you think could be put in place to limit the risks associated with medical incapacitation?

15) Do you have any further comments?

Feedback on the proposal must be provided to the CAA by close of business on Monday 19th June 2017. The official feedback form can be found at the end of this document.

Email: consultation@caa.govt.nz

Post: Elizabeth Bolton Senior Policy Advisor

Civil Aviation Authority

1 https://www.caa.co.uk/General-aviation/Pilot-licences/Introduction-to-licensing/What-is-a-non-EASA-aircraft-/

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PO Box 3555 Wellington 6140

We are also available to meet with you to discuss this review and receive your feedback in person. To arrange a meeting, please contact us with your preferred time and place.

Please note that, once received, submissions become public information that can be requested under the Official Information Act 1982. Please indicate clearly if any part of your submission is commercially sensitive, or if for any other reason you do not want it disclosed.

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Executive Summary 1. The Civil Aviation Authority (CAA) is consulting on whether or not an alternative Private Pilot

Licence (PPL) should be developed that allows for a lower standard of medical certification. The CAA is also seeking views on what a suitable alternative standard of medical certification might be, taking into account the costs and benefits associated with the various options.

2. New Zealand pilots operating on a PPL must hold a Class 2 medical certificate. The New Zealand PPL, including the medical standard, is aligned with the International Civil Aviation Organization (ICAO) standard. Other types of private/recreational licences in New Zealand have medical requirements based on domestic medical standards of a non-aviation specific nature. Internationally, some states, including the United Kingdom and the United States, have developed or are in the process of developing an alternative private licence with lower medical standards.

3. The nature of the risks associated with medical incapacitation in the PPL sector in New Zealand are such that they are considered to be relatively low, based on reported occurrences and the characteristics of the sector. When the standard of medical fitness associated with obtaining and maintaining a Class 2 medical certificate are balanced against the nature of the risks, the current requirements may be disproportionate.

4. The objective of this review is to consider whether the medical certification standard for the PPL can be reduced without inappropriately reducing levels of safety. This includes identifying potential alternative medical certification standards.

5. Options considered as part of this analysis include:

· retaining the status quo;

· introducing an alternative aviation medical certificate;

· requiring PPL holders to obtain a commercial driver medical certificate with passenger endorsement medical certificate;

· requiring PPL holders to obtain a private driver licence medical certificate; or

· introducing a self-declaration system.

6. All options have associated costs and benefits. All alternatives to the status quo are associated with the potential for an increased level of risk to differing degrees in that they rely on lesser standards of medical certification. This potential risk is mitigated to some extent by the operating characteristics of the PPL sector, with pilots generally not exercising the full range of available PPL privileges. Any decision to introduce one of the options considered as part of the analysis may need to reflect these factors in the form of reduced privileges as a means of mitigating any increased level of risk.

7. This review does not consider changes to the medical certification for the ICAO PPL or Part 149 pilot certificates. Regardless of the outcomes of this analysis, New Zealand pilots will continue to have the option of the ICAO PPL standard with a Class 2 medical certificate, or the pilot certificates issued by Part 149 organisations and the associated medical standards.

8. The CAA medical certification fee is also outside the scope of this review.

Status quo and problem Background New Zealand’s PPL sector

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9. Currently, aeroplane, helicopter, and glider pilots operating privately may apply for a PPL. There is no PPL equivalent for private balloon pilots. Subject to holding the relevant ratings, a PPL holder may:

· act as pilot-in-command or a co-pilot of an aircraft for which the pilot licence is granted and for which the pilot holds a type rating;

· carry passengers with no restrictions;

· fly in accordance with the Instrument Flight Rules (IFR) subject to holding an Instrument Rating;

· fly at night;

· operate outside New Zealand;2

· fly cross country; and

· perform aerobatics.

A PPL holder may not operate for remuneration, or hire or reward.

10. At 1 January 2017 there were 12,174 recorded PPL holders, 2,065 of which held an active Class 2 medical certificate, and 320 of which held an active Class 1 medical certificate.3

Class 2 medical certification 11. Medical certification is designed to ensure that licence holders are physically and mentally

able to perform their duties, and that they are not at risk of medical incapacitation.4 The ICAO Manual of Civil Aviation Medicine defines medical incapacitation as “any physiological or psychological state or situation that adversely affects performance”.5

12. In order to exercise the privileges of a PPL, the pilot must hold at least a Class 2 medical certificate. This is aligned with the ICAO standard. To obtain a Class 2 medical certificate, a general medical examination must be undertaken five yearly when the holder is under 40 years of age, and two yearly once the holder is over 40. The medical examination is conducted by an Aviation Medical Examiner (AME). In addition, other tests including electrocardiograms (ECGs), cardiovascular risk estimations, blood lipid and blood sugar estimations, chest x-rays, spirometry, and audiometry, are required at various intervals, depending on the age and health of the pilot.

13. The types of tests required for a Class 1 medical certificate, and a Class 2 medical certificate are similar. The general level of medical fitness required for a Class 2 medical certificate is lower, however, and more flexibility is likely to be applied to a Class 2 medical assessment.6 Differences, where they exist, between a Class 1 and a Class 2 medical certificate relate to the frequency of testing, special vision examinations, and distance and intermediate visual acuity. A detailed comparison is set out in Appendix 1.

14. The cost of obtaining a Class 2 medical certificate is related to the age and health of the pilot. Costs in routine cases range from approximately $560 - $800. Costs include the medical

2 Subject to recognition and any restrictions imposed by the state the pilot is operating in.

3 The PPL is a lifetime licence. The number of active medical certificate holders represents the number of pilots eligible to exercise the privileges of the licence.

4 International Civil Aviation Organization, Manual of Civil Aviation Medicine, p I-2-i.

5 International Civil Aviation Organization, Manual of Civil Aviation Medicine, p 1-3-1.

6 International Civil Aviation Organization, Manual of Civil Aviation Medicine, p V-1-3.

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assessment, any additional tests, and the fixed CAA medical certification application fee. The CAA fee is currently $272.17 (excluding GST). This will reduce to $105.00 (excluding GST) on 1 July 2017. The cost of a Class 1 medical certificate, required for all types of commercial licence, is similar, albeit that the frequency of certification and testing will result in comparatively greater cost increases over time.

International developments 15. Several countries have recently reviewed and have made, or are making changes, to the

medical certification standards for the PPL that involve the acceptance of medical certification standards lower than those of the ICAO Class 2 medical certificate.7 The United Kingdom (UK) introduced a UK PPL in 2016, and the United States Federal Aviation Administration (FAA) has recently introduced the BasicMed rules, both of which establish an alternative private licence with a lower standard of medical certification. The Australian Civil Aviation Safety Authority (CASA) has also issued a discussion document requesting submissions on medical certification standards, including for the PPL and recreational licences.

16. Under the new UK PPL, participants are able to sign a declaration attesting to their medical fitness (a Pilot Medical Declaration). Pilots declare that they meet the Driver and Vehicle Licensing Agency (DVLA) Group 1 Ordinary Driving Licence (ODL) standard. A pilot will not be able to self-declare where he or she is flying an aircraft with a Maximum Take-Off Mass (MTOM) between 2,000 kg to 5,700 kg, and is suffering from certain conditions.8 In addition, pilots flying aircraft with an MTOM of less than 2,000 kg and taking medication for any psychiatric illness will not be able to use the self-declaration system. In both cases the pilot will need to visit an AME and apply for a Light Aircraft Pilot Licence medical certificate

17. The new FAA BasicMed rules9 introduce a self-declaration system which will allow pilots to operate without an FAA medical certificate. In order to be able to take advantage of the self-declaration system, the pilot must: hold a medical certificate issued by the FAA; or have held a FAA medical certificate at any point during the past ten years; or subsequently obtain a FAA medical certificate, prior to entering the system. The most recent FAA medical certificate held by the pilot cannot have been revoked, suspended, or withdrawn, and an application cannot have been denied within the preceding 10 years. Pilots will need to complete an online medical education course within the two years prior to an application, and biannually thereafter. Pilots will not be able to use the new system where they have been diagnosed with a mental health or neurological condition, and the pilot’s medical specialist considers that the pilot is unable to, or is at risk of, being unable to fly safely. Furthermore, a pilot may not use the system where the pilot’s driver licence has been revoked as a result of a clinically diagnosed mental health condition. Additional requirements apply to pilots with mental health disorders, neurological disorders, or cardiovascular conditions.

18. Both the UK PPL and the new FAA private pilot licence are associated with reduced privileges in relation to a range of areas of operation, including:

· aircraft size;

· aircraft power;

· the numbers of passengers carried;

· IFR operations;

· night flying;

7 See Appendix 2 for a detailed comparison of alternative PPLs and recreational pilot licences in New Zealand, the UK, the United States of America, and Australia.

8 See Appendix 2 for details of the conditions which disqualify pilots from using the new system.

9 The regulations come into effect on 1 May 2017.

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· altitude; and

· speed.

The restrictions reflect the physiological risks posed by certain activities, and the consequences associated with medical incapacitation. For example, flying at certain altitudes may have implications for some medical conditions, while restrictions on passenger numbers reflect the level of risk society is willing to accept in terms of the consequences of any safety failure. A detailed overview of restrictions associated with alternative private/recreational licences in the UK, the United States, and Australia is set out at Appendix 2.

Occurrences involving medical issues in the private flying sector 19. Occurrence reporting provided to the CAA shows that between 1995 and 2015, there were 18

reported occurrences involving private pilots and medical issues. The reported occurrences include medical incapacitation. In some cases medical incapacitation cannot be definitively identified as a contributing cause of the accident due to the fatal nature and circumstances of the accident limiting post-mortem investigation and analysis. Table 1 also includes occurrences where it was later discovered that the pilot did not hold a current medical certificate, albeit that medical incapacitation was not identified as a causal factor or the main causal factor in the accident or incident.

Table 1

20. Of the occurrences cited in Table 1, seven held a PPL (not all of those pilots held a current

medical certificate), while one pilot was flying on an American pilot licence at the time, but also held a New Zealand PPL and Class 2 medical certificate. Five of the occurrences involved pilots flying on certificates issued by Part 149 organisations. Three of the pilots were flying privately on commercial licences at the time of the occurrence. The licence type for one of the occurrences is unknown.

21. In terms of the consequences, 14 of the 18 reported occurrences resulted in fatalities, with 22 fatalities in total. Seven of the fatalities were passengers. 11 of the fatalities involved PPL pilots. No serious injuries were recorded.

What is the problem? 22. Analysis of reported occurrences and the type of flying undertaken by PPL holders in New

Zealand indicates that the nature of the risk associated with medical incapacitation amongst

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PPL holders in New Zealand could be relatively low. The nature of this risk may not warrant the standard of fitness required by, and the cost of, the Class 2 medical standard.

Risk in the PPL sector 23. The relatively low level of reported serious occurrences involving medical issues in the PPL

sector could suggest that there may be a relatively low risk of medical incapacitation and non-compliance with the relevant medical standards.10 The potential remains that occurrences with less serious consequences are not always reported to the CAA, and that those occurrences that do come to the CAA’s attention, tend to do so as a result of the significant consequences.

24. In terms of the private flying sector at as a whole, five occurrences were reported in relation to Part 149 organisation pilot certificates, and no occurrences involving medical issues have been reported in relation to RPL holders since its introduction in 2008. Holders of an RPL and a Part 149 organisation pilot licence are not required to hold a Class 2 medical certificate. The lack of reported occurrences in the RPL sector indicates that a reduced standard of medical certification in the private flying sector is not necessarily associated with an increase in reported occurrences involving medical issues. It is accepted that some of the risk is reduced via limitations on the privileges of both licences, and that the RPL has been an option for a relatively short period of time.

25. Not only is the reported incidence of medical incapacitation and non-compliance with medical certification requirements relatively low in the PPL sector, but the type of flying undertaken by private pilots in New Zealand considerably lessens the consequences of safety failure resulting from medical incapacitation for pilots, passengers and third parties. For example, New Zealand private pilots typically carry a small number of passengers. Of the private flying hours reported to the CAA in 2015,11 19,236.69 related to four seater aircraft, followed by 9,942.04 in two seater aircraft, and 5,392 in six seater aircraft. In addition, New Zealand private pilots generally fly lower powered aircraft compared to those operating in commercial sectors. In 2015, 39,665.57 hours were reported in relation to single engine aeroplanes and helicopters. By comparison, 2,191.31 private flying hours were reported in relation to twin engine aeroplanes and helicopters. Furthermore, anecdotal evidence suggests that despite the wide range of privileges allowed by the PPL, New Zealand PPL pilots are typically flying VFR, at low altitudes, during daylight hours, in good weather, and often in sparsely populated and non-built-up areas.

Standard of medical fitness 26. The types of tests required for a Class 2 medical certificate and a Class 1 medical certificate

are similar. This is despite the greater degree of risk posed by commercial pilots to passengers and third parties in the event of a safety failure resulting from medical incapacitation. The reasoning for the similarity in the types of testing is that while PPL holders cannot fly for hire or reward, they can, in principle, fly very large and powerful aircraft, internationally and at high altitudes and speeds. In New Zealand, however, PPL holders are typically flying small, low powered aircraft over sparsely populated and non-built-up areas, and during daylight hours. The risk posed by New Zealand PPL holders, in practice, may not be commensurate with the risk associated with exercising the full range of available PPL privileges.

Cost of a PPL 27. The Class 2 medical assessment costs approximately $560 - $800, possibly more in some

cases. In addition, the costs are ongoing and will increase as the pilot ages. Based on prices advertised online by medical practitioners, the difference between the cost of obtaining a Class 2 medical certificate, and the cost of obtaining a Class 1 medical certificate required by

10 Refer to Appendix 3. 11 The obligation to report flying hours for non-hire and reward operations applies to New Zealand registered aircraft issued with a standard category airworthiness certificate or a restricted category airworthiness certificate.

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commercial pilots are not significant. This is despite the level of risk being comparatively lower in the PPL environment. As noted, there is an assumption inherent in the ICAO Class 2 standards that PPL pilots may potentially exercise the same privileges as a commercial pilot (apart from operating for hire and reward) insofar as factors such as aircraft size, speed and operating altitude are concerned.

Objective

28. The objective of this review is to determine whether medical certification standards for the PPL can be reduced without inappropriately reducing levels of safety. This includes identifying any appropriate alternative standard. An alternative medical certification system would need to be associated with a standard of medical fitness and costs that are commensurate with the nature of the risk posed by PPL holders.

Options Retain the status quo

29. The status quo is associated with a relatively low accident rate. In addition, the current PPL medical certification standards are aligned with the ICAO standard.

30. Retaining the status quo will not address the possible imbalance between the standard of medical fitness and the cost of gaining Class 2 medical certification, and the nature of the risk posed by the typical New Zealand PPL pilot.

31. While the RPL and Part 149 organisation pilot certificate do offer an alternative to pilots flying privately, both are associated with restrictions on privileges. Restrictions on size, passenger numbers and night flying limit the range of activities that may be undertaken. The UK CAA and the FAA have determined that a middle ground is required in terms of offering private licences with reduced medical standards and associated restrictions, but with a greater range of privileges than existing recreational licences.

Develop an alternative CAA standard

32. In order to accommodate the nature of the potential risk associated with PPL operations, the CAA could develop an alternative aviation medical standard. This would be tailored to the particular risks associated with the private pilot environment, and retain the elements of medical certification considered necessary to ensure aviation safety. The ability to tailor the medical certificate to the aviation sector would ensure that elements of medicine of particular relevance to aviation would be included. This is unlike using the medical certification systems of another sector which may not fully reflect the particular physiological risks posed by flying, or the consequences associated with medical incapacitation in flight.

33. The development of an aviation specific medical certificate administered by the CAA would also enable the CAA to retain oversight of the medical certification of PPL holders. This would continue to provide the CAA with assurance that the medical certificates meet the requisite standards, are properly issued and assessed, and effectively manage any risks within the system.

34. The CAA medical certification administration fee and the cost of visiting a specialised AME form part of the overall cost of Class 2 medical certification. The administration fee is a standard fee that applies to all CAA medical certificates and appropriately reflects the cost to the CAA of administering the medical certification system. Introducing an aviation medical certificate administered by a General Practitioner (GP) may alleviate some of this cost, albeit that the status of the certificate as an aviation medical certificate may be compromised. Due to the limited reduction in costs to the sector associated with an alternative aviation medical certificate, it is likely that private pilots may still be faced with costs that are potentially disproportionate to the relative risk posed by the sector.

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35. Developing a new aviation medical standard would likely involve some material but as yet unquantified level of cost for the CAA. The development of the standard itself would require significant resources from the CAA medical team. Once adopted, the CAA would still be responsible for the administration of the new standard. Administration associated with an additional aviation medical standard has the potential to divert medical resources away from other aviation sectors, including medical certification associated with the higher risk commercial sector. The diversion of resources away from higher risk sectors has the potential to impact on safety and may be counterproductive. The CAA Regulatory Operating Model accepts that oversight of the private and recreational sector is required, but assigns less resource to this area due to the lower consequences of failure and impacts on third parties.12

Adopt the commercial driver licence medical certificate (with passenger endorsement)

36. Drivers operating commercially in New Zealand are required to demonstrate a higher standard of medical fitness than private users of motor vehicles,13 and must produce a New Zealand Transport Authority (NZTA) medical certificate when applying for or renewing their licence. Applicants must meet a standard of medical fitness that would be expected for a driver taking fare paying passengers or operating a heavy vehicle. The standard of medical fitness while comprehensive is not as high as the Class 2 aviation standard, and may better reflect the nature of the risk posed by the New Zealand PPL sector.

37. An application for a commercial driver licence medical certificate is assessed by a GP rather than an AME. The level of additional testing associated with the commercial driver licence is lower than the additional testing required for a Class 2 medical certificate, and would be associated with a decrease in costs for the individual pilots. The costs of obtaining a commercial driver licence medical certificate include the cost of visiting a GP (quotes online range from $45 to $135), plus the cost of any additional tests.

38. Since 2008, pilots have been able to obtain an RPL which relies on the commercial driver licence medical standard. There has been a notable uptake of the RPL since its introduction. Despite the move to the lower standard, to date there have not been any reported occurrences involving pilots flying on an RPL where medical issues have been identified. This may in part be due to the limitations on privileges associated with the RPL, and its relatively recent introduction.

39. A change in medical standards to the commercial driver licence standard may be commensurate with the nature of the risk. Pilots would be subject to a comprehensive medical assessment, but at a lower level than the current Class 2 requirements. This would significantly reduce the cost associated with medical certification. An RPL pilot is required to have undertaken the same programme of training and testing as a PPL pilot. If the commercial driver licence medical standard were to be accepted as a suitable alternative, then there would be no material difference between the licences. On this basis, consideration would need to be given to whether the co-existence of the two licences was necessary.

40. Adopting the NZTA medical certificate may raise concerns in relation to oversight, as the NZTA medical certificate is based on standards provided for in land transport legislation and guidance. The CAA has no input into the development of the legislation or guidance. Unlike a Class 1 or 2 certificate issued by an AME, the CAA does not regulate GPs issuing the certificate. From this point of view, there is limited ability to exercise oversight of GPs issuing NZTA medical certificates.

41. To date, no serious issues have come to light with oversight by the CAA in the context of the RPL. Applicants must still submit a copy of the completed medical assessment form to the CAA. While the medical certificate for the RPL is not associated with the same level of scrutiny or specialist expertise as the Class 2 medical certificate, the requirement to submit a

12 The CAA Regulatory Operating Model, Version 2, 5 February 2014, p 7.

13 NZTA, Medical aspects of fitness to drive, A guide for health practitioners, p 8.

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completed copy of the form to the CAA ensures that records are held in relation to each pilot, and may be referenced where concerns arise.14

Private driver licence medical standard 42. Some private drivers also require a medical certificate. For example, those over 75 must

obtain a medical certificate periodically to retain their driver licence. The private driver licence standard differs from the commercial standard in a number of respects including in relation to: epilepsy; neuromuscular conditions; brain tumours; locomotor conditions; vision; serious head injuries and intracranial lesions; insulin dependent diabetes; hearing; and mental health.15

43. Both private flying and non-commercial driving are private activities. The risks associated with both relate to risks to self and non-fare paying passengers, and other users of the same area, for example the same airspace or the same stretch of road. It could be argued that the reduced risk to third parties posed by private pilots is commensurate with the risk posed by private drivers.

44. The nature of the risks associated with PPL flying, however, is considered to potentially justify a higher medical standard than that provided by the private driver licence. While a private vehicle may cause damage and loss of life when involved in a vehicle accident, any event involving an aircraft has the potential to cause considerably more damage and loss of life via the potential for collisions with other aircraft, buildings, and persons on the ground. Furthermore, it is problematic in the aviation environment for a pilot or an untrained passenger to take action in an aircraft in flight in the event of the sudden onset of any significant event of pilot medical incapacitation. The lower medical standards in the private driver licence medical certificate may not be sufficient to mitigate these risks.

45. The lower standards in relation to psychological health in the private driver licence medical assessment are also of particular concern, due to recent high profile accidents where the pilot committed or may have been attempting suicide.16 This has been an issue in New Zealand relatively recently; in 2014, a private pilot suffering from depression is believed to have intentionally crashed his small aircraft into the ocean.17

Self-declaration 46. Requiring PPL holders to fill out a form declaring whether or not they have relevant medical

conditions will alleviate concerns associated with the cost of obtaining a medical certificate. This option would remove the need for a visit to a GP and any additional testing associated with medical certification.

47. A self-declaration system would place the onus on the pilot to declare his or her medical fitness, rather than relying on medical expertise. If one assumes that a private pilot generally only flies when feeling well due to the recreational element of the activity, then by extension, a pilot will only declare him or herself fit to fly when assured of his or her own health. Similarly, if there is a change in the health of the pilot, the pilot will be less likely to undertake a recreational flight as there is no commercial pressure to do so.

48. Conversely the lack of medical oversight places the pilot, passengers and third parties at considerable risk. A pilot may feel physically well despite underlying medical issues and legitimately declare that he or she has no known medical issues due to a lack of diagnosis.

14 One exception is the medical certificate for RPL student pilots, which does not need to be submitted until the pilot applies for a licence.

15 NZTA, Medical aspects of fitness to drive, A guide for health practitioners, http://www.nzta.govt.nz/assets/resources/medical-aspects/docs/medical-aspects.pdf . 16 For example the Germanwings accident of March 2015.

17 Accident number 14/1266.

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This would place reliance on an individual’s honest but uninformed opinion as to his or her own health and fitness to fly.

49. The complete reliance placed on the pilot’s honesty also places the system at risk of abuse. While this is a risk within the current system in terms of information disclosed to an AME or a GP, the risk is mitigated by mandatory testing and oversight by a medical professional. The occurrences in Table 1 include four instances where the pilot did not have current medical certification,18 two instances where the pilot chose to fly despite considerable personal stress,19 and one incident where the pilot stole an aircraft while suffering a mental health condition.20 These examples of either deliberately choosing to fly despite known medical problems, or exercising poor judgement when under stress, suggest that there remains a risk that pilots may choose to declare themselves medically fit to fly, despite being at risk of physical or psychological incapacitation.

50. A self-declaration system could potentially result in number of pilots remaining the system who, by their own assessment, are physically and psychologically well, but may not pass the requirements of a medical test, of whatever nature, due to a lack of diagnosis of relevant medical conditions.

Conclusion

51. Preliminary analysis indicates that the nature of the risks associated with medical incapacitation amongst PPL holders in New Zealand are such that they may not always justify the standard of medical certification and the cost associated with a Class 2 medical certificate.

52. Options considered as part of this analysis include: retaining the status quo; an alternative CAA medical certificate; the NZTA commercial driver licence medical standard; the NZTA private driver licence medical standard; and a self-declaration system.

53. All options are associated with costs and benefits, and all options involving a change to the status quo, involve a potentially increased level of risk exposure to differing degrees in that they include lesser standards of medical certification.

54. The potential risk posed by PPL holders is significantly reduced by the nature of PPL activities in New Zealand, which generally do not reflect the full extent of all available PPL privileges. A decision to introduce a lower medical standard based on the nature of the risks in question may need to reflect these mitigating factors in the form of reduced privileges.

55. This consultation is intended to test the results of our initial analysis, establish the costs and benefits associated with the options identified, and collect further information on privileges in the context of any increased risk.

Next steps · Following consultation, the CAA will analyse all submissions received. · Based on this analysis, the CAA will consider whether to progress with a formal proposal for

the introduction of new medical standards via a Civil Aviation Rule (CAR) amendment. · Any decision to propose an amendment to the CARs would be taken in conjunction with the

Ministry of Transport and follow the normal policy development process. · If a decision were made to develop a proposal to amend the CARs, a bid would need to be

made to include the proposed changes on the Rules Programme. This is subject to Ministerial and Cabinet approval.

18 Accident numbers 97/315, 98/2360, 01/2660 and 14/1266.

19 Accident numbers 09/3231 and 98/2354.

20 Accident number 05/2992.

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· If a change were to be included on the Rules Programme, the CAR development would follow the usual processes, including the publication of a Notice of Proposed Rulemaking.

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Appendix 1

CAA Class 1 and 2 medical examination requirements timetable and standards

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Appendix 2 Comparison of alternative private/recreational pilot licences in New Zealand, the UK, the USA and Australia

New Zealand RPL New UK PPL

(UKPPL and NPPL)

FAA PPL with reduced medical certification21

CASA PPL with reduced medical certification – the Recreational Aviation Medical Practitioner’s Certificate (RAMPC)22

Size Act as pilot-in-command of a single engine non-pressurised aeroplane with a MCTOW of 2,000kg or less, for which the pilot holds an aircraft type rating; or act as pilot-in-command of a single engine helicopter with a MCTOW of 1,500kg or less, for which the pilot holds an aircraft type rating.

Non-EASA aircraft23 with a weight limit of 5,700 kg.

Authorised to carry up to six seats and with a MCTOW of no more than 6,000 pounds (no limitations on horsepower, number of engines, or gear type).

Recreational aircraft only which are: single-engine aircraft; certified for single-pilot operations; certified with a maximum take-off weight of no more than 1500kg; and not rocket or turbine powered.

Passengers One passenger (provided the passenger has been informed that the pilot does not hold a medical certificate issued under the Act).

Up to three. Up to five. One passenger provided that prior to boarding the aircraft, the passenger has been told that he or she holds a RAMPC that is of a lower medical standard than a class 1 or class 2 medical certificate and also has conditions associated with it.

The limitations on the number of passengers you can carry do not apply if you have another pilot with you who occupies a flight control seat, has either a class 1 or 2 medical certificate and is authorised to pilot the aircraft.

IFR/VFR No IFR. IFR requires EU Class 2 audiogram. Day and night VFR and IFR. No IFR.

Night flying No night flying. Yes with colour vision test. Day and night VFR and IFR. No night flying.

Aerobatics No aerobatics. Not stated. Not stated. No aerobatics.

21 https://www.faa.gov/news/updates/media/final_rule_faa_2016_9157.pdf

22 PPL holder using a Recreational Aviation Medical Practitioner’s Certificate (RAMPC). The RAMPC is based on is based on a modified unconditional driver’s licence medical certificate for a private motor vehicle.

23 http://www.caa.co.uk/General-aviation/Pilot-licences/Introduction-to-licensing/What-is-a-non-EASA-aircraft-/

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Speed Not stated. Not stated. Cannot exceed 250 knots indicated airspeed Not stated.

Airspace Must not fly into or out of a controlled aerodrome unless the licence holder has provided the Director with evidence of a successful colour vision screening test. Must not fly over a congested area of a city or town, except for the purpose of take-off and landing.

Not stated. Up to 18,000 feet above mean sea level. You can only fly below 10,000ft.

The limitations on flight above 10,000ft do not apply if you have another pilot with you who occupies a flight control seat, has either a class 1 or 2 medical certificate and is authorised to pilot the aircraft.

Restrictions on holding alternative medical certification

Disqualifying conditions listed in the NZTA Medical aspects of fitness to drive – a guide for medical practitioners.

The pilot must visit an AME and apply for a Light Aircraft Pilot’s Licence (LAPL) medical certificate if the pilot has experienced any of the following and is flying an aircraft greater than 2,000 kg MTOM: being prescribed medication for any psychiatric illness; Bipolar disorder, psychosis or a diagnosis of personality disorder; drug abuse or alcohol misuse or addiction (or conviction for drink/drug driving); being prescribed medication or treatment for angina or heart failure; cardiac surgical procedures including cardiac device implantation; recurrent fainting or collapse (syncope); unexplained loss of consciousness; insulin treatment; chronic lung disease with shortness of breath on exertion; any neurological condition requiring medication; seizures or epilepsy; significant functional physical disability likely to impair safe operation of normal flight controls.

If the pilot is flying an aircraft of less than 2,000 kg MTOM, and taking medication for a psychiatric illness, the pilot must consult an AME and apply for a LAPL medical certificate.

The pilot must:

· hold a medical certificate issued by the FAA; or

· have held a FAA medical certificate at any point during the 10 year period preceding the date of enactment; or

· obtain an FAA medical certificate after the date of enactment.

The most recent medical certificate issued by the FAA cannot have been revoked or suspended, cannot have been withdrawn, and an application cannot have been denied within the preceding 10 years.

Where a person has a mental health disorder, a neurological disorder or a cardiovascular condition, the person must obtain an Authorisation for Special Issuance of a Medical Certificate.

Persons with a clinically diagnosed mental health condition, or neurological condition, may not use BasicMed if the person’s medical specialist considers that the person is unable to safely exercise BasicMed privileges, or may reasonably be expected to make the individual unable to exercise BasicMed privileges. A person is also prohibited from using BasicMed where the

A pilot will not be able to use the RAMPC where the pilot has any of the following conditions: Blackouts; Acute Myocardial Infarction; Angina; Coronary Artery Bypass Grafting; Percutaneous coronary intervention (PCI) e.g. angioplasty; Atrial Fibrillation Paroxysmal arrhythmias (e.g. SVT atrial flutter, idiopathic ventricular tachycardia); cardiac arrest; Cardiac Pacemaker; Implantable cardioverter defibrillator (ICD); ECG changes: Strain patterns, bundle branch blocks, heart block; Aneurysms - abdominal and thoracic; Valvular heart disease; Dilated Cardiomyopathy; Hypertrophic Cardiomyopathy; Congenital Disorders; Heart Failure; Heart Transplant; Hypertension; Syncope; Diabetes treated by glucose lowering agents other than insulin; Insulin-treated diabetes; Musculoskeletal Disorders; Dementia; Seizures and Epilepsy; Ménière’s disease; Aneurysms (unruptured intracranial aneurysms) and other vascular malformations of the brain; Head Injury; Neuromuscular conditions; Stroke; Space-occupying lesions (including brain tumours); Subarachnoid haemorrhage; other neurological conditions; psychiatric conditions; sleep apnoea; Narcolepsy; Substance use disorder; Visual Fields; Monocular vision; Diplopia; Cancer; ECG changes; heart failure; hearing; physical limitations; transient ischaemic attacks (TIA); Multiple Sclerosis; Cerebral Palsy; Parkinson’s disease; head Injury; Renal

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person’s driver’s licence is revoked by the issuing agency as a result of a clinically diagnosed mental health condition.

calculus disease; Vestibular disorders; CASA Audit; and Visual Acuity.24

Validity periods To be issued every five years. If the person is 40 years of age or older, the medical certificate must have been issued within the previous 24 months

Pilots will need to complete a form on the CAA website to declare that they meet the DVLA medical standard. Pilots under 70 will need to do this once, while pilots over 70 must confirm their declaration every three years.

The pilot must undergo a medical examination by a state licenced physician every four years.

The pilot will also need to complete a medical education course in the 24 months prior to acting as a pilot in command of a covered aircraft and demonstrate proof of completion. This will need to be renewed on a biannual basis.

A RAMPC is valid for up to 24 months from the date it is signed by the medical practitioner. If you are 65 or older, the certificate is valid for up to 12 months.

24 http://services.casa.gov.au/avmed/pilots/info/rampc/rampc_disqualify.asp

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Appendix 3 Reported occurrences in the New Zealand private flying sector where medical issues have been identified (1995 to 2015)

Date Accident number Licence Medical certification Possible cause Fatalities

09/02/1997 97/315

PPL (No current medical certification)25

No current medical certification

Engine failure rather than medical incapacitation. The pilot had been issued with a letter informing him that he was considered permanently unfit to fly.

None

28/08/1998 98/2360

PPL (No current medical certification)

No current medical certification (previously held a Class 2)

The pilot could not obtain a medical certificate for medical reasons. The cause of the accident could not be determined.

Two

26/08/1998 98/2354 Unknown Unknown The pilot was under personal stress at the time as he was conducting an aerial search for a missing vessel. His friend was on the vessel. The aircraft struck a powerline and then an electric fence on landing.

None

11/05/1999 99/1311

PPL Class 2 The pilot may have suffered an in-flight incapacitation. Three

04/01/1999 99/1 FAI gliding certificate Gliding medical certificate The pilot had severe coronary artery disease. The pilot’s gliding medical certificate and declaration did not disclose his cardiac history.

One

19/12/2000 00/4122

TAIC report number 00-015

CPL/PPL Current Class 2 (Class 1 had expired)

The pilot had previously had his medical certificate suspended following a vehicle accident. The pilot had a history of behavioural problems. The pilot was considered medically fit at the time of the accident, as the legislation at that time (2000) did not permit the CAA to make a person medically unfit for behavioural problems.

Three

07/08/2001 01/2660

PPL (No current medical certification)

The pilot did not hold any form of current medical certification

The pilot died as a result of a cardiac event, the onset of which occurred in flight.

One

17/12/2003 03/3668 FAI Gliding Certificate, Silver Badge

Medical Declaration and Certificate

Post-mortem examination showed that the pilot died of multiple injuries consistent with a high speed impact. The pathologist commented that although these injuries were the final cause of death there was a lesion present on the brain that may have contributed to loss of control of the aircraft.

One

17/09/2005 05/2992 CPL Class 1 The aircraft was stolen from Ardmore. The pilot threatened to fly the aircraft into the Sky Tower eventually landing in the water off

None

25 The PPL is a lifetime licence. The number of active medical certificate holders represents the number of pilots eligible to exercise the privileges of the licence.

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Kohimarama. The pilot was suffering with mental health issues at the time.

26/04/2008 08/1753

PPL Class 2 The autopsy found that the pilot had significant heart disease. A medical condition leading to an episode of pilot incapacitation or distraction could not be fully ruled out. The CAA medical opinion was that such an event was unlikely to have directly contributed to the cause of the accident.

Two

28/10/2009 09/4139 Gliding NZ Qualified Glider Pilot Certificate

Gliding New Zealand Medical Declaration and Certificate

Post-mortem examination determined that the cause of death was from internal injuries. The post mortem indicated the pilot had coronary heart disease (unsuspected).

One

21/08/2009 09/3231 ATPL Class1 and Class 2 The PA28 unintentionally strayed close to the Whenuapai ILS so an aircraft on approach was instructed to stop its descent. The pilot of the PA28 was eventually contacted and given directions to continue to North Shore. The pilot's relative had recently passed away. The pilot admitted that he was stressed and grieving when he made mistakes.

None

27/09/2010 10/3704 RAANZ certificate Novice Shiftweight

RAANZ The information available suggests that the pilot most likely suffered some form of in-flight medical incapacitation and was unable to return the aircraft to controlled flight. Toxicology blood tests found therapeutic levels of anti-depressant medication in the pilot’s blood so medical opinion is that it was likely that he was still taking his medication. A 20mm thickness of the wall of the left ventricle of the heart was also noted. A cardiologist review of the post mortem findings noted that that thickness ‘suggests significant left ventricular hypertrophy’ which can also be associated with increased likelihood of cardiac arrhythmia.

One

20/03/2011 11/1148 PPL Class 2 The pilot had a heart disorder (myocarditis). It could not be determined whether this was a contributory factor in the accident.

One

18/01/2012 12/181 Gliding New Zealand B certificate

Class 2 During the final phase of flight, the fact that no apparent attempt was made to recover the glider suggests that the pilot may have experienced some degree of incapacitation; however this could not be positively established. Although the pilot was wearing a parachute there was no apparent attempt made to bail-out of the glider and use the parachute. This could also suggest that the pilot had been incapacitated to some degree.

One

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On balance of the information available it is considered that the cause of the accident may have been due to some degree of pilot incapacitation.

30/03/2013 13/1524

The pilot held a New Zealand PPL but was flying on an FAA licence at the time

FAA medical certificate and a New Zealand CAA Class 2 medical certificate

It appears that the pilot knowingly did not disclose to the FAA or the CAA that he had been diagnosed with a Generalised Anxiety Disorder (GAD) or Major Depressive Disorder (MDD), or that he was taking medication to treat that diagnosis. Had the pilot declared the diagnosis of GAD or MDD, or the medication that he was taking for his condition, it is likely that neither the FAA nor the CAA would have issued him with a medical certificate.

Two

25/03/2014 14/1266 PPL (No current medical certificate)

No current medical certification

The pilot is believed to have deliberately crashed his aircraft into the ocean. The pilot had a history of psychiatric illness and had been acting out of character in the period leading up to the crash.

One

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Feedback Form

The questions posed in the “Providing Feedback” section of this document are reprinted below. This feedback form is also available as a separate document on our website. We are also interested in any views you may have that are not covered by these questions. Please submit your response by close of business Monday 19th June 2017 to: consultation@caa.govt.nz

or

Elizabeth Bolton Civil Aviation Authority PO Box 3555 Wellington 6140

Name of Submitter Interest in this consultation Contact details

Question number

1 What is your view on the current PPL medical certification standards?

2 What is your view on adopting an alternative CAA medical standard?

3 What is your view on adopting the commercial driver licence medical standard?

4 What is your view on adopting the private driver licence medical standard?

5 What is your view on a self-declaration system?

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6 What medical conditions, if any, do you think should prevent a pilot from flying on a reduced medical standard and why?

7 Are there any other systems you think the CAA should be considering? What are they and why?

8 The new UK PPL restricts pilots to three passengers, and the new FAA private licence with a BasicMed restricts pilots to five passengers. What number of passengers do you think pilots flying on a lower standard of medical certification should be restricted to and why?

9 The new UK PPL restricts pilots to non-EASA aircraft of no greater than 5,700 kg MCTOW. The new FAA BasicMed restricts pilots to aircraft authorised to carry up to six seats and with an MCTOW of no greater than 6,000 pounds (approximately 2,721.5 kg). What do you think is an appropriate size of aircraft for private pilots flying on a reduced medical standard, and why?

10 Given the level of risk posed by PPL holders may be mitigated to some extent by the prevalence of single engine aircraft, should a PPL with a reduced standard of medical certification be limited to single engine aircraft? If not, why?

11 Do you think private pilots flying on a reduced standard of medical certification should have restrictions placed on the altitude at which they can fly? If so, why, and what do you think the restriction should be?

12 Do you think private pilots flying on a reduced standard of medical certification should be able to fly IFR? If so, why?

13 Do you think private pilots flying on a reduced standard of medical certification should be able to fly at night? If so, why?

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14 Should private pilots operating on a reduced standard of medical certification be able to perform aerobatics? If so, why, and what other restrictions do you think could be put in place to limit the risks associated with medical incapacitation?

15 Do you have any further comments?

Please note that once your submission has been received it becomes public information that can be requested under the Official Information Act 1982. Please indicate clearly if any parts of your submission are commercially sensitive or if there is any other reason that you do not want that information to be disclosed.