Air ambulances will have to increase prices or levy a fuel surcharge and pass on additional costs of mandatory upgrades, Frank Halmes coo of Luxembourg Air Ambulance (LAA) warns.

Halmes points out: "Jet fuel has increased just over 75 per cent in over 14 months and, seeing as fuel represents approximately 28 per cent of an air-ambulances direct operating costs, it is hurting operators all over Europe."

The sector, and LAA, cannot keep absorbing the increased costs, he warns.

"On top of this operators have had to invest on average #400,000 in avionics to fulfil the latest EASA requirements. Of course this makes the aircraft and airways safer and can only benefit the patient and crews, but with the cut-price rates in the air-ambulance market, something has to give," Halmes says.

"Just as the airline industry has been adding fuel surcharges to tickets, an increased amount of operators have been raising their hourly rates. And this is understandable, considering that you cannot operate safely in one of the toughest aviation jobs by cutting corners and compromising safety."

Halmes says LAA prices instead will have a clear fuel price adjustment clause. "Nobody knows what the fuel price will do in the future. If they drop in the future then our prices can decrease. We think this is a fair way to deal with the problem."

He adds: "When fuel prices began to rise in 2004, most people felt the pinch at the pump, wishing perhaps they'd bought that hatchback instead of the X5. Some responded by car-pooling, by combining errands or by simply making fewer trips. But air ambulances do not enjoy the luxury of such options. When an air ambulance performs a mission, it's usually a matter of life or death."

Luxembourg Air Ambulance has three Lear 35s for ambulance work and a Lear 60 for passenger charter.