PHECC’s weak legislation presents risk to public, Minister is warned

The weak legislation underpinning the Pre-Hospital Emergency Care Council (PHECC) presents an “unacceptable risk” to the public, the Minister for Health has been warned.

In a letter on 19 December 2025, PHECC Chair Dr Tomás Barry informed Minister Jennifer Carroll MacNeill: “It is inexplicable that the need for modern robust legislation governing the regulation of pre-hospital emergency care, and the practice of paramedicine, has still not been addressed, despite being raised as a priority matter of concern with the Department of Health for over 10 years.”

According to The Future of Paramedicine, published by PHECC in 2016, it has limited ability to apply robust sanction measures to protect the public, but also to maintain standards and public confidence
in the profession.

PHECC does not have the power to restrict a practitioner’s registration through the imposition of conditions or the suspension or cancellation of registration, stated the report. PHECC can only determine whether a practitioner should be advised, admonished or censured, and must rely on a service provider to limit or restrict the practice privileges of a practitioner. PHECC’s inability to cancel registration would also extend to any practitioner convicted of a serious crime (PHECC’s Director can refuse new registration/re-registration on these grounds). The current arrangements also do not incorporate protection of title.

In his correspondence, released by PHECC under Freedom of Information law, Dr Barry outlined that serious concerns about PHECC’s legislative framework had been detailed in a 2019 submission, annual letters to the Minister from the PHECC Chairperson, and in his recent letters to Minister Carroll MacNeill. These clearly demonstrated “the continuing and unacceptable risk to the public and, concurrently, the reputational risk to the Minister and the Department of Health”.

Furthermore, the legislative deficiencies “continue to impede the important development of two new grades of specialist paramedic”.

Dr Barry’s correspondence was sent with his Chairperson’s Comprehensive Report for 2024. The records show Dr Barry had also sent correspondence to the Minister, dated 10 December 2025, but this was fully redacted as it contained legal advice on legislation obtained by PHECC. Correspondence was sent to Dr Barry by a Department Assistant Secretary on 22 December 2025 and this was also redacted on the same basis.

A Department spokesperson said PHECC was established in 2000, and its legislative functions were amended in 2004 and 2008.

“Amendments in 2004 included additional provisions regarding the registration of practitioners and fitness to practise. The establishment order and amendment orders have been brought under primary legislation by the Health (Miscellaneous Provisions) Act of 2007. The PHECC implementation of these powers has worked to ensure patient safety in the pre-hospital emergency care sector in the years since its establishment.”

The Department was “working closely with PHECC in respect of its legislative framework including items identified by PHECC as priorities for amendment”.