Australian paramedic details staffing crisis in New South Wales

A recent report by the federal Productivity Commission revealed that the New South Wales (NSW) Ambulance service lags behind the national average in per-capita funding as well as every measure of patient satisfaction.

Only 59 percent of patients in NSW, Australia’s most populous state, were satisfied with the length of time they waited for an ambulance to arrive, compared to the national average of 64.5 percent, which is itself low.

Total expenditure on ambulance services in the state was just $136.68 per person in the 2019-20 financial year, an increase of 25 percent over 2010-11. In the same decade, the national spend increased by 34 percent to $159.46 per person.

An ambulance in Sydney earlier this year (Credit: Wikimedia, Helitak430)

Staffing levels fell compared to population in NSW. While the number of full-time equivalent positions increased by 39 percent across the country during the decade, NSW staffing levels grew by only 18 percent. This was despite the state’s population having increased by 23 percent since 2010, compared to a national increase of 17 percent.

World Socialist Web Site reporters spoke to a NSW paramedic about the conditions ambulance workers face.

“We are hugely understaffed at the moment. There needs to be an injection of permanent staff. We are overworked. Instead, the ambulance service has introduced part-time and contract work, with no permanent security for the workforce. The existing workforce isn’t happy with that because it doesn’t address the existing understaffing.

“Because the minimum operating levels haven’t been increased for 10 to 15 years, workloads have increased massively. You almost never get your breaks. There’s a never-ending stream of jobs that mount up and not enough ambulances and staff to cover those jobs. The prospect of getting any meaningful down time or rest is non-existent.

“A huge amount of your pay is penalties in lieu of breaks. If you take breaks, then you are actually taking a pay cut because your base salary is quite low. Miss your two allocated breaks, you get a penalty. Over two weeks, missing all your breaks amounts to several hundreds of dollars in pay. On top of that you are doing shift overtime, more than 12 hours. Most of the time you are finishing one, two, or even three hours after your shift is supposed to end.

“On the off chance that you may be able to get an allocated 30-minute break, after that you are straight back out and working continuously. On a night shift, even if you get that break it is hugely fatiguing to continuously go to difficult and stressful jobs. It all contributes to huge levels of fatigue, demoralisation and burnout. This has been a problem for decades.”

A 2018 study of Australian paramedics found that 55.9 percent suffered total burnout and 62.7 percent suffered work-related burnout. The rate of suicide among paramedics is four times that of the general population.

“Rostered shifts in Sydney are 12 hours and 15 minutes long. A day shift could be a 6:45 am start. You have 15 minutes to do a pre-shift check of the ambulance, sign out any restricted medications, and prepare yourself and the vehicle to respond. If you find any issues you have to deal with it in that 15-minute window. Often, because the workload is so high, a dispatch centre will call and request you go out before you complete the mandatory checks.

“That contributes to a whole bunch of negative interactions for paramedics. If you don’t sign out medications then you can’t administer them to patients. If some of the equipment, like oxygen cylinders, is missing in our kit then we can turn up on scene without them because we were told to leave before checking.

“The unions have a token disagreement or opposition to the staffing levels, and are vocal on the need for more staffing, and a response to fatigue levels. But the unions never carry out any meaningful campaigns to rectify this.

“The Health Services Union (HSU) has demanded that minimum operating levels be increased, which is part of their social media campaigns, but haven’t mobilised any real action to effect that change.”

A “day of action” was organised on February 26 in response to moves by the NSW Ambulance service to employ graduate interns on a part-time-only basis. The “action” consisted of workers changing the insert on their uniforms to read “undervalued paramedic” instead of “paramedic.”

“The day of action campaign was a non-event. It will never eventuate into anything or solve the problems that paramedics have. It makes it appear to workers that the unions are attempting to do something without taking steps to solve the problem or carry out any real industrial action that will actually cause change.

“When you have a workforce that is dissatisfied with how the system is being organised, workers will want to see their union is doing something, so the unions are forced to carry out these campaigns in order to appease their membership. It is to legitimise their existence.

“The Australian Paramedics Association (APA) was formed on the back of the scandals in the HSU and because paramedics were not satisfied with their representation in the HSU. But the APA operates in the same framework as the HSU. They follow the rulings of the Industrial Relations Commission. They are essentially just another union without any ability to change anything.

“The workers at Smeaton Grange [a Coles warehouse in southwest Sydney] are going through a similar thing as paramedics went through of being dissatisfied with their union and splitting from it. But if they build a new union without a new political perspective to guide them then they will head down the same road they are on now.

“The APA has meetings with the ambulance service where they express their opposition. They will take pictures of ambulances delayed at hospitals with short paragraphs saying the government needs to respond to the hospital delays, staffing levels and fatigue.

“The APA came out a year or two back with a wage campaign, and demands for increased annual and wellbeing leave and some others. They said they would push for 15 percent pay rise over a number of years and listed all these demands they were going to push for. But that never eventuated. That was before the freeze on public sector wages.

“Then the government froze our wages and the APA has done nothing about it. So the government did the opposite and the APA allowed that to happen. There is no organisation from either union to oppose that. The campaign for wage increases amounted to nothing and instead has led to a pay cut.

“Paramedics need to realise that the unions that exist now aren’t going to effect the changes that paramedics require. It is only through a political perspective to address the real problem, which is capitalism, that workers will be successful in changing their conditions.

“The real task for workers is to confront capitalism and all its contradictions and problems, which is the root cause of the deteriorating conditions for all workers.”