Ongoing concern about paramedicine regulation

There is ongoing concern in the Pre-Hospital Emergency Care Council (PHECC) and the HSE about legislative “deficiencies” in the regulation of paramedicine. As previously reported by the Medical Independent, PHECC informed the Department of Health in 2019 that the situation placed the public “at risk”.

The Director of the HSE National Ambulance Service (NAS) Mr Robert Morton raised the matter during a presentation to the PHECC Council in December 2022.

Mr Morton said primary legislation was “urgently required” to address PHECC’s legislative “weaknesses”. His presentation also cited the development of specialist paramedicine as key to the NAS’s strategic plan, according to minutes.

In October 2022, PHECC Chairperson Dr Jacqueline Burke (PhD) informed the Council of an extended call with the Department regarding the legislative deficiencies and the “considerable time which had elapsed in addressing these”.

The following month, Dr Burke told the Council that the Department informed her “some work had commenced on the matter” and fundamental progress was envisaged by the end of 2023.

“However, the Chair pointed out that that this may not meet the expectations of Council members who are frustrated by the lack of progress to date. A meeting with the Minister for Health may be required…. The importance of legislative change in order to protect the public was reiterated.”

In July 2019, Dr Burke warned the then Minister Simon Harris that the failure to adequately regulate pre-hospital emergency services put the public “at risk” and posed a “significant reputational risk” to the Minister and Department.

Dr 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 or enforce these standards generally, she added. These matters had been raised with the Department by the previous Council, the letter outlined.

The Future of Paramedicine, published by PHECC in 2016, stated that it had no enforcement powers to impose mandatory registration on people who wished to practise as emergency medical technicians, paramedics, or advanced paramedics.

In addition, PHECC did not have the power to restrict a practitioner’s registration through imposition of conditions or suspension or cancellation
of registration.

PHECC had not commented by press time.