APPENDIX: THE GOVERNMENT RESPONSE
Introduction
This paper sets out the Government response to the
Committee's update report on Air Travel and Health, published
on 12 December 2007.
The Government welcomes the Committee's continuing
interest in this subject. The Government also welcomes the Committee's
recognition that much has changed for the better in this area
following its previous inquiry in 2000.
The Government's response incorporates contributions
provided by the Department for Transport (DfT), HM Treasury (HMT),
the Department of Health (DoH), the Civil Aviation Authority (CAA),
the Health and Safety Executive (HSE) and the Department for Innovation,
Universities and Skills (DIUS). In each case the Committee's recommendation
is reproduced followed directly by the Government response.
Regulatory Arrangements
Recommendation 5.1 We welcome the establishment
of the AHU within the CAA. However, we recommend that the AHU
and the CAA work together with Government departments and the
aviation industry in raising the profile of its work so that it
becomes the focus for airlines, passengers and health care professionals
in their quest for information on aviation health matters. The
AHU should become the body responsible for handling queries and
complaints from passengers on health issues and should publish
guidelines on how those queries will be handled.
Government response
We consider that the Aviation Health Unit (AHU) has
made significant strides since its inception. But we agree there
is scope to raise its profile. In the course of 2008 we intend
to consult colleagues about transferring the chairmanship of the
inter-departmental Aviation Health Working Group (AHWG) from the
DfT to the Head of the AHU. This means that the AHU would have
more visible responsibility for aviation health issues in the
UK. The Department would however retain responsibility for the
continuing study into the cabin air environment. DfT would also
expect to remain fully engaged as the Government Department with
statutory responsibility for the health of persons on board aircraft.
The Committee recommended that the AHU should become
the body responsible for handling aviation health queries and
complaints. In relation to queries, the Government considers it
does not make sense to take responsibility away from airlines,
especially airlines which have developed medical departments.
We should not wish to discourage airlines from maintaining their
own expertise and engaging with their own customers. Moreover
many queries should start with the passenger's General Practitioner
who knows the individual's medical history. The AHU should certainly
be a back-up for GPs, hospitals and airlines and an alternative
avenue of information for passengers.
In relation to complaints, the Committee heard evidence
that few passenger complaints are received about aviation health.
Again the Government would not wish to disturb the normal practice
that complaints about any aspect of airline experience should
go first to the airline concerned. Nor would we wish to prevent
passengers raising aviation health complaints with the Air Transport
User's Council (AUC), especially as a passenger may have more
than one subject of complaint. The AUC certainly knows it can
refer specialist issues to the AHU.
In addition, the AHU reviews any Mandatory Occurrence
Reports received by the Safety Regulation Group of CAA which refer
to health.
The AHU's web page already gives post, telephone
and email contact details. The CAA has ensured that its
general enquiry points also have this information to hand. Communication
within the CAA has been focussed by presentations from the head
of the AHU and the Health and Safety Adviser to ensure that staff
are aware of the responsibilities of the Authority in relation
to health.
Recommendation 5.2 We agree with the House
of Commons Transport Committee that the United Kingdom cannot
and must not transfer any further responsibilities from the CAA
to EASA until it is clear that EASA is competent to exercise such
responsibilities. We recommend that the Government make the strongest
possible representations to the European Commission and EASA that
the high priority afforded to aviation health in the United Kingdom
as a result of the work of the AHWG, the CAA and the AHU must
be replicated within EASA.
Government response
The Government supports the development of a comprehensive
European regulatory system, centred on an effective European Aviation
Safety Agency (EASA), as part of its commitment to establish and
maintain a high, uniform level of aviation safety across Europe.
The Regulation to extend EASA's competence to air operations and
flight crew licensing is expected to be adopted in the next few
weeks. The Government, together with the CAA, will continue to
work through the Management Board to promote institutional reform
within EASA and ensure that the Agency delivers an efficient,
high quality safety regime.
Recommendation 5.3 We applaud the Government
for having taken the steps necessary to make aviation health a
priority. The United Kingdom has always been at the forefront
in aviation issues and our regulatory arrangements continue to
be seen as a model by other countries. However, we recommend:
- that the Memorandum of Understanding
between the HSE and the CAA, and in particular its Annex 8, should
spell out who has specific responsibilities for the health and
safety of passengers;
Government response
The CAA and the HSE have good contacts and meet regularly
to look at the arrangements between them. They will consider afresh
whether Annex 8 of their Memorandum of Understanding can be given
greater clarity with regard to their shared responsibility for
the health and safety of air passengers.
The context in which that shared responsibility operates
is set by the different legal and jurisdictional boundaries of
the bodies concerned. The CAA, which has jurisdiction throughout
the UK, has responsibilities under the Civil Aviation Act 2006.
The HSE, which has jurisdiction in GB (there is a separate HSE
for Northern Ireland), has responsibilities under s.3 of the Health
and Safety at Work Etc, Act 1974. Neither the HSE nor the CAA
can act on health and safety matters outside UK/GB boundaries,
or in relation to passengers or crew on board foreign aircraft.
CAA does not yet have enforcement powers for its new statutory
function in relation to the health of persons on board aircraft.
But it is intended to amend the Air Navigation Order (ANO) to
provide these powers.
- that the HSE and CAA review
the interpretation of "occupational health" as it applies
to air crew, to ensure that emerging health issues are adequately
reflected in regulatory arrangements.
Government response
All parties, including the Government, the CAA and
the HSE share the Committee's view that emerging health issues
should be adequately reflected in regulatory arrangements. All
are members of the AHWG which enables good contact with stakeholders
in respect of aviation health issues.
CAA and HSE consider the specific duties under the
Civil Aviation Act 2006 and the requirements for the maintenance
of adequate health and safety protection for crew members, set
out in Regulation 6 of the Civil Aviation (Working Time) Regulations
2004, provide an adequate regulatory framework to respond to any
current or emerging health issues.
Research
Recommendation 5.4 We recommend that the Government
fully support Phase II of the WRIGHT Project including investigations
on flight-related factors which may increase the risk of VTE,
the relationship between seating and VTE, and effective preventive
measures.
Government response
This Government agrees in principle with the Committee's
recommendation to support Phase II of the World Health Organisation
Research Into Global Hazards of Travel (WRIGHT) study, aimed at
finding how to reduce safely the risk of travel-related venous
thrombosis. The researchers wish to study two groups: those at
high and intermediate risk. The second group would involve several
tens of thousands participants. Any research on such a scale must
be considered in the context of air travel as a global phenomenon.
The UK was the only individual nation to contribute to Phase I.
We believe a European or international collaboration would be
appropriate to raise the required funds for Phase II.
Recommendation 5.5 We recommend that the Government
bring forward an amendment to Section 23 of the Civil Aviation
Act 1982 which regulates the use of information from air crew
medical records, so that anonymised data can be extracted and
used to carry out epidemiological research projects.
Government response
The Government is sympathetic to the Committee's
view and the CAA's view that anonymised pilot medical records
should be made available for epidemiological research studies.
In light of both medical and economic benefits to be achieved
from sharing such information, the Government will look into how
appropriate changes might be introduced into the Act when a legislative
opportunity arises.
Recommendation 5.6 We recommend that jet lag
should be studied as a confounding effect of DVT as part of Phase
II of the WRIGHT Project. Other research projects, such as FACE
should include jet lag in their studies. We also recommend that
the CAA, as the body responsible for the health and safety of
air crew while on board an aircraft, commission a study into the
possible long-term health effects that jet lag may have on air
crew.
Government response
The second phase of the WRIGHT study seeks to investigate
effective and safe interventions to reduce the risk of symptomatic
thrombosis associated with long travel.
The AHWG will consider, alongside other priorities,
whether there is a gap in knowledge about the possible long-term
health effects that jet lag may have on air crew and a proven
hypothesis to justify further work.
The FACE project (Friendly Aircraft Cabin Environment)
completed its work in 2006. It addressed environmental comfort
parameters which depend on noise vibration and air quality. The
project was co-ordinated by Alenia Aeronautica of Italy. A link
is attached.[3]
Recommendation 5.7 We recommend that in addition
to contributing to international research projects, the Government
and the Research Councils explore ways to increase the research
capacity in aviation health that exists within the United Kingdom.
A strong research base in this country is essential if awareness
and understanding of aviation health are to be increased across
the wider medical profession.
Government response
The Government recognises the importance of a joint
approach to aviation research. We agree that there are clear benefits
in forging a link between the AHU, the Research Councils and University
Departments. This recommendation will be taken forward through
the Head of the AHU.
The Department for Innovation, Universities and Skills
(DIUS) provides funding to Research Councils through the Science
Budget to support the whole range of their activities. Research
Councils recognise the need to support a strong research
base and will continue to support world class research within
and across all disciplines and research areas through
their responsive mode funding schemes. In continuing their support across
the UK research base, Research Councils must take into account
their priorities which have been set for the Comprehensive Spending
Review period.
The Medical Research Council (MRC) currently funds
a range of research which could be of relevance to aviation health,
this includes:
- research into infection and immunity
some of which may have relevance to infections acquired or spread
during air travel. The MRC Centre for Outbreak Analysis and Modelling
at Imperial College London has the mission to understand how best
to control epidemics using public health measures, travel restrictions,
drugs and vaccines and will look at diseases such as Severe Acute
Respiratory Syndrome (SARS) and avian influenza;
- providing long-term funding to Professor A J
Harmar's team at the University of Edinburgh for their research
on the control of peripheral circadian rhythms. This research
will increase our understanding of the mechanisms by which circadian
rhythms are controlled and the impact of these rhythms on physiology
and metabolism. It may lead to a better understanding of jet-lag,
and ways to prevent or treat it;
- co-funding the Clots in Legs Or sTockings after
Stroke (CLOTS) Trial—A Randomised Trial to Establish the
Effectiveness of Graduated Compression Stockings to Prevent Post
Stroke DVT—run by Professor M Dennis' team at the University
of Edinburgh. The results of the trial may have some relevance
to DVT in air travellers.
Recommendation 5.8 We find surprising and
frustrating the number of EU-led research projects that have not
published their reports. We recommend the Government should take
an interest in these projects and if possible expedite the publication
of their results.
Government response
The Head of the AHU is Medical Chair of the Ideal
Cabin Environment project (ICE) sponsored by industry and the
European Commission. We remain mindful of the need to maintain
confidence in EU-led research projects. This can only be achieved
through polices that embrace robust commitments to timely research
delivery. Therefore AHU will explore options for engaging with
the Commission on the expedient delivery of research where appropriate.
The Cabin Environment
Recommendation 5.9 We recommend that the CAA
implement the recommendations of its own research into aircraft
seating standards, and increase the regulatory minimum distance
between seats to at least 28.2 inches. The Government should also
make the strongest possible representations to EASA on this subject
when they take over responsibility on this issue.
Government response
The purpose of the research commissioned by the CAA,
"Anthropometric Study to Update Minimum Seating Standard",
was to ensure that seating standards are such that passengers
would be able to evacuate an aircraft quickly in the event of
an emergency.
There is no scientific evidence to determine a proven
link between the increase in aircraft seating legroom—and
in particular the relatively small increase specified—and
the promotion of health. The Committee's report in 2000 advised
against using the concept 'economy class syndrome' for DVT, and
we agree.
Any move to increase the minimum seat pitch will
have to be taken on a European-wide platform by EASA once it assumes
responsibilities for regulation of operations. Many long-haul
flights already operate above the minimum.
Deep Vein Thrombosis
Recommendation 5.10 We recommend that the
Government urgently review the level of air passenger duty levied
on "premium economy" seating. We further recommend that
they explore ways in which the airlines can be encouraged to offer
extra space to passengers for a modest premium.
Government response
In the final sentence of paragraph 4.2 the report
"agrees with BATA that premium economy seating should be
taxed at the standard rate of Air Passenger Duty (APD)";
we assume that the Committee means the reduced rate of APD, as
premium economy seating currently attracts the standard rate.
The APD liability of premium economy seating was
considered by HM Revenue and Customs (HMRC) as part of their consultation
'Air passenger duty: Consultation on the definition of class of
travel'. The outcome of this consultation, which closed on 31
July 2007, was that reducing the APD liability of premium economy
travel would add considerable complexity to the system and would
lead to an estimated overall revenue loss of £70 million.
A summary of the responses to this consultation has been published
on HMRC's website (www.hmrc.gov.uk).
The Chancellor announced, at the 2007 pre-budget
report, the Government's intention to replace APD with a per plane
based tax from November 2009, which would remove any distinction
between classes of travel. A further consultation document was
published on 31 January 2008, and the consultation closes on 24
April.
Recommendation 5.11 We recommend that the
Government and the AHU work together with airlines and others
in providing consistent travel advice to passengers on the risks
associated with self-medicating with the intention of preventing
DVT.
Government response
The Government agrees that consistent evidence-based
information is essential in providing advice on possible interventions
to reduce the risk of DVT. In 2004 the AHWG commissioned Synovate
Healthcare to carry out a study aimed at quantifying the extent
of aspirin usage amongst UK long-haul aircraft passengers, which
appeared to be 20 per cent.
We recognise the importance of consistent and accurate
advice on the risks associated with self-medicating, with the
intention of preventing DVT. To this end, information covering
the relevant Frequently Asked Questions (FAQ) on the AHU website
will be modified in accordance with research findings. We shall
also raise this at the AHWG in order to promote industry-wide
consistency of information to passengers.
Infectious Diseases
Recommendation 5.12 We recommend that the
Government and the airlines advise passengers on the proven benefits
of good hand hygiene in the reduction of disease transmission
and in particular that passengers clean their hands before eating
on board an aircraft. In the event of a disease outbreak that
could lead to a pandemic, we recommend that as part of their contingency
plans airlines flying from affected regions should provide bactericidal
wipes and alcohol gels to limit the spread of disease in-flight.
Government response
The Government takes seriously the public health
responsibility it has to encourage behaviours that minimise disease
transmission. The DoH advises the general public about the importance
of hand and respiratory hygiene. Last year, the Department sponsored
public health information campaigns stressing the importance,
amongst other things, of hand-washing. The campaigns were targeted
at the population as a whole and were not specific to the travelling
public. In normal circumstances, eating on board an aircraft is
no different to eating elsewhere, and we do not see a particular
need for a message to passengers.
Generally, airlines provide aircrew with guidance
on how to manage symptomatic passengers (or crew) in flight, in
accordance with the World Health Organisation and the International
Air Transport Association (WHO/IATA) guidance, and this would
be reinforced in the event of a pandemic.
In addition, airlines typically offer passengers
the use of a scented hand wipe. An alcohol hand rub would probably
be the most effective hand hygiene measure on board flights and
can be obtained in miniature dispensers. Whilst it is debatable
whether the use of the recommended measure would prevent any contagious
disease by someone who is incubating the illness and asymptomatic
throughout the flight, we would encourage airlines to consider
supplying the hand rub particularly during a disease outbreak
that could lead to a pandemic.
Recommendation 5.13 We recommend that the
Government and the regulators limit the amount of time that passengers
can remain in an aircraft when the ventilation systems are non-operational
to 30 minutes.
Government response
Generally, aircraft on the ground are provided with
ventilation via either the Auxiliary Power Unit or ground power.
However, we do not agree with the recommendation to set a limit
of 30 minutes on the time passengers are on-board without ventilation
systems. There are a number of reasons that preclude timely departure
or arrival times, and each case is dependent on the particular
circumstances. Additionally, the wide variations in parameters
such as temperature, humidity and airflow (doors open or closed)
would make a single time limit impractical. Passengers would not
necessarily welcome being evacuated after 30 minutes if the loading
and unloading delayed their flight.
Nonetheless, we encourage airlines and airport operators
to discuss and explore appropriate options in accordance with
their own policies and procedures including the conditions prevailing
during such delays. This topic has been discussed at length in
the Aviation Occupational Health and Safety Group. The AHWG will
remind airlines and airport operators, via their associations,
to ensure that they have developed and communicated appropriate
policies and procedures. For example, BALPA's Cabin Operating
Temperature—Guidance to Crews, available from the BALPA
Flight Safety Department, is a useful document outlining key issues
and possible mitigations of discomfort.
Air Crew Occupational Health
Recommendation 5.14 We are reluctant to recommend
the modification of CAP 371 until more evidence is presented.
We recommend, however, that the Government together with the CAA
(including the AHU), the unions and airlines work together to
find a way of ensuring that pilots have appropriate rest periods
and to monitor fatigue complaints by pilots. We also recommend
that the CAA, as the body responsible for the health and safety
of air crew while on board an aircraft, commission a study into
the long-term effects of fatigue in air crew.
Government response
The Government accepts this recommendation. The CAA
has, since the inception of CAP 371 Avoidance of Fatigue in
Air Crews and based on a recommendation in the Bader Report,
provided a forum for industry stakeholders to review and advise
the CAA on aircrew fatigue issues. The forum consists of experts
representing the breadth of activities within the aviation industry,
including cargo, short and long haul operations, together with
representation from pilot associations, and medical and sleep
research experts.
This body reviews data from the Confidential Human
factors Incident Reporting Programme (CHIRP), the Mandatory Occurrence
Reporting Scheme (MORS) and associated Air Safety Reporting System
(ASRS) which provides a means of identifying fatigue related safety
issues, for subsequent review and action by the CAA.
In addition, the CAA maintains an open approach in
encouraging aircrew to report fatigue related safety issues to
flight operations inspectors, and flight standards staff, as a
means of obtaining feedback on actual operating conditions.
This has now led the CAA to develop a continuous
improvement approach to the management of flight time limitations.
As a result, the quality of roster planning and delivery will
be improved with lower levels of work cycle disruption, which
detracts from crew performance and alertness, both in the short
and long term. As part of this process improvement, operators
will be required to implement a Fatigue Reporting System, in conjunction
with Fatigue Awareness and Countermeasures Training, leading to
more sustainable work patterns.
As the industry moves towards a more systematic and
objective approach to Fatigue Risk Management, operators will
also be able to utilise the SAFE fatigue analysis model, which
the CAA has recently developed in conjunction with QinetiQ, allowing
objective roster planning and assessment.
With the transfer of legal responsibility for rulemaking
in the field of operations to EASA, we consider that any assessment
of long-term occupational health associated with aircrew operations
should be undertaken as a European research project, in which
the CAA (including the AHU) would participate.
Recommendation 5.15 We welcome the fact that
the Aviation Occupational Health and Safety Working Group, chaired
by the CAA, is looking into noise-induced hearing loss. However,
pending the outcome of this work, we recommend that the CAA work
with airlines to review the availability of personal protection
equipment so that pilots will be better able to protect their
hearing.
Government response
The CAA are of the view that the data supplied by
a number of airlines provides no objective evidence to cause concern
about ambient noise levels on the flight deck or in the cabin,
particularly given the benefits of modern aircraft types. Advice
from the HSE stresses the need for local data and local analysis
to formulate a proper risk assessment of the noise levels within
different operations.
It is for the CAA and operators to ensure that all
crews are afforded effective hearing protection, on the ground
and while operating on the flight deck. However, even when modern
noise-attenuating headsets are provided, it is recognised that
crews may severely reduce the effectiveness of such devices by
using them improperly, for example by leaving one ear uncovered.
Nonetheless, the CAA will be inviting operators to submit information
on the level of personal protection provided for their crews and
the nature of the advice or procedures that they have in place
to ensure effective use. Thereafter, the Aviation Occupational
Health and Safety Steering Group will determine whether new or
additional guidance might be warranted.
Contaminated Air Events
Recommendation 5.16 We recommend that the
CAA carries out an awareness campaign aimed at airlines and pilots
to highlight the importance of reporting contaminated air events
and encourages airlines to follow the spirit as well as the letter
of the rules on reporting these events.
Government response
The CAA has regular contact with industry Flight
Safety Departments through its monthly MOR Listing. Through this
system, the CAA will remind operators of the importance of reporting
all contaminated air events that meet the requirements of the
MOR Scheme.
A reportable occurrence means any incident which
endangers or which, if not corrected, would endanger an aircraft,
its occupants or any other person. The CAA's CAP 382 The Mandatory
Occurrence Reporting Scheme, reflects Directive 2003/42/EC
of the European Parliament, and of the Council of 13 June 2003,
on occurrence reporting in civil aviation which requires, amongst
other items, ''events requiring any use of emergency oxygen by
any crew member' and 'crew incapacitation'.
In addition, the air sampling activity on commercial
airlines planned for 2008 will raise the profile of the issue
with crew.
Recommendation 5.17 We recommend that the
AHWG-sponsored research to identify the substances produced during
a fume event be completed urgently. It should be followed up by
an epidemiological study on pilots to ascertain the incidence
and prevalence of ill health in air crew and any association there
might be with exposure to the chemicals identified in the AHWG-sponsored
study, paying particular attention to the synergistic effect of
these chemicals.
Government response
We agree that the AHWG-sponsored research to identify
the substances produced during a fume event should be completed
urgently. The Government has always made it clear that
we would not want anyone to be at risk to their health when flying,
and we are working hard to fill the knowledge gap in this area.
We have taken the first steps by engaging Cranfield University
to oversee functionality tests on equipment which might be capable
of capturing substances released during a fume event. We have
published the report, following peer review by experts in the
UK, Europe and the USA. We have accepted Cranfield's recommendation
for further tests, and a Steering Group to oversee the next phase
has started work. It is our view that only after the air sampling
data have been obtained can we decide how best to assess any health
impacts. We agree that assessment must take account of the synergistic
effect of substances.
Recommendation 5.18 We recommend that the
Government works with manufacturers, airlines and the regulator
to take effective action in preventing oil and hydraulic fluid
leakages into the aircraft cabin.
Government response
The Government accepts this recommendation. We share
the Committee's view of the importance of preventing oil and hydraulic
fluid leakages into the aircraft cabin. No one wants oily or chemical
smells in the aircraft cabin, and the conclusions of the COT evidence
review into fume events noted the need to reduce fume events irrespective
of health impacts.
It should be noted that airlines and the CAA have
already made considerable efforts to minimise fume events. Good
engineering maintenance practice is clearly an important part
of this. But we are also interested in the extent to which operational
practices may or may not have an effect on the likelihood of an
event. DfT has commissioned a short data analysis project to try
to determine if there is any correlation with operational practice.
The AHWG remains our principal forum for addressing health concerns
with aviation stakeholders, and it is through that body that discussions
between Government, airlines and the CAA take place. Manufacturers,
represented through the Society of British Aerospace Companies
(SBAC) were invited to join the AHWG in 2007 and accepted.
Recommendation 5.19 We recommend that a protocol
should be made available to health professionals, in particular
Authorised Medical Examiners, on how to deal with air crew who
suffer contaminated air events. We recommend that airlines, the
regulators and the Government work together to improve the support
given to pilots claiming to suffer ill health following a contaminated
air event.
Government response
The Government considers that any protocol must be
based on an understanding of the substances found during a fume
event and the link to ill health in crew. The AHWG has already
discussed this at length and found it impossible to draw up a
genuinely useful protocol at this stage of the debate. Of course,
pilots should receive appropriate medical management and support
according to their symptoms.
Information and Education
Recommendation 5.20 We recommend that the
Government and the regulators review the manner in which information
on fitness to fly is offered, giving due consideration to their
target audience. As the authoritative provider of information
for passengers on air travel and health, the Government must ensure
that information is available to all, not just people who have
Internet access.
Government response
The Government accepts this recommendation. The AHU
works closely with airlines and other key stakeholders, to disseminate
consistent travel advice. Those without access to the internet
can request information by telephone, and relevant documentation
can be printed and posted.
The Head of the AHU has written a number of articles
for medical journals, and further articles are planned, targeted
at the GP audience, in order that they may disseminate appropriate
information to their patients. In addition, from March 2008, a
section of the AHU website will have professional medical information
that can be downloaded.
The CAA publication Travelling Safely is currently
being redesigned. This offers a unique opportunity to address
health issues, and highlight the AHU and other sources of pertinent
information. This will be of value to those who do not have Internet
access.
Recommendation 5.21 We recommend that the
general practitioner postgraduate curriculum should include a
basic overview of aviation medicine. Continuing professional development
in the form of specialised courses should be made available for
healthcare professionals with an interest in this area.
Government response
The responsibility for specifying the content of
the general practitioner training curriculum rests with the Postgraduate
Medical Education and Training Board (PMETB), the competent authority
for postgraduate medical training in the UK. PMETB is an independent
professional body. The Government will draw the Committee's recommendation
to the attention of the Board.
The post-registration training needs of NHS professionals
are decided by local NHS organisations against regulatory requirements,
local NHS priorities, through appraisal processes and training
needs analyses informed by Local Delivery Plans, and the needs
of the service. Funding for continuing professional development
is included as part of the baseline allocation made by the DoH
to Strategic Health Authorities. It is for each Strategic Health
Authority to decide its own priorities for investment and to focus
training resources where they are most needed.
Recommendation 5.22 We further recommend that
various specialties such as cardiology, orthopaedics and psychiatry
follow the lead of the British Thoracic Society in producing guidelines
on fitness to fly with the intention of informing GPs and other
healthcare professionals; and that these publications should be
made available in electronic form and hard copy to all GPs. In
the course of time the collection of these guidelines would form
a valuable (paper) reference manual.
Government response
We agree with this recommendation. It is a function
of the medical Royal Colleges and Faculties to work to improve
clinical standards. These professional bodies are therefore best
placed to consider how the Committee's recommendation could most
appropriately be implemented on the basis of coherent and soundly-based
guidelines. DfT through the AHU recently consulted the Royal College
of Obstetricians and Gynaecologists on introducing guidelines
to assist airlines in managing new legislation arising from the
new Gender Directive which has an impact on travel during pregnancy.
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