A Paramedic’s Message for the Government

I recently stumbled across this reply to the current spin doctoring regarding ambulance in the media. I could not have said it better myself, so I simply present it for your perusal.

In response to the usual line of spin being trotted out but the current coalition government, regarding the additional numbers of paramedics, record funding, best clinical KPI’s etc……..
A couple of points to consider…….Clinical performance figures are affected by specific response times. As an example, if a patient suffered a cardiac arrest and is, at the time considered ‘salvageable’, due to a cardiac rhythm which suits defibrillation and we get there quickly and successfully resuscitate, this statistic is measured. If there is a significant delay to ambulance arrival and that cardiac rhythm has deteriorated to a non-defibrillatable rhythm, then that statistic is not counted in our KPI’s, so the figures quoted are really measuring our clinical performance in patients that we DO get to in a reasonable time frame. Clearly this doesn’t show the whole picture.
Secondly, I applaud the coalitions willingness to increase resources. Unfortunately, simply throwing money and resources at the issue isn’t the answer. Historically our workload grows at about 10% each and every year, which reflects an aging population and the ongoing growth in population, particularly in the peripheral areas. In my 17 years in Ambulance, recruitment has NEVER kept up with this increase in demand, and thus we have the problem we face today of blocked emergency departments, ramped ambulances and the service’s inability to meet demand. Successive governments unfortunately (and I include both coalition and labor) have not had the vision to adequately study the problem and formulate solutions, other than throw out a few carrots for political gain…sounds great to say that we increased funding, but is that funding targeted appropriately…..rarely. Unfortunately management in AV are subservient to a toxic culture in the department of health, which treats ambulance like minions. No one is willing to listen to the paramedics who are forced to endure the ‘results’ of this inaction.
Many of the initiatives detailed above have had little effect on the overall problems encountered with our ability to respond to emergencies. The motorcycle unit is merely a clock stopper and in my ‘ informed’ opinion, is a gross waste of taxpayers money. Upgrading the helicopter fleet looks great and will provide many exciting photo opportunities, but will not have any appreciable effect on our overall performance within the service. They were only replaced a few years ago anyway and are already excellent aircraft.
The ‘new’ MICA units you mention are actually a redeployment of existing MICA paramedics from being spread around various branches and now being centralised in majors regional centres. Whilst there is some value to this move, there are a number of negative flow on effects also and often services to reduce access to MICA skill sets in the more remote and smaller townships. A questionable move in my humble opinion.
In regard to response times, yes, they have improved slightly over the past few months….by 0.7%, but are still the worst they have ever been, certainly in my 17 years in the job. Other first world countries (LAS as an example) have a target of reaching their sickest patients in 8 minutes at the 90th percentile. Our target of 15 minutes is woeful at best and should seriously be looked at. It will never be achieved whilst we have th resource hungry dispatch system that sends 2 MICA single responders, the fire brigade and an ALS truck to someone suffering dementia who has a cough. Did you know that we have dispatch codes for: “Sick Person; can’t sleep” and “generally unwell; penis problems” ? And we continue to send ambulances to these ridiculous minor ailments that could easily be managed alternatively.
There are plenty of highly experienced, qualified and trained people in Ambulance Victoria, who have the capacity to work solutions to these issues, without blindly throwing money at the problem. At the end of the day, where does it stop? If you guys have thrown all this record funding at ambulance and have employed record numbers of paramedics, then who is it still so poor? I think the answer is obvious. The health minister will not listen to those who have intimate knowledge of the problems, but prefers to listen to his Health advisors and AV mangers who have agendas and only willing to let certain information out of the bag, lest they seem incompetent and fail to achieve their next promotion.
Let me tell you that despite what our outgoing CEO might have said recently about morale, I can tell you that it’s the lowest I have ever seen. We lost another 34 year veteran last week to suicide, the 10th in the past 4 years. The rate of depression and suicide is some 20 times higher than the average community member. The pressure of the job, the ongoing EBA and seeming inability of the incumbent government to recognize the increased education, skills and training of Paramedics and the desire to strip Paramedics of much needed working conditions is frustrating at best. The offer currently on the table isn’t fair, seeks to impose unnecessary travel conditions on rural paramedics and removal of union facilitation in an organization that has been shown through their own surveys to be rife with bullying and poor management culture. This will never be agreed to and this alone has placed an enormous stress of Paramedics over the past two years. Issues of the DoH fabricating evidence, hiding of response times, millions of dollars of taxpayers money been spent on attempting to tarnish the reputation of paramedics with statewide full page newspaper ads labelling us thugs and greedy money grabbers is and will always be unacceptable in my view. Labor fought hard in our previous EBA due to a financial crisis that beset the state at the time, but they never resorted to these sorts of tactics.
I know you’re in a difficult position with all this, but when you simply trot out the spin from the Health Minister as some sort of “we’ve done a great job”, I don’t feel you give the very large number of local Paramedics much credit.
But thank you for being willing to discuss the issues and talk the hard talk.

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One Response to A Paramedic’s Message for the Government

  1. Jim Hall says:

    Well worded, unemotional, factual and to the point.
    Excellent correspondence.

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