South Australia is considering moves to protect the title ‘paramedic’. Currently the term is unregulated and anyone can call themselves a paramedic. If the Health Practitioner Regulation National Law (South Australia) (Protection of Title—Paramedics) Amendment Bill 2013 (SA) is passed into law then a new section 120A in the Health Practitioner Regulation National Law (South Australia) Act 2010 (SA) will make in an offence for a person to:

… knowingly or recklessly—
(a) take or use the title of “paramedic”, whether with or without any other words; or
(b) take or use a title, name, word or description that, having regard to the circumstances in which it is taken or used, indicates or could be reasonably understood to indicate the person is a paramedic,
unless the person holds qualifications prescribed by regulations made by the Governor under the Act for the purposes of this section.
Maximum penalty: $30 000.

For the purpose of the section ‘paramedic’ will be defined to mean “a health practitioner who provides pre-hospital emergency care services or community-based alternative models of care as a result of a request for emergency medical assistance.” This still retains the focus on paramedic practice as the practice of emergency health care, not extended alternative care that some ambulance services are exploring.

Putting that issue aside, it’s not clear why a definition is required. The proposed s 120A does not say it is an offence to use the title ‘paramedic’ unless you are, in fact, a paramedic (however defined) rather it says you are not to use the title ‘paramedic’ unless you have the prescribed qualifications.

What those qualifications will be remains to be seen, however in introducing the Bill the Hon. J.J. Snelling, Minister for Health and Ageing, said:

The Council of Ambulance Authorities has established an accreditation scheme for education courses in Australia to ensure that graduates meet the requisite education and training standards for employment as a paramedic in Australia and New Zealand. These qualifications will form the basis of the qualifications that will entitle a person to take the title of ‘paramedic’. Most paramedics employed in Australia hold a tertiary qualification and have completed an internship program. (Hansard, House of Assembly – Wednesday, 16 October 2013, Page 7282).

It appears that the members of the Council of Ambulance Authorities are the Australian state ambulance services (including St John in WA and the NT), Wellington Free Ambulance, St John New Zealand, St John Papua New Guinea and Ambulance NZ (see http://www.caa.net.au/about-us/the-members). This excludes private paramedic service providers and that could be make CAA qualifications contentious.

Regardless of the qualifications adopted, it is hoped there will be some transitional provision to ensure that paramedics who have been in the industry for many years, but who do not have a University qualification, continue to be able to practice as, and call themselves, paramedics. That is anticipated as there is power to allow the Minister to grant an exemption from the restriction. For example the Minister could, to borrow from the words of the Tasmanian Bill (see ‘New law for ambulance services in Tasmania – Update‘, 7 September 2013), grant an exemption to anyone with a “qualification and experience that the [Chief Executive of the SA Ambulance Service] is satisfied demonstrates a satisfactory level of understanding and competence” or some similar words. If an exemption is granted, anyone who falls within its terms could still use the title ‘paramedic’.

On the other hand, the Minister has said that there is a

“… distinction between the role of the paramedic from an ambulance officer and volunteers. Ambulance officers and volunteers have completed a comprehensive program focused on the provision of pre – hospital emergency care. The fundamental difference between these levels of healthcare providers is the expansive and internationally accepted scope of practice of a paramedic.” (Hansard, House of Assembly – Wednesday, 16 October 2013, Page 7282).

It may follow that only those with accredited qualifications will be called paramedics and others, including those with many years’ service, will be left with the title ‘ambulance officer’. How the Minister deals with these issues remains to be seen.

The anomaly in this amendment is that the Health Practitioner Regulation National Law is part of a national cooperative scheme to provide uniform regulation of registered health practitioners, such as doctors and nurses. Paramedics are not registered health practitioners, and will not be with this new Act. Putting the provision in the Health Practitioner Regulation National Law (South Australia) Act 2010 (SA) will move that Act away from the other states and territories.

This provision could be included in the Health Care Act 2008 (SA) that governs the provision of ambulance services in South Australia but it may be thought that putting it in the Health Practitioner law better reflects the standing of paramedics as health professionals – as the Minister said “The decision of this Government to proceed with the protection of the title ‘paramedic’ will assist with the transition of South Australian paramedics into any future national regulatory scheme” (though he also said the thought paramedic registration is at least two years away (Hansard, House of Assembly – Wednesday, 16 October 2013, Page 7282)).

Michael Eburn
29 October 2013

PS Attached is a Member Update issued by Paramedics Australasia setting out their response to the South Australian Bill.
PA Member Update – SA Paramedic Title
Michael Eburn
30 October 2013

For the latest word on the passage of this Bill- and the definition of ‘paramedic’ that was finally settled on, see South Australia Legislation PA Update2