Today’s correspondent is a paramedic currently working
… for a private Paramedic company on a mine site. I am also a long serving Paramedic with Queensland Ambulance Service of over 28 years and still work as a casual for QAS.
I would like to put a request to you to possibly investigate the and hopefully help make change to an outdated QLD Health regulation for Paramedics working outside the state service.
Paramedics will all require registration by the end of the year as are all health care professionals. Paramedics working for Queensland Ambulance Service (QAS) are authorized to administer certain drugs as per drug protocols under the license of the Medical Director of QAS and are not required to consult and have autonomy to administer those drugs as per the drug protocol.
I am currently employed as a casual for QAS and have been employed with QAS for over 28 years.
My full time employment is now with a private sector Paramedic company working on a mine site as a Paramedic. Mine site industrial Paramedics have the same qualification’s as QAS and will all be registered the same as state Paramedics. Mine site Paramedics work under similar drug protocols as QAS but are required to consult a Doctor and do not have the same autonomy to administer most of the drugs in our drug protocol.
All Paramedics will have mandatory Indemnity Insurance and to be known as a Paramedic will require registration with AHPRA.
My request to you is to have the same professional respect for the mine site Paramedics as the State Paramedics with QAS and have the Health (Drugs And Poisons) Regulation 1996 (Qld) changed to reflect the current changes in professionalism with Paramedics and registration.
I have addressed these issues in an earlier post – see Administering drugs when paramedics are registered (October 3, 2018).
I note that the Health (Drugs and Poisons) Regulation 1996 (Qld) deals with the authority of ambulance officers employed by the Queensland Ambulance Service in regulations 66, 174, 262 and Appendix 2A. It is wrong to say that an officer’s authority to carry and administer scheduled drugs comes from ‘the license of the Medical Director of QAS’. It comes from the Health (Drugs And Poisons) Regulation 1996.
Other people are also authorised to carry drugs eg Queensland Ambulance Service—first responders (r 174A); members of St John Ambulance Australia—Queensland (r 174B) and Registered nurses (rr 67, 175, 263). I will not go through the details of when they can carry those drugs or the endorsements needed. The point is that the Regulations do provide for people to carry drugs whether that is on registration or upon certification by an identified office holder.
As it is now well known, from 1 December paramedics will be registered health professionals. That won’t automatically change the drug legislation but it may be that there will need to be changes. For example, the regulation uses the term ‘paramedic’ but this is not defined. With the introduction of registration it will, I suggest be taken to mean a ‘registered paramedic’ but that won’t help my correspondent as the term is used in the context of ambulance officers employed by QAS.
What that means is that, with registration, paramedics will still be able to carry and use drugs because they are working for QAS, not because they are registered paramedics. But given the term ‘paramedic’ will then mean something, the regulatory may in due course make provision for registered paramedics to carry drugs in the same way that there are regulations for ‘registered nurses’.
As I have noted elsewhere, the changes to paramedic practice that registration will bring will not happen overnight. It will take time for governments to be confident that registered paramedics are appropriately supervised by the Paramedicine Board and that the public interest warrants allowing registered paramedics to carry drugs away from their employer. Equally, it will take time to address these issues. Professional registration is only the first step. Registration will however empower paramedics by giving them a professional voice to lobby government.
Whether the right to carry and administer drugs will be given to paramedics or remain with their employer remains to be seen. These are not new or unforeseen issues. As I said in my previous post:
… in my view, paramedic registration is going to change the nature of paramedic practice, but it won’t do that overnight. Once paramedics are registered it will be possible for health departments to make rules that relate to ‘paramedics’, for example they will be able to make rules to the effect that ‘a paramedic may carry the following drugs’ (or some such). That they will be able to do that doesn’t mean they will and it certainly doesn’t mean they will when registration commences. Deciding what authority to give to paramedics will depend on evidence and arguments and timing submissions eg when poisons legislation comes up for review.
It would then follow that in Queensland currently, it would not be legal for a QAS credentialed paramedic to possess S8 and S4 drugs whilst working for someone other than the QAS, other than under reg 163AA of the Health (Drugs and Poison) Regulation 1996.
Yes, or if the other employer also had a relevant drug authority and could, in accordance with the terms of that authority, authorise an employee to carry and use the drugs. But in short a paramedics authority to carry and use drugs comes with their employer, it’s not personal so they cannot carry it with them.
Given the large number of first responder organisations now at large, who are not listed in the regulations as having endorsements to possess s4 and s8 drugs, it is curious why no form of prosecution has been made by the respective authorities. Would you hazard a guess?
Two reasons, not all authorities are in regulations so they may and probably do have an authority issued by the relevant department. Second even if they do not have an authority, law is not self executing. If people are carrying scheduled drugs without authority that has to be detected by a regulator who has to collect admissible evidence and determine prosecution warrants the resources ahead of other issues. It’s only likely to arise if this go wrong.