Weaknesses in the powers of the State’s regulator for ambulance services are posing a “serious risk to the public” and a “reputational risk” to the Government, the Department of Health was warned last year.
The Pre-Hospital Emergency Care Council (Phecc), which regulates ambulance services, repeatedly raised concerns that it did not have powers to remove individuals with serious criminal convictions from its register of medics.
In a April 21st, 2022, letter, the council warned Minister for Health Stephen Donnelly that the shortcomings in its legal powers meant there was a “serious risk posed to the public”, as well as “reputational risk” for him and the regulator.
The correspondence said the council was “extremely concerned” about the “weakness of the current legislation” underpinning its role. The “significant restrictions” on its powers meant the regulator was “compromised” in its ability to protect the public, it said.
Dr Jacqueline Burke, chair of the council, previously drew attention to the regulator’s lack of powers in a December 24th, 2021, letter to Mr Donnelly.
“Our lack of ability to remove a practitioner from the Phecc register, even those with serious criminal convictions, is a growing and urgent cause of concern,” she wrote.
The council’s ability to take fitness-to-practise cases against emergency medical technicians (EMTs) or paramedics were “severely lacking”, she wrote.
“The weakness is also exacerbated by the lack of powers of compellability of witnesses or documentation” during fitness-to-practise hearings, she said.
Correspondence between the regulator and the department was released to The Irish Times under the Freedom of Information Act.
Dr Burke added that as the titles of EMT and paramedic were not protected, they were “open to abuse as unscrupulous individuals may present themselves in these roles”.
There was also no mandatory requirement for ambulance staff or first aid volunteers to register with the council, meaning people could “operate with impunity” if they wished.
There was “no statutory requirement” for an ambulance provider to register with the regulator, she said. First aid courses were also unregulated, which meant training of “questionable standards” was being advertised online.
The council had no powers of inspection to make sure registered companies or voluntary first aid organisations were providing safe care, she said.
The letter said the council was “very concerned at the lack of progress” of a review of the relevant legislation that had been scheduled for 2019.
“We cannot emphasise strongly enough the continuing risk to the public and, concurrently, the reputational risk to the Minister and department caused by the weakness in our current legislative framework,” she said.
A spokeswoman for the council had met department officials to discuss the required legislation on February 21st.
A spokesman for the department said it met with officials from the regulator “on an ongoing basis as part of the governance arrangements for State bodies”, with a range of issues discussed during meetings.
David Hall, who runs the State’s largest private ambulance service, Lifeline Ambulance, said the council was “not a fit regulator” as a result of the legal weaknesses.
Mr Hall, who previously sat on the council several years ago, questioned “how many convicted sex offenders are currently on the Phecc register”, but could not be removed.
The powers of the council needed to be overhauled to put it on similar footings to other regulators, such as the Medical Council, he said.
