Anyone can claim to be a paramedic, but steps are being taken to freeze out the fraudsters who blight the profession. Patrick Butler reports

According to the News of the World, a growing army of bogus and fake paramedics, including convicted child molesters, are preying on disaster scenes to get ghoulish kicks and reflected glory.

The paper's dossier of phoney ambulance staff is unsettlingly comprehensive: from lone opportunists who cruise the roads in search of car crashes to private cowboy operations which offer services to fetes, festivals and sports meetings.

There is virtually no legal redress against them. Anyone can set up in business as a paramedic as long as they do not give out prescription drugs or attempt major treatments. But that is about to change. The Ambulance Service Association has begun balloting all paramedics with a view to setting up a national register.

This will provide professional regulation in the style of the UK Central Council for Nursing, Midwifery and Health Visiting, with powers to strike off paramedics who breach a new code of conduct. If it comes to fruition as expected by 2000, the paramedic register will also give 'closure of title'.

Eventually this will mean that only those paramedics who are on the register will legally be able to call themselves paramedics.

The proposed arrangements will provide a strong and enforceable means of ensuring that only those who have met national standards of training and competence, and can show they have been maintaining these standards, will be able to describe themselves as state registered, says the ASA.

Paramedics will be regulated under the Council for the Professions Supplementary to Medicine, alongside radiographers, physiotherapists and others. The CPSM will have legal powers to act against non-registered paramedics who describe themselves as paramedics.

Like nurses or physiotherapists found guilty of misconduct, it will be possible to strike paramedics off.

Ambulance service managers claim NHS paramedics who are sacked for misconduct can find employment with cowboy outfits which do not check references.

Mike Willis, chief executive of West Country Ambulance trust, says registration fits into the government's agenda of raising quality standards and safeguarding the public against poor clinical practice. There will be recognised qualifications and a duty to ensure skills are regularly updated. It will ensure the quality of care delivered by somebody claiming to be a paramedic will be of a guaranteed standard, says Mr Willis.

Registration is also welcomed by the service as an acknowledgement of its status and skills, putting practitioners on a par with state registered nurses. It recognises that paramedics have moved a long way forward and that the public have great expectations of them, says Keith Nuttall, Royal Berkshire Ambulance trust chief executive.

It has the backing of the Joint Royal Medical Colleges and the British Medical Association, and ministers are believed to support it in principle.

Unison, the largest ambulance service union, welcomes the idea, but wants it to be the first step towards a more general NHS registration. 'We believe there is an argument for all healthcare workers to be registered. This will stop certain people practising as paramedics, but they could go elsewhere as a qualified ambulance technician, ' points out Unison national officer Maggie Dunn.

Few expect it to stop the weirdos - the fantasists who scan the 999 radio waves and carry dayglo bibs and blue flashing lights in their car boots. But it will make their life more difficult, and give the police more ammunition with which to take action against them.