This short question comes from a paramedic student in NSW who wonders:
… if I’ll actually be able to practice the skills I’ve been taught with a private ambulance company once I complete the diploma. And will it change once paramedic registration starts?
This of course assumes that my correspondent has secured a job which I’ll assume has occurred.
Today paramedicine is a largely unregulated field. Today it’s up to the employer to determine what the graduate paramedic is employed to do, ie the scope of practice. It will also be up to the employer to determine whether the new graduate must undergo supervised practice or further training before being allowed to work on his or her own or as the senior member of a team.
Once registration is in place, the Paramedicine Board will have a role in determining what is required for registration. They may require a period of internship or supervised practice before registration, or they may allow a paramedic to be registered upon graduation but impose a condition on the paramedic’s registration that restricts their practice. Alternatively the Board may allow full registration upon graduation, with no restrictions. I can’t say what the Paramedicine Board will decide to do.
I realise I misunderstood the question and this student is doing a diploma, not a degree. It will be up to the paramedicine board to determine which qualifications are suitable for regisration as a paramedic. Qualifications for registration haven’t been determined but it is expected that, with the exception of Diplomas issued by Ambulance Service of NSW, a diploma program will not be sufficient for registration.
For those that have a diploma and relevant experience, they may be registered under the grandfathering provisions – see ‘Grandparenting’ paramedic qualifications (April 26, 2017).
So the answer should be:
Today paramedicine is a largely unregulated field. Today it’s up to the employer to determine what qualifications are required for the job and the paramedic’s scope of practice. It will also be up to the employer to determine whether to employ people with a diploma and whether the new graduate must undergo supervised practice or further training before being allowed to work on his or her own or as the senior member of a team.
Once registration is in place it will be the paramedicine board that will determine whether the Dipoma is sufficient for general registration or will be allowed for registration under the grandfathering provisions. If the Diploma is not sufficient then my correspondent will not be able to be employed as or use the title ‘paramedic’.
My correspondent may be employed in a role that is not a paramedic role and again it will be up to the employer to determine what his or her role will be.
Could it be that the question was about the non-Paramedic role of event medic or industrial medic, where registration will likely continue to be irrelevant? The writer seems to have a Dioloma, probably not from ANSW so may well not be recognised for registration, but will continue to be adequate and relevant to employers of sub-Paramedic roles. Why shouldn’t this role be included in registration, possible called a “Respobder” or EMT? Similarly, the various Volunteer Ambulance roles could be included, possibly just as “Ambulance Officer”. Registration’s principal role is to protect the public, the Paramedic role isn’t the only one that can cause harm in the pre-hospital environment.
Fair point and now I look back I see I did misunderstand the question. The student is doing a diploma, not a degree. So the answer is that that once registration is in place and depending on the approach of the paramedicine board my correspondent may be eligible for registration under the grandfathering clauses if he or she has been practicing as a paramedic, but if the diploma is completed after registration is in place then again depending on the paramedicine boards assessment of qualifications, the student may not be eligible for registration.
Registration if for paramedics (however defined). People with qualifications that do not allow them to register will not be able to use the term paramedic so people will know that a paramedic is registered and others are not. Given how long it’s taken to get paramedic registration it would be a long way to require others to be brought in and they don’t have the same capacity for high risk interventions.
This comment is slightly off this topic but related. I was having a conversation with someone the other day about scope of practice and whether an organisation could employ paramedic graduates and allow them to undertake the same range of skills and interventions as the Paramedicine Board would deem appropriate for a registered paramedic, without actually calling them paramedics. The short answer to that, as Michael has alluded to is Yes. In Australia, health care professionals have been accorded a large measure of freedom in terms of the way in which they have been regulated with regard to the scope of their practice. This breadth of scope has been permitted by the common law right to practice medicine. In Australia, anyone can treat a sick person even if they have no training in any type of healthcare at all provided the individual involved provides informed consent. As Michael has noted, the only restriction is that the person providing the service must not hold themselves out to be someone that they are not. That is, they cannot identify themselves as a medical practitioner unless they are registered as a medical practitioner. This is because this title, along with 13 other titles are protected at law in Australia under the Health Practitioner Regulation National Law Act. It is the title, not the scope of practice that is restricted at law.
This is because the government recognises that although this may mean that patients/consumers aren’t as protected as they may otherwise be if we adopted a regulatory model similar to Belgium’s, which legally links the scope of practice to registered practitioners, the govt values consumer choice to seek healthcare from whomever they choose, and the inherent flexibility afforded by the title- protection -only model over legally restricting the provision of certain tasks by certain professions.
There is one other obvious legal restriction on the scope of practice of any type of health care provider in Australia and that is the prescription of pharmaceuticals. Only medical practitioners, nurse practitioners, vets and dentists are authorised to prescribe certain drugs. However, a large number of pharmaceuticals can be purchased over the counter, and certain employers are authorised to supply and administer particular types of drugs. People are free to order pathology and other diagnostic tests themselves provided they are prepared to pay a publicly unsubsidised rate for them. One way to address this issue, if the profession believes it may become an issue, is to lobby the government to mandate that any public health employer only employ registered paramedics to perform the work typically associated with being a paramedic. Not sure what the possibility of that actually happening is and I think it would be even less likely to happen in the private sector….