To the Editor: In a media release dated 30 August 2011, the
Professional Board for Emergency Care of the Health Professions
Council of South Africa states: ‘The HPCSA remains committed to the
discontinuation of the Basic Ambulance Assistants (BAAs), Ambulance
Emergency Assistants (AEAs) and paramedic Registers, thereby halting the current short courses offered.’ The closure of the registers is pending the promulgation of the relevant regulations by the Minister
of Health.
While the proposed discontinuation of the registers is to be welcomed,
the subsequent halting of the short courses is disturbing because it
displays a woeful lack of insight by the Professional Board into the
real world of operating ambulance services in South Africa.
As far back as 1982 I and other medical colleagues appealed to the
HPCSA to register advanced trained ambulance persons from the
provincial ambulance colleges in the Cape Province and Natal. The
reason for our request was that for the first time ambulance personnel
had been trained to administer specific drugs such as adrenaline and
atropine to patients.
We did not suggest registration of the basic or intermediate courses,
which even today form the backbone of trained ambulance personnel
delivering a service throughout the country.
It was predictable that to open registers for thousands of personnel
with short courses would lead to an unmanageable administrative
nightmare, especially when associated with collection of fees – and to
what purpose? Effectively the short courses are upgraded first aid
courses with the accent on ambulance operations in order to provide a
professional service to the public – certainly an asset and not a
hazard.
To discontinue these short courses as opposed to the registers will be
catastrophic to all the state-operated Emergency Ambulance Services,
which to a greater or lesser extent depend on these personnel. While
the registers should be discontinued, the courses should continue as
at present, subject to HPCSA accreditation of training facilities.
If all short courses were to be halted, what remains? (i) A 3-year
degree course offered only by the universities of technology, and (ii)
the 2-year ECT (Emergency Care Technikon) course.
Apart from the additional financial burden of effectively employing
only ambulance personnel with diplomas or degrees in the state health
service, it is tantamount to a waste of state resources, as no more
than 5% of patients require advanced life support.
The remaining courses are also more theory than practical, so even at
greater cost it is more unlikely that the public will be better
served!
Is this the role of the HPCSA?
A G Mac Mahon
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