Mr. Robert Morton:

I will speak about the number of registered paramedics in Ireland. Our colleagues in the PHECC, the regulator which registers paramedics, would probably say that there are approximately 2,500 paramedics registered in Ireland at the moment. It is probable that approximately 1,400 of them work in the NAS and between 800 and 900 of them work in the DFB. When those numbers are extrapolated, the number of actual registrants who do not work for the NAS or the DFB is probably very small. Many of them do not live and work in the jurisdiction. Of those who do, some of them work in other areas. For example, there are many registered paramedics who work in the HSE but do not necessarily work in the NAS as they have secured other positions. The numbers overall are small in the context of what we want to achieve.

I can add my own direct experience to the conversation about people who have secured registration in Ireland. I am a registered paramedic in Australia and the UK. I have not done the same training programme as a paramedic in the UK or Australia; I have done Irish paramedic training. To spin it around, if somebody who comes from the Marshall Islands, for example, secures registration in Ireland, we need to ensure they are familiar with our practice, they have worked as an autonomous practitioner and they are safe to be individually privileged by the clinical director. Ultimately, this is about patient care and safety. We have to assure ourselves that these paramedics are safe to practise. That has been the basis of the competency-based assessment. That assessment is based on the clinical practice guidelines which are available to anybody to scrutinise. They are on the PHECC website, so we expect applicants to be familiar with them. Our experience has been really mixed. We have come around to the view that the best way forward is not to throw the baby out with the bathwater. What the Senator is highlighting is exactly that. It is a pass-or-fail assessment. The applicant either passes the test or does not. We have come around to the view that the best way forward is to take the applicants in, subject to all the other employment checks, and effectively finish off their training in the Irish context. We fully accept that the model, as it stands, is not delivering what we need. It is not going to make the necessary contribution we need to our workforce plan, which is why we are going to change it. We have already decided to change it in 2023.