In Private paramedics transporting patients on public roads – Part 1 (November 4, 2022) I said 

What I infer we are talking about are companies that provide event health services or on-site work health services. I will assume that the relevant providers are employed by a company that contracts to provide on-site services at say, a mine, rather than paramedics directly employed by the mine site.  The power of employees of a mine to transport will be the discussion of a second post on this subject.

This is that second post.

The issue here is whether a company that employs paramedics, provides them with an ambulance and expects them to provide onsite health services which may include transporting injured workers around the work site is operating an ambulance service and whether those paramedics may take their injured colleague on a public street to a public hospital.

General principles

Let’s start with general principles.  Assume that someone you know is injured and needs to go to hospital. In no jurisdiction would anyone consider that you are operating an ambulance service if you decided to drive them to hospital in your own car. You may do that without reference to the jurisdictional ambulance service, or you may ring triple zero and being advised of the probable wait time decide to take them yourself.  Further ambulance services encourage everyone to save triple zero for an emergency, so if you determine the person needs to go to hospital but it’s not a life-threatening emergency you are encouraged to transport them yourself.  In any event you do not need permission and no-one would suggest an offence has been committed – so prima facie anyone can take anyone to hospital if they want to.

Further even a taxi driver commits no offence if he or she drives someone to hospital even though he or she will expect to get paid for that transport.

If that’s true let’s change the story a bit and assume that two paramedics live together.  A neighbour knocks on their door and asks for assistance. For whatever reason the paramedics decide to take the person to hospital rather than wait for the ‘duty crew’. One drives, the other is in the back with the patient. They provide care within their scope of practice taking into account the limited equipment that they have. Perhaps they are controlling bleeding by continuing to apply pressure and are monitoring pulse/BP/SPO2. They are not operating an ambulance service in that there is no formal service, no advertising that a service will be provided.  They are driving their neighbour to hospital. The fact that they are paramedics is just their neighbour’s good luck.

The conclusion from the discussion, above, is that anyone can drive someone to hospital if they want to. 

Work Health and Safety

Now let us assume a person is at work and they become ill or are injured.  The model Work Health and Safety Regulations 2011 (adopted in all jurisdictions other than Victoria) r 42(1) says:

A person conducting a business or undertaking at a workplace must ensure:

(a) the provision of first aid equipment for the workplace; and

(b) that each worker at the workplace has access to the equipment; and

(c) access to facilities for the administration of first aid …

Further regulation 43(1) says

A person conducting a business or undertaking at a workplace must ensure that an emergency plan is prepared for the workplace, that provides for the following:

(a) emergency procedures, including:…

(iv) medical treatment and assistance;

Just as anyone can driver their neighbour or friend to hospital, so may a person drive their work colleague to hospital. Again, ambulance services urge people to only call triple zero in an emergency. The first aid officer may think whatever happened it is not an emergency that warrants an ambulance so drives the person to hospital. Again, they commit no offence even if paramedics at the hospital think the case was an emergency (so they were providing ‘emergency’ transport) and even if they are getting paid their first aid allowance.

In short, anyone can drive someone to hospital if they want to.  So, what’s to stop paramedics employed by a company who operates a business with a large industrial site or, for the purposes of our discussion let us assume a mine site, from driving their colleague to hospital? In that earlier post – Private paramedics transporting patients on public roads – Part 1, I identified the legislation that prohibits private ambulance services to operate without a relevant licence or authority.  I won’t repeat those here but it may be worth referring back to those.

Big Hole Mining Company

Assume Big Hole Mining Company employs paramedics and buys an ambulance. The paramedics are directly employed as part of the onsite medical service.  It could be argued that Big Hole Mining Company is then providing ambulance services, but I don’t think so. In the context of my fictitious Big Hole Mining Company, they have WHS responsibilities to provide emergency care for their staff taking into account the nature of their work and their work site which may be very large and diverse. They are required to consider the nature of their workplace, the size of their site, the possible injuries and have appropriate emergency including emergency health services.  If they determine they need paramedics (and/or doctors or nurses) on site they are meeting their obligations. Having on site paramedics who can collect and transport injured workers to an on-site medical centre is not holding them company out as providing an ambulance service but rather they are meeting their duty to their employees and others on their work site.

Can their staff transport on the road?

I think so, but the answer does depend on the jurisdiction.

First rules prohibiting private ambulance services in NSW and Victoria are limited to services that operate ‘fee or reward’ or ‘payment’.  Provided the onsite paramedics, or the employer, is not charging the employees, or anyone else (eg a workers compensation insurer) for the service they are not acting for ‘fee or reward’ or for payment so are not caught by those provisions.

Second, I would also argue that they are not providing services ‘similar’ to those provided by NSWAS or Ambulance Tasmania. NSWAS and Ambulance Tasmania provide fee for service operations where they will respond to anyone that calls even though they have no pre-existing relationship with the caller.  They will also provide an on-site event health service at a concert or sporting event, but they do not set up ongoing medical centres at someone’s workplace. A workplace crew that only transports staff and visitors from the workplace as part of the employer’s WHS responsibilities is not, arguably, providing a service similar to the NSWAS or Ambulance Tasmania as that is not a service that either Service offers.

The mining company may be in breach of the law in Queensland, the ACT and South Australia. In Queensland the company must not ‘directly or indirectly imply that the person provides or participates in providing ambulance transport’. But they are providing ambulance transport even if that is only around their own work site – see Paramedical Services Pty Ltd v The Ambulance Service of New South Wales [1999] FCA 548.

In the ACT ambulance services are ‘the provision of medical treatment and pre-hospital patient care, and includes the transport of a patient by ambulance or medical rescue aircraft’ (Emergencies Act 2004 (ACT) s 60).  The staff paramedics are employed exactly to provide those services, so arguably even having an onsite ambulance that never leaves the workplace is, without approval from the Minister, a breach of the Emergencies Act 2004 (ACT) s 63.

The clearest prohibition appears in South Australia.  In South Australia an emergency ambulance service (Health Care Act 2008 (SA) s 3):

(a) responds to requests for medical assistance (whether made by 000 emergency telephone calls or other means) for persons who may have injuries or illnesses requiring immediate medical attention in order to maintain life or to alleviate suffering; and

(b) is set up to provide medical attention to save or maintain a person’s life or alleviate suffering while transporting the person to a hospital;

A work-based ambulance service responds to requests for medical assistance so meets the criteria in paragraph (a). If they transport them to a work medical centre that’s fine; but if they proceed to hospital they then meet the criteria in (b) so would appear to be an emergency ambulance.  If they are just driving an injured worker home, then there’s no issue, so they could transport a patient on a public street, but not a patient who needs intensive care enroute to hospital.

The mischief rule

One of the rules of statutory interpretation is the ‘mischief rule’ where you ask what is the mischief or problem that the statute was trying to fix.  I think the aim of all those prohibitions was to stop private ambulance companies competing with state services and entering the emergency market without supervision and regulation (remembering that these provisions have their history before paramedic registration).   The governments don’t want inner-city firms entering into contracts with All Paramedic Ambulance Pty Ltd where All Paramedic says, ‘call us, don’t call 000 and we’ll get their faster’.  Part of the issue is that the parties who contract cannot know or identify who is a good service provider and who is not. It seems to me that a company that employs its own paramedics to work within a work site, and even transport staff to hospital, is not the sort of service that the legislation is intended to prohibit but on a literal interpretation they may be caught at least in Queensland, South Australia and the ACT.  I would suggest that in all cases what is meant to be prohibited is a person or company setting up and advertising that they will provide ambulance services and particularly in NSW and Victoria, will charge to provide those services.

The ‘mischief rule’ can only be relied on where a literal reading of the legislation is incoherent or would lead to absurd results (such as a taxi driver being guilty for taking a person to hospital and wanting payment for the fare). It would be hard to apply in SA where the law is clearest. In that state if you are driving a person to hospital and you are ‘set up to provide medical attention to save or maintain a person’s life or alleviate suffering while transporting the person to a hospital’ then you need an emergency ambulance service licence, or to call the SAAS (or seek to rely on the ‘sudden defence’ exceptions discussed in Part 1).


There is no simple rule that says private paramedics cannot transport on a public street.  To that extent it is either a myth or a useful shorthand given all the other prohibitions. 

The problem with the prohibitions on the provision of ambulance services is that they are written in such broad terms they could, arguably, cover many services and actions that are not intended to be caught – taxi drivers driving a person to hospital, people doing first aid and work places providing the very emergency medical services that the WHS legislation requires them to provide. There has to an interpretation to limit the application of the literal provisions.

To resolve that the mischief rule asks us to look at why those prohibitions are in place. I suggest they are a consumer protection provision to stop people approaching workplaces and event organisers and offering to provide emergency services where those potential clients are not in a position to judge the service being offered.  And we don’t want private ambulance companies competing for work or – as in the bad old days of the tow truck industry – fighting for work at the scene of a car accident.

The prohibitions are, in my view, out of date given paramedic registration (see Michael Eburn and Ruth Townsend ‘Paramedicine in 10 years: What will it look like?’ (2019) 46 Response 18-20) but even so they remain.  The critical question then for paramedics employed by industry asking whether they can transport patients on a public road is to look at the terms of the prohibitions on the provision of ambulance services, and ask whether they are providing the sort of services that the legislation is intended to prohibit.

Where a hypothetical company like Big Hole Mining Pty Ltd employs paramedics as part of its WHS responsibilities, I don’t think the Mining company is providing ambulance services any more than it is operating a hospital if it has doctors on site.  It’s arguable that if they transport patients by ambulance – whether on site or on a public road – they may be breaching various prohibitions (particularly in Queensland, South Australia and the ACT), but I don’t think that is the mischief the law is intended to prevent.  And is there really a problem if mining staff in far west NSW or Queensland are driven to the local hospital in a company owned ambulance whilst being treated by company employed paramedics given they could lawfully be driven there by the shift supervisor in the company ute?

There may be good reasons not to transport patients off site.  Taking the ambulance away may require production to stop. And it may annoy the local ambulance/ health service.  And it may not be best practice depending on the skills and resources of the onsite team vis-à-vis the jurisdictional ambulance crew. But there is no simple legal rule that says an employer cannot arrange to have their employee taken to hospital by whatever means they wish, and the patient/staff member agrees to.


It may be a surprise that there is no simple answer to the question ‘can private paramedics transport patients on public roads?’  Except in the Non-Emergency Patient Transport and First Aid Services Act 2003 (Vic) the issue of public roads does not get a mention.  There is nothing in the Road Transport legislation nor ambulance services legislation that says ‘only jurisdictional ambulance services can transport patients on public roads’.  The prohibition (if there is one) has to be implied by the various prohibitions on the provision of unauthorised ambulance services and that begs the question of whether paramedics employed by industry as part of the onsite emergency response are providing a relevant, and otherwise prohibited, ambulance service.

Those provisions are so wide such that even a first aid officer could be in breach – but no-one seriously reads them so literally.  The prohibition is really aimed a private companies that advertise a service to the world – contract with us for your ambulance service – rather than companies the employ paramedics and provide an ambulance as part of their on-site emergency response.

For related discussion see

This blog is made possible with generous financial support from the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.