Few events illustrate the misguided priorities of the Victorian government as does its refusal to resolve its dispute with paramedics in the state. The dispute – which has been ongoing for months – seems no closer to resolution than when it first arose. It follows disputes with firefighters, police and nurses in the southern state.

Significantly, the major sticking-point is not the remuneration of the paramedics, but the enforced extra hours of work. Usual shifts for paramedics are 10 and 14 hours, making up the 24-hour day. But very often, 14-hour shifts can extend to 18 or more hours. Every day, Victorian paramedics work on average an extra 800 hours beyond their usual 10- or 14-hour shifts.

The dispute with the state’s paramedics is symptomatic of the evolving health crisis in the state. There are insufficient GPs, with many older practitioners retiring and younger doctors reluctant to take up positions. Many GPs have closed their lists to new patients as they struggle to meet the demand. Hospital emergency departments are overrun, leaving ambulances banked up for hours waiting to hand over patients. The Victorian government is cutting funding to hospital services, adding to the growing crisis. There is a shortage of nurses. It is common for shifts not to be filled. The health system in Victoria is grinding to a snail’s pace.

Paramedics are ‘forced to work hours of involuntary overtime every day, either because they are ramped at a hospital, or dispatched to a case minutes before the end of shift and sometimes after their rostered finish time. That may seem reasonable in an emergency and any ambo you ask will tell you they expect to work overtime when a patient urgently needs their skills,’ claims the Union. Drive past any major public hospital in Victoria and you can see ambulances waiting, often for hours, to discharge their patients. ‘Our call-taking system categorises people who call 000 because they couldn’t afford a GP as an emergency,’ says the Ambulance Union. A significant number of people abuse the system, knowing that once the paramedics arrive, they have little choice but to transport the person to hospital. Accurate triaging by the call centres would reduce this misuse of the system.

Unlike some other states, where patients are admitted to the emergency department within 40 minutes to an hour of arrival, ambulances ‘ramp’ for hours in Victoria. There have been regular reports of the critical shortage of ambulances in Victoria. There would be no shortage of the ambulances and paramedics if dozens were not stuck outside hospital emergency departments waiting to hand over their patients.

The issue was highlighted by an accident involving an ambulance driver returning home after an 18-hour shift in rural Victoria. According to media reports, the experienced paramedic had reluctantly taken a job near the end of his usual 14-hour shift having been ‘ramped’ at the Wangaratta Hospital for several hours; as there were no other ambulances available. Several hours later, having collected a patient from Corowa in New South Wales and after delivering him to the Wangaratta hospital in Victoria, he fell asleep, running off the road on his return to Myrtleford. The ‘extremely experienced’ paramedic had not stopped throughout the whole 18.5-hour shift.

The pressure to work overtime is not isolated. Paramedics are ignored when simply requesting an on-time finish after double the hours worked by most employees. One ambo was dispatched to a non-urgent patient in a health facility three minutes before the end of shift. The paramedic pleaded with Ambulance Victoria management that she had to pick up her child from day-care but was refused. A colleague had to go to the childcare centre to take care of the baby until the paramedic finished over an hour late.

It was bad enough that the recent accident occurred; worse, Ambulance Victoria questioned his story, before eventually admitting that his narrative of the events was true. Apart from the near-fatal accident because of the unreasonable working hours, the incident highlighted a common complaint by the state’s paramedics, namely, that the Ambulance Service invariably backs anybody but their hardworking members.

A big part of the problem is the failure by Ambulance Victoria to adequately triage calls for assistance. Too often, ambulances are transporting people to hospital with a pimple on their bum, so to speak, instead of those in urgent need of treatment. Ask any paramedic; they can recount a litany of cases of patients being transported to an emergency department rather than going to a GP. Then there are others who manipulate the system to feed their drug habit. Every person who abuses the system is placing in danger those who genuinely require an ambulance in emergency situations.

Yet the Labor government can spend billions on a rail system that is questionable, along with other wasteful expenditure. The head of the militant CFMEU recently supported traffic controllers earning up to $180,000 per year to direct traffic around building sites with stop and go signs but allied health professionals earning much less remain overworked and underpaid. Recently, the nurses finally won a wage increase, but the ambos are still waiting. Although the union is negotiating with Ambulance Victoria, responsibility rests ultimately with the government which funds the service. Apart from a media release in February, the state opposition appears to have been silent.

Recently Swinburne University and the Royal Melbourne Institute of Technology surveyed Victorian Ambulance Union members. The survey found that the number of ambos looking at leaving the job in the next year has climbed to one in five. That’s already in a workforce where over half the paramedics have been in the job for less than five years. This means that many of the most experienced paramedics have left the service. Yet their skills and experience are critical in determining whether patients live or die. Their skills in critical emergencies are far greater than most GPs.

The provision of basic services such as health and education is the primary responsibility of state and territory governments.  Yet far too often – as the experience of the paramedics in Victoria illustrates – taxpayers’ funds are spent on vanity projects while basic services go wanting.