I have previously reported that the Health Practitioner Regulation National Law (South Australia) (Protection of Title—Paramedics) Amendment Bill 2013 (SA) (29 October 2013).  That Bill passed through the legislative process on 21 November 2013 and came into effect on 1 September 2014 (see The South Australian Government Gazette, 14 August 2014, p 4027).

The Health Practitioner Regulation National Law (South Australia) Act 2010 (SA) Schedule 2, s 120A(1)(a) says that a person ‘must not knowingly or recklessly (a) take or use the title of “paramedic” …’ unless they hold the qualifications set out in clause 11A of the Health Practitioner Regulation National Law (South Australia) Regulations 2010.   The prescribed qualifications include a degree in paramedicine from an Australian or New Zealand university, various diplomas or qualifications leading to registration as a paramedic in the United Kingdom, South Africa, or Ireland.

Section 120A(1)(b) (when read with s 120A(2), the definition of ‘paramedic’) says that a person must not:

… 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 health professional who provides emergency medical assessment, treatment and care in the pre-hospital, or out-of-hospital, environment.

The Minister may approve other qualifications for the purposes of the regulation (cl 11A(1)(g)) or may grant an exemption from the requirement to hold a prescribed qualification (s 120A(4)).  The Minister has in fact granted some exemptions and these appear in The South Australian Government Gazette, 7 August 2014, p 3957-3958).    Strangely enough, there are two, separate exemptions, the first says:

I, JACK SNELLING, Minister for Health, in accordance with Clause 120A (4) of Schedule 2 of the Health Practitioner Regulation National Law (South Australia) Act 2010, exempt the following classes of persons from the requirement to hold a prescribed qualification to practise as a paramedic in South Australia:

It then lists various categories of people, student paramedics, a paramedic employed by SA Ambulance but who does not hold the prescribed qualifications but has relevant and recent experience, a person employed as a paramedic by an ambulance service ‘which has entered a Memorandum of Understanding with, or is otherwise authorised by, SA Health or SA Ambulance Service Inc. in relation to the provision of emergency medical assessment, treatment and care in South Australia’ or a person assisting during a public health or other declared emergency.

The second exemption begins

I, JACK SNELLING, Minister for Health, in accordance with Clause 120A (4) of Schedule 2 of the Health Practitioner Regulation National Law (South Australia) Act 2010 exempt the following classes of persons from Clause 120A (1):

That exemption applies to ‘a person employed as a paramedical aide by a domiciliary care service provided by Country Health SA Local Health Network or the Department for Communities and Social Inclusion.’  So those ‘paramedical aides’ can call themselves a paramedic, no problem.

The problem is with the first exemption where the Minister purports to rely on s 120A(4) to ‘exempt the following classes of persons from the requirement to hold a prescribed qualification to practise as a paramedic in South Australia’.

Sect 120A(4) says

(4) The Minister may, by notice in the Gazette, confer exemptions from this section—

(a) on a specified person or specified classes of persons; or

(b) in specified circumstances or specified classes of circumstances.

There is, however, nothing in section 120A that says you need these qualifications to practice as a paramedic, only that you need them to take the title ‘paramedic’. The first exemption issued by the Minister simply makes no sense when read in context with the Act.  The inference has to be that he intends to allow those people to use the title ‘paramedic’ but that it is not what the exemption says.

The matter is further complicated by the SA Health.  A colleague from St John Ambulance (ACT) has drawn to my attention their web site where they explain the effect of the new law.  They say

The Act will only apply to those persons practising as paramedics in South Australia.

It will not apply to persons employed as first aid officers, ambulance officers or St John Volunteers.

That the Act will only apply in South Australia is axiomatic.  The South Australian parliament can’t make laws for other states so of course one can be called a paramedic in Victoria without meeting the South Australian requirements.

The statement that the Act ‘will not apply to persons employed as first aid officers, ambulance officers or St John Volunteers’ again makes no sense.  There is nothing in the Act, its regulation or the various exemptions that says that this is the case.  The best that can be inferred is that the Department believes that taking the title ‘first aid officer’ or ‘ambulance officer’, or wearing a uniform that says ‘St John Ambulance’ would not indicate, nor could it reasonably be understood to indicate that the person is a ‘paramedic’ and so there is no breach of s 120A(1)(b).  There is nothing in the Act, the Regulations that would allow any of those people to call themselves a paramedic unless they also fell within the various exemptions discussed above.

This is not the first time where it has appeared that Ministers in the South Australian government have not read or understood the law they appear to be administering – see ‘Compensation for South Australian SES volunteers’ (6 August 2012) (but see also ‘Changed compensation rules for SES and Marine Rescue volunteers in South Australia’ (23 March 2013)).  It’s one thing on the floor of Parliament but here presumably the Minister had the advice of the Department and of Parliamentary Counsel so why the exemption is stated to be an exemption ‘from the requirement to hold a prescribed qualification to practise as a paramedic in South Australia’ when that is not the language of the Act is not at all clear.  It appears to be very poor drafting or a belief that the Act as passed does more than protect the ‘title’ of paramedic, but it doesn’t.