Today’s correspondent is:
… a recent graduate from a paramedic degree and I have attained registered status from AHPRA. I have so far been unsuccessful in attaining employment with an ambulance service, so I have continued working at a supermarket where I have worked for the last several years during my university degree. During this time I have always had a first aid and CPR certificate and had been paid a ‘first aid allowance’ from my employer as I am a designated first aider in my workplace. Recently my first aid certificate and CPR has expired, normally in this circumstance my employer offers to pay for the required training to reattain the first aid certificate, in this instance my employer (who was aware I was studying and had graduated from a paramedicine degree) has asked me to provide my paramedic degree/registration as a means of continuing my status as a ‘designated first aider’. In addition to this, on the list of designated first aiders it was proposed that I would be designated as a ‘paramedic’, and these lists are displayed at each of the various workplace first aid kits.
Having done some brief reading I came across your article titled ‘professional insurance for nurses providing on site first aid’ I have become thoroughly concerned that I could land myself in trouble if I go along with the proposed idea from my employer as I have no PII insurance and very limited idea about potential legal liability to myself while being registered as a paramedic but not currently engaged in employment as a paramedic. My general feeling that this arrangement is inappropriate and I should just reattain my first aid and CPR certificate to avoid complications, but I was just interested on your thoughts about this or perhaps if you had written or could recommend some literature which may shed some light.
The Model Work Health and Safety legislation provides that a Person conducting a business or undertaking must ensure that there are persons to deliver first aid in the work place (Model Work Health and Safety Regulations r 42). It’s no longer the case that regulations say that a first aider has to have a particular first aid certificate. The PCBU has to do a risk assessment and have the first aid procedures, equipment and people suitable to the workplace and risk – see Model Code of Practice: First aid in the workplace (25 May 2018). It follows that it’s not unlawful for the PCBU to say to a registered paramedic ‘I’ll pay you the first aid allowance based on your current registration as a paramedic’ without requiring the paramedic to do another first aid course or recertification.
Only a paramedic can use the title ‘paramedic’ so putting that title on the first aid lists is not problematic.
If my correspondent retains a ‘first aid and CPR certificate’ and is listed as a first aider on the first aid lists … it makes no difference at all. My correspondent IS a registered paramedic. What it says on the lists and what other qualifications are held in no way changes that position.
If he or she is going to provide some care to the sick or injured he or she is going to ‘skills and knowledge as a health practitioner’, it will be impossible not to. I have argued that if a paramedic steps up to an unexpected accident and provides first aid that should not be regarded as practicing their profession (see Eburn, M ‘Registered paramedics, insurance and first aid – looking for coherence in law’ (2019) 16 Australasian Journal of Paramedicine) but that argument would be much harder to make if you are being paid to provide first aid regardless of whether that’s a professional paramedic salary or a first aid allowance. What follows is that Professional Indemnity insurance is required (see Paramedicine Board, Professional indemnity insurance arrangements registration standard (17 May 2018)). Relevant insurance can be provided by an employer but it must meet the requirements set out in  of that Standard.
As an employee my correspondent’s employer will be vicariously liable for any negligence. That liability will meet (a) but whether it would be accepted that this cover extended to (b) and (c) would require consideration of the insurance arrangements in place.
What follows is that my correspondent could argue that
- he or she is not, simply by being designated as a workplace first aider not practicing the profession of paramedicine; and/or
- that the cover provided by the employer meets the requirements of the Professional Indemnity Registration Standard.
Who wants to have an argument? The sensible alternative is to buy some PII. It’s readily available and reasonably cheap, for example Guild Insurance in collaboration with Paramedics Australasia (of which I am a board member) offers PII for an ‘employee first responder < 20 hours per week’ for $110 a year. For an ‘employee paramedic < 20 hours per week’ the quoted annual premium is $121. There are other PII providers available and having PII would allow my correspondent to easily take advantage of other opportunities that may arise as he or she looks for work in the paramedic field.
My correspondent is a registered paramedic. If he or she is going to be paid to provide first aid in the workplace then prima facie PII is required. There are arguments against that proposition so one can be prepared to work on that basis and be prepared to run those arguments should the issue arise, or one could invest in some PII and all the problems go away.
Could you please provide some clarification on PII? My understanding was that to be registered you must have PII. I understand for many people this comes from their employer(s) however I was of the understanding as well that you must have cover 24/7, 365 days, which covers you should you be working employed, volunteering (either or both with provided cover from the employer) but also teaching, being in the community and potentially rendering first aid services. You outlined in this post that it’s almost impossible to provide first aid services (planned or as a Good Samaritan) without practicing as a paramedic. Even if you aren’t putting in IV’s and decompressing chests you are still using your brain which is full of paramedic knowledge. I have cover through my union and clarification in writing that this covers me for all the activities I do with different employers, states and environments however, in the example below, should this paramedic be holding their own PII to satisfy the Board requirements to hold registration and, irrespective of how broadly our employers PII may cover us, to cover themselves.
The answers are found in the Paramedicine Board’s Professional indemnity insurance arrangements registration standard (17 May 2018)) (https://www.paramedicineboard.gov.au/Professional-standards/Registration-standards/Professional-indemnity-insurance-arrangements.aspx) and my article, Eburn, M ‘Registered paramedics, insurance and first aid – looking for coherence in law’ (2019) 16 Australasian Journal of Paramedicine (https://ajp.paramedics.org/index.php/ajp/article/view/663).
1. You don’t need PI insurance to get registered, you need it when you practice your profession (Health Practitioner Regulation National Law s 129).
2. You need cover when you are practising, not ‘24/7 365 days’.
The answer to the question ‘should this paramedic be holding their own PII to satisfy the Board requirements to hold registration and, irrespective of how broadly our employers PII may cover us, to cover themselves’ is in the post- “If he or she is going to be paid to provide first aid in the workplace then prima facie PII is required. There are arguments against that proposition so one can be prepared to work on that basis and be prepared to run those arguments should the issue arise, or one could invest in some PII and all the problems go away.”
Vicarious liabilty ?
Your employer is responsibile for your actions. So is your volunteer group, should you be a volunteer first aider.
Further, my ubderstanding is ( for Nurses and doctors anyway ) …. is that you need to be covered by your own private policy …. when in PRIVATE PRACTISE.
Meaning, you work for yourself, and you charge a fee for ‘professional services’ …..
As I said in the post
“As an employee my correspondent’s employer will be vicariously liable for any negligence. That liability will meet (a) but whether it would be accepted that this cover extended to (b) and (c) [of the Paramedicine Board’s Professional indemnity insurance arrangements registration standard (17 May 2018)] would require consideration of the insurance arrangements in place.”
If a registered health professional is working for a health service for example a paramedic working for a jurisdictional ambulance service, there will be no problem but a paramedic working at a supermarket and being paid a first aid allowance would want to ‘ask what is covered by the third-party PII arrangement.’
The notion of vicarious liability will indeed ensure that the employer is liable for any negligence by the staff member in his or her capacity as a first aid officer, but it doesn’t address the issue of whether or not there is compliance with the Health Practitioner Regulation National Law.
Private practice is not the test nor is ‘you work for yourself, and you charge a fee for ‘professional services’. You need PII when practising the profession for which a health practitioner is registered. The definition of ‘practice’ from the registration standard, quoted in the post Exploring paramedic professional indemnity insurance (https://emergencylaw.wordpress.com/2019/06/15/exploring-paramedic-professional-indemnity-insurance/) says practice is ‘any role, whether remunerated or not…’
Whether a practitioner charges a fee for professional service is irrelevant. Whether they are employed or not is relevant as that does bring in the issue of vicarious liability but it does not mean that any cover provided by the employer meets the requirements of (b) and (c) of the Paramedicine Board’s Professional indemnity insurance arrangements registration standard (17 May 2018).
For further discussion on what it means to practice the profession do read my paper in the Australian Journal of Paramedicine – https://ajp.paramedics.org/index.php/ajp/article/view/663