Recent developments as the new National Law evolves to cover the paramedic profession
Federal and state and territory health ministers met in Melbourne on 24 March 2017 at the Council of Australian Governments Health Council and addressed a range of health related matters with the progression of paramedic registration high on the agenda.
Ministers considered a draft of the Health Practitioner Regulation National Law Amendment Bill 2017. The Bill, once enacted, will make a number of important reforms to the operation of the National Registration and Accreditation Scheme and the powers of the National Boards and the Australian Health Practitioner Regulation Agency.
The Bill responds to recommendations arising from the Independent Review of the National Scheme undertaken in 2014–15. It contains the following key reforms:
- Introduction of national registration for paramedics, including the establishment of a Paramedicine Board of Australia, with all the same powers and functions as the other 14 National Boards
- Improvements to the governance of the National Scheme, to: enable Chairpersons to be appointed on merit from any of the members of a National Board, not just the practitioner members, and to enable the Ministerial Council to make changes by regulation to the structure of National Boards following consultation
- Recognition of nursing and midwifery as two separate professions rather than a single profession, with the professions continuing to be regulated by the Nursing and Midwifery Board of Australia
- Improvements to the complaints (notifications) management, disciplinary and enforcement powers of National Boards to strengthen public protection and ensure fairness for complainants (notifiers) and practitioners
- Other technical amendments to improve the efficiency and effectiveness of the National Scheme.
The reforms are being progressed in two stages. This Bill is stage one, and a second stage reform process, including a broad public consultation process, will commence during this year. Once the Bill is finalised, it will be passed to Queensland (as the ‘host’ state under the law) for enactment.
The Bill establishes the Paramedicine Board of Australia, which will be responsible for regulating paramedics with regulatory and other support provided by the Australian Health Practitioner Regulation Agency. The Bill also amends the National Law to require people who use the title ‘paramedic’ to be registered – the ‘protected’ title provisions. Paramedics will be subject to the same regulatory arrangements as the other health professions regulated under the National Law, including registration processes, accreditation of training programs, national standards, and procedures for managing the health, performance and conduct of registered paramedics.
The regulation of paramedics as part of the National Scheme is expected to:
- Protect the public by: establishing minimum qualifications and other requirements for the registration of a person as a paramedic; providing powers to deal effectively with paramedics who have an impairment that affects their practice, are poorly performing or who engage in unprofessional conduct or professional misconduct; and preventing persons who are not qualified, registered and fit to practise from using the title ‘paramedic’ or holding themselves out to be registered if they are not,
- Facilitate the provision of high quality education and training in paramedicine through the accreditation of training programs for registration purposes,
- Improve transparency and accountability in the delivery of public and private sector paramedicine services, and
- Provide a suitable regulatory framework for the public and private sector paramedic workforce.
Paramedics Australasia provided feedback on the draft National Law during the consultation period earlier in the year and commented on a number of key provisions within the law including a strong endorsement of the newly branded Paramedicine Board of Australia and its broad powers under the legislation. PA also offered its full support for the proposed ‘grandparenting’ provisions in the draft legislation, which are fundamental in ensuring appropriate arrangements are in place for the current paramedic workforce when registration commences in the second half of 2018. PA also provided feedback on the New South Wales exemption for Diploma qualified paramedics by proposing that a ‘sunset’ clause be inserted into the National Law with the PA submission validating this suggestion when stating, “This additional measure would still maintain the intent of the exemption and certainty for New South Wales Ambulance whilst providing the broader sector with comfort that this unique exemption is not perpetual”. The full submission is available on the PA website.
The formation of the Paramedicine Board of Australia, guided by the overarching principle of public protection, will shape the paramedic profession from a regulatory and educational perspective for the next generation. Section 33 describes the mandatory requirements for membership of National Boards and gives rise to some interesting dynamics. The National Board consists of members appointed by the Ministerial Council. The size of the Board is also determined by the Ministerial Council, with the average board being 10–12 members. Members of a National Board are appointed as ‘practitioner’ members or ‘community’ members. At least half, but not more than two-thirds, of the members of a National Board must be persons appointed as practitioner members. The practitioner members of a National Board must consist of: (a) at least one member from each large participating jurisdiction (NSW, WA, SA Queensland and Victoria) and (b) at least one member from a small participating jurisdiction (NT, ACT and Tasmania). At least two of the members of a National Board must be persons appointed as community members. At least one of the members of a National Board must live in a regional or rural area.
In terms of eligibility, in deciding whether to appoint a person as a member of a National Board, the Ministerial Council is to have regard to the skills and experience of the person that are relevant to the Board’s functions. A person is eligible to be appointed as a practitioner member only if the person is a registered health practitioner in the health profession for which the Board is established. A person is eligible to be appointed as a community member of a National Board only if the person is: (a) not a registered health practitioner in the health profession for which the Board is established, and (b) has not at any time been registered as a health practitioner in the health profession under the National Law or a corresponding prior Act.
PA looks forward to the appointment of the Board and is keen to assist its deliberations around the many and varied issues of importance which will need to be addressed during the transition phase of the new law.
PA will also continue to provide members will information on registration as it becomes available whilst being readily accessible to respond to queries as they arise.
Board Director, Paramedics Australasia
Chair of the Australian National Registration Working Group