Paramedic Registration: Who Does the Law Cover, What are the Objectives of the Law and What is a ‘Protected’ Title?

By Peter Jurkovsky

As all members will no doubt be aware, after a decade long campaign by Paramedics Australasia, the goal of registration for paramedics in Australia is now a foreseeable reality.

In October last year, the Council of Australian Governments (COAG) Health Council agreed to proceed with amendments to the Health Practitioner Regulation National Law (the National Law) which will bring paramedics into the scheme alongside 14 other regulated health professions with a predictive commencement date of September 2018.

The next phase towards registration will involve a significant amount of policy development, legislative drafting and administrative work over the next 18 months to bring the process to fruition.

Awareness of your duties under the National Law is fundamentally important as a registered health professional, both from a personal and collective perspective. Paramedics Australasia will be publishing a series of articles and communiqués over the period leading toward registration to ensure all members are fully informed of these rights and responsibilities.

This article will address the coverage of the National Law, the objectives and the often-quoted notion of a ‘protected’ title.

There are currently 14 registered health professions within the National Scheme. They are:

  • Chiropractors
  • Dental practitioners (including dentists, dental hygienists, dental prosthetists and dental therapists)
  • Medical practitioners
  • Nurses and midwives
  • Optometrists
  • Osteopaths
  • Pharmacists
  • Physiotherapists
  • Podiatrists
  • Psychologists
  • Aboriginal and Torres Strait Islander health practitioners
  • Chinese medicine practitioners (including acupuncturists, Chinese herbal medicine practitioners and Chinese herbal dispensers)
  • Medical radiation practitioners (including diagnostic radiographers, radiation therapists and nuclear medicine technologists)
  • Occupational therapists.

The Australian Health Practitioner Regulation Agency (AHPRA, the agency that supports the national boards to implement the National Scheme) Annual Report stated that 657,621 health practitioners across the 14 professions were registered in Australia in 2015–16, up from 637,218 in 2014–15.

The largest registered health profession is nursing where 380,208 enrolled nurses, registered nurses and midwives were registered across Australia in 2015–16 representing 57.8 percent of all registered health practitioners across the National Scheme while there were 107,179 medical practitioners registered in the same period with this profession making up 16.3 percent of all registered health practitioners.

The National Scheme has a number of objectives, including to:

  • help keep the public safe by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered
  • facilitate workforce mobility for health practitioners
  • facilitate provision of high quality education and training for practitioners
  • facilitate the assessment of overseas qualified practitioners
  • facilitate access to services provided by health practitioners, and
  • enable the continuous development of a flexible Australian health workforce.

It is notable that while protection of the public is the guiding principle within the law, broader aims are identifiable and it will be interesting to monitor which of these will impact paramedic practice in the years to come.

The National Law importantly restricts the use of ‘protected’ titles. This means that it is unlawful for someone to knowingly or recklessly take or use a title to make someone believe they are registered in one of the registered health professions, as well as other practices including using a specialist title when the person does not have specialist registration.

The protected title is part of the ‘contract’ made between the government and the professions. The government gives the professions exclusive rights to use certain titles and to perform certain roles. In exchange, the government can then be predominantly assured that anyone using those titles or performing those roles will be appropriately trained and up-to-date so that quality can be assured. In this way, it protects the public from the harm that could be caused by people practising a profession when they are not qualified.1

Based on other professions and using nursing as a direct comparator, the title that will primarily be protected under the Act will be ‘paramedic’. Nursing protects the titles: nurse, registered nurse, enrolled nurse, nurse practitioner, midwife and midwife practitioner. Other titles that may be considered for protection could be advanced life support paramedic, critical care paramedic and intensive care paramedic – these determinations will be a matter for the newly formed board in 2017.

Section 113 of the National Law is the primary offence provision for breaches of the protected titles requirements and can give rise to fines of up to $30,000 for individuals or $60,000 for corporations.

In the next issue of Rapid Response, the vexed issue of professional indemnity insurance for registered health professionals will be addressed in detail to alleviate many of the misconceptions that permeate the discussion and to provide members with a clear understanding of their needs in the future as we progress towards registration.2

Peter Jurkovsky

Chair, Australian National Registration Working Group

References

  1. Jeremy Holmes. Why professions have protected titles. The Pharmaceutical Journal, 9 March 2009.
  2. For a recent discussion on this issue, see Dr Michael Eburn, Australian Emergency Law at https://emergencylaw.wordpress.com/2016/12/10/paramedic-registration-insurance-and-the-role-of-an-employer/