Today’s correspondent is concerned about the private event health services market in New South Wales. I’m asked:
… does NSW Ambulance have any control over private providers and if there is any legislation short of the festival guidelines that rule over these events. Or speedway, motocross, and rodeos, as there has been some serious injuries of late being reported in the media…
The answer is that in New South Wales the private event first aid/health services market is unregulated. Anyone with any qualification can set themselves up and offer to provide event health services (provided they don’t use the title ‘paramedic’).
It is my view, and I have argued elsewhere that in my view many if not all those providers will be acting contrary to the Health Services Act 1997 (NSW) s 67E (see Changes to ambulance legislation in NSW – about time too! (August 24, 2015) but note that the although the changes discussed there did pass through the Parliament, the Health Services Amendment (Ambulance Services) Act 2015 (NSW) has never been commenced; and Michael Eburn and Jason Bendall ‘The provision of Ambulance Services in Australia: a legal argument for the national registration of paramedics’ (2012) 8(4) Australian Journal of Paramedicine, Article 4)) . Section 67E says:
(1) A person must not:
(a) directly or indirectly provide or take part in the provision of transport for sick or injured persons for fee or reward, or
(b) conduct for fee or reward any operations similar to the operations carried on by the Health Secretary under this Chapter,
without the consent of the Health Secretary and except in accordance with such conditions (if any) as the Health Secretary may from time to time impose…
(3) This section does not apply to:
(a) the St John Ambulance Australia (NSW) in respect of operations similar to the operations lawfully carried on by that body immediately before the day on which this section commences, or
(b) the Royal Flying Doctor Service of Australia (NSW Section), or
(c) the mines rescue company, within the meaning of the Coal Industry Act 2001 , (or a member, director or employee of that company) in the exercise of mines rescue functions under Division 3 of Part 3, or Part 4, of that Act, or
(d) a member of the New South Wales Mines Rescue Brigade established under the Coal Industry Act 2001 , or
(e) any person (or class of persons) prescribed by the regulations.
(Those organisations listed in s 67E(3)(a) to (d) do not need the Health Secretary’s approval, their approval having been given by the NSW Parliament).
The ‘operations carried on by the Health Secretary under this Chapter’ is the provision of NSW Ambulance. Ambulance services are ‘services relating to the work of rendering first aid to, and the transport of, sick and injured persons’. NSW Ambulance will, for a fee, provide on-site health services at a public event – see NSW Ambulance, Special and sporting events user charges (1 February 2016). Anyone providing event first aid services is, in my view, conducting ‘operations similar to the operations carried on by the Health Secretary under this Chapter’.
Further, some people believe that the prohibition in s 67E(1)(a) on the provision of ambulance transport means that one cannot drive a patient to hospital, but that is not what s 67E says. The idea that private providers can transport around an event, say from the site of injury to a medical centre, was put and rejected in Paramedical Services Pty Ltd v The Ambulance Service of New South Wales  FCA 548. In that case, Justice Hely ‘concluded that the provision of event prehospital care and patient transport, even if that transport is limited to transportation around the event site, for example from a first aid post to a medical centre, was the provision of ambulance services and was, therefore, illegal without appropriate approval.’
When I, along with Jason Bendall wrote our article (cited above) we made an FOI application to NSW Ambulance asking how many approvals had been given under the then equivalent of s 67E. At that time the answer was ‘none’.
Recent deaths at music festivals prompted the NSW Government to move to issue Guidelines for Music Festival Event Organisers: Festival Harm Reduction (February 2019) there is also government advice for organisers of other events – see https://www.dpc.nsw.gov.au/tools-and-resources/event-starter-guide/health/ and advice from the Australian Institute for Disaster Resilience – Safe and Healthy Crowded Places Handbook (2018). Guidelines do not however regulate private providers of event health services.
Under the Work Health and Safety Act 2011 (NSW) any person or business conducting a business or undertaking must have in place adequate emergency and first aid procedures but that doesn’t regulate how, or by whom those services are to be provided (see Work Health and Safety Regulation 2017 (NSW) r 42; WorkCover First aid in the workplace: code of practice (July 2015)).
Victoria is moving to regulate this sector – see Review of the Non-Emergency Patient Transport Act 2003 and Regulation and Licencing of First Aid providers – Discussion Paper (28 June 2019) (see also Report on regulating first aid forum – Melbourne (May 16, 2019)). If and when that regulatory scheme is introduced, Victoria will be the first jurisdiction to regulate the sector.
I can break my correspondent’s question into several questions. They were:
… does NSW Ambulance have any control over private providers…
… and if there is any legislation short of the festival guidelines that rule over these events.
In my view the Health Services Act 1997 (NSW) s 67E is or should be relevant and it could, or should, be used to restrict private providers to those that have the approval of the Health Secretary. That would be consistent with the finding in Paramedical Services Pty Ltd v The Ambulance Service of New South Wales, but my understanding is that this Act has never been enforced in that way.
Or speedway, motocross, and rodeos, as there has been some serious injuries of late being reported in the media…
Speedway, motocross and rodeos and other events may well have their own standards of what type of health care is provided but that is a matter for the relevant governing bodies rather than legislation – see for example Confederation of Australian Motor Sports Medical Services/Requirements: Medical Services at Motor Sport Events (1 January 2018).