The scheduled ‘participation’ date for paramedic registration is 1 September 2018, now less than one year away. After all the time, effort and expertise expended by the sector – led by Paramedics Australasia – in striving for this goal for over a decade, it is timely to reflect on the law itself and the manner in which it will shape the paramedic professionalism in the future.
The registration and regulation of health practitioners in Australia was the subject of a once-in-a-lifetime overhaul in Australia in 2010 when all states and territories in Australia implemented the Health Practitioner Regulation National Law Act 2009 (the ‘National Law’). The history of the design and development of the lawwas a significant achievement from an administrative perspective with all state and territory governments reaching agreement to consolidate 75 Acts of parliament which previously oversaw health practitioner regulation throughout Australia and to further condense 97 state and territory health profession boards into an integrated single national framework. This was no mean feat and clearly the most significant reform in this area since Federation.
The new National Law, has a unique construct, whereby Queensland acts as a ‘host’ state due to constitutional limitations, implemented a comprehensive range of provisions. The National Law has a range of objectives and guiding principles that address the primary and fundamental notion of public protection through to health workforce planning and the administrative and educational aspects of the regulatory scheme.
Two areas currently under review will have a significant impact on current and future paramedics alike. The first is the Independent Review of Accreditation Systems within the National Registration and Accreditation Scheme for health professions, while the second is through a discussion paper on mandatory reporting under the Health Practitioner Regulation National Law.
PA will be engaging in these review processes to advocate on behalf of members.
Independent Review of Accreditation Systems
Accreditation under the National Law falls under two broad categories, being the profession-based accreditation of programs of study and the academic accreditation of institutions that provide that education.
The National Law specifies that each National Board must decide whether its accreditation function will be undertaken by an external entity (accreditation council) or a committee established by the relevant National Board. One of the primary differences between the two approaches is the operating model. A council is generally an independent not-for-profit registered company, while a committee is established by a National Board with secretariat support provided by the regulator, the Australian Health Practitioner Regulation Agency (AHPRA).
The 179 page draft report was published on 12 September 2017. It outlines possible reform options to streamline accreditation processes and enhance governance structures within the National Registration and Accreditation Scheme (NRAS). The aim is to achieve greater cost-effectiveness through consistency and collaboration across professions and delivery of an educational foundation for a health workforce capable of responding to the evolving needs of the community.1
The newly formed Paramedicine Board of Australia (PBA) will be tasked with this responsibility on behalf of the sector with this decision being a priority in its first days of office. Under the legislation, the PBA also has the option of utilising the current Council of Ambulance Authorities Paramedic Education Program Accreditation Scheme to accredit programs of study for the purposes of registration in paramedicine.2 The Board’s early decisions in this area will have a significant impact on the paramedic educational sector and graduating students for many years to come.
Mandatory reporting under the National Law
Mandatory reporting in the health and social welfare fields has been, until now, predominately associated with child abuse allegations and communicable disease reporting. The transition into the realm of health practitioner ‘conduct’ has caused consternation within the health professions with a number of professional bodies being critical of their implementation.
The National Law obliges disclosure if ‘notifiable conduct’ is observed by a health practitioner in relation to their own conduct or any other registered profession. This is defined as: practising while intoxicated by alcohol or drugs, engaging in sexual misconduct in connection with practice, placing the public at risk of substantial harm because of an impairment and placing the public at risk because the practitioner has practised in a way that constitutes a ‘significant departure from accepted professional standards’.3
The main criticism of the mandatory reporting laws is that a registered health practitioner may be reluctant to seek assistance, for a real or perceived impairment, from a fellow registered health practitioner in circumstances where the treating practitioner is obliged to mandatorily report if they reasonably believe one of the categories of notifiable conduct has been transgressed. While this is the primary concern among the professions, many other significant issues flow from these provisions. Hence the call to reform them and create national consistency due to the fact that some states have variations to this obligation, where, for example, treating practitioners in Western Australia are exempted from these mandatory reporting obligations. It is heavy stuff, there is no question about it, and with all the positives which flow from this momentous event, professional registration also brings with it burdens, which must be addressed. PA will be submitting a response to the discussion paper to address many of these concerns.
With the participation date now imminent, paramedics need to be fully aware of their rights and responsibilities under the National Law and, PA, as your representative body, will continue to keep you informed on all matters registration as we progress towards the participation date.
Chair, Australian National Registration Working Group
- Independent Review of Accreditation Systems within the National Registration and Accreditation Scheme for health professions. Draft Report September 2017 Available at www.coaghealthcouncil.gov.au/Portals/0/Accreditation%20Review%20Draft%20Report_U.pdf
- Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2017– Section 311.
- Health Practitioner Regulation National 2009. Sections 140 &141.