Ambulance Active Spring 2018 by Countrywide Austral

16 2018

PROTECT OUR AMBULANCE WORKERS

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VOLUME 8 ISSUE 2 2018 Cover photo: Caption.

NCAU appears at Senate inquiry

Annual Conference

06 18

Protect our ambulance workers

Study shows the job causes PTSD

AUSTRALIAN CAPITAL TERRITORY Steve Mitchell E: TWUAmbulance@act.twu.com.au P: 02 6280 9353

NORTHERN TERRITORY Erina Early E: erina.early@unitedvoice.org.au P: 0400 030 834

NEW SOUTH WALES Greg Bruce E: GBruce@ambulance.nsw.gov.au P: 0408 020 609

QUEENSLAND Debbie Gillott E: debbie.gillott@unitedvoice.org.au

Ambulance Active Official Publication of National Council of Ambulance Unions

12 22

PUBLISHER Ambulance Active is published by Countrywide Austral. Countrywide Austral adheres to stringent ethical advertising practices and any advertising inquiries should be directed to:

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REGULARS From the President 05 States of Activity 14

FEATURES 06 NCAU appears at Senate inquiry 09 SA ramps up public campaigns 10 Tassie starts industrial action 12 Protect our ambulance workers 18 Annual Conference 20 NEPT private sector lack of care 22 Study shows the job causes PTSD

SOUTH AUSTRALIA Phil Palmer E: info@aeasa.com.au P: 08 8340 3511

VICTORIA Danny Hill E: Danny.Hill@unitedvoice.org.au P: 0419 383 152

TASMANIA Tim Jacobson E: tim@hacsutas.net.au P: 1300 880 032

WESTERN AUSTRALIA Pat O’Donnell E: wa@unitedvoice.org.au P: 08 9388 5400

Disclaimer: Countrywide Austral (“Publisher”) advises that the contents of this publication are at the sole discretion of the National Council of Ambulance Unions and the publication is offered for background information purposes only. The publication has been formulated in good faith and the Publisher believes its contents to be accurate, however, the contents do not amount to a recommendation (either expressly or by implication) and should not be relied upon in lieu of specific professional advice. The Publisher disclaims all responsibility for any loss or damage which may be incurred by any reader relying upon the information contained in the publication whether that loss or damage is caused by any fault or negligence on the part of the publisher, its directors and employees. Copyright: All advertisements appearing in this publication are subject to copyright and may not be reproduced except with the consent of the owner of the copyright. Advertising: Advertisements in this journal are solicited from organisations and businesses on the understanding that no special considerations other than those normally accepted in respect of commercial dealings, will be given to any advertiser.

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PRESIDENT

DANNY HILL, PRESIDENT, NCAU

the PRESIDENT WELCOME TO OUR FIRST DIGITAL issue of Ambulance Active. Since establishing in 2008, the National Council of Ambulance Unions (NCAU) has had a goal to provide better communication between ambulance union members. This was helped with the NCAU partnership with Countrywide Austral in producing the Ambulance Active Journal in 2011. Now we are going a step further by delivering the journal in electronic format so it can be more easily accessed, and articles can be shared on social media. Our hope is to develop Ambulance Active with a more clinically focused content alongside industrial updates so that union members can submit their own research and articles to be circulated around Australia. We need your input so please send in your stories, ideas and pictures. In August we held our annual NCAU conference in Melbourne where we focused on the theme of mental health. It was great to hear how engaged each of the unions are in the mental health of their members and holding employers to account on their handling of mental health matters. But the work here is a long way from being complete and we need to continue pushing employers to do more to avoid mental health injury rather than just reacting to it once it occurs. We had a fantastic presentation at the conference from Professor Jane Burns on AMBULANCE ACTIVE

“ It was great to hear how engaged each of

the unions are in the mental health of their members and holding employers to account on their handling of mental health matters.

”

many of the available digital apps that our members can easily download onto their mobile devices that assist in early detection of fatigue, depression, anxiety, stress and mental health issues. With this new electronic forum we can share these with you. We also had a presentation from the Paramedicine Board of Australia. With the registration process well under way now, it is important that the unions have a wellestablished relationship with the board so we can assist our members in any issues they have with registration. This NCAU conference was also an important one as two long-term stalwarts of the NCAU announced their decision to take a step down from their positions. Greg Bruce from NSW decided to step down as Secretary and Steve Mitchell from ACT decided to step down as Vice President. Both Greg and Steve have been powerhouses for the Australian ambulance workforce and a true source of leadership

and friendship to us all. All the more impressive is the fact that their work for the NCAU and their individual unions was done in their own time, being full-time paramedics. Greg and Steve, we thank you for your tireless efforts. Finally, this was the last official appearance of my predecessor at the AEAV and NCAU, Steve McGhie. Steve has been the President of the NCAU since its inception in 2008 and he announced his retirement from the NCAU position at the 2017 conference in Sydney. Few will forget his karaoke efforts at the Sydney conference and the outrageous judges’ decision to declare Queensland the winner of the competition. I fear this controversy will haunt the NCAU for many years to come. We know our friends like Steve, Steve and Greg will continue to be involved in the NCAU family and we look forward to seeing them at future conferences. Take care everyone.

NCAU and HSU at the Senate inquiry.

NCAU APPEARS AT SENATE INQUIRY By Jim Arneman NCAU Project Officer – Paramedic Registration

ON WEDNESDAY 7 NOVEMBER, the National Council of Ambulance Unions was invited to give evidence to the Australian Senate inquiry into “The role of Commonwealth, state and territory governments in addressing the high rates of mental health conditions experienced by first responders, emergency service workers and volunteers”. The hearing was held at Parliament House, Canberra. NCAU Secretary Mick Grayson and I represented the NCAU. Health Services Union Ambulance Section Councillors Terry Savage, Steve Fraser and Michael Callanan also presented evidence on behalf of members. In opening, I emphasised the importance of the Senate Committee’s recommendations to the future mental health and well-being of paramedics, noting that many submissions had been

From NCAU’s perspective, what is needed is a Commonwealth driven oversight and coordination to ensure lessons are learned and best practice programs and frameworks are adopted nationally. received highlighting best practice initiatives and a range of programs. Our recommendations also called for the establishment of a dedicated first responders care network of health professionals and rehabilitation providers. This network was proposed as a national initiative. It would aim to provide consistent care by professionals who are accredited as having targeted knowledge of first responders’ unique circumstances and needs. Senator Urquhart asked about the need for presumptive legislation around PTSD/

PTSI nationally to avoid some of the adversarial circumstances that occur when workers’ compensation claims are being determined. NCAU’s position is that a COAG-level reference group should be established to consider if an intergovernmental agreement or national law approach is needed to presumptive legislation. If so, the Commonwealth has an important role in harmonising these laws. Steve Fraser from HSU spoke about the NCAU recommendation that AMBULANCE ACTIVE

a preservation age of 60 years be permanently legislated by the Federal Government and never increased for paramedics, other first responders and emergency services workers, to enable all first responders to retire with dignity. This recommendation was mirrored in the Australian Police Federation submission and attracted a number of questions from senators. There was discussion as well as questions around the damage often caused by independent medical examiners to members with psychological-based claims and the damage done and the symptoms exacerbated by having to relive traumatic events. NCAU made the point that a national agreement on provisional liability for psychological claims, if not blanket presumptive legislation, should be considered to address these issues. We also raised the issue of inconsistency around how claims are handled across jurisdictions, making the point that Safe Work Australia has proposed a model Best Practice Framework for Claims Management, which would provide a consistent approach to this area. Research supports that a facilitated and engaged claims process has the potential to improve return to work rates by enabling injured workers to access targeted care in a timelier fashion. NCAU believes such an approach should be covered by the recommendations of the Senate Committee. New NCAU Secretary Mick Grayson spoke about the sometimes increased stresses caused by incidents in regional areas due to a lack of resourcing. Steve Fraser drew the senators’ attention to the increasing workloads and demand faced by all paramedics, inflexible rostering, increasing occupational violence and issues impacting on communications centre members. In my conclusion, I noted that the preliminary findings of the beyondblue national survey clearly states that the impact of work practices and culture are at least as significant as trauma when it comes to psychological injury. We believe that investment in cultural change and leadership capabilities in ambulance services will go a long way to improving mental health and wellbeing outcomes for members into the future. In closing, I would like to acknowledge the great work of Simone Haigh from HACSU Tasmania, and Senator Urquhart in getting this inquiry up and running. NCAU hopes that the recommendations of the Senate Committee will be far ranging and the outcomes enduring. AMBULANCE ACTIVE

NCAU Mental Health and Wellbeing Project Officer Jim Arneman.

NCAU National Secretary and HSU Councillor Mick Grayson.

HSU Vice President Steve Fraser.

HSU Councillor Terry Savage.

NCAU RECOMMENDATIONS TO THE SENATE COMMITTEE: 1. NCAU calls on this Senate Committee to recommend the COAG Health Council and the Mental Health Principal Committee be tasked with reforming processes that impact on the mental health and well-being of first responders, specifically: • The introduction of a Federally administered national first responders care network, which will accredit health professionals, including general practitioners, psychologists, psychiatrists and allied health professionals, to deal specifically with first responders with mental health issues. It is recommended that the network incorporates a specialist rehabilitation provider service, with specific and accredited expertise in dealing with first responders, emergency workers and their unique circumstances. • Endorsement of and mandating the use of best practice National Standards for dealing with post-traumatic stress disorders in first responder agencies. • Endorsement of and mandating the use of best practice National Standards for dealing with suicide prevention in first responder agencies. 2. NCAU calls for this Senate Committee to endorse the creation of an intergovernmental agreement on provisional liability for psychological injury claims, arising from first responder service, to minimise the ongoing impact of psychological injuries.

3. NCAU calls on this Senate Committee to recommend that the COAG Health Workforce Principle Committee be tasked with examining the viability of introducing tiered health funding to facilitate demand-based recruitment of adequate paramedics in ambulance services nationally. 4. NCAU calls for the Senate to recommend the establishment of a national stakeholder working group, reporting to the COAG Council of Attorneys General, to assess the benefits of a coordinated national law approach to presumptive legislation covering PTSD and other psychological injuries in first responder/emergency services agencies. 5. That the Federal Government legislate that a preservation age of 60 years be permanently legislated to be never increased for paramedics and other first responders and emergency services workers, to enable them to retire with dignity. Watch the parliamentary broadcast of NCAU and Health Services Union representatives here http://parlview.aph. gov.au/mediaPlayer.php?videoID=424628&operation_ mode=parlview#/4 All submissions made to the Senate inquiry can be found here https://www.aph.gov.au/Parliamentary_Business/ Committees/Senate/Education_and_Employment/ Mentalhealth/Submissions

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SA RAMPS UP PUBLIC CAMPAIGNS Ambulance ramping continues to be a major problem across Australia, increasing at many major hospitals. AMBULANCE EMPLOYEES Association South Australia (AEA-SA) has launched a community campaign calling on the public and members to tell their story of how ambulance ramping is affecting them. AEA-SA recently took part in a round table meeting with the SA Government and other health unions – Australian Nursing and Midwifery Federation (SA Branch) and South Australian Salaried Medical Officers Association – to discuss ramping and overcrowding in emergency departments, which the union believes is contributing to ambulances being ramped. Currently in SA, around 100 patients occupy acute beds who are post (or sub) acute. These patients need care but not acute care, so do not need to be in the major hospitals. The majority of these patients have disabilities that require modifications to where they live, but due to a gap in the funding between the old disability scheme and the NDIS, those modifications cannot be made until at least the end of 2018. At a joint press conference held in October, the unions called on the SA Government to resolve the current crisis situation, and launched individual public campaigns to ‘Stop Ramping’. AEA-SA is encouraging members to distribute flyers to patients negatively affected by the practice of ramping including those who have had delayed treatment at hospital emergency departments or ambulance response as a result of being ramped. Members are also being asked to share how the practice of ramping has affected

AMBULANCE ACTIVE

their role caring for patients. A sponsored ad is also running on the public AEA Facebook page inviting the public to send stories also. The AEA-SA campaign is not ‘industrial action’ at this stage, members are simply empowering the community to have their say. Since the initial meeting and press conference, discussions have been

positive. A number of proposals have been announced for SA such as the opening of new beds ‘as soon as possible’, developing policies around ‘no bed, no transfer’, direct admissions, and an offstretcher policy modelled on those that exist in the ACT and QLD. AEA-SA will continue to run its public campaign until solutions are realised.

TASSIE STARTS INDUSTRIAL ACTION HACSU-TAS MEMBERS HAVE commenced industrial action because of the Tasmanian Government’s lack of progress with enterprise bargaining (EB) negotiations. EB meetings commenced in June 2018, however, no meeting has occurred since September as government negotiators continue to hold firm on the ‘up to 2 per cent’ line. Workload in Ambulance Tasmania is the highest in the nation on a per capita basis, and resourcing is insufficient, evident by the worst response times in the nation. Ramping at hospitals is causing significant delays to response times. The report on Ambulance Service Development Planning commissioned by Ambulance Tasmania, which was

undertaken by Operational Research in Health (ORH) in 2014, remains a Cabinetin-Confidence document. In early November, Ambulance Tasmania employees commenced low-level bans as follows: • Wearing HACSU branded t-shirts, badges, caps and other items pertaining to the campaign at their choosing and speaking with members of the public about the campaign if the opportunity arises. • Members are endorsed to undertake discussions with the media when requested to do so by their union. • Members will attend rallies and participate in meetings designated as part of the broader public sector campaigns, including speaking at rallies or meetings if asked.

• Members will work to rule, claim all allowances and take their breaks on time as appropriate. • Members will put themselves first in relation to fatigue management and only accept overtime shifts at their choosing. Members will not accept any rostered overtime. • On-road staff will undertake chalk writing on ambulances as determined by the HACSU Ambulance Employees SubBranch Executive. HACSU State Secretary Tim Jacobson said the union understands the health system requires about 100 extra paramedics. “These figures are backed up by internal review documents that never seem to see the light of day,” Mr Jacobson said. “The State Government will say they are putting on 42 more paramedics, but it’s simply not good enough. AMBULANCE ACTIVE

RAMPING AFFECTS US TOO Are we safe, are our patients? No alarms. Out-of-sight patients, no oxygen or suction access should something arise. Breaches of confidentiality whilst treating patients, staff using the areas where our patients are ramped to push critical patients who are intubated and ventilated past other patients on the ramp. Reduced infection control measures, lack of sharps containers … the list goes on. Lack of privacy when going to the one toilet we have, medical investigations and examinations done without curtains or privacy. Should I go on? And we are told that we are in the “same team” as the hospital staff. NO we aren’t. The patients we bring to the hospital even when they are on the ramp are in a place of safety. They are in the hospital (even if they are stuck in a corridor) surrounded by doctors nurses and allied health professionals. The patients in the community are not … they rely on us to be there for them, caring for them. We can’t do that when we are ramped!

“These extra employees will be directed to country stations to deal with long-term fatigue issues, but the issues associated with hospital ramping and lack of resources to respond will remain the same.” As in many states, ramping continues to be a massive problem in Tasmania. “We think that the community is often unaware of the consequences of ramping,” Mr Jacobson said. “Our State Operations Centre, the Triple Zero (000) call centre, is significantly under-resourced. Combine this with a lack of crews to send to patients and you have a perfect storm. “Our members have the worst resources and the worst pay in the nation. The Health Minister must recognise this and fix both of these important issues.” AMBULANCE ACTIVE

PROTECT OUR AMBULANCE WORKERS Nothing angers our members more than an attack on one of their own. By Danny Hill NCAU President

THAT WAS DEMONSTRATED RECENTLY in Victoria when our entire membership mobilised within hours to express their outrage at an injustice that showed massive problems in our legal system. A system that protects violent offenders but doesn’t protect emergency workers. In 2016, two women attacked and violently assaulted two paramedics in Reservoir after a day-long binge on bourbon, champagne and cannabis. Paramedic Paul Judd suffered serious fractures to his foot, on which he has had

surgery three times to repair and has been off work since. He still has many months of rehabilitation to go. Let alone the psychological damage. His paramedic partner Chenaye Bentley has also tried to cope with the trauma of this event, and has since relocated to rural Victoria. The two women were sentenced to jail by a magistrate for eight months and four months respectively. But the pair immediately appealed against their sentences, and in May 2018 County Court Judge Barbara Cotterell upheld the appeal and quashed the prison terms.

Judge Cotterell took into account special circumstances and did not apply a custodial sentence to the women. They received community corrections orders of 150 hours over three years and 50 hours over two years respectively. This means one offender will do community service for one hour per week for three years and the other will do 30 minutes of community service per week for two years. The night of that decision it was clear that we needed to take strong action against this decision. AMBULANCE ACTIVE

“ The AEAV executive

was overwhelmed with calls and messages from angry paramedics demanding to know what their union would be doing about this.

”

The AEAV executive was overwhelmed with calls and messages from angry paramedics demanding to know what their union would be doing about this. I recall the phone conversation between former NCAU President Steve McGhie and myself as we brainstormed ideas about how we were going to respond. “Let’s get paramedics to turn up in uniform tomorrow to every politicians’ office in Victoria to demand action,” I said. Steve said, “I’ll go you one better. Let’s put the writing up on the trucks”. Within a matter of hours the members were sending us their pictures of chalkedup ambulances with the message “It is not OK to assault paramedics” blazing across the windows. Overnight social media was flooded. One picture received over 2 million hits in 24 hours. We have never had that sort of response. There was little else in the media for days. That night we had calls from Ambulance Minister Jill Hennessy who gave us an assurance that urgent work would be done and a day later the AEAV and The Police Association Victoria had an emergency meeting with Victorian Premier Daniel Andrews where we demanded change to legislation that allowed these women to walk free. We were pleased when Premier Andrews committed to making the following changes to Section 10AA of the Victorian Sentencing Act 1991. 1. Attacks resulting in injuries against emergency workers, including police, paramedics, firefighters and health workers delivering or supporting emergency care, like nurses and doctors, will now be treated as category 1 offences and will require courts to impose a custodial sentence, not a community-based order such as a Community Correction Order (CCO), (there will be a prohibition on CCOs for assaults on emergency workers). AMBULANCE ACTIVE

“IF YOU DRINK AND DRIVE YOU LOSE YOUR LICENSE, IF YOU ASSAULT A PARAMEDIC YOU ARE GOING TO JAIL.” 2. The special reasons exception which applies to all statutory minimum prison sentences will be substantially narrowed so that impairment due to alcohol or drugs can no longer be used as an excuse, psychosocial immaturity will be removed as a special reason, and the court must give significantly less weight to the life circumstances of the offender. 3. The rights of the Director of Public Prosecutions (DPP) will be strengthened so the DPP can appeal where the narrowed special reasons exception is found to exist. A reference group was also formed, which included the unions, to work through other issues such as public campaigns around respect for emergency workers, bystander behaviour and verbal abuse.

These changes have since been passed by Parliament. It will never repair the damage done to Paul and Chenaye but if the same circumstances occur again, offenders will get jail time. This outcome would not have been possible without the strong collective action from the membership and the joint message from Ambulance Victoria and the Union. It was good to see Ambulance Victoria CEO Tony Walker standing in front of a chalkedup ambulance saying ‘enough is enough’. For our membership, this was a bitter and upsetting matter that hit a raw nerve for us all. But it was also a demonstration of the formidable collective power that our members can wield when they see an injustice and know that action is needed to fix it.

NCAU ACTIVE

ACT

New South Wales

The Enterprise Agreement expired 30 June 2017 and ACT Ambulance Service specific negotiations are ongoing. Pay increase will not be less than CPI with an increase backdated to 1 October 2017. Finalising the EA is a priority for 2019. The State Government agreed to appoint an independent Workforce Planning Review into the ACT Ambulance Service. The review considers funding requirements for ambulance in the ACT and provides recommendations for a future funding model tied to demand. It is an important piece of work, recognising that population and workforce demographics are changing. The over-65year-old demographic is increasing, the paramedic workforce is ageing, and new technologies are being introduced. All of these facts point to the need for a review to change services now that will meet future expanding demands. The Workforce Planning Review is about assuring long-term strategies are introduced to sustain a workforce that can deliver high quality pre-hospital care. Put simply, TWU is advocating for an ongoing budgetary model that supplies staff and resources to meet demand. TWU has undertaken the following initiatives to improve mental health and wellbeing: • Appointed a Manager of Wellbeing • Introduced the Mental Health and Wellbeing Plan • Introduced formalised operational debriefing • Respectful Workplace and Difficult Conversations training conducted for all staff • Psychological First Aid – MANERS training, all staff • RESPECT training for frontline supervisors and managers, to provide skills around talking to and dealing with staff with psychological challenges • Provided referral pathways and options. More proposed mental health and wellbeing initiatives include: • Planned mental health response and escalation guidelines • Mandatory access for new recruits • Partner and family resources • Psychological screening • Wellbeing Oversight Committee with external membership • Independent external measurement of results against agreed benchmarked KPIs.

United Voice New South Wales’ wages campaign was a civil disobedience and not an industrial campaign boycotting the $80 payment for the working with children check fee. As an outcome of the campaign, NSW was able to achieve an overall increase in wages plus 750 extra paramedics.

AMBULANCE ACTIVE

NCAU ACTIVE

Northern Territory United Voice Northern Territory made a strong and valid case around why change was needed for the NT Ambulance Service if best practice is to be achieved. The submission identified key factors highlighting St John Ambulance NT’s inability to run an ambulance service under these points: • Adequate paramedic levels • Responsible management • Equipment • High staff retention • Proper training and support • Work hours The Minister for Health announced in February 2017 that Professor Neale Fong would undertake an independent review of the NT road ambulance services to consider and gain an understanding of the future of road ambulance services in the NT. Report summary: • 76 findings listed • 44 recommendations made • The independent reviewer dismissed claims that the ambulance service should be brought under NT Government control.

New Zealand PTSD is also a big issue for First Union New Zealand, highlighted by the recent suicide of a Triple Zero call taker from the communications centre. The union is also dealing with pay negotiations, life funding by government to St John Ambulance and staffing in rural areas in non-peak times.

NT INCIDENTS BY STATION/CENTRE 2015/16

2016/17

% Change

21,346

22,729

3,256

3,812

17%

920

1,193

30%

11,579

12,782

10%

2,258

2,407

TOP END Darwin Katherine Nhulunbuy CENTRAL AUSTRALIA Alice Springs Tennant Creek

Queensland CERTIFIED AGREEMENT 2017 For the first time in two years, members had the opportunity to vote on wages and conditions, having previously gone through two forced arbitrations. This spoke volumes on members wanting to achieve pay parity and maintain current conditions, with 84.2 per cent of staff voting, with a resounding 98.4 per cent voting ‘yes’. The increases varied for individual officers based on years of service and positions held but by the end of the third year of the agreement members will be anywhere between $9000 and $24,000 per annum better off. As well as achieving increases to the base rate and having the meal overtime allowances reintroduced, the union also achieved domestic violence leave and aggregate rate on long service leave, meaning members do not face a pay cut when they take leave. Members saw the first increase into their pockets at the beginning of 2018 with back pay to 1 September 2017. The second increase occurred on 1 September 2018. This was an incredible achievement for United Voice Queensland members and a big acknowledgement and thank you to the 10 delegates on the negotiating team who worked very hard to deliver these outcomes.

INDUSTRIAL The past year has seen wins for members in: • Graduate paramedic placement, rosters, transfers, WHS issues, wages underpayment • Dispute resolutions • Better access to accrued time • Flexible working arrangements • Patient transfer officers securing casual conversion to FTE, WHS issues, transfer requests • EMDs trainees career progression, upgrade to ergonomically suited consoles and chairs AMBULANCE ACTIVE

SAFETY TASKFORCE The Safety Taskforce continues to meet on a monthly basis to ensure that the implementation of the 15 taskforce recommendations into paramedic safety remain on track and within the agreed time frames. This year has seen: • A reduction during the past financial year in reported occupational violence incidents by 12.2 per cent • Progress continue on the design and feasible integration and alerting solution between satellite PTTs and the operation centres. Migration of a back-end infrastructure to implement the duress solution is in progress. • SAFE2 training refresher course completed with 3,570 officers completing the mandatory program. • A revised education package for the continuation of safe training is being developed so participants can be more engaged and interactive. This will include online interactive scenarios. • Sharing of information between Queensland Mental Health and Queensland Ambulance Service project is on track facilitating the development of information sharing between QAS, QPS and QH regarding mental health attendances. • Situational awareness – flags/caution notes from QPS is progressing with a business case being reviewed and progressed for signing. An MOU will then be required and developed between QAS and QPS for the sharing of information. • Media – a refresher and rebadging of Zero Tolerance – No Excuse For Abuse is currently being planned.

PROFESSIONAL REGISTRATION Union representatives on the QAS registration steering committee have been part of the consultative process continued on page 15

NCAU ACTIVE

ensuring members are being kept up-to-date with information on the registration journey. Information has been regularly communicated through member emails and bulletins. The union has campaigned around the upcoming registration encouraging members to get prepared and to sign on for the AHPRA updates.

MEMBERSHIP Density continues to increase across the sector with an almost 20 per cent increase in membership over the past financial year. Retention is 90 per cent with 36 per cent of recruitment coming from union delegates, where 32 new leaders have been introduced in the past year.

South Australia The current Enterprise Agreement just expired (November 2018). The main items include maternity leave, increased sick leave and paramedic registration fees and Professional indemnity insurance coverage. EMDSO has been unable to meet its KPIs in over a year, which is 95 per cent of Triple Zero calls answered within 10 seconds. Resourcing continues to be an issue as working conditions worsen with ambulance workers finishing late more often and some crews, all in country locations, are on call for up to 96 hours straight. The administration area cannot complete tasks to maintain compliance and clinical education is unable to meet business as usual standards. The fleet cannot keep up with servicing vehicles, stretchers and medical equipment, and SA Ambulance only has five spare vehicles across the state, when it should have 25.

Tasmania Enterprise Bargaining negotiations are under way. The Government offered all public sector employees a 2 per cent increase. A number of important components were missing in the 2016 EBA and we are working to change this in these negotiations. Among these are: • SOC (Communications) – no progress • Education – Cert III and Cert IV training • New structure – currently one call taker for three EMDs • Five people is ‘minimum staffing’ • Extraordinary leave scheme – collective sick leave • Not supported by Government but is part of the EBA • Police already have the same scheme

• Improved rostering – guaranteed days off online changes • Basic roster built on the principle of fouron four-off • Where changes occur, workers must have at least equal days off to what was previously worked HACSU Tasmania is planning for 42 new paramedics by 2021 to fix fatigue issues associated with country stations. The roster currently is four days on four days off. The Clinical Review released in May 2017 provided recommendations for these issues: Short-term demand pressures • New staff Secondary triage and partnerships • Work with AV • healthdirect • Working with community-based healthcare to develop alternate pathways ECP and urgent care centres • ECPs to work on the urban fringe • FIV vehicles – specific ECP/ICP skills for back-up or first response • More ECP appointments – from ICP base • Follow WA’s Urgent Care Centre models ECP/ICP training • Secure a partner for nationally recognised training at this level Patient management plans • Develop method to deal with ‘frequent flyers’ ED interface • Arrivals boards at A&Es • Work with hospitals to define ‘unacceptable delays’ • Paramedics to change scope to include bloods prior to hospital arrivals NEPTS • Protocol to be developed for NEPTS referrals • Consider: • Major events to be covered by NEPTS • Post registration of paramedics – seek clinical governance amendments • Enable NEPTS to be used in MCI or excessive demand context Organisational structure • Internal structure review • When to use Department of Health support resources

Victoria The union is representing a number of members working at Refcom who are experiencing difficulty in accessing flexible working arrangements. It is disappointing that the matters have escalated to the point of requiring the Fair Work Commission’s assistance to resolve these roster negotiations which have been outstanding for a number of months.

Members sent a strong message to Royal Flying Doctor Service with 82 per cent rejecting its non-union agreement. The union lodged a bargaining dispute with the Fair Work Commission, and the first conciliation conference took place in July 2018. Members participated in industrial action at NPT, which put forward a revised wage offer of 3 per cent plus CPI wage increases at a cost with shift penalties being almost halved and a 68 hour reduction of personal leave. The union also lodged a dispute regarding non-payment of public holiday day in lieu entitlements for part time members who work fixed days. The day in lieu for public holidays for ambulance employees is an entitlement which arises from the Ambulance and Patient Transport Industry Award 2010 and is a minimum standard for the sector. ESTA refused to meet its obligations to commence bargaining as of 1 June 2018 claiming that the agreement renegotiation clause was “aspirational”. This was unacceptable and the unions launched a prosecution in the Federal Court of Australia regarding the breach of the Agreement. Post-Federal Court action the parties have commenced bargaining and negotiations have been progressing positively. Negotiations are not yet completed with St John and the union agreed to bring forward an initial wage increase from the first full pay period in July 2018 with a 3.5 per cent wage increase for PTOs and 3 per cent for ATAs and communications members. The union wrote to Ambulance Victoria informing them that the union rejected their management structure proposed as part of the Operational Review. The appropriate forum for the parties to negotiate a revised management structure for operational paramedics is enterprise bargaining. The union will not accept our STM members’ positions being abolished nor any model which claims to improve clinical governance but does not include better utilisation of paramedic educators and an increase in the number of clinical support officers. The model also failed to improve resourcing in the communications centres. The union made a submission for the paid meal beak in the Award to be extended to all operational employees, ie ATAs and PTOs in the private sector and not just operational employees engaged by an ambulance service. In a preliminary decision, the Fair Work Commission agreed with the union’s submission and a determination of the Exposure Draft to confirm this position is expected soon. AMBULANCE ACTIVE

NCAU ACTIVE

Western Australia

MEETING WITH SENATOR ANNA URQUHART

WA paramedics are continuing to fight for a better ambulance service for all Western Australians, and greater recognition and solutions surrounding mental health of first responders.

In July, United Voice WA made a submission on behalf of members to the national Senate inquiry into the mental health of first responders. Submissions included recommendation on:

CONTRACT EXTENSION

1. Formal recognition from all governments that frontline emergency service workers can suffer adverse psychological effects from trauma experiences at work.

In June the State Government made an announcement of a short-term extension of the St John Ambulance contract, to allow for comprehensive renegotiations of the contract terms over the next two years. Union members previously met with the Deputy Premier and Health Minister Roger Cook earlier this year and urged him to take immediate action on staffing numbers, health and wellbeing and the lack of government oversight of the service. This contract extension will allow for the development of specific KPIs that would improve government oversight and better support all ambulance staff. This is a big win for all ambulance staff and will ensure the government has the ability to make informed decisions to ensure that all Western Australians are receiving the quality of ambulance service they deserve.

2. That state governments ensure key performance indicators and reporting are sufficient and appropriate to hold ambulance service providers accountable to ensuring a quality ambulance service including the health and well-being of their employees. 3. That the Commonwealth Government work with all state and territory governments to introduce presumptive

workers’ compensation laws that benefit ambulance service including the health and wellbeing of their employees. 4. That all governments ensure that the compensation processes for personnel affected by mental health conditions are not such as to exacerbate the condition of individuals’ concerns. St John Ambulance delegates also met with Tasmanian Senator Anna Urquhart, who is directly involved in the inquiry, to discuss specific mental health concerns in their workplace. During this meeting, delegates shared examples of the issues particular to Western Australian paramedics, who are employed by an organisation, rather than the State Government. After the meeting Senator Urquhart attended a local hospital emergency department to talk to paramedics and strongly encouraged them to send in individual submissions into the national inquiry.

MEETING WITH THE MINISTER OF COMMERCE Long-serving paramedic and delegate Pat O’Dal, United WA Secretary Carolyn Smith and Assistant Secretary Pat O’Donnell represented Western Australian Paramedics in a meeting with the State’s Industrial Relations Minister Bill Johnston. Representatives of the Western Australian police and firefighters were also in attendance. The meeting spoke to the importance of presumptive legislation for posttraumatic stress injuries (PTSI). Mr O’Dal spoke of the need to change the current system of first responders needing to establish their PTSI as a direct result of their work. First responders are more likely to suffer from PTSI and stress-related injuries due to the nature of their work. The process as it exists at the moment is not conducive to people accessing the workers’ compensation system and the drawn out process means there is potential for responders to experience escalated and repeated trauma through having to share their story time and again. The shift of the presumption would also put pressure on first responder employers to make positive changes in the workplace to address PTSI. The Minister committed to a further meeting after more research had been conducted to discuss this important matter. AMBULANCE ACTIVE

ambulance officers

Ambulance Service

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Ph: 02-8627 3314

NATIONAL COUNCIL OF AMBULANCE UNIONS

ANNUAL CONFERENCE MELBOURNE • 16 & 17 AUGUST 2018

Nearly 100 union delegates from around Australia gathered in Melbourne over two days in August to share issues, challenges and achievements from the past 12 months. CHAIRED BY NEW NCAU PRESIDENT, Danny Hill (AEAV), the conference was an opportunity to farewell and thank outgoing President Steve McGhie, and acknowledge the work of other NCAU executive retirees, Steve Mitchell (TWU-ACT) and Greg Bruce (United Voice – NSW). The resignations of these long-standing executives opened nominations for three positions, which were filled. The new NCAU Executive is as follows: President: Danny Hill, Vic Vice President: John Urquhart, Qld Secretary: Mick Grayson, NSW Assistant Secretary: Simone Haigh, Tas Treasurer: Leah Donaldson, SA Special mention was made in relation to the NCAU Conference competition winner, Peter James (Tasmania), who was unable to attend. Peter will attend the 2019 conference instead. The NCAU would like to thank Victorian State Health and Ambulance Minister Jill Hennessy for delivering the opening address. Ms Hennessy became the first Ambulance Minister for Victoria in 2015. AEAV enjoys a good working relationship with the Victorian State Government. A conference highlight was the presentation delivered by Professor Jane Burns on mental health. Professor Burns has looked at the issue of mental health and supports a mental ‘fitness’ approach to improving mental health and suggests using digital health solutions like apps.

Victorian State Health and Ambulance Minister Jill Hennessy.

Professor Burns recommends co-creation and co-support is needed for designing mental health programs. Police Health Group CEO Scott Williams gave a presentation on the organisation’s services for people working in emergency services, which is a not-for-profit memberowned organisation that only covers people working in the emergency services. For more details about the organisation, please visit www.policehealth.com.au

Steve McGhie.

NCAU thanks everyone at AEAV who coordinated this year’s conference, and those who attended locally and from interstate.

The 2019 NCAU conference will be held in South Australia. More details to come.

AMBULANCE ACTIVE

New South Wales.

New Zealand.

South Australia.

Northern Territory.

Western Australia.

Victoria.

ACT.

AMBULANCE ACTIVE

NEPT PRIVATE SECTOR LACK OF CARE IN VICTORIA, JEFF KENNETT’S LIBERAL State Government privatised NonEmergency Patient Transport (NEPT) work in the mid-1990s . Since then, this private sector of patient transport has grown exponentially. Employees in this private sector, made up of Certificate III trained patient transport officers and Diploma trained ambulance transport attendants, have seen their clinical scope of practice expand from regular hospital bookings to nonurgent Triple Zero calls. Two years ago, the Victorian Government worked with the union to look

at a way to improve emergency response times, which had blown out and people were dying as a consequence. Cardiac arrest patients were waiting for more than 30 minutes for an ambulance, that was probably attending to a cut finger. AEAV agreed that the despatching process had to change, hence a transformation in receiving and processing Triple Zero calls. Ambulance Victoria has implemented a wider scope of clinical work to be processed through their secondary triage service call centre.

AEAV agreed this would allow highly skilled paramedics to be more available for high acuity cases, and not have to attend to some medium-low acuity cases. This has been a positive change. Overall, patients are more often getting the right resource for the right case but the union agreed to these changes if the private sector was regulated properly. It is disappointing that we are now seeing this as the case with some of these private companies focusing on profits and compromising patient care. The following issues have been highlighted: We are currently bargaining with individual private companies who are attempting to cut back wages, penalty rates and working conditions.

Employees being treated with disregard to their safety and well-being by being forced to attend and check their vehicles out in hospital car parks, with their storage cupboards on the outside of the hospitals.

Employers forcing employees to work with out-of-date equipment (defibrillation pads), out-of-date oxygen cylinders, out-of-date servicing of equipment (stretchers) and in one case an employer had not registered the ambulance vehicle.

AMBULANCE ACTIVE

LIGHTS AND SIRENS? ONLY FOR SOME Imagine dropping your nine-year-old child off at school, going to work and getting a call that she has broken her arm. You are informed that 000 has been called and breathe a sigh of relief. You leave work and arrive at school, only to find there is no ambulance in sight. Your child is moaning in pain at the sick bay. A while later, a nonemergency patient transport vehicle arrives. You learn that Ambulance Victoria has downgraded your child’s care to ‘low acuity’ and outsourced the job to a cheaper private non-emergency

transport company. This cost-cutting measure is the new standard set by Ambulance Victoria and the State Government in the push for faster 000 response times for ‘code 1’ cases. It means that thousands of Victorians will be left worse off whilst private non-emergency companies profit and compete for contracts. Do we really want underpaid, undertrained and underresourced employees to care for our vulnerable patients? It’s time for the State Government to put people before profits and reform the non-emergency sector.

FASTER 000 TIMES? NOT FOR EVERYONE While Ambulance Victoria and the Victorian Government have been quick to pat themselves on the back for faster Triple Zero response times, this has come at a shocking cost to thousands of patients who have been downgraded and told to wait until cheaper nonemergency patient transport vehicles are available. Recently an 84-year-old woman was left lying on her side in the middle

of a shopping centre with a broken and deformed hip for over an hour because Ambulance Victoria deemed her a ‘low acuity’ patient. Rather than send an Advanced Life Support Paramedic, a cheaper private non-emergency transport vehicle was dispatched. It is clear that Ambulance Victoria’s costcutting measures and pursuit of faster 000 times has left vulnerable patients

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waiting for hours, often in horrendous pain. Even worse, patients have been incorrectly downgraded, leaving them without help and in potentially lifethreatening situations as underpaid and undertrained non-emergency patient transport workers are dispatched. The Victorian Government needs to step up and intervene so that all Victorians get the healthcare they deserve.

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This document is issued by Emergency Services Superannuation Board ABN 28 161 296 741 the Trustee of the Emergency Services Superannuation Scheme ABN 85 894 637 037 (ESSSuper). This information is general information only. It should not be considered a substitute for reading ESSSuper’s Product Disclosure Statement (PDS) that contains detailed information about ESSSuper products, services and features. Before making a decision about an ESSSuper product, you should consider the appropriateness of the product to your personal objectives, financial situation and needs. It may also be beneficial to seek professional advice from a licensed financial planner or adviser. An ESSSuper Income Stream PDS is available at www.esssuper.com.au or by calling 1300 650 161.

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AMBULANCE ACTIVE

19/6/18 4:48 pm

STUDY SHOWS THE JOB CAUSES PTSD A new study by Griffith University has confirmed that a significant number of ambulance officers suffer from posttraumatic stress disorder (PTSD) as a result of stress associated with the exposure to trauma that comes with the job. THE STUDY, COMMISSIONED BY United Voice Queensland and completed in partnership with Ambulance Employees Association South Australia (AEA-SA) and United Voice Northern Territory, aimed at gaining a better understanding of organisational factors that affect paramedic and support staff experiences of work and employment, and how these impact on psychological health and wellbeing. It involved 1,216 surveys and 72 interviews with emergency services employees in Queensland, South Australia and Northern Territory. The Improving People Management in Emergency Services Summary Report, launched in October 2018, showed provisional PTSD diagnoses can be made

for 10 per cent of Queensland and 8.5 per cent of South Australian ambulance staff. An additional 6.6 per cent and 4 per cent of respondents in each state respectively were found to be close to a provisional diagnosis. Recent changes in the measurement instrument for PTSD has meant that many people who would previously have had a provisional diagnosis are now excluded. Anxiety is also at very high levels among the workforce. Those with severe and extremely severe anxiety comprise around 40 per cent of the sample in all jurisdictions. Depression features strongly too with around 17 per cent of Queensland and South Australian participants returning surveys that indicate severe or extremely severe depression.

United Voice Queensland co-ordinator Fiona Scalon said that although respondents reported benefiting from organisational support for problems arising from trauma, the union would continue working with the Queensland Ambulance Service to improve these systems. “This study clearly shows that the pressures of the job are taking their toll. It’s important for ambulance services to have credible evidence to guide employee support policies and provisions,” she says. “This is an issue United Voice is tackling on behalf of our members because it’s really important for communities to have healthy cohorts of ambulance officers who can carry their vital role to the best of their ability.” AMBULANCE ACTIVE

The summary report was officially launched in October, marking the start of an AEAV campaign to ensure SA Ambulance is properly staffed, resourced and funded. AEA-SA Secretary Phil Palmer said, “This is an important campaign to ensure ambulance workers can get on with their job of looking after the community without having to risk their career, and their wellbeing, every time they report for work. “Stress is, today, the asbestos of the ambulance industry. Much more work is needed to make a very difficult and risky job safer. “The community needs first responders to ‘walk towards danger’, to put themselves in harm’s way to provide care; so the government, on behalf of the community, should care for them in return.” Griffith University Researcher Associate Professor Keith Townsend said, “The report shows that there is some great support within QAS, however, many paramedics are still struggling.” “We have a great opportunity for management and the union to work together to find ways to improve the paramedics’ experience,” he says.

KEY FINDINGS FROM THE REPORT • More symptoms of PTSD are reported by employees with longer tenure of employment. • Those with more symptoms have higher intention to quit and poorer ability to do their work. • Social support is a key factor in these findings, with those reporting greater support also less likely to have symptoms of PTSD. • Those with severe and extremely severe anxiety comprise around 40 per cent of the sample in all jurisdictions. • Fatigue remains a major problem for more than half of all staff in each jurisdiction. • Interviewees across all geographical areas report persistent high fatigue, affecting their ability to perform and desire to stay in the service for the long‑term. • Around one in every five employees say that they are seriously looking for another job. • Improving People Management in Emergency Services Summary Report was prepared by Griffith University for United Voice Queensland, the Ambulance Employees Association of South Australia, and United Voice Northern Territory. “Following the Commonwealth and State Government’s Senate inquiry, we need to have unions, managers and health ministers sitting down and finding solutions to these problems.” “Our frontline staff do a tremendous job and we need to find novel ways to ensure

they can continue performing the great work that they are doing.” Findings from this report will be used to guide practitioners and policy makers on human resource management and support in emergency service organisations.

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