'Risk to public': Paramedics regulator unable to remove criminals
When regulators cannot remove those who pose a risk, public safety must come first.
![By Aisling Kenny - 10/09/2026 - RTÉ - [Ireland] - Image via RTÉ](https://static.wixstatic.com/media/afdf7c_a029782677ab426f883727eab62d7412~mv2.jpg/v1/fill/w_500,h_500,al_c,q_80,enc_avif,quality_auto/afdf7c_a029782677ab426f883727eab62d7412~mv2.jpg)
Correspondence obtained by RTÉ Prime Time under Freedom of Information shows that the independent regulatory body overseeing paramedics and emergency care technicians in Ireland has been repeatedly warning successive health ministers of risks to the public due to weaknesses in its powers.
The Pre-Hospital Emergency Care Council (PHECC) is responsible for "protecting the public by independently co-ordinating, developing, reviewing, regulating, and governing standards of excellence for the safe provision of quality pre-hospital emergency care."
It maintains a register of practitioners who meet training and skills standards for working in ambulance services.
However, in a series of letters starting in 2021, the Council has warned it does not have the legal power to remove individuals it deems to be of concern from its register, including people with criminal convictions.
In a December 2021 letter to then minister for health Stephen Donnelly, the council's chair at the time said there is a "continuing risk to the public" caused by weaknesses in legislation, which it described as a "growing and urgent cause for concern."
By 2024, the Council was describing itself as "beyond frustrated and concerned" at a lack of progress on what it described as an "urgent patient safety matter".
In correspondence sent to the current Minister for Health Jennifer Carroll MacNeill in December 2025, the PHECC said it was "inexplicable" that legislation has still not been strengthened, despite the issue having been identified as a priority "for over 10 years".
The chair of the council, Dr Tomas Barry, called for an "urgent meeting" with the minister to discuss the issues.
In the letter to the minister last year, PHECC said it was aware of at least 13 registered practitioners with criminal convictions who had been on the register at some stage, eight of whom had convictions for sexual assault.
The letter added: "It is important to note that these are only the cases that PHECC has become aware of, as there is no mechanism or obligation for the employer, registrant, courts or gardaí to inform PHECC in these circumstances. The employer does not usually inform PHECC, and it is rarely in the registrant's interests to do so. In this context, the above shortcomings in PHECC's legislative framework are very concerning."
The regulator has also warned that its powers when investigating misconduct are limited.
The PHECC cannot carry out inspections in the same way as other regulators. It cannot compel people to participate in an investigation, and the sanctions available to it do not include the power to restrict someone from practicing.
Dr Alan Eustace, Assistant Professor of Private Law at Trinity College Dublin, said it is unusual for a regulatory body not to have the power to remove somebody from the register.
"To take the example of nursing, the board there does have the power to cancel the registration of somebody who has been found after a fair procedure, fitness to practice inquiry, to be guilty of poor professional practice or falling short of a professional code of conduct," he said.
"And that would certainly include something like sexually inappropriate behaviour... But the ambulance regulator does not have the same power to remove people in those circumstances."
Asked what would be required to change the current law for the ambulance regulator, he said ministerial action could address the issue.
"All the powers of this council are set out in statutory instruments. So, it would require action from the minister for health, but it wouldn't require legislation to give it that power. This can be done through a statutory instrument by the minister."
According to correspondence obtained from PHECC, even in circumstances where "serious findings" are made by a PHECC Fitness to Practice Committee, the only sanctions available are advice, admonishment or censure.
"The register is entitled to continue to practice unrestricted," documentation from PHECC states. "This means the public may not adequately be protected from harm or risk."
In response to concerns raised earlier about harassment and bullying within the National Ambulance Service, Minister Carroll MacNeill said, "every member of staff has the right to work in an environment characterised by dignity, respect, and professionalism."
"While I acknowledge efforts to improve the culture and strengthen the HR function in our National Ambulance Service, there is much more to do," the statement added.
A response to a further request for comment regarding the specifics of the correspondence sent by PHECC has been sought by RTÉ.
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Dignity4Patients Commentary: This article raises serious concerns about the ability of regulators to protect patients and the public when paramedics with criminal convictions cannot be removed from practice. Where there are credible concerns about an individual’s suitability to work in a position of trust, patient and public safety must be the priority. Regulatory systems must have clear and effective powers to act where necessary, ensuring that safeguarding is not compromised by gaps in legislation or oversight.
