National Registration for Paramedics - What lies ahead?

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Paramedics Australasia, the peak body for paramedics in Australia and New Zealand, announced in December that a consensus of state and territory governments has now paved the way for national registration of paramedics - Australia’s most trusted profession. Paramedics are set to become the 15th health profession regulated nationally.

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National registration follows a ten-year advocacy campaign by Paramedics Australasia to demonstrate to Australian Health Ministers that only national registration and an accreditation scheme for paramedics will provide a regulatory framework to protect the safety of the Australian public.
President of Paramedics Australasia Dr. Peter Hartley says, “Paramedic practice in Australia has evolved substantially over the past two decades from being primarily emergency care and transport providers to today performing an important role in the primary and emergency health-care system.”
Paramedics have become an integral component of the Australian health workforce according to Dr. Hartley. “The clinical scope of practice for paramedics today includes critical interventions and invasive procedures such as the administration of thrombolytic medications for patients experiencing heart attacks and schedule 8 medications for analgesia,” he says.
Extended care paramedics are performing a wide range of specialist primary care procedures that treat patients at home instead of transporting them to hospital. In addition, intensive care paramedics are providing critical care to patients in ground ambulances and helicopters across the state. “We believe modern paramedics help to make healthcare more effective and more efficient, however, at the same time, this enhanced skill-set comes with a greater risk to patients,” comments Dr. Hartley.
Paramedics Australasia demonstrated to the state and territory Health Ministers that there was significant risk to the public to warrant regulation of Australian paramedics under the National Registration and Accreditation Scheme (NRAS). Fourteen health professions are currently regulated nationally through the Scheme: Chiropractic, Dental, Medical, Nursing and Midwifery, Optometry, Osteopathy, Pharmacy, Physiotherapy, Podiatry, Psychology, Aboriginal and Torres Strait Islander health practice, Chinese medicine, Medical radiation practice and Occupational therapy.
The Australian Health Practitioners Regulation Agency (AHPRA) administers NRAS and supports the National Boards in decision-making, administrating the procedures for managing registration and notification matters, provides legal interpretation, makes recommendations to the Board and committees and is a point of contact for registration enquiries from practitioners, employers, governments and stakeholders.
There are currently approximately 13,000 paramedics working in Australia. The largest employers are state and territory emergency ambulance services and the Australian Defence Force with around 18% of paramedics working in the private sector. In 2012, 122 private sector employers of paramedic staff were identified and it is anticipated that this number has grown in the last couple of years.
Over the period of the sustained advocacy campaign by Paramedics Australasia there has been overwhelming support for national registration by their paramedic members in Australia and New Zealand. In 2012, 87% of a total of 3841 Paramedics Australasia member respondents supported the inclusion of paramedics in NRAS.
Internationally, paramedics are registered as healthcare professionals in many overseas locations e.g. United Kingdom, Ireland, Canada and South Africa. The Paramedics Australasia New Zealand Chapter has made significant progress with the New Zealand Government in the last eighteen months and also looks set on a path to national registration and subsequent increased protection of the public.
The way forward
So what is the path ahead for registration of Australian Paramedics in the national scheme? Paramedics Australasia is working closely with the state and territory health departments and Ministers and in particular with the current lead agency, the Victorian Department of Health and Human Services (DHHS) and AHPRA.
Dr. Hartley comments, “A lengthy planning phase lies ahead of us to progress the inclusion of paramedics in the NRAS including a period of targeted consultation, scoping and development of policy, and collaboration for the legislative development processes required to secure amendments to the Health Practitioner Regulation National Law as in force in each state and territory.”
The path is sure to be lengthy and challenging but the outcome is clear to Dr. Hartley who says, “Paramedics Australasia is ready for the challenges ahead and the ultimate benefits to the Australian community from increased public health safeguards.”
Paramedics Australasia anticipates paramedics will be nationally registered before the end of 2018.
As at 30 June 2015, statistics produced by AHPRA show there were 637,218 registered health practitioners in Australia with most registered in New South Wales and the least in the Northern Territory. The largest registered health profession is Nursing and Midwifery with 370,303 followed by Medical at 103,133 and at the smaller end Aboriginal and Torres Strait Islander health practice at 391 and Osteopathy at 2,000.
AHPRA’s stated role is:

• Supporting the National Health Profession Boards in their primary role of protecting the public.


• Publishing national registers of practitioners so important information about the registration of individual health practitioners is available to the public.


• Managing the registration and renewal processes for health practitioners and students around Australia.


• Enabling the public to make a complaint about a registered health practitioner or student.


• Managing investigations into the professional conduct, performance or health of registered health practitioners in some jurisdictions.


• Working with the Health Complaints Commissions in each state and territory to make sure the appropriate organisation deals with community concerns about individual, registered health practitioners.

Although each of the Health Profession Boards operates under an individual instrument of delegation and health profession agreement there are five mandatory registration standards common to all Boards including criminal history, professional indemnity insurance arrangements, continuing professional development, English language skills and recency of practice.
Dr Peter Hartley
Dr Peter Hartley is President of Paramedics Australasia. He is Associate Professor and the Director of Learning and Teaching at Victoria University within the College of Health and Biomedicine. He has a multi-discipline background in health, sociology, education and had over 27 years ambulance experience in Australia. He commenced his career with the Metropolitan Ambulance Service in Victoria in 1986 and has worked as a paramedic in both metropolitan and rural locations. Peter has a long history as a paramedic academic lecturing in the discipline both nationally and internationally and has delivered numerous papers and courses throughout Canada, United States and Europe. His current commitment is focused on the advancement of paramedicine’s recognition as a professional entity and working towards national registration of paramedics in Australia and New Zealand.