Inadequate pre-hospital care regulation ‘puts public at risk’ — PHECC Chair

The failure to adequately regulate pre-hospital emergency services puts the public “at risk” and poses a “significant reputational risk” to the Minister for Health and Department, the Chairperson of the Pre-Hospital Emergency Care Council (PHECC) has warned Minister for Health Simon Harris.

In correspondence sent with her Chairperson’s report last July, Dr Jacqueline Burke stated that “during this year, we (PHECC) have had to explain in public that while we can set and monitor standards, we have no medium to enforce their use”.  PHECC did not have the ability to enforce registrants’ use of its clinical practice guidelines (CPGs) or enforce these standards generally, she added.

These matters were raised with the Department by the previous Council, the letter outlined. While Dr Burke acknowledged that legislative change was “neither easy or rapid”, she was concerned that “failure to adequately control and regulate pre-hospital care puts the public at risk and poses a significant reputational risk to the Minister and the Department”.

In his response last October, Minister Harris said he had asked officials to examine the concerns.

PHECC has “no enforcement powers” to impose mandatory registration on people who wish to practise as emergency medical technicians, paramedics or advanced paramedics, according to The Future of Paramedicine, published by PHECC in 2016. “In the interest of public safety, PHECC requires similar enforcement powers to healthcare regulators.”

The report outlined how PHECC was “limited in its ability to apply robust sanction measures to protect the public”.

“For example, unlike all of the other statutory healthcare regulators, currently PHECC does not have the power to restrict a practitioner’s registration through the imposition of conditions or the suspension or cancellation of registration.

“PHECC can only determine whether a practitioner should be advised, admonished or censured. PHECC must rely on a service provider to limit or restrict the practice privileges of a practitioner through the triple-lock mechanism.”

The triple-lock mechanism refers to credentialling practitioners, approving service providers, and practitioners being privileged by their service provider.

PHECC Director Mr Richard Lodge said all registrants are obliged to participate in Fitness to Practise hearings. As well as licensing practitioners, PHECC also licenses CPG providers of pre-hospital emergency care “who are obliged to follow strict practice guidelines carried out by PHECC practitioners”.

The Department is conducting “an options appraisal” on how to strengthen PHECC’s role, said a spokesperson.