Today’s question comes from NSW and relates to the use of the title ‘paramedic’. My correspondent says
AHPRAs webpage says:
A person must be registered with the National Board if they:
- Take or use the title ‘paramedic’ in a way that could be reasonably expected to induce a belief that the person is registered under the National Law, (s 113(1)(a)) and/or
- take or use a title, name, initial, symbol, word or description that, having regard to the circumstances in which it is taken or used, indicates or could be reasonably understood to indicate, that the person is a paramedic or is authorised or qualified to practise in the paramedicine profession, (s 116(1)(b)) and/or
- claim to be registered under the National Law or hold themselves out registered under the National Law, (s 116(1)(c)) and/or
- claim to be qualified to practise as a paramedic (s 116(1)(d)).
I have noticed however that within the NSW service certain groups continue using the title without being registered. Several discussions have been had internally but it appears that the advice keeps being that as the government service we have certain exemptions from these provisions. Vocational entry officers and retired staff for example. In my station the vocational guys have the word Paramedic on insignia and often on their uniform, including in big lettering on their backs. Emails and other correspondence is generally addressed using the tile (eg Paramedic Eburn) even if they’re less than half-way through the course.
Outside the service I also see numerous companies such as Paramedical Services Pty Ltd and the Australian Paramedical College using paramedical as part of their trading name although they do not offer approved qualifications.
What are the actual rules around this and does the NSW service really have exemptions for the use of the title for their students and retired officers?
The website is just an interpretation of the law. We need to go to the actual legislation. The Health Practitioner Regulation National Law (NSW) s 113(1) says:
A person must not knowingly or recklessly–
(a) take or use a title in the Table to this section, in a way that could be reasonably expected to induce a belief the person is registered under this Law in the health profession listed beside the title in the Table, unless the person is registered in the profession, or
(b) take or use a prescribed title for a health profession, in a way that could be reasonably expected to induce a belief the person is registered under this Law in the profession, unless the person is registered in the profession.
The relevant title for paramedicine is ‘paramedic’. So, we can rewrite s 113(1) to say:
A person must not knowingly or recklessly–
(a) take or use [the title ‘paramedic’]… in a way that could be reasonably expected to induce a belief the person is registered under this Law in the health profession [of paramedicine…], unless the person is registered in the profession [of paramedicine], or
(b) take or use [the title ‘paramedic’]…, in a way that could be reasonably expected to induce a belief the person is registered under this Law in the profession [of paramedicine], unless the person is registered in the profession [of paramedicine].
Further, s 116(1) says:
A person who is not a registered health practitioner must not knowingly or recklessly–
(a) take or use the title of “registered health practitioner”, whether with or without any other words; or
(b) take or use a title, name, initial, symbol, word or description that, having regard to the circumstances in which it is taken or used, indicates or could be reasonably understood to indicate–
(i) the person is a health practitioner; or
(ii) the person is authorised or qualified to practise in a health profession; or
(c) claim to be registered under this Law or hold himself or herself out as being registered under this Law; or
(d) claim to be qualified to practise as a health practitioner.
There is one key exemption to this rule as it applies to paramedics. You can, according to the Paramedicine Board ‘… call yourself a ‘paramedic’ while your registration application is being considered as long as you submitted your application before participation day on 1 December 2018’ (see https://www.paramedicineboard.gov.au/Registration/After-youve-applied.aspx and Health Practitioner Regulation National Law (NSW) s 315).
New South Wales ambulance has no exemption that allows them to give the title to ‘paramedic’ to anyone who is not registered as a paramedic (or who applied for registration before 1 December 2018 and whose application is still being considered). NSW cannot call someone a medical practitioner who is not a doctor, they cannot call someone a paramedic who is not a registered paramedic.
A person who ‘holds a Diploma of Paramedical Science issued by the Ambulance Service of New South Wales’ has a qualification that leads to registration (Health Practitioner Regulation National Law (NSW) s 312) but that does not mean a student who has not yet completed the diploma, and been registered, can use the title. Students, including students in the NSW Ambulance Diploma, may be registered as student paramedics (Health Practitioner Regulation National Law (NSW) ss 87 and 313) but this still does not give them the right to use the title ‘paramedic’.
A person could use the title ‘retired paramedic’ or ‘student paramedic’ as those qualifiers – retired and student respectively – would not suggest that the person is registered – see https://www.paramedicineboard.gov.au/Professional-standards/FAQ/Fact-sheet-Using-the-title-paramedic-after-1-December-2018.aspx see also The use of protected titles by students and others (January 30, 2018).
The use of the term ‘paramedical’ ‘… as part of [a] … trading name …’ probably doesn’t breach the Act either. No-one would think that the company Paramedical Services Pty Ltd is a registered paramedic anymore than one would think the Australian College of Nursing is a registered nurse. The use of the word ‘paramedic’ or ‘paramedicine’ or even ‘paramedical’ could be problematic if it was used on the side of a vehicle and gave the impression that the vehicle was staffed by registered paramedics (see ss 113(2), 116(2) and 117(3)) but that all depends on context.
Conclusion
The rules set out in the Health Practitioner Regulation National Law (NSW) ss 113(1) and 116(1) quoted above, along with rules 113(2), 116(2) and 117 referred to but not quoted, are ‘the actual rules around’ the use of the title ‘paramedics’.
The rules do not give ‘the NSW service … exemptions for the use of the title for their students and retired officers’. Only a registered paramedic can use the title ‘paramedic’.
Australian Emergency Law 
Very well explained.
Would this mean that a vehicle with ‘paramedic’ or ‘paramedical …’ staffed by PTO’s EMTs or RMTs is in breach?
This is what I said in the post “The use of the word ‘paramedic’ or ‘paramedicine’ or even ‘paramedical’ could be problematic if it was used on the side of a vehicle and gave the impression that the vehicle was staffed by registered paramedics (see ss 113(2), 116(2) and 117(3)) but that all depends on context.” I can’t add more to that.
Hi,
I’m a Vocational Ambulance Officer (NSW). We gain our Diploma in Paramedicine at the end of our first year of training. Once we have our Diploma, I believe we are then classed as Trainee Paramedic.
Due to recent changes in registration requirements, Vocational Paramedics may still be classed as Ambulance Officers until registered. The same applies for those who are Unversity trained.
Hope that clears some things up!
You may be classed as a ‘trainee paramedic’ by NSWAS but that’s an internal matter. You’re a student paramedic when a student in the Diploma ((Health Practitioner Regulation National Law (NSW) s 313). Of course you can use the title ‘ambulance officer’ until registered, that is not a protected title. The answer is clear, if you are a registered paramedic you can use the title paramedic, if you are not a registered paramedic, you cannot use that title.
The public barely know what a paramedic is. How do we expect them to understand the difference between an ambulance officer, trainee paramedic and a registered paramedic? Internal communication is one thing but we cannot really control what other people choose to call us.
The law isn’t much interested in what lay people call you, it is interested in how you and organisations you work for represent yourself to others.
I previously said in another thread …
That the public once respected the title, and the person wearing the ‘paramedic shield’.
As it is now being realised, there is an over-sight in not enforcing the random use of the word ‘paramedic’.
Of course NSWAS students will parade around wearing ‘Paramedic’ on their uniform if given the opportunity to ….
There are several administrations to blame for the decline in standards here.
But overall, NSW Government will ALWAYS justify the actions of it’s bureaucratic bumbling fools ….
I’m not sure I would agree with all these points. First I suspect the public never distinguished between those wearing the ‘paramedic shield’ (ie intensive care paramedics) and ambulance officers and people in the first aid post at an event. I’m sure people would have said, when needing first aid ‘go and see the paramedics’ without making any distinction. Readers Digest has rated Australia’s most trusted professions and paramedics have been consistently rated 1 or 2 but that does not mean those that voted understood the term. I suspect that the public respect and value those that turn up in an ambulance when they call triple zero, not paramedics as they were defined.
Second, I don’t think it is ‘now being realised, there is an over-sight in not enforcing the random use of the word ‘paramedic’.’ That was realised as part of the argument to register paramedics. Before 1 December 2018 anyone could call themselves a paramedic and the word ‘paramedic’ meant whatever the person using it meant it to mean. The fact that paramedic had some cultural value but was in fact undefined lead to enforcing the use of the word. It is no longer random – only those that are registered can use the title. If others are using it, that is contrary to law but of course law can only get obeyed if people know and understand it (and the comments here suggest even those in the industry don’t fully understand it). Further regulators need to be made aware of a breach before they can do anything. So there is not an ‘over-sight in not enforcing the random use of the word ‘paramedic’.’ The power to enforce the use of the word has only existed since 1 December 2018 and it takes time for the process to settle.
I’m not sure what you see has been a NSW Government bungle, NSW did (albeit reluctantly) come on board with registration. And although my correspondent says people in NSW Ambulance have ‘paramedic’ insignia when not yet registered, other commentators have disputed that.
I don’t believe the commentators on Facebook are disputing that some people wear insignia, uniform items or tabbards they shouldn’t. I of course don’t presume to know what occurs at every single station across the state but I believe what most are saying is that it is not meant to happen.
A person who has completed a 3 year bachelor degree in Paramedicine (with or without practical experience in the field) will be registered as a Paramedic and therefore allowed to use the title.
To my understanding registration and legally protecting the title “Paramedic” is designed to ultimately protect Patients. Making sure Patients receive a standard of care, skill, experience and education when being treated medically. Any deviation from this is now illegal.
However the field of Paramedicine is unique because we go to the Patients, instead of them going to a Physio/GP/Doctor/Hospital staffed with Nurses etc… and therefore i feel needs unique consideration. It’s just my thoughts but around Australia I see people dressed in the same uniforms as Paramedics with the only difference being a small insignia to differentiate. Driving the same looking van/vehicles touting EMERGENCY and others features. I feel that the Public should have the right to clearly understand who has turned up to treat them, what their level of skill, experience, education and title is before they make an INFORMED decision around treatment. They automatically receive this when they go to their Physio, GP, health clinic etc… In the pre-hospital setting it falls on the individual and organisation to clearly define this for the public.
I think we have a way to go. But it’s great that people are starting and engaging in the discussion around it .
I think it’s going to take a while for our culture to come to terms with the fact that the title is now actually restricted. I believe there’s going to continue to be an attitude among a lot of people that leads to sentences like … ‘Sure it’s protected, but COME ON – this guy has been in an ambulance for 20 years, just because he didn’t register with AHPRA doesn’t mean he’s NOT a paramedic anymore”
When, of course, that’s exactly what it means.
What is eventually going to change this is are notices from the Board (or whatever other appropriate body, I don’t know who would do it) saying ‘You’re breaking the law. Stop it, or charges will follow’
There’s an old saying that sometimes you have to shoot the leader to turn the herd. This is a cultural change that we need to make as a profession and it’s going to take time. Hopefully, we can all do it carefully and compassionately. It’s a pretty hard blow to someone if they have thought of themselves as a paramedic for a lot of their life and then they suddenly have to face the fact that they can’t legally call themselves that anymore.
But whether we do it hard and fast, or slow and gentle, it’s going to take time for situations like this to resolve.