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Paramedic Self-Regulation Process

The current paramedic system is overly complex, inconsistent, outdated, has too many layers and does not include paramedics working in all contexts of health care.

A College of Paramedics would reduce bureaucratic layers, complexity and ensure all paramedics are registered under one regulator.

History of events

The Health Professions Regulatory Advisory Council (HPRAC) is a third party agency contracted by the Ministry of Health to advised the Minister of Health on whether health providers should become self-regulated professionals. “On December 20, 2013, HPRAC submitted its report to the Minister of Health on whether the Paramedic profession should be regulated under the RHPA." [1]

Volume 1

Volume 2

The HPRAC Executive Summary stated “ Although we recognize that paramedics are skilled health professionals who have earned the respect of their peers, HPRAC recommends that paramedics not be regulated under the RHPA because the application did not meet our primary criterion threshold for risk of harm and because self-regulation of paramedics is not in the public interest. Although paramedic practice entails a degree of risk of harm to the health and safety of the public, and the current oversight system is overly complex, the oversight system as a whole is sound and adequately addresses risk of harm to patients.

After this report was received, the Minister of Health, Honorable Deb Matthews, called for an additional two weeks of consultation.

As of January, 2015, the former Minister of Health, Dr. Eric Hoskins (OLP), did not make a decision on whether paramedic self-regulation would move forward. 

Subsequent Minister of Health Deb Matthews (OLP) and Minister of Health Christine Elliot (OPC) have also been engaged on this very important issue. Please stay tuned for further updates as we continue to work with the Ministry of Health and other stakeholders.

Ontario Paramedic Association's position

It's the Ontario Paramedic Association's position that the HPRAC report was incorrect in its assessment that paramedics do not meet the threshold for “risk of harm”. We believe the question is not whether paramedics pose a risk of harm to the public, but a question of what is the most appropriate form of mitigation for reducing the risk of harm? What is the most appropriate regulatory system that includes all paramedics? Our position is echoed by the Ontario Association of Paramedic Chiefs (OAPC), the Paramedic Association of Canada (PAC) and many other organizations and stakeholders from across Canada.

In order to understand this, one must acknowledge that most Ontario paramedics work under two regulatory bodies:

  1. The Emergency Health Services Branch of the Ministry of Health
  2. A Base Hospital system that employs paramedics to provide continuing medical education and investigate complaints, Base Hospital Physicians extend their license to paramedics, enabling them to perform controlled medical acts in the field. These physicians do not provide direct supervision of paramedics in the field. That is, paramedics work under standing orders and function independently in the field, with the ability to contact the physician in uncommon circumstances where a medical order or advice is needed. Under a self-regulation model, paramedics would continue to have the ability to consult with a physician from the field, when needed, but paramedics would be responsible and accountable for the controlled acts that they provide in the field.

Our concern is that the current system is overly complex, as HPRAC acknowledges. It is also inconsistent, outdated, and does not include all paramedics who are working in all contexts of health care across Ontario. In fact, we estimate there are between 1,500 and 3,000 paramedics in Ontario who are completely unregulated. This poses a significant risk to the public and must be addressed through a college of paramedics.


[1] "Paramedics - Health Professions Regulatory Advisory Council." 2011. 8 http://www.hprac.org/en/projects/paramedics.asp