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To achieve these objectives, PA believes that health care policy should:• recognise the benefits of holistic care delivered by health professionals operating in a multidisciplinary/interprofessional practice environment;

• ensure an equitable health system by providing para-medic services for all according to need and regardless of race, creed, gender, location or economic circumstances;

• establish funding arrangements at Federal, State and Territory levels that facilitate the delivery of integrated health care services and minimise duplication of effort by optimising the use of available physical and human resources;

• ensure responsiveness, quality and high service standards through appropriate governance structures, including practitioner and community engagement that recognises the legitimate role of stakeholders in the planning and delivery of health care;

• provide adequate educational opportunities for the recruitment, training and professional development of paramedics that will ensure a competent and sustainable workforce; and

• provide a national regulatory regime for the accreditation of service providers and the independent registration of paramedics that together will ensure consistent service standards and public safety. Paramedics zealously guard their status as Australia’s most trusted profession , and have embraced professional and ethical standards intended to ensure the maintenance of that position. As a profession they want to provide a level of patient care that ranks with world’s best practice.

Nonetheless PA notes that paramedic services (aka Ambulance Services) in several Australian jurisdictions have been subject to government inquiries because of perceived operational inadequacies or deficiencies in the recent past. Unfortunately the catalysts for many of these inquiries have been associated with managerial deficiencies or public concern at provider responses rather than being aligned with the health care system and patient outcomes under health care performance standards and indicators. These inquiries show the need to examine a number of policy, governance and practice issues which to date have not been adequately addressed by the health reform process or captured within government datasets. The paucity of data related to pre hospital patient outcomes and the need to integrate information on the total patient journey has been confirmed through direct discussions with the Australian Institute of Health and Welfare (AIHW) [9]. More research is needed but will depend on proper recog-nition of prehospital medicine as an integral component of healthcare.

Patient safety in pre hospital medicine is another issue that has been poorly studied and documented within Australia. The uncontrolled nature of much of pre hospital medicine delivery creates servicing challenges that increase the risks of adverse events. Even so, the available data is inadequate to hold significant opportunities for improvement. Collaborative action is needed to better identify pre hospital patient safety incidents and practices that affect overall patient outcomes. PA is focussed on the need to facilitate the health care role of paramedics in the interests of the patient. It wants to see pre hospital medicine integrated with other health services so as to create a seamless system of care beginning at the point of need.

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