This question comes from a registered Paramedic who is

…also a qualified Practitioner [in a health field that is not registered under the Health Practitioner Regulation National Law] and, while this is currently not regulated, the [Professional Association] provides Membership and practice oversight. In order to join as a practitioner and teacher I needed to provide them with evidence of my training as well as my indemnity Insurance … but they also asked me for a current First Aid certificate. When I stated that I am a current registered Paramedic they stated that this didn’t matter and that the law required all health professionals even registered Doctors, nurses and paramedics to produce a current First Aid certificate. They only require HLTAID003 however it is an added expense of course and I find it extraordinary that registered health practitioners would need to provide this by Law. Can you shed any further light on this for me please?

I did ask if my correspondent could direct me to the law they were referring to. They were told ‘that it was a requirement in the National Code of Conduct for Health Care Workers’.

The National Code of Conduct for Health Care Workers is a product of the Council of Australian Governments (COAG). The National Code is set out as Appendix 1 to the COAG communique of 17 April 2015 (see also COAG Health Council Final Report: A National Code of Conduct for health care workers (17 April 2015)). The National Code is a recommendation. On its own it has no legal effect. It was a recommendation of the COAG report that:

That a National Code of Conduct for health care workers in the terms set out in Appendix 1 be approved as the basis for enactment of a nationally consistent code-regulation regime for all health care workers.

and

That jurisdictions use their best endeavours to enact or amend legislation to give effect to the National Code of Conduct and a nationally consistent code-regulation regime for health care workers.

New South Wales, South Australia and Queensland all had forms of a code for unregistered health professionals prior to the National Code.  NSW still retain its code whereas South Australia and Queensland have amended theirs to bring them into line with the National Code. The National Code has been adopted in Victoria: see Public Health Regulation 2012 (NSW) Schedule 3, Health Ombudsman Regulation 2014 (Qld) and National Code of Conduct for Health Care Workers (Queensland), Health and Community Services Complaints Regulations 2019 (SA), Schedule 2 and Health Complaints Act 2016 (Vic) Schedule 2.

The NSW code says (at [3] emphasis added):

(1)       A health practitioner must provide health services in a safe and ethical manner.

(2)       Without limiting subclause (1), health practitioners must comply with the following principles–…

(k)       a health practitioner must ensure that appropriate first aid is available to deal with any misadventure during a client consultation…

The National Code, along with the codes in Queensland, South Australia and Victoria says (at [7] in South Australia, [5] in the other states and the National Code; emphasis added):

1)         A health care worker must take appropriate and timely measures to minimise harm to clients when an adverse event occurs in the course of providing treatment or care.

2)         Without limiting subclause (1), a health care worker must:

a) ensure that appropriate first aid is available to deal with any adverse event …

The question

My correspondent was told ‘that the law required all health professionals even registered Doctors, nurses and paramedics to produce a current First Aid certificate’. I am asked if I can ‘shed any further light on this’ claim. The material above shows that neither the NSW nor the National Code require a registered health professional to have a standard first aid certificate.

The Codes require that a practitioner ‘ensure that appropriate first aid is available to deal with any adverse event’ but does not prescribe any qualifications for that purpose. Having a paramedic on site would be a way to ‘ensure that appropriate first aid is available to deal with any adverse event’.

A registered paramedic could practice their second profession without a first aid certificate and without being in breach of the NSW or National Code. A professional association however may require practitioners to have a first aid certificate, as that makes it easier for the membership secretary to tick off that they have provided the necessary certification. If the paramedic wanted to join that Association they would need to get a certificate or persuade them that Registration as a paramedic means you meet the Code’s requirement and you can and do ensure ‘that appropriate first aid is available to deal with any adverse event’.

One can understand for example that doctors and nurses might have to get a first aid certificate because it may have been years since they have done anything that looks like first aid or CPR. For paramedics, at least those actively employed, providing ‘appropriate first aid’ is their key role – it’s what sets paramedics apart from other health professions (and see the discussion in Eburn M. Registered paramedics, insurance and first aid – looking for coherence in law. Australasian Journal of Paramedicine [Internet]. 2019 Feb.4 [cited 2020 Aug.1];160. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/663). The problem is that paramedics, and readers of this blog may have a view of what paramedics do and what paramedic registration means, but others may not.

Conclusion

The NSW Code of Conduct and the National Code of Conduct for Health Care Workers adopted in Queensland, South Australia and Victoria require a person practicing as an unregistered health professional to ensure that appropriate first aid is available. They do not prescribe the qualification to meet that requirement. It is up to the practitioner to determine what is ‘appropriate first aid’ and how they will ensure that it is available. If the practitioner is also a registered paramedic he or she may quite reasonably believe that their presence (along with any necessary equipment, eg a first aid kit and an AED) meets these requirement. The Codes do not require the practitioner to have an HLTAID003 first aid certificate.

A professional Association can of course set its own membership requirements. They could insist, as part of their rules, that a potential member have an HLTAID003 first aid certificate but that is a different matter and not a matter of law.