The Use of Para-medicals for Primary Health Care in the Commonwealth

The Use of Para-medicals for Primary Health Care in the Commonwealth

A Survey of Medical-Legal Issues and Alternatives You do not have access to this content

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John M. Paxman, Francis M. Shattock, N. R. E. Fendall
01 Jan 1979
9781848592865 (PDF)
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  • Preface

    This survey was undertaken at the request of the Commonwealth Secretariat. It has as its focal point legislation in Commonwealth countries pertaining to the use of paramedicals, particularly in the area which has come to be known as primary health care. The materials upon which the survey was based were supplied by various Commonwealth Governments in answer to a request sent to them from the Legal Division of the Commonwealth Secretariat.

  • Introduction

    At one point in Through the Looking Glass, Lewis Carroll has Alice complaining incredulously to the Queen about the fact that they seemed to be getting nowhere though the two had been running side by side for quite some time. Befuddled by the turn of events, Alice volunteers that if they had been running that fast in her country “You'd generally get to somewhere else”. The Queen is heard to retort, somewhat indignantly, that in her realm one must run that fast just to stay in the same spot.

  • Paramedical— The Search for a Definition

    A term which can satisfactorily be applied to the non-doctor cadres involved in health care has yet to be found. Among those often used are “health and auxiliary personnel”, “allied health personnel”, “nonphysicians”, “aides”, “assistants”, “auxiliaries” and “paramedicals”. Of these paramedicals appears to be the most widely used, though it is not without its drawbacks.

  • The Case for Expanded Roles for Paramedicals

    In the past decades gallons of ink have been spilt in articles describing programmes utilizing specially trained paramedical personnel. Out of this mass of literature and experience has arisen a cohesive body of knowledge which demonstrates rather conclusively the practicality of tapping this source of manpower. At the outset, it seems appropriate to rehearse briefly the reasons for expanding the use of paramedicals in primary health care.

  • Legislation and the Medical and Health Care Professions

    The principal sources of regulation of the health care professions are the statutes on the practice of medicine, nursing and midwifery, the rules promulgated pursuant to them and the public health statutes and regulations. These statutes, rules and regulations for the most part define who can do what and under what conditions. They define, either explicitly or by inference, the practice of medicine, nursing and midwifery, and limit the right to engage in practice to licenced or registered individuals.

  • Sanctions Against Unauthorized or Negligent Medical and Health Care Practice

    The sanctions which may be applied against persons who engage in the unauthorized practice of medicine are a key concern of paramedicals undertaking expanded health care service roles. If they exceed the scope of their traditional practice, they place themselves in jeopardy, not only of disciplinary action from their own professions, but also of civil and criminal liability under the medical practice statutes. These would ostensibly apply where a nurse, a midwife or another non-doctor participated in health care activities without proper authorization.

  • Primary Health Care, Paramedicals and the Law: A Brief Critique

    In the realm of primary health care the expressed needs are for diagnosis, treatment and midwifery. If primary health care is restricted to preventive medicine, however important it is, the community will not be satisfied. Their need is for relief of pain and treatment of illness.

  • Legal Alternatives for Expanding the Roles of Paramedicals in Primary Health Care

    Given the present state of affairs it is impossible to consider providing primary health care to the populations of most Commonwealth countries without first considering expanded roles for paramedical personnel. As we have seen there is considerable variation among nations in the use of paramedical personnel. Some of this variation corresponds to variation in statutory law, some to differences in regulations.

  • Conclusion

    First, whether to expand the roles of paramedical personnel or not is not a legal decision. It is a political one, that is to say a matter of national health policy. To be sure any decision of this sort is not without its legal elements, but if the will to change the current system controlling health care delivery is lacking, laws and regulations will not be changed.

  • Footnotes and Annexes
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