Obligations on medical practitioners to advise the CAA
He says New Zealand’s Civil Aviation Act, which obliges medical practitioners to advise the CAA if they have any concerns that their pilot or air traffic controller patient’s medical condition may interfere with aviation safety, is one of the strongest legislations in the world – and provides medical practitioners with complete protection for disclosure.
“The Act overrides the Privacy Act and the threshold for reporting is very low. A GP only has to suspect that a pilot or air traffic controller’s condition may interfere with aviation safety. Basically, if they have a question in their mind, that’s generally enough.
“Apart from the effect of medications, recreational drug and alcohol use are of concern to us. Even occasional use of recreational drugs is unacceptable. Similarly, if a GP feels their pilot patient is drinking excessively, we want to know. We consider drinking above the Health Promotion Agency’s safe limit to be a yellow flag.”
There are around 9,000 active pilots and air traffic controllers in New Zealand with a current medical certificate and 45 designated medical examiners who are able to issue the certificates on behalf of the Director of the CAA.
A big part of the work of Claude and his team is issuing accredited medical conclusions (AMCs). A favourable AMC allows flexibility to be applied where a pilot has a condition considered to be of aeromedical significance (for example, one which may compromise flight safety). The AMC will specify restrictions that may apply, such as the pilot being cleared to fly only if there are two pilots in the cockpit.
“It’s a robust system. Everything is peer reviewed and co-signed,” says Claude. “Sometimes, the process we undertake to reach the conclusion will include obtaining a copy of the GP notes. These can be useful in giving us a better feel for the issues under consideration. Occasionally they reveal an important condition that has not been disclosed.”
Pilots and air traffic controllers must also notify the CAA when there is a change in their medical condition. “Some pilots will ground themselves, as they are required to do, but they are still obliged to tell the CAA. We have the occasional one who doesn’t. Sometimes it’s a genuine oversight, sometimes it is not.
“Of course, they may have an optimistic view on their fitness to fly. That’s why we need GPs to report to us. Unless we are told, we may not know.
“I remember one case where the GP was extremely reluctant to report the pilot because they were concerned about breaching privacy. They must do so. As far as I know, there’s never been any negative consequences on a reporting GP.”
Claude says the benefits of our legislation are evident. “In 2015, when a German pilot committed murder-suicide by deliberately crashing the plane he was piloting, killing all 150 people on board, neither the aviation authority nor the airline knew he was mentally unwell, even though several doctors did, but didn’t report it.”
GPs are welcome to phone the CAA – anonymously, if they wish – to discuss any concerns they may have about a pilot or air traffic controller patient. “From there, the next step for the GP will be clearer. In some cases, we can say it’s not a concern and it doesn’t need to be taken any further.”