Inclusion

At the October 2016 COAG meeting, the health ministers agreed to proceed with amendments to the Health Practitioner Regulation National Law Act 2009 (Qld) (the ‘National Law’) that will require paramedics to be regulated by the NRAS alongside the 14 other health professions that are currently regulated by the scheme. A draft amendment Bill is tabled to be presented to the Queensland Parliament in September 2017. Despite the initial expression by NSW Health of its reluctance to participate in the scheme, all health ministers agreed that paramedics will be registered by the scheme in all

jurisdictions.422

The agreement by the health ministers to include paramedics in the national regulatory scheme is a significant step forward in the paramedic professionalisation project. This step recognised the potential power of the law to facilitate the professionalisation project by providing a mechanism for paramedics to regulate themselves, to gain control over their own work and to meet their objective of being granted the same legal status as other comparable healthcare professions.

421 _{NSW Health, Submission to Senate Legal and Constitutional Affairs Committee, Parliament of}

Australia, The Establishment of a National Registration System for Australian Paramedics to Improve and

Ensure Patient and Community Safety, January 2016, 8.

422 _{Council of Australian Governments (COAG), Health Council Communiqué 7 October 2016}

http://www.health.gov.au/internet/main/publishing.nsf/content/4EF9C42740F7FC4ECA258045001C0397/ $File/dept006.pdf>.

This descriptive chapter has described why paramedics wanted to be regulated as professionals, what they hoped that would provide and has explained the process by which they successfully navigated to inclusion in the NRAS.

The discussion in chapter 2 outlined the discourse of professionalisation within the sociological literature. The chapter has demonstrated that paramedics whether they knew it or not, identified the essential aspects of being a profession and recognised the value of those aspects to their standing and practice. Over time the paramedic workforce moved from an ad hoc approach to professional development to an organised professional project that has resulted in achieving the discipline’s objective of being regulated as health professionals. The discourse moved from a focus on educational reform to a focus on legislative reform, which occurred somewhat opportunistically, in response to social and political circumstances.

Paramedics successfully used the national social and political discourse on patient safety (discussed further in Chapter 5) to argue for regulation under the national regulatory scheme not just because they thought they posed a threat to the public. The discourse shows that paramedics believed regulation as professionals was the next step in their occupational evolution towards professionalism. That is, it would result in their ability to control their own work by allowing them to standardise qualifications for entry to the profession, accredit educational programs that would reflect the unique and specialised knowledge and skills of the discipline, protect the title to limit use by outsiders, increase the mobility and thus work opportunities for paramedics to work beyond the control of traditional state- based ambulance services, and to monitor and hold to account paramedics who might work below the standard expected and set by the profession. This would in turn contribute to the continuing development of paramedic moral and technical authority and associated political power that would allow the discipline to engage in the development of healthcare and healthcare workforce policy - something that they had complained was missing from their practice in their Forgotten Profession report – and that would provide evidence of their professional legitimacy.423

423 _{PA, The Forgotten Health Profession: A Commentary Highlighting the Omission of Paramedics and}

Paramedic Services From National Health Care Policy Considerations, 2010

The discussion in chapters 2 and 3 have demonstrated that paramedicine has achieved most of the elements of a profession and deserves the remaining elements. It is argued in the rest of this thesis, that regulation under the NRAS will achieve that objective. National regulation will allow paramedics, via the Paramedicine Board, to complete the final steps towards their establishment as a profession. It can be expected that the benefits argued for by paramedics, both to them, their patients and the community, will flow with that professional standing.

The next chapter provides a brief history of the National Law. It then examines the body of the Act and maps it against the attributes associated with professions (unique purpose, specialised skills and knowledge, moral and technical authority, self-regulation and a code of ethics (professionalism)) to consider if the law can facilitate the professionalisation of non-professional healthcare disciplines; more particularly, to consider if the law can provide paramedics with the professional status that they are seeking, particularly with autonomy over their work, mobility, flexibility and control over education, practice and conduct standards.

Part II—The Regulation

The Health Practitioner Regulation National Law

Act

The previous chapters identified elements common to a profession, and then outlined the social and historical development of paramedicine and examined the discourse on paramedic professionalisation against those elements. It identified that while the discipline has had ambitions to professionalise and has been slowly professionalising it has not yet fully realised that goal. It also identified that the profession believes that regulation under the National Law will help them achieve this objective.

This chapter provides a brief history of the National Law and why it was developed. It then examines the body of the Act and maps it against the attributes associated with professions (unique purpose, specialised skills and knowledge, moral and technical authority, self- regulation and a code of ethics (professionalism)) to consider the role of the law in the professionalisation of paramedics in Australia.