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In happier times, (i.e. before I ran out of dough), I flew 22 'missions' for Angel Flight. I had a PPL and a CIR multi.
I had some discussions with AF regarding the necessity of having an IR for operations in Victoria, especially in winter. My contention was that AF pilots there should have a CIR to prevent a repeat of the Horsham prang during which lives were lost. (A 'push on' PPL got himself into weather he couldn't handle. Not only could he not handle the conditions, it appears from the CASA report that he couldn't interpret a forcast either.)
Unfortunately, AF didn't agree. After all, it is based in Queensland where the 'weather is beautiful one day, better the next'! (Who do they think they are kidding?)
AF 'missions' are, in my opinion, equivalent of charter. The patient has to be got to the destination on time. Expensive medical types are waiting and are working to a tight schedule.
Perhaps, as a minimum, CSF pilots should hold a CPL met qualification; an IREX would be better.