The Health Select Committee 2008 recommended registration for ambulance officers.

Existing systems to address clinical standards are inconsistent and do not work adequately.

The safety of the public is not properly protected by the current systems of ambulance officer education and competence management.

NZAA calls for regulation of all ambulance officers: ICP, Paramedic and EMT.

We acknowledge there is ongoing debate about exactly which ambulance officers should be registered.

We understand that one view is that only ILS and ALS officers should be registered - and this is the stance Ambulance New Zealand have taken in signaling their intention to apply for regulation for ILS and ALS under the HPCA Act 2003.

An alternative view is that in New Zealand large numbers of ambulances are crewed by BLS ambulance officers (EMT's) - and regulation needs to address this for the safety of the public.

Many rural and remote areas are served by EMT's - these BLS practitioners have a huge responsibility, they too care for critically ill and injured patients, and often have to make difficult clinical decisions about whether to transport or leave a patient at home.

NZAA believes EMT's also need regulation.

While registering ILS and ALS officers seems to fit well with a "degree equivalent" qualification standard for professional registration, it also poses a few hard questions:

1. How will members of the public react to learning that on some occasions, their critically ill children will be cared for by registered paramedics, but on other occasions, their loved ones will be cared for by unregistered, unregulated EMT's?

If ILS and ALS is the proper standard for achieving registration - then registration will further highlight the gap between the service we should provide (fully crewed ILS and ALS), and what is actually able to be provided given the current low level of central government funding: lots of single crewed EMT's.

(We understand this will not be an issue for those areas served by Wellington Free Ambulance).

2. The dominant provider based ILS qualification is nowhere near a "degree equivalent", how much wishful thinking is required to pretend that it is?