Paramedics make life and death decisions every day. But unlike doctors, nurses and midwives, they don't have to be registered.
Wellington Free Ambulance’s medical director Andrew Swain says: “Anyone can technically call themselves a paramedic.”
And that’s something they want the government to change.
For 25 years paramedics have been calling for national registration – because an unregulated workforce puts them - and the public - at risk.
"There is a potential for harm ...there are groups out there that are unregulated, don't have proper governance or accountability and we feel like that needs to be rectified," Mr Swain said.
"There are instances when a paramedic has performed poorly - has lost his employment with one of the major ambulance providers and sets up independently and there is no way to transfer that across - when you have a register they have to perform to a particular standard."
Registration would mean all paramedics would have to meet set levels of qualifications and training
A national body would also develop codes of conduct and handle complaints and discipline.
And paramedic Laura Robertson says it would give them the professional respect they deserve. "It is really important for us to be recognised for what we are because we are all proud of the profession and what we do all day."
Registration would cost about $425 a year.
And the union Paramedics Australasia is hoping the health ministry will help out.
"Otherwise it's an extra cost on paramedics who arguably are somewhat limited in their ability to pay," NZ chair Sean Thompson says.
Health Minister David Clark says he's working on a fix and will introduce a change to the rules later this year.
"The profession itself wants to be regulated - and I think that is a pretty reasonable request," he said.
Maori Public Health boss Lance Norman told politicians today that 35 per cent of Maori still smoke, along with 25 per cent of Pasifika and 12-13 per cent of all other ethnicities.