A huge thanks to Brian Westwood, a St John volunteer ILS Paramedic from Darfield, for providing this blog:

Registration and volunteers

The unique thing about the ambulance service as a health profession is that it is made up in bulk by volunteers, something few if any of the other registered health professions have. This adds a level of complexity to the issue and while registration may be the right thing for the paid staff there are questions that hang over the volunteer members.

What's in it for me? What most people want to know is what personal benefit (or loss) will this involve.

Registration does provide good career development opportunities for paid staff but I doubt whether it will make any difference to the professionalism of most volunteers.

As a volunteer I have no interest in the development of my ambulance career, transferability of skills or how I'm perceived by other health professionals. I am in this to do my bit for my community. That's not to say I don't take the job seriously. Volunteering for ambulance service is a serious business.

However, let's be honest, not all volunteers see it this way. Some seem to see it as a hobby to be dabbled in or for the kudos of being called an ambulance officer. Others simply can't commit the time they really need to but are unwilling to accept that this affects their skill maintenance levels.

This is where registration may provide a wider benefit to the community at large.

While there are clear criteria for retention of ATP based on periods of absence from patient care, these don't always seem to be observed - whether through organisational apathy, lack of resources or political will to enforce the rules. Registration would help transfer responsibility and the 'bad cop' role to an external body. While it's an unpopular sentiment registration could be a mechanism to get those marginal volunteers to either step up or step out.

However that will only be beneficial if registration is at BLS level. From what I've heard in the discussions and from staff it's quite clear the dominant opinion is towards registration of ILS and above.

Any volunteer who has made it through to ILS is not a marginal volunteer. So registration at this level for a volunteer brings me back to the same question - where's the benefit to the Paramedic or the patient?

We have the HDC Code of Rights and inquiry system, clinical standards, clinical supervision at regional level and CCE already in place to help mitigate patient risk. Why waste up to $1,000,000 on a new level of bureaucracy?

There is also concern over an increase in litigious costs and the real possibility of requiring liability insurance. Costs employers are unlikely to cover.

On the flip side I think registration is great for paid staff. It provides career development opportunities, improves transferability between services and countries and it will probably lift the kudos of the profession, which has value in its own right. Arguably a more 'professional' work force has long term benefits for patients, but is the current workforce lacking in skills and professionalism that much already that there is a current risk to patient care?

It is a problem for paid staff that many of the benefits of registration mean very little to volunteers.

Ambulance officers are the second most trusted profession in the country, so respect isn't an issue, and most volunteers have their own career develop challenges outside of the ambulance service. Unless there is a genuine and clear benefit for patient safety and I am not convinced there is, it’s hard to see the value in it for the average ambulance volunteer but I don't believe volunteers should hold back the opportunities that paid staff can gain through registration and for these reasons I'd support registration if it came to a vote.

Brian Westwood

St John volunteer ILS Paramedic