Today’s another question from a member of the Queensland Ambulance Service. I am told that:
… the Queensland Ambulance Service (QAS) is implementing a roster enhancement at our rural station. By creating an additional afternoon shift into what was previously a 10-hour day shift and 14-hour on-call overnight. The on-call component requires QAS Paramedics to take an ambulance to their residence with schedule 8 narcotics to respond to incidents from home.
This practice is common at rural stations within the QAS with on-call officers being on duty for the duration of their on-call shift and being paid an allowance to respond from home. The concern I have is, the QAS have an expectation that with the addition of the afternoon shift to our roster that during our on-call period there will be 4-hours where the on-call officer ceases on-call; after 0700 and before they commence the afternoon shift at 1100 on the same day.
This creates a dilemma: having an ambulance vehicle at an officer’s personal residence, logged off and off duty, with S8 Narcotics still in the officer’s possession. The problem is that officer then has a vehicle at their residence when off duty for 4 hours or whilst trying to maintain sleep for their fatigue break.
QAS have had these types of rosters in place for a number of years, and I have been told that there is approval for such a circumstance having a vehicle at a private residence with S8s off duty. I myself cannot find reference in the Drug Management Code of Practice or AHPRA allowing Paramedics to have S8s at home whilst off duty other than being told “it’s a QAS approved practice”
The following is what was provided in the email advising the structure of approving rosters within the QAS.
“The roster approval process formally considers background, issues, consultation, financial implications, legal implications, human rights implications and is ultimately signed off by the Chief Operating Officer. The roster compliance is also endorsed by the following: Chief Operating Officer, Deputy Commissioner Operations, State Governance and Assurance Unit Manager, Regional Assistant Commissioner, and a United Workers Union Representative.”
Additionally, I fear litigation as the optics are poor by having that vehicle and drugs in my possession whilst off duty. What are my obligations? Am I obligated to treat my neighbour if they see the Ambulance at my house whilst I am off duty? Am I found to be negligent if I decided to attend Bunnings in the 4 hours before I commence my afternoon shift and a member of the public sees the QAS vehicle at my residence and brings their sick/injured child for treatment and I’m not there? Or the drugs get stolen damaged etc from my vehicle while I’m not there?
We can deal with one issue immediately and that is, whatever the answer, it has nothing to do with AHPRA. It is not AHPRA that regulates a paramedics authority to possess drugs or issues of rosters etc. This is all down to QAS.
The authority of a QAS officer to be in possession of s 4 and s 8 drugs is found in the Medicines and Poisons (Medicines) Regulation 2021 (Qld) sch 5. An ambulance officer is authorised to possess ‘an S4 or S 8 medicine mentioned in the extended practice authority called ‘Queensland Ambulance Service’’. Each medication must be the subject of a health management protocol indicating such things as indications and contra-indications for the medication, dosages, how it is to be administered etc (Extended practice authority: Queensland Ambulance Service (11 March 2025) Appendix 2, [3]). For ambulance officers not working as Isolated Practice Area Paramedics these are generally to be found in the Drug Therapy Protocols that form part of the QAS Clinical Practice Manual (and see for example the protocol for Morphine (July 2022)).
Schedule 8 drugs must be kept secure. Where they are kept must comply with the departmental standard for the secure storage of s8 drugs (Medicines and Poisons (Medicines) Regulation 2021 (Qld) r 197)). Where drugs are in the possession of a QAS Ambulance Officer they must be kept:
i. … at a place an ambulance officer is attending to treat patients; or
ii. kept in a Queensland Ambulance Service (QAS) vehicle.
Where the drugs are in a QAS vehicle concealed they must be in a ‘metal compartment designed for storage of the bag, box or container in a QAS vehicle. The QAS vehicle must be locked when unattended’ (Queensland Government, Queensland Health Departmental Standard Secure storage of S8 medicines (v 2, 1 July 2023), Table 3, p. 9).
What follows from that is that the ambulance officer, even if not ‘on call’, is permitted to possess those s8 drugs if that is consistent with the authority granted by QAS. The authority to park the ambulance at home, with s 8 drugs in it is the same whether they are ‘on call’ or not; they are relying on the authority given by QAS. It follows that if it has been signed off by the appropriate decision makers, that gives sufficient authority.
Equally provided the drugs are kept in a locked QAS vehicle then the storage requirements are met.
Let me then turn to the specific questions:
Am I obligated to treat my neighbour if they see the Ambulance at my house whilst I am off duty?
Am I found to be negligent if I decided to attend Bunnings in the 4 hours before I commence my afternoon shift and a member of the public sees the QAS vehicle at my residence and brings their sick/injured child for treatment and I’m not there?
Or the drugs get stolen damaged etc from my vehicle while I’m not there?
Whether you would have a duty to assist if someone knocked on the door would depend on the facts. Cases like Stuart v Kirkland-Veenstra [2009] HCA 15 and Dekker v Medical Board of Australia [2014] WASCA 216 might suggest not; but Lowns v Woods (1996) Aust Torts Reports 81-376 points the other way. The problem is all those cases would be distinguishable – Kirkland-Veenstra and Dekker’s case say there is no general duty to rescue but specific circumstances may give rise to a duty. The police in Kirkland-Veenstra had no power to act so could be under no duty but that would not be the case here. Dr Dekker had no equipment and good reason not to stop at the accident and there as no evidence led as to what she might have done to make a difference other than what she did, which was drive to the police station and report the accident. None of that applies where a paramedic, even if they are tired, is at home with a fully equipped ambulance signposting that they are a paramedic. Dr Woods on the other hand was not ‘off duty’ he was at work, ready to see patients.
In Lowns v Woods (1996) Aust Torts Reports 81-376, Dr Lowns was found liable for failing to go and render assistance to a person who was nearby when he had been asked to assist because he was a doctor. In that case, however, he was at his place of practice ready willing and able to see patients. He was not ‘off duty’. The critical point however is that he was identified as a doctor by the red light and sign at his practice. In the same way someone who comes and knocks on the paramedic’s door because they can see the ambulance parked there is not knocking on a neighbour’s door, they are knocking on a paramedic’s door, and they are seeking assistance from QAS. I agree that the optics would be bad if the paramedic refused to assist or if their partner said ‘I’m not going to wake them, they’re not on call, go and ring triple zero and they’ll send someone’.
Lowns v Woods turned on the presence of a particular provision in the Medical Practice Act 1938 (NSW) (now repealed) that said it was professional misconduct for a medical practitioner to fail to render emergency assistance when asked. That rule is not part of the Health Practitioner Regulation National Law save that NSW has kept it in the version of the national law that applies in that state (see Health Practitioner Regulation National Law (NSW) s 139C(c)). That section is still limited to medical practitioners (not paramedics) and means that conduct can amount to ‘unsatisfactory professional conduct’.
Lowns v Woods also turned on its particular facts and admissions from the Doctor in particular that if he had attended, he would have been able to successfully treat Patrick Woods, even though the paramedics who attended could not. The standing of the case as a precedent is unclear in light of subsequent decisions such as Dekker v Medical Board of Australia [2014] WASCA 216 (see Further legal ruling affecting ‘Doctors as ‘good Samaritans’ – do I have to stop?’ (January 3, 2015)).
As I have said when discussion Lown’s case, who are you going to sue? The doctor who comes and says ‘there’s nothing I can do, let’s leave it to the paramedics’ or the doctor who says ‘no, I’m not coming’? The outrage that was felt by Patrick Woods’ parents was transferred to legal action. I can imagine that a person who knocked on a paramedic’s door, where there is an ambulance parked outside, and who was told ‘I’m not coming I’m off duty’ would be equally outraged and would, if there were adverse outcomes for them or their family member that could have been avoided with more timely care, want to sue and/or make a complaint about poor professional performance.
I would make the argument that if you have an ambulance parked outside your house, stocked with the tools of trade, you are not ‘off duty’, what you are is ‘not on call’ that is QAS won’t ring you, but if someone knocks on your door they are approaching QAS, not you personally. As you represent QAS and they have called QAS (even if they have not called triple zero; see Failure to attend by NSW Police and Ambulance (December 18, 2013)) then it would have to be arguable that QAS could be liable.
It’s quite a different situation if you are not at home. In the same way someone could go and knock on the door of the ambulance station, but if there’s no one there, then there is no one there. A person knocking on the door is looking for the paramedic, not the ambulance and if you’re not there then there is nothing you, or they, can do.
You cannot be liable if the drugs are stolen provided, they were secured as required by the Departmental Standard for the Secure storage of S8 medicines. That is all you can reasonably be expected to do, and you will not be liable for the criminal conduct of others.
Conclusion
I see no problem with having the ambulance, stocked with s 8 drugs, at a paramedic’s home whilst the paramedic is not ‘on call’ if those arrangements have been endorsed by QAS and the drugs are secured in the ambulance as required by the Queensland Health Departmental Standard Secure storage of S8 medicines.
Whether there would be a duty to assist if someone knocked on the door would be debatable and would depend on the particular facts and circumstances. I would think, on balance, there would be a duty to do something if there was reason to think there was a life threatening emergency in circumstances where action by the paramedic is likely to save a life or prevent long term threats to health and safety. Whatever the outcome, the person is more likely to seek legal redress if you say ‘I’m not on duty, call 000’ than if you say ‘I’ll come and see what I can do’.
There could be no liability if someone knocks on the door and you’re not home.
There could be no liability if someone steals the drugs provided they are secured as required by the Queensland Health Departmental Standard Secure storage of S8 medicines.
This blog is a general discussion of legal principles only. It is not legal advice. Do not rely on the information here to make decisions regarding your legal position or to make decisions that affect your legal rights or responsibilities. For advice on your particular circumstances always consult an admitted legal practitioner in your state or territory.
Australian Emergency Law 
interesting perspective on a QAS Paramedic while off duty the ambulance vehicle and the safe storage of S8 drugs. Especially on a QAS vehicle being allowed to be parked at a private residence of an off-duty Paramedic. I just looked at the Queenland Medicines and Poisons Act 2019 in your link. the legislation states S8 drugs are to be secured within a safe. refer “Table 1: General requirements for an S8 safe in the Queensland Health Departmental Standard
Secure storage of S8 medicines – version 2 1 July 2023″Outcome Minimum requirements
It is not possible to easily
remove the S8 safe from
the premises in which it is
located.
The S8 safe:
i. weighs more than 350kg; or
ii. is securely attached to the premises.
Note – See the glossary for a definition of securely attached to the
premises.
The S8 safe restricts unauthorised access to the content of the safe.
The S8 safe has the following body, door and lock properties:
i. constructed of mild steel plate of not less than 10 mm
thickness; and
ii. constructed with continuous welding of all joints; and
iii. fitted with a door constructed of mild steel plate of not less
than 10 mm thickness, swung on hinges that do not allow the
door to be opened if the hinge is removed, the door being
flush fitting with a clearance around the door of not more
than 1·5 mm; and
iv. fitted with a fixed locking bar, welded to the inside face of the
door near the hinge edge, which engages in a rebate when
the door is closed; and
v. fitted with a 6-lever lock securely fixed to the rear face of the
door. Does this mean the off-duty paramedic while off duty with the QAS vehicle parked at their home is responsible for the securety and storage of the S8 drugs and has to remove all S8 & even s4 drugs and lock all the s8 & s4 drugs securely within a fixed bolted safe on their premises meeting the required standards of the Queensland Health Departmental Standard Secure storage of S8 medicines
No it doesn’t meant that. You are looking at table 1 of the Queensland Health Departmental Standard Secure storage of S8 medicines which is headed ‘general requirements for an s 8 safe’. It says what are the requirements for a safe, not when the drugs have to be in a safe. Ambulance officers do not have to keep the drugs in a safe, if they did they couldn’t leave them in an ambulance when delivering a patent to hospital. Table 3 is ‘other acceptable s 8 safes’ and it is that table that says drugs that are the possession of an ambulance officer may be kept in the locked ambulnace in a metal compartment designed for that purpose.
G’day Michael, the author of the inquiry above, I wanted your take on the Fair Work Commissions – Right to Disconnect applying to the given scenario.
The Right to Disconnect Fact Sheet states:
“contact, or attempted contact, from:
• their employer, or
• another person, if the contact or attempted contact is work-related.”
Although not common place, I know of officers working the Roster with 4 hours off duty who have been contacted whilst not on duty for work related reasons. Whether the dispatcher didn’t realise they were actually logged off and but saw the ambulance vehicle ‘polling’ at that officers location, or the dispatcher felt the case required dispatch to the officer anyway.
Reviewing what you stated:
“on balance, there would be a duty to do something if there was reason to think there was a life threatening emergency in circumstances where action by the paramedic is likely to save a life or prevent long term threats to health and safety.”
I totally agree with you on that point however, if another person, i.e. a member of the public attended an officers residence seeing the vehicle there and wanted a band aid or a dressing for their fathers leg ulcer, would that constitute a contravention of that officers right to disconnect?
I feel the expectation of the public would be much greater when in possession of an Ambulance Vehicle then say, stopping that officer in the street on days off asking for some advice because that person knows the officer is paramedic.
Don’t get me wrong, I understand that it may appear trivial, just give the guy that dressing, who knows then it may escalate to, “can you have a look at that ulcer for me?” Again maybe considered trivial however, being at home off duty with the vehicle at an officers residence doesn’t in my opinion afford the officer the 4 hours who is not on duty the ability to disconnect. For longevity in the profession I believe you need time away and the ability to disconnect.
My self and many of my colleagues feel wouldn’t it just save potential issues if the 4 hours a vehicle is logged off at an officers residence and that officer is off duty just be avoided all together by redesigning the roster for this not to occur?
Makes sense to me
The Fair Work Commission Right to Disconnect Fact sheet can be found here – https://www.fwc.gov.au/documents/resources/right-to-disconnect-fact-sheet.pdf. There are issues to be considered when deciding what is ‘reasonable’, but if paramedics are really off duty they should have the right to refuse to answer the phone or other calls from the coordination centre. If the dispatchers have the right to call then presumably the officers aren’t really ‘off duty’, they’re on-call and presumably should be paid an on-call allowance.
As the Fair Work Ombudsman says (https://www.fairwork.gov.au/employment-conditions/hours-of-work-breaks-and-rosters/right-to-disconnect) “Employers and employees are encouraged to discuss out of hours contact and set expectations that suit the workplace and the employee’s role. Where possible, there are benefits to having these conversations before out of hours contact happens.” The expectations for any contact during the 4 hours should be discussed and clarified so everyone knows where they stand.
As for members of the public, the ambulance service cannot control them and is not responsible for the decision of those members who might chose to knock on their neighbours door either because they know they are a paramedic or can see the ambulance parked on the property. I suppose anyone always has the right to not answer a knock on their door if they don’t want to. One would hope QAS would also recognise that you have the right to refuse to deal with people with minor injuries such as those suggested above.