Public Health News South Africa

Emergency care personnel, practicing with fraudulent certificates

PRETORIA: According to the Health Professions Council of South Africa (HPCSA), thousands of emergency care personnel are practicing with fraudulent certificates and are treating the South African public. Over 400 members have already been de-registered by the Professional Board for Emergency Care, while an additional 1 000 members will be removed from the register later this month.
Emergency care personnel, practicing with fraudulent certificates

This follows an in-depth investigation by the board in collaboration with the Hawks into the quality of training and education provided by the Limpopo Ambulance Training Academy (LATA).

LATA's fraudulent registrations resulted in people who have no training and education in emergency care, working as emergency care personnel.

"These people are treating patients in sometimes life-threatening situations without quality emergency care training and we cannot allow these fraudsters to put the public at risk," Raveen Naidoo, chairperson of the Professional Board for Emergency Care said.

Regular inspections conducted

The board conducts regular inspection visits to various colleges and training providers across the country; an inspection team discovered the fraud earlier this year.

All institutions offering emergency care training, which fall under the ambit of the Professional Board for Emergency Care, must be accredited and in compliance with the conditions of accreditation as well as the education and training standards, as determined by the board.

Africa Transformation Network (ATN) from Goodwood, Cape Town is also not permitted to offer Basic Ambulance Assistant (BAA) and Ambulance Emergency Assistant (AEA) training. The board regularly updates the list of accredited education and training providers.

The regulator will not register anyone holding a qualification obtained from a training centre involved in the issuing of fraudulent certificates as well as from an unaccredited institution, as the council needs to ensure that capable and properly qualified members treat patients when they need it most - in an emergency.

Naidoo was adamant about upholding the integrity of the profession, saying, "The board is warning any registered member who is involved in any criminal, unprofessional and unethical conduct to stop immediately. The board does not tolerate this type of conduct and will launch an investigation into the conduct of any emergency care personnel suspected of disgraceful conduct. We will not allow a handful of corrupt people to bring our highly-esteemed profession into disrepute."

Employers called on to ensure staff have legitimate qualifications

The HPCSA is calling on all employers to ensure their emergency care staff, who obtained certificates from LATA and who are registered with the council, have legitimate qualifications.

"We are again urging students to first check with the HPCSA to ensure the training centres they are enrolling in are accredited institutions", Naidoo said. "Prospective students are welcome to contact the council or visit the HPCSA website to verify a training centre's accreditation. Unsuspecting students are also being conned out of money and a prospective career by fly-by-night training centres offering training that is not accredited with the council."

"Emergency care practitioners are there to protect and serve the community and the South African public should never [have to] question the knowledge, work ethics and capabilities of any emergency care worker," he said.

The board is also concerned about the following:

Ambulance patient care

Practitioners treating patients in these circumstances are warned that they may expose themselves to charges of abandonment and unprofessional conduct and they are reminded that they remain responsible for their patient's condition until they are handed over to another healthcare professional.

Research has shown that a single practitioner cannot optimally perform important medical procedures such as ventilation and resuscitation, and leaving the patient alone in the back whilst being transported is, for obvious reasons, most undesirable.

Naidoo said that emergency medical service managers who condone this practice cite staff shortages as reasons for one-man crew ambulances. "This matter needs to be urgently addressed by senior management of affected areas and should be rectified with immediate effect as patient care is compromised."

Submission of fictitious claims

The council has received complaints from patients and emergency care personnel regarding the submission of fictitious claims by privately-owned ambulances.

Some errant ambulance operators instruct staff to "upgrade" every call to Advanced Life Support (ALS) in order to claim higher rates from the medical aids. This results in cases being delayed at the scene or on route in order for a paramedic to reach the patient before he is admitted to hospital. Patients are coerced into requesting higher intervention or medication than necessary.

Practitioners practicing outside their scope of practice

Any emergency care team is made up of individuals who have various levels of training and expertise. They are geared to provide the best possible treatment to the public in any emergency. Although we understand that quick decision-making is critical in a life-threatening situation, the board would like to remind all members that practicing outside your scope of competencies is unacceptable and the board will be investigating any of its members who are not abiding by the various capabilities. A comprehensive capabilities list is available on the HPCSA website.

Accident scene photographs and distribution via social media

Practitioners are reminded that the taking of photos without the permission of the patient is an infringement of the patient's right to privacy and dignity and this must be respected at all times. Under no circumstances may a practitioner take photographs without the consent of the injured patient.

"With social media changing the way in which we share information and news, the board would like to remind members that it does not support the distribution of personal images and videos of patients involved in an accident via social media," Naidoo said.

Strikes

The board would also like to remind all emergency care staff that emergency care is classified as an essential service and therefore members are not allowed to participate in any strike action. The board views this as a very serious offence and personnel involved will face charges of unprofessional and unethical conduct.

In closing, the HPCSA remains committed to the discontinuation of the Basic Ambulance Assistants (BAA's), Ambulance Emergency Assistants (AEA's) 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.

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