Last week the Federal Government announced a $1.2M grant would be awarded through the Alberta College of Paramedics applying on behalf of Paramedic Regulators across Canada. This funding is earmarked for a two year project to increase labour mobility within the profession and develop a foreign credential recognition process.
In the spring of 2008, the Paramedic Association of Canada invited regulators and representatives of Human Resources Canada to a meeting in Victoria to discuss labour mobility. During the two years prior to that, PAC had attempted to facilitate a review of the Paramedic Mutual Recognition Agreement developed in 2003, knowing that full labour mobility as outlined in the Agreement on Internal Trade had not been achieved. Unfortunately it took a no-nonsense deadline of April 2009 issued by the country’s Premiers to finally get regulators to the table. A plan was developed at that Victoria meeting that would see all provincial regulators begin discussions later in the year to achieve labour mobility compliance as mandated by their respective governments…a request from PAC that the association be included in those discussions was vetoed by two of the three regulators present at the time.
Subsequent to their further meetings related to labour mobility, the regulatory agencies deemed it would be beneficial to organize more formally in an effort to collaborate on other areas of common interest…professional titles, scope of practice, standardized examinations and foreign credentialing to name a few. This formed the basis for their federal funding application and the creation of the Canadian Organization of Paramedic Regulators.
Now…please humour me as we review some history…
The concept for development of the NOCP dates all the way back to 1993 and CSAP - the Canadian Society of Ambulance Personnel (predecessor to PAC). Both the idea and the association had their ups and downs, but in April of 1998 the project was resurrected, and for the next three years consensus meetings involving all paramedic stakeholders were held across the country. In June 2001, the PAC Board of Directors approved the National Occupational Competency Profiles for Paramedic Practitioners and the document was then accepted the Canadian Medical Association as the basis for accreditation of paramedic education programs.
At the 1996 Annual General Meeting of CSAP, President Doug Major suggested that “reciprocity will be driven by economic forces, NAFTA and the Agreement on Internal Trade”. In September of 2000, Canada’s paramedic regulators attempted but were unable to reach consensus on an agreement to address barriers to labour mobility within the profession. Following completion of the NOCP, PAC re-convened meetings of the regulators to identify issues that prevented ratification of the draft Mutual Recognition Agreement and to develop strategies to resolve these issues. As a result of that initiative, all participating provincial regulatory bodies agreed to sign the “Agreement on Labour Mobility for Paramedics in Canada”. This document used the NOCP as the basis for paramedic labour mobility. Despite completion of the Paramedic MRA in 2003, it remained difficult to achieve true labour mobility for the profession as intended by the AIT. As alluded to earlier, PAC attempted unsuccessfully to re-convene discussions through the profession’s federal labour mobility coordinator.
In 2007, PAC initiated a process to review and update the Competency Profiles. Recognizing the difficulty and expense associated with assembling stakeholder consensus meetings across the country as had been done in the initial development of the NOCP, PAC established a review committee with invited representation from all major stakeholder groups…employers, educators, regulators, physicians and practitioners. Further consultation was affected using two electronic national stakeholder surveys to validate the proposed profile revisions as PAC prepared to present a revised competency profile to its Board of Directors for consideration in the spring of 2010.
And that brings us to today…
Professional regulators have a legislated responsibility for public protection, and as such the mandate to ensure competence, control practice and set regulatory standards. They are also obligated, both morally and legislatively, to ensure labour mobility within their profession. These concepts are not new and in fact ones that PAC has supported and helped realize over the years in the past absence of a formal national regulator group.
The Paramedic Association of Canada is a membership-based organization accountable to its members, and while development of the profession is at the forefront of PAC, it has always been sought through the promotion of quality and professional patient care. The association has been a nexus for consensus building amongst stakeholders, working to develop relationships consistent with providing excellence in emergency medical services health care.
I commend the regulators on their initiative to construct a more formal organization to address interprovincial scopes of practice and further the concept of a national exam. I applaud their successful bid to obtain funding for work in areas of professional development. But I’m both surprised and disappointed by the “less than lukewarm reception” that this newly formed entity has shown to PAC. Despite a long history of provincial regulators encouraging PAC in the development of the NOCP; despite the resulting regulatory and professional benefits afforded paramedicine through program accreditation with the Canadian Medical Association; despite PAC’s past efforts and successes to facilitate labour mobility; despite PAC’s long standing vision to establish a national exam and a national registry; despite the association’s work to further research in EMS…members of the newly formed Canadian Organization of Paramedic Regulators now question PAC’s ongoing role in these areas of professional responsibility.
PAC has been working with representatives of the national regulators group in an effort to find common ground for the revision and maintenance of the National Occupational Competency Profiles. But I perceive great reluctance on the part of some regulators to acknowledge PAC as a significant and relevant stakeholder; past, present or future. And last week’s funding announcement making reference to the development of a “standard of competence for each of the four levels of practice of paramedicine” (EMR, PCP, ACP, CCP) has only served to further that perception.
