Thank you to Arthur Cronwright, Extended Care Paramedic, Wellington Free Ambulance, for providing this blog:

A comparison with South Africa


Arriving in New Zealand a couple of years ago from South Africa, I know from my experience there that registration brings true national standards, a higher level of assurance for public protection and help shape and construct our professional identity as competent health care professionals. In South Africa, it works like this:


The Health Professions Council of South Africa (HPCSA) and Paramedic qualification structure.


•    South African Paramedics are currently registered from BLS through to ALS level and above. However the current BLS, ILS and ALS structure will eventually be phased out and changed to “ECT” (Emergency Care Technician) and “BTech Paramedic” only.

•    During the transition phase; affected Paramedics are given opportunity through bridging programs to obtain the relevant qualifications.

•    The ECT will be the new national ILS level and will eventually replace the vocational ILS qualification.

•    The BTech Paramedic is an ALS paramedic with extended scope

•    In the near future there will no longer be BLS level paramedics practicing or registered in South Africa

•    A separate register will still be held for Defence force paramedics as they will have an extended scope for field operations .

•    The HPCSA holds a separate register for each qualification

•    All these registers fall under governance of the Professional Board for Emergency Care Practitioners

•    This board consists of the HPCSA Director General as chair, Legal representation, Trauma Doctors, ALS, ILS, BLS paramedics, and lay persons.

•    The Professional board convenes regularly to review national guidelines

•    Each profession within the entire medical field has an individual professional board, and each of these boards fall under the HPCSA umbrella.

•    Because Paramedics are registered in SA, it ensures a national standard and lends itself to paramedics to change agency or transfer to other states or provinces without having to prove competency or undergo more ATP assessments.

•    There are those agencies in SA that quite rightly uphold a higher standard than the national average; and are entitled to assess individual paramedic competency through an assessment prior to employment.





•    The HPCSA registration in SA means that paramedics enjoy autonomy (and accountability) within the scope of practice applicable to each qualification level

•    Each Paramedic is expected to uphold his/her level of proficiency and training according to the national standard appropriate for his/her qualification level and scope of practice.

•    This also means that Employers, Training organisations and CPD providers have to undergo accreditation and registration with the HPCSA and are held accountable for ensuring paramedics are trained and skilled according to national standard.

•    Paramedics in South Africa are required to accumulate Continuing Professional Development (CPD) points over two year cycles in order to maintain registration.

•    The HPCSA does random audits on individuals and EMS agencies to ensure compliance.

•    EMS companies are held accountable to ensure that all Paramedics are registered, and thus most companies will register the Paramedics on their behalf and have compulsory CPD workshops etc.

•    Registration fees are paid annually by each paramedic. Some employers pay on behalf of their employees to ensure their staff are registered; and make salary deduction arrangements with each individual.


Arthur Cronwright

Wellington Free Ambulance