A NSW paramedic writes:
With the imminent start of registration for the paramedic profession will ambulance state awards needs to be updated to reflect this new registration board requirements to maintain employment.
The current NSW ambulance Award has no specific requirements to obtaining and maintaining employment as a paramedic to being registered.
If an individual does not apply for registration then the current award would not be breached and so the employment of that officer must continue without registration.
Yet at the same time use of the term paramedic and employment in that role would presumably be in breach of some other award or standard under which the registration board has been created.
If the ambulance award needs to be updated to cover a requirement to obtain and maintain registration this would take time as any change to the award must be negotiated and approved by the relevant unions, employers and industrial bodies.
No such negotiation has yet apparently started, which raises the question what happens when registration comes into effect.
It’s true that the Operational Ambulance Officers (State) Award (NSW) does not deal with registration. It says (p. 4) that a person is a paramedic if they are:
… an employee who has successfully completed the necessary and relevant training and work experience as determined by the Service to become a Paramedic and who is appointed to an approved Paramedic position. Provided that such an employee shall be required to undertake and successfully complete further instruction/in-service courses necessary for the maintenance of their clinical certificate to practice and the reissue of their clinical certificate to practice every three (3) years.
In Queensland (Ambulance Service Employees Award – State 2016 (Qld), p. 44) a paramedic is:
(a) … an employee [of QAS] who provides a high standard of pre-hospital emergency patient care and the provision of ambulance transport services for members of the community.
(b) A Paramedic must possess at least a Certificate IV in Basic Emergency Care or Associate Diploma of Applied Science (Ambulance) with no additional skills or qualifications or recognised equivalent (as determined by the QAS Commissioner) at the Paramedic P1 skill level.
Once registration comes into effect only a person who is registered with the Paramedicine Board as a paramedic will be able to use that title. Just that one example makes it clear that these awards will have to change to reflect the changing nature of what it is to be a paramedic.
The use of the term ‘paramedic’ by someone who is not registered will be an offence under the Health Practitioner Regulation National Law (see Is ‘Doctor’ a protected title? (February 14, 2018)) but the National Law does not set details of scope of practice or the like so there is no offence to practice paramedicine, or nursing, or as a medical practitioner – only an offence to use a protected title. So a person who is currently employed as a paramedic but who, for whatever reason does not register, could keep doing what they are doing, they just couldn’t call themselves ‘a paramedic’. So the use of the ‘term’ is a breach of the national law, not an award. But continuing in the role will lead to interesting industrial issues because, no doubt, the Ambulance Service will need (or want) to amend the award to say that a paramedic must be a registered paramedic but where does that leave a person who’s been performing their job under the current award, but who doesn’t want to register?
I can’t say what will happen when registration comes into effect, but it is something ambulance services should certainly be discussion with their employees.
The current NSWA uniform has the word paramedic across the back. Would a non registered person still be able to wear the uniform?
With my employment in the private sector – we have already determined that IAW the impending registration, an employee will only be able to hold the title where they have met the required criteria and obtained registration from the Board. Where an officer has not obtained registration or where an officer has lesser qualifications than the Bachelor Degree, eg. Diploma of Paramedic Science or Cert IV Health Care ((Ambulance) etc, a different title will e designated, and they will practice IAW their clinical scope as per the private service’s protocols, pharmacology and procedures, only where engaged by the business in their capacity.
The title protection isn’t a problem for us.
in accordance with
Seeing as you’ve been appointed to the Paramedicine Board of Australia – can you shed some light on something for me please.
I understand that only those with a Bachelor’s Degree in Paramedicine/Paramedical Science/Clinical Practice Paramedicine etc or those working for a state ambulance service (with a recognised Diploma) will be able to ‘REGISTER’ as a Paramedic with the Paramedicine Board of Australia and that’s fine with me as it does provide some protection for the term ‘Paramedic’.
I am currently studying a Diploma in Paramedical Science at present (with a view to study the Bachelor’s degree in the future) and was wondering if I can’t (when my my studies are completed) call myself a ‘Paramedic’ – what would those like myself, with a Diploma be called or what title would they be entitled to use?
Technically a ‘medic’ is not a protected name as St John’s Ambulance volunteers here in NSW (with a basic first aid course and limited knowledge) call themselves ‘medics’ as do Military trained medical personnel (with a diploma in nursing and also a diploma in paramedicine and advanced field experience/training) so there is no definition of what a ‘medic’ actually is or what they are trained to do.
Would the Paramedicine Board of Australia be willing to look at the possibility of registration of those with a Diploma in Paramedicine Certification (that don’t meet the required qualification standard to be registered as a Paramedic or to use that term) in another protected category ie: ‘Registered EMT’ or ‘Registered Medic’ or something like that to again, differentiate themselves as people trained to a certain level, with a required education qualification and able to provide a certain level of care with that qualification.
There defiantly needs to be more transparency around what I can see as 5 different levels of qualifications.
1. Bachelor Qualified (Paramedic)
2. Diploma Qualified (Paramedic)
3. Cert IV Qualified (Health Care)
4. Cert III Qualified (Patient Transport)
5. Basic First Aid Qualified
The above 5 levels of education and qualifications should all have a registered term/definition by which they are able to be labeled from an employment perspective and also that term protected for use by someone with that level of qualification only.
The Paramedicine Board of Australia has made a great first step – but I believe they have a lot more work to do on this to ensure those with all qualifications have some sort of protocol and legal obligation to follow.
Why not allow the first 4 a category of registration with Paramedicine Board of Australia based on qualifications and assign a protected working title to each.
I’d love to hear your thoughts on the above if you are able to comment at all.
I’ve been co-opted onto the board of Paramedics Australasia, ‘the peak professional organisation representing practitioners who provide paramedic services to the community’ (https://www.paramedics.org/about/) not the Paramedicine Board of Australia (http://www.paramedicineboard.gov.au/)
It is expected that, three years after the commencement date of registration, only those holding a degree or a diploma issued by NSW Ambulance will meet the qualifications for registration (but that is yet to be determined by the board).
For the first three years there will be ‘grandfathering’ to allow those currently practising as paramedics to register as paramedics, and to retain that registration even after the end of the three year transition period.
As noted in earlier posts, the Health Practitioner National Law stops people using protected titles. If your Diploma doesn’t meet the educational requirements and if you are unable to meet the ‘grandfathering’ requirements, then you would not be able to register as a paramedic, but you could use any non-protected title to describe yourself, including ‘medic’ (unless in the circumstances that gave rise to the impression that you meant ‘paramedic’ and were just using it as a short form).
The point of restricted titles is to let patients and those that contract for paramedic services that you are not a paramedic. If you are not paramedic they may want to question what you can do, what your skills are etc. But for registered paramedics they can know what the minimum skill set is and that there are procedures in place to make sure you are a fit and proper person to hold yourself out as being able to meet the practice standards that apply to paramedics.
What the attitude of the Paramedicine Board of Australia would be to registering different classes of paramedic remains to be seen. The power of the board will be limited. If a Board could just choose to register people, the Nurses Board could have registered paramedics. To get a profession onto the registration scheme requires convincing evidence to the government that the profession meets the criteria set out in various policy documents. The government has agreed that ‘paramedics’ are to be registered, not ‘EMT’s” or ‘Medics’. The paramedicine board may be able to register them, but they would all be registered paramedics but within different classes or scope of practice, just as there are enrolled nurses, registered nurses, nurse practitioners etc. But they can’t just create a new profession.
The paramedic board is there to register ‘paramedics’ (whatever that may end up meaning). They’re unlikely to be interested in registering patient transport officers or first aiders as that is the very point. They don’t need to be; once you have paramedics registered you know that a PT officer or a first aid officer is not a paramedic.
You finish you analysis with the statement that “I can’t say what will happen when registration comes into effect, but it is something ambulance services should certainly be discussion with their employees”.
We now know that the participation day is 1 December 2018, however to my knowledge NSW Ambulance has failed to commence any form of consultation whatsoever with it’s employees about the required material change in terms of employment.
There has been no direction to comply, nor has there been any indication at all what will occur when a large number of current operational staff inevitably do not comply with the new requirement to appear on the public register on participation day.
It now appears likely that we will end up with the position that operational service delivery across NSW may be significantly compromised, because the jurisdictional ambulance service has ignored a sensible approach to consult and negotiate with their employees (either through the unions or directly with their employees) about a material change in the conditions of their employment.
This process is reminiscent of the approach taken when the arrangements for the provision of Rescue Services by the then Ambulance Service of NSW were changed without consultation or negotiation, and instead staff were simply informed by text message the night before that they were not to turn up to work the next day.
Given the apparent unwillingness of the NSW Ambulance Executive to engage constructively on these issues, do you have any thoughts on a professional, pragmatic and constructive manner for NSW Ambulance Paramedics to progress the issue and ensure service delivery continues.
In addition, do you have any comments about the intersection between Industrial Law, the required changes to the current industrial agreement and the new registration arrangements. I’m sure many Paramedics would be interested if there was any particularly persuasive, relevant precedents which may guide us through the now inevitable last minute discussions with our employer.
I’m not sure how much of an issue it will be. Current paramedics will be able to continue to practice just as they are now even if they can’t use the title ‘paramedic’. In that respect, however, I understand that paramedics don’t need to be registered by 1 December, they just need to have applied by 1 December. The Paramedicine Board (at https://www.paramedicineboard.gov.au/Registration/How-to-apply.aspx) says “You can call yourself a ‘paramedic’ while your registration application is being considered as long as you submit the complete application before participation day (the day regulation of paramedicine takes effect).” No doubt it will take time for the industrial issues to work themselves out.