The body responsible for regulating paramedics in Ireland has been sounding the alarm for years about a serious gap in its powers, and those warnings have largely gone unheard. Correspondence obtained by RTÉ Prime Time reveals that the Pre-Hospital Emergency Care Council, known as PHECC, repeatedly wrote to health ministers flagging that it simply does not have the legal ability to remove convicted criminals from working as paramedics.
That is not a minor administrative headache. That is a regulator telling the people in charge, in writing, on multiple occasions, that the public could be at risk, and the response from successive ministers has been inadequate at best.
PHECC oversees the registration and standards of paramedics and emergency medical technicians across the country. These are the people who show up when someone is having a heart attack, when there has been a serious road accident, or when a vulnerable person calls for help in the middle of the night. The level of trust placed in them by the public is enormous, and rightly so. The vast majority of people working in pre-hospital emergency care are dedicated professionals. But the system designed to protect the public from the rare bad actor is, according to PHECC itself, not fit for purpose.
The core problem is straightforward. Unlike other healthcare regulators in Ireland, PHECC does not have the statutory powers needed to strike someone off the register based on a criminal conviction alone. Other regulators covering doctors, nurses, and pharmacists have stronger legislative backing that allows them to act decisively when a registrant is convicted of a serious offence. PHECC has been asking for the same tools and has not received them.
The correspondence obtained by RTÉ shows this is not a new concern that has only recently come to light. The warnings were sent to health ministers over a number of years, which makes the lack of action even harder to explain. When a regulator flags a risk to public safety once, it could be put down to the slow pace of government. When it flags the same risk repeatedly and nothing changes, that becomes a policy failure.
The Department of Health has acknowledged that legislative reform in this area is needed. But acknowledgement is not the same as action, and in the meantime the gap in powers remains open.
From a practical standpoint, what this means is that if a paramedic were convicted of a serious crime, PHECC could find itself in a position where it struggles to remove that person from the register in a straightforward way. The regulator may have to rely on lengthy fitness to practise processes that were not designed with criminal convictions as the primary trigger. That is a slow and complicated route to an outcome that should be simple.
For patients and members of the public, this is unsettling. Emergency situations are by definition moments of extreme vulnerability. People who call an ambulance are often frightened, in pain, or unable to advocate for themselves. The assumption that the person arriving to help them has been properly vetted and can be removed from practice if they pose a risk is a reasonable one. Right now, that assumption is not fully backed up by law.
PHECC has been doing what a regulator should do in this situation. It identified a problem, it documented it, and it escalated it through the proper channels. The failure here does not sit with the regulator. It sits with the political and legislative process that has failed to respond in any meaningful timeframe.
Health reform in Ireland has a long history of moving slowly, and pre-hospital care has often been lower down the priority list compared to hospitals and GP services. But regulatory gaps are exactly the kind of thing that tends to only get fixed after something goes wrong, and by then the damage is already done.
The RTÉ Prime Time investigation has now put this issue firmly in the public eye, which may finally create the pressure needed to get the legislation moving. The ask from PHECC is not complicated or controversial. It wants the same powers that other healthcare regulators already have. Giving a regulator the basic tools to protect the public should not require years of correspondence and a television investigation to get over the line.