Ray Bange from Paramedics Australia has brought the following to our attention.  

South Australia has released a new code of conduct for unregistered health professionals.  The scheme is modelled on the NSW Scheme and is intended to provide better protection for patients/consumers.  Details can be found on the Unregistered Health Practitioners: Code of Conduct web site.

The Code of Conduct says:

An unregistered health practitioner is someone who provides a health service and who doesn’t have to be registered with a registration authority in order to provide his or her service.

The Health and Community Services Complaints Commissioner:

suggests that any provider who is supplying services that are consistent with the definition [of a health service], and where a reasonable person, could reasonably claim that they are seeking and receiving health services, then the Code applies to that practice.

In the Commissioner’s view services such as those provided by counsellors, massage therapists, homeopaths, iridologists, naturopaths, reflexologists and Reiki healers are just a small number of examples of unregistered health service providers.

The definition of a health service set out in the Health and Community Services Complaints Act 2004 (SA) s 4 includes ‘an ambulance service’ so there is no doubt that a paramedic is providing a health service and is an unregistered health practitioner.  Other ambulance type services, whether the providers of non-emergency patient transport, on site industrial paramedics and St John Ambulance volunteer first aid services would also appear to fall within the definition of a health service (being service providers who provide “a service designed to benefit or promote human health” (Health and Community Services Complaints Act 2004 (SA) s 4) and/or an ambulance service that is “the service of transporting by the use of an ambulance [a vehicle that is equipped to provide medical treatment or to monitor a person’s health and that is staffed by persons who are trained to provide medical attention during transportation] a person to a hospital or other place to receive medical treatment or from a hospital or other place at which the person has received medical treatment” (Health Care Act 2008 (SA) s 3).

Unregistered health professionals have to comply with the code which imposes ethical obligations that are not controversial, eg provide services in a safe and ethical manner, don’t make claims you can’t meet, practice infection control, don’t practice under the influence of drugs or alcohol, don’t financially or sexually exploit your patient/clients, don’t lie to your patient/client, comply with privacy laws and keep appropriate records.

Controversially may be the obligation to maintain ‘reasonable insurance’ but that should not be an issue for paramedics who are employed as it will be their employer, as a health service provider that has to maintain insurance and who will be vicariously liable for any default by their employee.

The Health and Community Service Complaints Commission can receive and deal with complaints regarding unregistered health practitioners and allegations that they have failed to comply with the code of conduct.  If the Commissioner is satisfied that there has been a breach of the code and the person or service provider “poses an unacceptable risk to the health or safety of members of the public” then the Commissioner may make a prohibition order so that the person cannot provide health services, impose conditions on their practice and/or publicise information about the provider in order to warn the public.  Failure to comply with the terms of the Commissioner’s order is a criminal offence with a maximum fine of $10000 or 2 years gaol, or both (Health and Community Services Complaints Act 2004 (SA) ss 56A-56F).

Unregistered health practitioners and unregistered health services have to display a copy of the code but that obligation does not apply to “Premises of the SA Ambulance Service Inc.” and presumably, premises includes an ambulance.   So even though Paramedics are unregistered health practitioners and the ambulance service is a health service they do not need to display the code but do need to comply with its other provisions.  Paramedics and presumably first aiders who are not working for SA Ambulance will have to display and making available the prescribed information.

Michael Eburn and Ruth Townsend

25 March 2013