Position Statement on Statutory Regulation of Physician Associates

Prepared on the 23 October 2024

This statement articulates the position of the Medical Council on the scope of practice and regulation of physician associates (PAs) in the Irish health care sector.

The Medical Council is the independent statutory body which regulates medical practitioners in Ireland. Its primary purpose is to protect the public by setting high standards of professional conduct, education, training, and competence among doctors. The paramount concern of the Medical Council is the safety and well-being of patients.

The PA Role

The Medical Council is aware that PAs are being trained and employed in the Irish health care system, working under the supervision of doctors to support the provision of health care, contribute to patient management, and improve healthcare access. The Medical Council considers that is it essential that these PA roles are defined with respect to their scope of practice.

PAs cannot be seen as a substitute for doctors and the Medical Council cannot support medical roles being replaced with non-medical roles. While PAs are qualified healthcare professionals, they are not autonomous practitioners, and their training, skills and competence are not comparable to that of a registered medical practitioner.

The absence of clear role definition and scope of practice can lead to blurring of lines of professional responsibility and accountability thus compromising patient safety. It is the opinion of the Council that the tasks and scope of practice of the PA role requires clarification. This scope of practice should delineate the specific clinical tasks and responsibilities that PAs are authorised to perform, considering their training, experience, and competency level.

Regulation of PAs

The Medical Council welcomes the timely production of a framework to guide future decision-making on the regulation of health and social care professionals by the Department of Health and looks forward to engaging in any deliberations on the regulation of PAs.

As it stands, the Medical Council is of the opinion that it is not the appropriate regulatory body for PAs. The compounding factors are that:

• the Medical Practitioners Act 2007, (as amended in 2020 and 2023) has no provision to regulate health professionals other than doctors.
• the potential for emerging patient safety risks arising from confusion for patients, as observed recently because of regulation of PAs by the GMC in the UK.