JOINT COMMITTEE ON TRANSPORT debate -
Wednesday, 18 Oct 2006

Aviation Safety: Presentation.

Chairman

The next item on our agenda is a discussion with Mr. Fintan Towey, principal officer, Aer Lingus division of the Department of Transport, and Mr. Kevin Humphreys, director of safety regulation, Irish Aviation Authority, concerning the regulations and monitoring of first-aid equipment aboard flights and the question of the pricing structure with regard to safety standards in the aviation industry. I welcome Mr. Towey and Mr. Humphreys and Ms Annetje Roodenburg, air medical officer of the Irish Aviation Authority, and Ms Aideen Gahan, company secretary of the Irish Aviation Authority.

I draw witnesses' attention to the fact that members of the committee have absolute privilege but the same does not apply to witnesses who appear before the committee. Members are reminded of the long-standing parliamentary practice to the effect that members should not comment on, criticise, or make charges against a person outside the House or an official by name in such a way as to make him or her identifiable.

I propose that we hear a short presentation from Mr. Humphreys and that this will be followed by a question and answer session. We all know the reason this matter has come before the committee, namely, the tragedy that took place on a recent flight to Ireland. Through Deputy Wilkinson, we received correspondence from the two nurses who were on the flight. We decided we could do nothing about the past situation but we wanted to find out who is responsible for monitoring the equipment and for training. This is why we have asked Mr. Towey and Mr. Humphreys to attend the committee meeting.

Mr. Fintan Towey

Aviation safety is regulated in Ireland by the Irish Aviation Authority under statute. For that reason, I will hand over to Mr. Kevin Humphreys, the director of safety regulation at the Irish Aviation Authority, to make a statement with regard to these issues.

Chairman

We appreciate that copies of his statement have been provided to the committee. On behalf of the members of the committee, I express our sympathy to the family who were bereaved as a result of the recent incident. Is that agreed? Agreed.

Mr. Kevin Humphreys

I propose to read the letter I sent to the committee yesterday, if that is in order. It states:

I refer to your invitation to the Joint Committee on Transport on 18 October 2006.

The Irish Aviation Authority regrets any loss of life or injury as a result of travelling by air and extends its deepest sympathy to the family of the young lady who died tragically on a recent flight to Ireland of natural causes.

The IAA is the safety regulator for civil aviation in Ireland. It has responsibility for regulating pilots, air traffic controllers, aircraft engineers, aerodromes, airspace, and aircraft. Aviation is regulated by international convention and is one of the most highly regulated industries in the world. The IAA regulates the aviation industry in Ireland to the highest international standards using highly qualified professionals who have extensive industry experience. Aviation safety standards are set in Europe by the European Aviation Safety Agency (EASA), the Joint Aviation Authorities (JAA)... [They are also governed worldwide by] the International Civil Aviation Organisation (ICAO). In common with the rest of Europe, the IAA ensures that the highest European safety standards are observed by Irish airlines as set out in the international regulations.

All airlines are regulated in an equal and fair manner by the IAA. All airlines, whether low cost, multi sector, short haul or long haul must observe the same international safety standards.

The IAA carries out extensive and detailed surveillance on all Irish airlines to ensure safety standards are maintained in accordance with the regulations. Its audit and surveillance programme includes detailed checks on all aspects of aircraft flight and maintenance operations including flight time and duty limitations, and where problems are found, the operator is given a short time to rectify these and this is followed up by the IAA. This is standard international practice.

I refer in particular to the following items raised by the committee.

1. Guidelines for Necessary Medical Equipment on Flights

The requirements for medical equipment on board aircraft is covered by joint aviation requirements. This covers the requirements for first aid kits, emergency medical kits, first aid oxygen and supplemental oxygen. The guidelines specify the number of first aid kits required relative to the amount of passengers carried. On short haul operations requirements specify that first aid kits must be carried. The contents of the kits are limited as the priority in these circumstances is to land the aircraft as quickly as possible in a location where expert medical assistance is available.

On long haul aircraft, where it may not be possible to land the aircraft in less than one hour [indeed, it may be much longer than one hour] emergency medical kits are also fitted. These kits contain additional items and are primarily for use by qualified medical personnel.

The contents of such medical kits are laid down in JAR-OPS 1, Sub-Part K.

If the committee requires it, I can furnish it with copies of JAR-OPS 1. The letter continues:

2. Monitoring of Such Equipment

Under these regulations an operator, i.e. the airline, shall ensure medical equipment is:

(i) inspected periodically to confirm, to the extent possible, that contents are maintained in the condition necessary for their intended use;

(ii) replenished at regular intervals, in accordance with instructions contained on their labels, or as circumstances warrant.

3. Training of Airline Staff in Basic First Aid

JAR-OPS requirements specify the following for cabin crew initial training . . .

"Medical Aspects and First Aid

An operator shall ensure that medical and first aid training includes: (i) instruction on first aid and the use of first aid kits; (ii) first aid associated with survival training and appropriate hygiene; and (iii) the physiological effects of flying and with particular emphasis on hypoxia"

Annual first aid refresher both theory and practical is required and must be completed by all cabin crew.

4. Low Cost Carriers

The Irish Aviation Authority assumes that the reference to "cheap airlines" refers to the growth of low cost carriers. The surveillance of low cost airlines is to the highest international standards. Low cost airlines operate to the same rigorous international safety standards as all other airlines. Our surveillance regime takes account of all risk factors including multi sector operations and non Irish bases and also includes line flying checks with all operators to ensure regulations are implemented in practice. The IAA regulates proactively and fully complies with all international standards and best practice. In addition to the IAA checks, other safety regulation authorities routinely conduct unannounced checks of Irish airlines at foreign airports under the European SAFA (safety assessment of foreign aircraft) programme. No significant findings have arisen concerning low cost or other operators during the past year. All serious incidents are investigated independently by the air accident investigation unit (AAIU) and the [reports and] findings [are] published. The IAA acts on all recommendations of the AAIU. Below we set out an overview of our surveillance regime which applies to all sectors regulated by the IAA.

Whom does the IAA audit?

The IAA audits: airlines; aircraft maintenance organisations; engineer training organisations; flight training schools; aerodromes; air traffic control services providers; [and] general aviation.

IAA Audit Checks of Airlines

Audits are carried out on the following areas: initial grant of air operators certificate (AOC); documents inspection; returned flight documentation; technical records; crew records — flight time & training; quality & safety management systems inspection; facilities and organisation inspection; flight inspection (flight deck & cabin); ramp inspection; navigation inspection; operations manual inspection; dangerous goods procedures; individual aircraft certificates; annual reviews; [and] safety audits.

SAFA Programme

This programme is conducted on behalf of the State, which as a member of the European Civil Aviation Conference must ensure that foreign operators using Irish airports are subjected to regular safety checks. The programme is implemented by the IAA and consists of: inspection of foreign operated aircraft in Ireland; monitoring results of inspections of Irish aircraft by other states; [and] follow up of inspection results with both domestic and foreign airlines. In addition, Irish registered aircraft are subject to such checks at European airports.

The Irish Aviation Authority is pleased to assist the committee in clarifying any issues it may have in relation to the safety of all passengers carried by operators holding an air operators certificate (AOC) and to furnish any information which may aid the committee.

Chairman

How many personnel of the IAA are involved in the monitoring of this equipment?

Mr. Humphreys

More than 70 personnel, inspectors and support staff, are engaged directly in the surveillance of our operators.

Chairman

From what airports do they operate?

Mr. Humphreys

The procedure is that we assign inspectors to each operator. In the case of a large airline, we would have a principal operations inspector and a principal air worthiness inspector. They would be backed up by two inspectors. These are usually pilots with many years of experience. On the air worthiness side, those undertaking the inspections are engineers with 20 to 30 years of experience in the industry. There is also a dedicated staff to inspect the cabins, including a retired cabin manager and a former training manager of Aer Lingus hostesses.

Chairman

The committee is not concerned about the general condition of aeroplanes because we are confident the Irish Aviation Authority will monitor their condition. That has always been the position. Our concerns relate to the medical equipment on board. How many persons are involved in monitoring that equipment and, on average, how many times per year are aeroplanes checked to ensure all equipment is present and working?

Mr. Humphreys

The equipment to which the Chairman refers is laid out in a schedule. There are two different types of kit, a first aid kit and a medical equipment kit. These are checked on every inspection, which may vary from six monthly to annually. The first aid kit is checked, as part of both air worthiness inspections and cabin inspections, to ensure it is sealed and has not been used. If it has been used, it must either be replenished or discarded. These checks are conducted both in a structured fashion, at least annually, and also on an ad hoc basis.

Chairman

How many random checks has the IAA carried out in the past 12 months? I do not wish to be awkward but the committee wishes to discover how monitoring will be conducted so that the situation that allegedly arose can never happen in future.

Mr. Humphreys

We are not convinced, in regard to this case, that there was anything by way of a shortfall in terms of equipment. With full respect to the unfortunate girl who died, this was not an aviation safety matter. There are international conventions in regard to the death of persons while on board an aircraft. Where death is self-inflicted, arises from natural causes or where the person is a stowaway, death or injury is not considered an aviation safety matter.

Chairman

Is Mr. Humphreys saying that as far as the IAA is concerned, this incident was a medical situation rather than a situation of aviation safety?

Mr. Humphreys

Absolutely. This is not just the view of the IAA; it is in line with the European position and meets the criteria of the International Civil Aviation Organisation, ICAO.

Chairman

Yes. In correspondence to the committee, however, there is the suggestion that if certain equipment had been in place on the aircraft, more might have been done for the individual concerned. We are all aware there can be no guarantees in such situations. I do not know what is contained in the medical report on this case. I assume it is being considered by the coroner in question and is not currently available.

Mr. Humphreys

That is correct. I will outline the judicial position. When a person dies on an aircraft, the judicial procedures that pertain depend on the jurisdiction in which he or she died. Technically, the state of occurrence for this incident is Belgium, which is where the aeroplane landed. The Belgian judicial authorities will carry out whatever post mortem or autopsy is required under that country's legislation. I am not sure whether the results will be made public.

As I said, the IAA does not consider this incident to be a safety matter. The international aviation community considers the death or injury of a person on an aircraft to have arisen as a result of being in that aircraft only in circumstances where there has been some malfunction or mishandling of the aeroplane or something like an explosive decompression.

Chairman

Has Mr. Humphreys a list of the medical equipment that should be included in the sealed box?

Mr. Humphreys

Yes.

Chairman

I accept that the box must remain sealed for obvious reasons. If it is opened, one cannot be certain whether items have been misplaced.

Mr. Humphreys

Absolutely. A first aid kit should include bandages — unspecified; burns dressing — unspecified; wound dressings, large and small; adhesive tape; safety pins and scissors; small adhesive dressings; antiseptic wound cleanser; adhesive wound closures; disposable resuscitation aid; simple analgesics such as paracetamol; antiemetics; nasal decongestant; gastrointestinal antacid; anti-diarrhoeal medication; disposable gloves; a ground-air visual signal code for use by survivors; a first aid handbook; and a list of contents in at least two languages, English and one other, which should include information on the side-effects of the drugs carried.

In terms of historical background, the original purpose of the provision of a first aid kit on aeroplanes was to allow for the treatment of the injured in the event of a crash. It is like a sealed dressing for a soldier, part of his initial issue.

Chairman

The list of contents sounds like something that would be carried in the Second World War.

Mr. Humphreys

The provisions I have listed relate to short-haul flights. I do not wish to get into a discussion on statistics but I point out that 18 billion passengers will be carried on commercial aircraft in the next ten years. Of that number, 244 will suffer heart attacks. The carriage of a defibrillator, which may not be suitable for use in all cases, will possibly save four lives.

Chairman

Mr. Humphreys has pre-empted my next question which related to the benefits of carrying defibrillators on aircraft.

Mr. Humphreys

I do not wish to go into the technical aspects of it. Some three years ago, I undertook an investigation into the case of a pilot who had died of a heart attack. Following this investigation, I recommended to the ICAO that defibrillators should be carried on aircraft. They are currently carried on long-haul aircraft but that was the decision of the operators. Defibrillators are carried on any flight where the aircraft will, at any point, be more than one hour from a suitable diversionary airport.

The question is whether a defibrillator is suitable in all cases and whether it is likely to save the life of the patient. The machine must be applied within the first four minutes of a heart attack. However, it takes three minutes for a non-medical person to recognise that a person has suffered a heart attack. This leaves one minute for the use of the defibrillator. The United States has mandated that all its carriers must carry the machines, on both long-haul and short-haul flights. The ICAO is considering the matter but it does not accept there is a requirement in this regard in the context of the statistics I mentioned.

Chairman

Defibrillators are not especially expensive.

Mr. Humphreys

The cost is $3,000 per unit. However, the cost of equipping the international fleet would be $300 million. I accept we cannot reduce this matter to monetary figures but the actuarial position is that the cost of saving one life would be $1.3 million.

Chairman

If it has been decided that a defibrillator should be standard equipment, there should at least be a requirement that all new aircraft should carry one.

Mr. Humphreys

I accept what the Chairman is saying and as I said——

Chairman

Has the authority made a recommendation?

Mr. Humphreys

——the Department of Transport recommended it. That is all we can do. Irish airlines operating long-haul flights carry defibrillators and full medical equipment. I have to hand another list regarding emergency medical aid kits carried in the aeroplane. In the main however, this assumes a doctor will be able to use it as it is not for the cabin crew to so do.

Chairman

Can cabin crew not be trained to do so? Everyone knows defibrillators are now being used by people in the community.

Mr. Humphreys

Of course they can be and are when the operator decides to carry them.

Deputy O. Mitchell

I thank Mr. Humphreys. One of the reasons this issue came to light is that of the rarity of fatalities on aircraft and people very rarely come forward to state the necessary equipment was not available. Admittedly, members depended on reports in the newspapers. There appear to have been a number of complaints. First, the staff did not know the whereabouts of the first aid kit. Second, after they found it, the equipment it should have contained was not present. Moreover, it was reported that equipment that was deemed to be essential was not and had never been on the aeroplane, even had the kit been complete. In his letter, Mr. Humphreys stated:

No significant findings have arisen concerning low cost or other operators during the past year. All serious incidents are investigated independently by the Air Accident Investigation Unit.

Is the authority saying this matter is under investigation, has been investigated or that, in general, it is happy with the low cost airlines? I am not being judgmental in this regard because there is a limit to the amount of equipment that can be carried on an aeroplane, particularly for short-haul flights. If one cannot get a cup of tea, one is unlikely to get heart surgery either.

Are the European aviation authorities considering the possibility of carrying additional items? The presentation noted that the joint aviation requirements, JAR, nominate a certain amount of equipment for short-haul flights and a certain amount for long-haul flights. Is this under consideration or does Mr. Humphreys believe there is a need to consider it?

Mr. Humphreys

I will ask Dr. Roodenburg to answer that from the medical perspective.

Dr. Annetje Roodenburg

The Joint Aviation Authorities, JAA, operations committee considers this regularly. The existing requirements in JAR-OPS are extensively discussed by the working group, which consists of experts from airline authorities and medical doctors. It considers what should be included and what one can use in an aircraft, as circumstances in an aircraft are different from those in a treatment room or on the ground. Questions regarding whether this should be changed and what should be included are under constant review.

Deputy O. Mitchell

Is the investigation into this case completed? Is it ongoing, or is there an investigation under way?

Mr. Humphreys

No investigation is taking place because this does not fall within the remit of the accident investigation board. The police or judicial authorities may investigate the event because it was a death in that jurisdiction. However, this would be the same as if it had happened anywhere. The problem we are faced with is that this poor unfortunate girl could have been in the same condition in the airport or shortly after disembarking. The question arises as to whether she would have been any better served.

Deputy O. Mitchell

I agree with Mr. Humphreys in this respect. However, a certain amount of equipment is meant to be on an aeroplane. In this instance, was it?

Mr. Humphreys

Yes, we are happy that what was supposed to be on board was on board. The doctor and the nurse probably expected there would be equipment on board. For example, my information is that the doctor asked for a stethoscope and intubation tube. It was explained that such items were not carried on board because they are not required on a short-haul flight. They would have been carried on a six hour flight. The schedule of equipment for first aid for an hour long flight is not the same as for a six hour flight and this was explained to them. This is the information I have received from the operator and the crew who attended.

Deputy O. Mitchell

As far as Mr. Humphreys is aware, the required equipment was being carried on that aeroplane.

Mr. Humphreys

I believe a disposable resuscitation aid was not on board. It is simply a mouth guard used when one gives cardiopulmonary resuscitation, CPR. However, that would not prevent one from giving CPR.

Deputy O. Mitchell

That was one of the items mentioned.

Deputy Connaughton

Was it not on board?

Mr. Humphreys

We believe not. However, it may not have been found by the person who was looking for it.

Deputy O. Mitchell

Staff are meant to be trained to know where such items are.

Mr. Humphreys

Yes of course, and she produced the medical kit.

Deputy O. Mitchell

Was this item supposed to be in the sealed medical kit?

Mr. Humphreys

Yes.

Deputy O. Mitchell

Had the kit been unsealed?

Mr. Humphreys

This is my information. However, as the incident took place outside our jurisdiction, it would be up to the Belgian authorities to investigate this incident or to initiate an investigation, if they so wished.

Deputy O. Mitchell

To Mr. Humphreys's knowledge, are they investigating this matter?

Mr. Humphreys

I am not aware they are.

Deputy Shortall

I thank Mr. Humphreys for the presentation. What is the role of the Irish Aviation Authority, IAA, in this respect? Mr. Humphreys has outlined the guidelines for carrying necessary medical equipment and noted that inspections are carried out by the authority annually at least. What happens if an airline fails to comply with such guidelines? What are the authority's powers in this regard? Is there a system of penalties for those airlines that are found not to be in compliance with the guidelines? Can Mr. Humphreys provide members with information on compliance rates on foot of the annual checks carried out by the authority?

Following on from the last question, does the IAA have a statutory role in investigating particular incidents that occur on the aircraft of Irish airlines, for which it has jurisdiction? Does any legislation cover its responsibility? Does the authority have any powers to carry out an investigation? The joint committee finds itself in a position whereby a number of allegations were made to it, as well as publically on the airwaves. Can the authority be of assistance to the joint committee in this regard? Does it have a role in establishing what actually happened on that aircraft? Does the IAA have the power to report on its findings in this regard?

Mr. Humphreys

In the case of a death or serious injury that is considered to be an accident or a serious incident, the investigative role is the responsibility of the accident investigation unit of up to three states that are involved, namely, the state of the operator, the state of registry and the state of the occurrence. Primary responsibility rests with the state of occurrence, because the incident happens within a particular jurisdiction.

Deputy Shortall

My question does not so much relate to that as to failure to comply with the guidelines set down by the authority.

Mr. Humphreys

If an operator, large or small, is inspected and is not in compliance, it is given an extremely short time in which to become compliant. However, Irish operators are in full compliance. For example, our low cost operator has been inspected outside this jurisdiction 136 times in the past nine months and non-compliance has not been found. This compares with 31 and 32 times for other carriers. We have carried out 279 inspections of one nature or other on our low cost carrier and have not had non-compliance.

Deputy Shortall

Over what period?

Mr. Humphreys

Over nine months.

Deputy Shortall

Non-compliance has not been found in a nine month period. Hypothetically, if the authority found a case of non-compliance, does a penalty system exist?

Mr. Humphreys

Yes.

Deputy Shortall

What is it?

Mr. Humphreys

The ultimate sanction would be to withdraw the operator's certificate.

Deputy Shortall

Very well. I refer to a scenario in which the authority carries out an inspection of an aircraft and finds the first aid box is missing or that its seal has been broken. What would it do in this case?

Mr. Humphreys

We would point it out to the operator, who would deal with it immediately. If it was not dealt with it, we would consider other sanctions. However, our operators comply all the time.

Deputy Shortall

Has there been any incidence of non-compliance in the past year?

Mr. Humphreys

We experience general non-compliances in the sense that the joint aviation requirements lay down every single aspect of how an aeroplane must be operated and maintained.

Deputy Shortall

I refer specifically to medical equipment.

Mr. Humphreys

No.

Deputy Shortall

So there is no incidence of non-compliance with those guidelines?

Mr. Humphreys

No.

Deputy Shortall

Does the IAA have any statutory function in respect of investigating?

Mr. Humphreys

Yes, we are entitled under our Act to investigate but we would not necessarily make it public.

Deputy Shortall

However, public allegations have been made about this incident in respect of medical equipment. Would the IAA have any role in investigating these allegations?

Mr. Humphreys

We could have a role but the allegations have not been made to us. We have not seen the correspondence. Deputy Shortall has been given correspondence but we have not received any.

Deputy Shortall

To follow on from that, if this committee hands over the correspondence containing the allegations about what happened, what can the IAA do?

Mr. Humphreys

We can summon the operator and interview the people who were on board. We can interview the operator and the cabin crew involved in the incident and establish if there were deficiencies. I do not wish to labour the point but the information I have received from my medical colleagues, states that there was nothing that would have been contained in a medical kit that could have saved this girl. I am not pre-empting——

Deputy Shortall

That is not the issue. The issue is whether that airline was in compliance with the guidelines set out and the IAA's role in investigating the matter to establish whether the airline was in compliance.

Mr. Humphreys

Absolutely, however, acceptable means of compliance are laid out under the regulations. If the joint regulations lay down that an airline must do something in a particular way and the airline shows it can carry out this action in its way, this will be acceptable. I am not trying to evade the issue. We are satisfied that the operator in question is in compliance with almost everything we have asked it to do.

Deputy Shortall

How does the IAA know this?

Mr. Humphreys

We know that because we inspect it and we have just——

Deputy Shortall

The IAA does not possess knowledge in respect of this incident. Mr. Humphreys is making assumptions for which I am not sure there is basis. I am not making any allegations. The allegations have been made by people who were on the flight and had medical experience. These allegations have been brought to our attention and we are now asking about the procedure for us to ensure they are properly implemented.

Mr. Humphreys

Deputy Shortall can forward the allegations to us and we will investigate them from operational, airworthiness and medical perspectives. If the airline was not in compliance with the guidelines, we will apply an appropriate sanction.

Deputy Shortall

It might be best to handle it in this fashion rather than the IAA making assumptions regarding what happened in this instance. It is important to keep an open mind until it is properly investigated.

Chairman

We will give the correspondence given to Deputy Wilkinson to Mr. Humphreys to allow him to examine it.

Mr. Humphreys

Thank you.

Chairman

Had the aircraft in question been examined at any time during the past 12 months by the IAA with regards to its equipment?

Mr. Humphreys

I believe it was but I would have to come back to the Chairman about the date, time and details of the inspection.

Chairman

Mr. Humphreys might confirm that to the committee.

Deputy Wilkinson

I thank Mr. Humphreys for his presentation, which undoubtedly presented matters as they should be. However, I was not impressed afterwards. I do not know how he can assume this airline is in compliance without seeing the documentation. I find it amazing.

The first I heard of this affair was when Kate Douglas, who was one of the nurses who answered the distress call on the flight with Nurse Scott, visited my clinic. Mr. Humphreys admitted that one part of the medical kit that should have been present was missing. I am not qualified to say whether it could have helped save the life of the young lady in question.

Another very serious allegation has been made. It is alleged that the medical kits were removed from the aircraft before they could be inspected. Mr. Humphreys stated that it cost upwards of €1 million to save a person's life. The pieces of medical equipment that were missing were relatively cheap. While mouth-to-mouth resuscitation could be given without that equipment, it was a very stressful situation for the medical staff and nurses involved.

I am not happy with Mr. Humphreys's explanations. I accept that he does not possess the correspondence and I will certainly hand over any correspondence I received. There were a number of witnesses to what the two nurses allege took place on the aircraft. I ask that the IAA meet those two nurses and hear their story at first hand. I am not in the business of condemning airlines and I deeply regret that the young lady passed away. I am not medically competent to say whether she would have lived had all the equipment been in place. However, the point made by the nurses was that the equipment which they badly needed and which was relatively cheap was not available. I did not meet Nurse Scott but Kate Douglas told me that the medical kits were removed from the aircraft before they could be inspected properly. This is very serious. I am passing on the story as it was relayed to me. The two nurses involved are solid people and I ask that the IAA meets them and hears their story. It is imperative that the IAA carries out a thorough investigation into all aspects of what took place.

Mr. Humphreys

In response to the comments made by Deputies Shortall and Wilkinson, I made no assumptions. I am basing my statement that this airline is in compliance on what regulations lay down and what we have found out through our investigations. I am talking about all aspects of this matter such as its training and machinery. Its aircraft are, on average, only two and a half years old. I am not here to defend any particular airline but——

Deputy Shortall

It was in compliance on the occasions when the IAA inspected it.

Mr. Humphreys

It has been inspected——

Deputy Shortall

It was not in compliance on this occasion. The IAA does not know anything about this occasion.

Mr. Humphreys

I accept that and make no assumptions about this event because I do not possess the details about it. I fully concede that medically trained people are very good at coming forward and assisting in medical emergencies on board on aeroplanes and that this happens on many aeroplanes. The emergency may vary from mere fainting or slight discomfort to a fatality. In fairness, the young cabin crew in this case did their best and it is stressful for them as well. The pilot and his crew did the best they could in the situation in which they found themselves. We must remember that the function of the captain and the crew——

Deputy Shortall

I am not sure that Mr. Humphreys is in a position to make these statements.

Chairman

Deputy Shortall should allow Mr. Humphreys to finish.

Deputy Wilkinson

On a point of order, I do not know where Mr. Humphreys is getting this information. He has told the committee that he does not have the statements from the nurses.

Mr. Humphreys

No, I do not have the statements from the nurses.

Deputy Wilkinson

Mr. Humphreys's comments are irrelevant in this case. I am talking about the two nurses, the missing equipment and the stress on those involved. When Mr. Humphreys reads the material, he might be surprised at the reaction of some of the cabin crew. I would rather he read the material at first hand. I again stress that it is very important to talk to the two nurses involved.

Chairman

In respect of Deputy Wilkinson's comments, the last paragraph of the letter we received from Nurse Scott and Nurse Douglas states that a letter had been sent to the IAA outlining their concerns but that they would appreciate it if the committee could also answer their queries because the letter stated that some very serious questions regarding the safety of passengers were raised as a result of this incident. Is Mr. Humphreys saying that the Irish Aviation Authority has not received correspondence from the nurses?

Mr. Humphreys

I would need to check to determine whether the authority——

Chairman

With all due respect, Mr. Humphreys is attending this meeting to discuss the incident in question and I would have expected him to bring every scrap of paper concerning it. The nurses wrote to the authority to outline their concerns according to their letter, which both Deputy Wilkinson and I must take as it stands.

Mr. Humphreys

Is the letter from Ms Suzanne Douglas?

Chairman

Yes.

Mr. Humphreys

The authority responded to her and outlined the training and requirements laid out in the regulations.

Chairman

Mr. Humphreys stated that the authority had not received anything from the nurses.

Deputy Connaughton

I welcome the witnesses. Much of what has been said relates to the information I would like to know is available when I fly, but I cannot understand a case such as this. I do not know the first thing about the two nurses, but I heard them on the radio. If even a non-fatal traffic accident occurred on the road outside Leinster House in the next hour, the Garda would investigate the matter and speak to the principals involved. It would want to determine the cause of the accident and what happened. A person died in a strange way up among the clouds, but the Irish Aviation Authority does not seem to have interviewed anyone. Is that the case?

Mr. Humphreys

That is correct.

Deputy Connaughton

Is that not an unusual state of affairs?

Mr. Humphreys

No.

Deputy Connaughton

I will rephrase my question. The situation might not be unusual for the authority, but it is unusual for everyone else. We must take responsibility for what we say when we do not have all of the evidence, and the authority has no more than we do, but does Mr. Humphreys agree that his organisation's normal course of action would have been to ask the principals for written or oral submissions to map out what happened and whether the first aid kit contained everything it should have? We now know that it did not, but does this mean that 30 other medical kits did not have all of their contents? A great deal of flying takes place between the authority's inspections.

I do not know whether the crew had sufficient language skills to deal with the situation. I heard the doctor on the flight speak about how the equipment he wanted was not present. Mr. Humphreys stated that if it had been a long-haul flight, the equipment would have been present.

Mr. Humphreys

Yes.

Deputy Connaughton

I have little knowledge of aviation. All of these matters are subject to the law of probability and only one person out of every few million will die, but I would not like to have been one of those 240 people who suffered heart attacks.

Mr. Humphreys

I could not agree more.

Deputy Connaughton

If GAA and soccer clubs with only 40, 50 or 100 people are equipped with defibrillators, does Mr. Humphreys agree that aeroplanes should be the first places to be similarly equipped considering the significant number of people who fly daily and despite the short timespan in which to use that equipment? Are defibrillators too costly and are we discussing profit margins? We must be realistic. Do ten or 12 people die each year because that equipment is not on short-haul flights?

I have another technical question. I understand that there is a small kit for short-haul flights and a large kit for long-haul flights. Would it be out of this world for short-haul flights to have the large kit? Does it weigh two tonnes? Would it take up a passenger's seat? These are the questions asked by ordinary people. Will Mr. Humphreys respond? I am bewildered by the fact that someone in his position did not meet the people on both sides of the argument. There should have been a vehicle to investigate the matter and people will wonder why there was none.

Deputy M. Brady

I welcome Mr. Humphreys. Most of the questions have been asked by the Chairman and others, but are crew members qualified in the administration of first aid and do they receive regular courses to update their skills? A good first aider can save a life and a bad first aider can lose one.

It is normal procedure in a ground-based workplace for the first aid officer on a particular floor to check the first aid kit daily to ensure everything is present. Does the same situation prevail in the aviation business? More elderly people travel than ever before, but are crew members aware if such a person has an illness? Would it not be in the crew members' interest to let them know if I have diabetes and where my insulin is, for example? Would they know how to treat a person suffering an epileptic fit? In most cases where a medical situation arises on an aeroplane, a doctor is sought or an announcement is made. Would it not be a good idea to eliminate confusion and know whether a doctor is on board before the flight?

While I do not want to labour the point, Mr. Humphreys stated that the authority does not have the full facts regarding whether the kit's items were present. From someone I know in the aviation business, I know that the kits are supposed to be checked daily. If the kit in question was checked prior to every flight, there should not have been a problem. Therefore, it is obvious that it was not checked.

I do not want to be repetitive, but Deputy Connaughton raised the matter of why there are different first aid kits on short-haul and long-haul flights. No one can understand it. If I suffer a heart attack, it does not matter whether I am on a long-haul or short-haul flight because it will take me the same length of time to die if I am not properly looked after.

Deputy Healy

I welcome Mr. Humphreys and the other witnesses and I support Deputy Wilkinson. Deputy Connaughton has put the situation in a nutshell and asked the questions I wanted to ask.

Mr. Humphreys confirmed that while the airline was compliant in many other situations, it was not in compliance in this instance. It is surprising that the authority has not investigated the matter because we know that Ms Douglas wrote to it. It appears that she received only a formal letter in reply and that there was no investigation. Will Mr. Humphreys confirm whether there will be an investigation into the incident on foot of Ms Douglas's letter and today's proceedings?

We have been told that airlines are compliant.It appears that it is not difficult to be compliant. The list of equipment reminds me of the contents of a first aid box in one's home.

Chairman

Or in the boot of one's car.

Deputy Healy

The doctor sought a stethoscope and an intubation tube which are minor pieces of equipment. In all towns and villages, organisations are purchasing defibrillators and placing them in the local sports clubs and factories. This may buy some time before an ambulance arrives. I do not understand the distinction between long-haul and short-haul. The list of equipment for either is minimal to the point of being useless. When was the list last reviewed and is it intended to review it in the near future?

Deputy Timmins

I apologise for having missed the presentation but I read the script provided. The Irish Aviation Authority and the Department are aware that there are defibrillators in the airport. Four successful saves have been carried out. I do not understand why State bodies and Departments are not proactive in this area. I suggested to the Department of the Environment, Heritage and Local Government that a requirement for defibrillators be included in planning permission for commercial premises greater than a certain size.

There was an investigation into an incident in recent years and either the Irish Aviation Authority or a court recommended that defibrillators be carried on short-haul and long-haul flights. Perhaps Mr. Humphreys is aware of the case to which I am referring and can elaborate on it. Why was this not followed up and implemented? This equipment costs between €1,600 and €4,000, a minuscule amount. It can save lives and, if one has already been trained in CPR, the additional training required is minimal.

Mr. Humphreys

The first aid kit is in a sealed box. The supplier certifies that it is fully equipped before it is sealed.

Chairman

When Mr. Humphreys carries out a check, is the box opened?

Mr. Humphreys

No.

Chairman

So, if the box is defective it will still pass the test once it has not been opened.

Mr. Humphreys

Yes.

Chairman

If someone goes to check a fire extinguisher, it must be tested before it can be certified. It is terrible that only the existence of the box is verified and the contents of the box are not checked.

Mr. Humphreys

Once the first aid box has been used, it must be replaced.

Chairman

We accept that. There should be a method of resealing the box once it has been checked to ensure it conforms to specifications. While we are not making any allegations about the supplier, if the box is defective when supplied, it will be defective when opened. I suspect the cost of the box is minimal considering the amount of equipment in it. That the Irish Aviation Authority checks the box by verifying that it is sealed is off the wall.

Mr. Humphreys

The operator checks it before a flight. The crew must check that it is in place.

Chairman

Mr. Humphreys told the committee that 277 aircraft were checked over the past year. Out of 277, how many first aid kits, if any, were opened?

Mr. Humphreys

I do not know.