The College of Paramedics recently published its five-year strategic plan (College of Paramedics, 2014) where it set out its vision for the next two to five years. The document should be important for all members of the paramedic profession but there is little doubt that it will go unnoticed among the majority of paramedic registrants. The College states that around 19% of paramedics who were registered with the Health and Care Professions Council (HCPC) in October 2013 were members of the College, which equates to around 3 700 members. The numbers are growing slowly but when the College of Paramedics membership is compared with other healthcare professions, it is concerning. The Chartered Society of Physiotherapists (2014) boasts 59 000 members even though there are only just over 47 000 registrants, and the British Dietetic Association (2013) has more than 7 500 members from a registrant population of just 8 355 (HCPC, 2014).
The low membership means that the College cannot legitimately claim to speak on behalf of the profession and the result is that the profession does not have the voice that it needs in what is a crucial time in its evolution. The roles and education of the paramedic are changing and there are threats to the profession from multiple agencies who believe that they can do a better job, yet paramedics have no single body that can speak with authority on behalf of them. The risks of allowing this to continue are significant. In 2010, the fire service put forward proposals to run England's ambulance services, and although nothing has yet transpired, it is unlikely that fire service chiefs will have completely dismissed the project. There is also competition from medics who now have a sub-specialty in pre-hospital emergency medicine, and there is a growing realisation that paramedics are not the only people who are capable of delivering care in the pre-hospital environment, and that they may not always be the best people to deliver it.
The reasons for the poor uptake of membership are unclear but one thing that is clear is that the paramedic profession needs a strong voice that represents the majority of the profession rather than a relatively small minority. Without a membership of at least 50% of paramedic registrants it is not possible to speak with authority, and this should concern all who have an interest in the paramedic profession. Perhaps it is time for the College to consider acting as a trade union as well as a professional body as this is a role that is undertaken successfully by the Chartered Society of Physiotherapists, the British Dietetics Association and the Royal College of Nurses. While this move would not assure a 100% membership, it is likely that paramedics would more readily subscribe to a professional body that could support them both as an individual and as a paramedic.