Ambulance Active Summer 2020

23 2020

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VOLUME 11 ISSUE 4 2020 Australasian Council of Ambulance Unions Elected Office Holders 2020 PRESIDENT Steve Fraser (HSU NSW)

REGULARS 05 From the President 07 From the Secretary 15 Industrial Reports

VICE PRESIDENT Sarah Stone (First Union NZ) John Millwood (UWU Qld) SECRETARY Jim Arneman (TWU ACT) ASSISTANT SECRETARY Erina Early (UWU NT) TREASURER Leah Watkins (AEA SA) ASSISTANT TREASURER Simone Haigh (HACSU TAS)

FEATURES 08 New Zealand Special Report 21 Paramedic found not guilty of causing patient’s death in ambulance rollover

22 Paramedics have one of Australia’s most dangerous jobs

24 Don’t let ketamine cost you your job!

TWU AUSTRALIAN CAPITAL TERRITORY Ben Sweaney E: ben.sweaney@twuact.org.au AMBULANCE DIVISION HSU NSW Stuart Hatter E: stuart.hatter@hsu.asn.au

Ambulance Active Official Publication of Australasian Council of Ambulance Unions

FIRST UNION – AMBULANCE PROFESSIONALS NZ Sarah Stone E: sarah.stone@firstunion.org.nz UWU NORTHERN TERRITORY Erina Early E: erina.early@unitedworkers.org.au

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

Level 2, 310 King Street, Melbourne • GPO Box 2466, Melbourne 3001 Ph: (03) 9937 0200 Fax: (03) 9937 0201 • Email: admin@cwaustral.com.au

27 NSWA moves to block ICP course selection opportunities

27 Update on COVID trainees and delayed inservice

29 Training volunteers is paid duty time!

29 AHPRA relaxes CPD requirements

Paramedic found not guilty

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due to COVID-19

30 Improvements for FWA officers 30 Award amendments 31 Palaszczuk Government must

cough up ambulance funding in state budget

31 Your right to representation 32 COVID-19 slashed health-care use by more than one-third across the globe

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Paramedics have one of Australia’s most dangerous jobs

UWU QLD Debbie Gillott E: debbie.gillott@unitedworkers.org.au

HACSU TASMANIA Chris Kennedy E: chris.kennedy@hacsu.org.au

AEA SOUTH AUSTRALIA Leah Watkins E: leah.watkins@aeasa.com.au

UWU AEA VICTORIA Brett Adie E: brett.adie@unitedworkers.org.au UWU WA June Congdon E: june.congdon@unitedworkers.org.au

Disclaimer: Countrywide Austral (“Publisher”) advises that the contents of this publication are at the sole discretion of the Australasian 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.

If you’re hurt at work, you need specialist help.

It’s not just a matter of processing a workers comp claim. It’s about claiming absolutely everything you’re entitled to and with ambulance workers, that gets complicated.

Did you know that the risk of serious injury among Australian paramedics was found to be more than seven times higher than the Australian national average?

When it comes to NSW ambulance workers compensation claims, it would be very hard to find a more experienced solicitor than Chantille Khoury. Chantille is a principal at Australia’s largest specialist personal injury firm, Law Partners, where she specialises in emergency service worker claims.

“When paramedics are injured at work, either physically or mentally, many are reluctant to seek compensation, or they don’t know who to turn to.”

As a member of NSW Ambulance you put yourself at risk every day and injuries from aiding immobile patients, drug-affected patients, motor vehicle accidents and exposure to traumatic events are all too common. If you’re hurt at work, it’s important to get good advice on your options.

“With ambulance workers, it’s not just a matter of processing a workers comp claim. They have their own set of rules relating to workers comp,

TPD and income protection which are unlike any other worker in NSW.” “It takes extensive experience and a thorough understanding of the system to properly manage a claim and make sure the officer receives absolutely everything they’re entitled to.”

Unfortunately claims are often processed as a standard workers comp claim, and the ambulance worker will never know what they missed out on.

“In particular, PTSD claims can result from exposure to traumatic events over a long period of time, so care needs to be taken to build these cases thoroughly. Many PTSD paramedics come to me in their 40s and 50s and they’re broken.

They start their careers very optimistic about their future, but by the time I see them they’re changed people.

They can’t continue doing the job they know and love and are at a loss, not knowing where to turn. I can at least provide them with a dedicated legal team, support them through their claims and make sure they get their full entitlements.”

If you’ve been hurt at work in NSW you can call Law Partners on 13 15 15 to arrange a confidential conversation with Chantille.

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Call Law Partners on 13 15 15 to arrange a confidential conversation with Chantille.

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13 15 15

lawpartners.com.au

REPORTS

the PRESIDENT A FESTIVE HELLO TO ALL THE ACAU union members. It has been an amazing year in both the clinical and Industrial Arenas. COVID 19 has had an enormous impact on our day to day lives as professionals and in our personal and family lives. While Australia and New Zealand have done particularly well in controlling the pandemic, the impact on the emotional wellbeing of people is still significant. This is particularly true of frontline health care workers and their families.

Remember to look after yourselves, your families and your colleagues.

Keep an eye on each other and if anyone seems to be struggling emotionally or physically, ask if they are ok and offer a hand. The approaching Christmas season can be a tough time for some so let’s look after one another.

The roll on of Christmas also marks the passing of time in this constant battle with a pandemic that has surprised us all.

Our Nations’ evidenced based and clinical response to the pandemic has kept the disease at bay and well controlled in our area of the world.

This has resulted in a gradual return to some normality in our lives. With that return to normality there is a rise in emergency calls and requests for paramedics that has once again begun to stretch our resources to the limit.

The same problems face an under resourced paramedic workforce.

Long hours, forced overtime, missed crib breaks, fatigue and the inevitable serious cases that we attend with no recovery time before the next case is ‘dropped down’.

While governments can be applauded for their approach to the COVID crisis they should be admonished for their lack of concern for an under staffed and underpaid paramedic workforce that continually steps up in the face of growing adversity. We are ‘rewarded’ with wage freezes, understaffing, absent PPE. These callous actions are too frequently disguised under the response “it is due to a unique time” or “it is because of COVID”.

Well, we are controlling this disease and returning to a normal life. It is time our governments and our employers started to really look at how they must truly reward

and support the paramedic workforce.

We must be given the respect and remuneration as professionals we are.

Your Unions will be continuing the fight for this these truly fair work conditions into and through 2021.

Enjoy Christmas take time to reset.

If you are working stay safe and look after yourselves.

Merry Christmas.

In Solidarity

Steve Fraser

B. HSc. (PreHosp. Care) ACAU President

About Steven: Steven is an operational paramedic in Northern New South Wales. He has been a paramedic since 1981 with the Ambulance Service of New South Wales. He qualified as an Intensive Care Paramedic in 1985 and has worked extensively in both metropolitan and rural settings across New South Wales. Steve was a member of the New South Wales Special Casualty Access Team and operated as a flight paramedic with the CareFlight helicopter out of Westmead Hospital. He spent time as an educator for New South Wales Ambulance before moving to rural New South Wales. Steve is also the Vice President of the Health Services Union NSW Branch.

AMBULANCE ACTIVE

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Thank

for all that you do.

Your dedication in caring for our community is inspiring.

You’re the reason why we do what we do.

And have been since 1912.

Visit qsuper.com.au to find out how we are supporting our members.

Product issued by the QSuper Board (ABN 32 125 059 006, AFSL 489650) as trustee for QSuper (ABN 60 905 115 063). Consider the PDS on our website to see whether QSuper is right for you. © QSuper Board.

REPORTS

the SECRETARY AS AN AVID CLINT EASTWOOD FAN, I thought I’d review this year through the lens of Sergio Leone’s immortal ‘spaghetti western’, The Good, the Bad and the Ugly!

THE GOOD… The magnificent response of paramedics and ambulance support staff generally, including comms and non-emergency patient transport, to the unprecedented challenges we’ve faced in dealing with COVID-19.

Unprecedented lockdowns, rapidly evolving PPE and practice modifications, hospital delays, border closures and a myriad of other challenges have been thrown at us this year. Many members have had to juggle the ongoing competition between shift work and family responsibilities with a host of new issues such as home schooling, partners losing jobs and other disruptions to life as we knew it.

Whilst different jurisdictions have faced differing challenges, a common thread has been the professionalism and adaptability and resilience shown by paramedics and other ambulance staff in dealing with what’s been thrown up with good humour, in spite of the pressures we’ve faced.

THE BAD….

Unfortunately, by way of showing thanks for the extraordinary efforts of their staff, many ambulance services have taken the opportunity afforded by the pandemic to freeze wages, delay back pay and renege on agreements. Now, more than ever we face significant threats to hard fought wages and conditions. This will continue into the austere times that lay ahead. Unity and solidarity and active unions have a vital role to play in ensuring that ambulance services are adequately resourced to enable us to continue to provide the high-quality patient care that is a hallmark of our profession. I know we will all step up to ensure the public are protected and wages and conditions defended.

THE UGLY… The hands down winner of the Ugly Award goes to St John Ambulance in New Zealand. After years of not paying penalties to staff who work nights, they reneged on a legal agreement to pay a 1.25% nightshift penalty in July this year, nearly 12 months after receiving $30m in government top up funding to enable this payment to be made. To add insult to injury, an openly accessible document on their website detailed a union busting strategy designed to divide the workforce and avoid their obligation to honour their agreement. The icing on the cake was their subsequent targeting of union delegates who exposed this outrageous strategy.

There are several articles in this edition of Ambulance Active that detail this deplorable behaviour. I encourage all union members to read them. If St John’s strategy was to divide the workforce, it had the opposite effect. In an historic vote, 84% of NZ members voted to mount a full-scale ambulance strike in response to St John’s provocation. This action was unprecedented in NZ. It shows the complete destruction of trust that has occurred as a result of St John’s action.

Pleasingly, St John’s made an offer at the eleventh hour to resolve the dispute.

This is now being voted on as his edition is being compiled. It should never have come to this.

IS IT APPROPRIATE FOR ‘NOT FOR PROFITS’ TO RUN MODERN AMBULANCE SERVICES? It highlights the need for a serious debate, in Australia and New Zealand, about whether it is appropriate for ‘not for profits’ to run modern ambulance services. Last years Australian Senate Inquiry into the Mental Health of First Responders and Emergency Service Workers expressed serious concerns around how St John’s in WA and NT

managed these issues. Recent New Zealand inquiries have found that St John’s are consistently not living within their means or meeting KPI’s. ACAU believes the time is right for governments in WA, the NT and NZ to seriously consider taking responsibility for running their own ambulance services, as is done in every other state and territory.

STAY SAFE I’ve recently returned to full time operational duties as an ICP in the ACT Ambulance Service after a protracted stint of project work. I’ve been seriously impressed with the quality of graduate and ambulance paramedics that I’ve had the privilege of working with in recent months.

I am optimistic that our profession is in great hands. I encourage all paramedics to support your local union and become active, the future of your profession, your wages and hard fought for conditions depend on how active you become in industrial matters as some of us older dinosaurs gracefully exit our careers!

I want to take this opportunity to wish each and all of you a safe and relaxing Xmas. Hopefully you can spend some quality time with kids, partners, family and friends and recharge those batteries to face the new year. I particularly want to thank all of my fellow ACAU executive for their support and encouragement through what has been an extraordinarily challenging year. To all of the delegates and activists who represent your fellow members as well as doing your day jobs, keep up the great work, yours is an oftenthankless task. This doesn’t diminish its vital importance in protecting the vulnerable.

Stay safe and happy.

In solidarity

Jim Arneman ACAU Secretary

About Jim: Jim is a Registered Intensive Care Paramedic who works for the ACT Ambulance Service. He was the inaugural Secretary of the National Council of Ambulance Unions, a position he held for three years, before taking on Project Officer roles for NCAU covering National Registration and Paramedic Mental Health. He has worked as a paramedic for over three decades in metropolitan, rural, regional and remote settings in several ambulance services. He is the current Secretary of the ACT TWU Ambulance Caucus and was elected unopposed as the inaugural Secretary of the Australasian Council of Ambulance Unions in 2019.

AMBULANCE ACTIVE

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INDUSTRIAL REPORTS

NEW ZEALAND SPECIAL REPORT Kia ora our Aussie cousins – well, what a year it has been.

Last month First Union ambulance members voted for the first time ever to walk off the job in two full 24 hour strikes – good old St John eh – driving New Zealand’s most trusted workforce to withdraw their labour.

The strikes were voted for after St John refused to honour a shift pay agreement we won in the last round of bargaining following nearly a year of bargaining and industrial action.

In the end, the strikes were averted just 15 hours before they were due to start after delegates voted to take a revised, fairer offer, bargained hard by First Union, back to their colleagues.

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But it was a long struggle in which St John wriggled this way and that trying to get out of their obligations. First St Jack they claimed they couldn’t afford it and then, after being bailed out to the tune of a $28m government top up, said they still couldn’t afford to pay both a pay correction and the agreed shift pay rate.

They also wanted to cut the pay of fully funded jobs for call takers and dispatchers and remove any reference to the minimum establishment roster.

To add to the insult some members of our team discovered an unlawful bargaining plan to split the unions, written by the St John Executive Leadership Team and then endorsed by their Trust Board.

The plan, posted on their intranet where

over 3000 people could see it, was written in February of this year at the time we attended a meeting with them to discuss better ways of working and improving the relationship. The plan detailed how they would do a ‘sweetheart’ deal with the two yellow unions and how they would drag out bargaining with First Union in the hope of First members switching unions. The documents also showed that the yellow ‘unions’ actually called St John three weeks before the shift pay was due to start to advise them how to get out of paying. Stopping even their own members from receiving the allowance.

Once St John discovered their own unbelievable blunder of publishing their plan to act unlawfully and breach AMBULANCE ACTIVE

INDUSTRIAL REPORTS

employment legislation, they proceeded to discipline the whistle-blowers and accuse the union of not bargaining in good faith!

This time members had no appetite for a build-up of action with a high level of disappointment turning straight into anger. We had started with a uniform ban and plenty of worker media interviews but jumped pretty much straight to the full AMBULANCE ACTIVE

strikes with over 84% of members voting yes. In the week of the strikes, members visited their MPs to keep them updated but decided to use the actual strikes days to be with each other, family and friends and be away from the stress and low morale of St John. Rather than picket they organised social events that varied from brunches, including swims, picnics, bbqs and cricket in the park. We had fantastic support across the Council of Trade Unions affiliate groups (the yellow unions are not affiliated) and we loved receiving your messages of solidarity.

Late last year the New Zealand government commissioned a report into St John and it showed that they are not living within their means and that they cannot meet their KPIs. The Minister for Health said on national radio that St John management should honour the promises they made to their workers and has since said they are watching closely. What we also saw was that ambulance officers will not accept this behaviour where their bosses lie, breach legislation and collective

agreements and try to turn workers against each other. We had an amazingly dedicated team of delegates around the country and, in particular, at the bargaining table. First union members stood together, supported each other and took action.

This sad attack from St John showed them in a shameful light and has done untold damage to their brand. Ambulance officers deserve better and we will keep fighting until we get it. They had a plan to break us but instead they made us stronger.

Wishing you unity in 2021.

Kia Kaha

Sarah Stone

National Ambulance Sector Co-ordinator Ambulance Professionals FIRST Union.

If you would like to read stories from ambos and see coverage of the campaign check out our public facebook page for Ambulance Professionals First.

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INDUSTRIAL REPORTS

Thoughts from our New Zealand members For the first time in my ambulance career of nearly 20 years tonight I am preparing to vote yes to walking off my shift.

FULL STRIKE, NOT JUST NONcompliance with paperwork and uniform but actually not turning up to my rostered shift.

Stating you are at a point where you will walk away is a scary thing but just like junior doctors and nurses we will make sure the public will get an ambulance if it’s an emergency, managers will have to step out of their offices, staff will have to be recalled but the public will be safe, at least as safe as they currently are with the service already running vehicles short.

To the public I’m personally sorry, I’m sorry it has come to this, it is not a decision taken lightly and one several years in the making.

To my colleagues, if it is not my shift being chosen to strike I will shift change with you so it is my shift and you don’t miss out on any pay if you need the money, this isn’t about just you but I understand the economic reality on staff already at financial breaking point. I encourage those staff who can, to also make this offer to staff who need it.

Can I just take a few minutes to explain my why, I am not a union delegate, I’m not a politician, I’m just the normal average frontline paramedic and mum. I love my colleagues, my patients and my job but I have been betrayed.

Firstly the broken shift pay agreement.

It is standard in hospitals and emergency medicine to be paid an allowance for unsociable hours, we have campaigned extensively to gain this parity over the last few years, our employers agreed to meet the standard paid to Auckland Hospital staff of T1.25 (they actually get T1.25 after hours weekdays and T1.5 on weekends but we agreed to the lower flat rate of 1.25) we agreed to delay the implementation to gain funding, we agreed to give them the time, that time came and went, funding was secured and still it has not been paid.

The offer on the table from SJ is to scrap the previous agreement and reduce the shift pay offer further to T1.15, this is apparently the recommendation of the PWC report.

SJ commissioned a report from PWC who worked for free to assess the pay and remuneration currently being paid to ambulance staff in NZ. It was to be an independent review but then SJ instructed on and set parameters

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around the report, making it far from independent and compromised the integrity of the report and in my opinion of PWC. The parameter that struck me most was the instructions from SJ to PWC not to use any international comparison especially from Australia our closest other service.

I don’t know the full outcome of the report, unfortunately SJ refuses to release this report to staff so their current rationale (albeit biased) for refusing to pay the already agreed shift pay and to work towards paying a market appropriate wage remains a mystery. I have no idea where the 1.15 reduced offer comes from as I know it is not in line with other healthcare providers so it appears to be plucked out of the air. There is a union court case pending over the broken agreement but who knows how long that will take, we had already agreed to a delay of implementation and that time has passed months ago. SJ blame COVID but are in no worse a financial position than they were when they made the agreement.

The financial lead and negotiations lead appear at odds over the figures and the company line on affordability.

The government has paid SJ the money needed to pay the shift pay already but this has not been passed on.

We know our pay is much lower than it should be and we know it is tens of thousands of dollars behind Australia.

There are of course other cards on the table for negotiation I’m not thrilled about especially SJ want to be free to change my roster, times and days of work without consultation. As a working mum this will destroy my already constant childcare juggle.

Over my career I have been involved in many actions with SJ to force them to give us meal breaks, then to pay a penalty for constantly breaking and missing them, boots for our feet, being able to share a roster as a working mum so you can juggle children, establishing minimum staffing requirements as it became cheaper to pay penalties than to adequately staff vehicles, it is always tedious and with the underlying feeling of being viewed by SJ as the gum on the bottom of the SJ shoe.

It was not that long ago that Peter Bradley the CEO stood in front of us and promised to sort the shift pay. I met with

him personally and he looked me in the eye and promised to sort the pay issue and the shift pay, yet here we are, he is the quintessential politician, can be very charming but not a man of his word nor of integrity.

The gains made were for not just us but those who follow us. But to SJ we are treated as ingrates who should be honoured to have such a highly respected employer. Respect built of the backs of their front line workers. Tired, overwhelmed and underpaid workers.

I have observed years of investment into buildings and assets with continued plea of poverty when pay negotiations roll round, every round its the same story, we are broke, we didn’t ask government for enough money, we will settle this year for less with the promise of a better offer next year when we have funds, those funds never arrive and if they do they are invested into assets over staff. Assets are depreciable and gain value, staff are disposable, a bum on a seat. Experience is seen as a liability not an asset.

Meanwhile the wealth of SJ as an entity rises, their property assets grow and their saleable infrastructure builds, poor decisions waste money on stuff that is of no value, services expanded without full funding in place pushing staff over their limits of what is reasonable, increasing scopes of practice without training or minimal training so lower qualified, less experienced and lower paid staff can fill more roles.

This is just my opinion and for that I cop to being jaded by years of being given the run around by SJ, having to fight for what should be basic common sense and to feeling personally betrayed by the CEO after the meeting I had with him last year.

A meeting where his off sider admitted her belief, we would never really walk off the job and the CEO had to admit we were no better off than 30 years ago when he was on the road therefore, he had not improved anything for his workforce.

I note there are pay cuts to our new PTS staff and to our emergency communication team. I’m sure they too are hurting right now and my heart goes out to them.

Kia Kaha my colleagues, stand tall, stand together and be kind.

To my family and friends thank you for your support, hug an ambo.

AMBULANCE ACTIVE

INDUSTRIAL REPORTS

I am a dispatcher. A tired, weary dispatcher.

I STARTED AS A CALL TAKER. I’VE heard the countless screams urging an ambulance to “just get here!” I’ve talked countless people through CPR on their loved one’s and I’ve had profanity directed at me because we still aren’t there yet after waiting too many hours.

Now, I manage a massive workload with too few ambulances. I have crews frustrated with being paged asking how long to clear from ED when I’m desperately trying to find someone to attend priority calls with no one responding (I understand the frustration - we are with you). I’m monitored with every single decision I make - which are hundreds over a single shift. I get one 30 minute break and short stops to go to the bathroom and fill my much-needed coffee cup. I have very strict parameters of what I can and cannot do. If a red call appears with no crew available I must page units at the hospital, regardless of how long they’ve been there or what they have just dealt with. I know very well they cannot clear within minutes of arriving at the hospital but it is required and if I don’t do it I am pulled to task.

I must monitor a screen with sometimes 20 jobs pending and many jobs active

with crews responding to scene and check for new notes going in every second and make the best decision for each incident - Often it’s a gut feeling, address history, knowing a particular patient from previous incidents or a single word that makes me select one patient over another that may wait many more hours.

It is a very heavy burden if I make the “wrong” decision by selecting to go to a patient that turns out to be not critically unwell over another that waited too long and is now gravely ill. I will think about that job over days, months, and years wondering if I could have made a better choice but the reality is, we don’t have enough ambulances and there was nothing in the job hinting it would be anything other than routine.

I get complaints from members of the public, my own colleagues and my managers that are often unfounded but it all adds to the already stressful life I lead being a dispatcher.

When I manage an incident well, I get nothing. No praise, no “well done”, and no “good decision”.

I save lives. I look after my crews - often at my own expense because what I do matters.

When we are short-staffed, I simply do not get a meal break. Often the recall page goes unanswered because staff on days off are already too exhausted from their own shifts.

I ask a colleague on an already busy channel if I can use the bathroom most dispatchers will feel extremely guilty for this and wait till the very last minute or when the workload settles enough. They load their already heavy workload with another and watch my channel for the 2 minutes it takes me to empty my bursting bladder. We get no extra pay for this or even so much as a “Thank you” from our management.

The next week instead we may get why did it take so long to do “X Y Z”.

I am worth every cent I earn. Nothing less. All I ask is for my pay to be fair, the unsociable hours I work to be recognised, and a little bit of kindness wouldn’t go astray either.

Signed, An exhausted, stressed and undervalued dispatcher.

I AM JUST 24 YEARS OLD. I have been with St John for just over 5 years (I started volunteering when I was 19), I have been on the road full-time for approx. 2 years. Within these 2 years I have attended more horrific jobs than I would have liked, seen my fair share of life-altering events and struggled to make ends meet due to how severely underpaid we are.

I currently hold an EMA (Emergency Medical Assistant role) and despite having completed a Bachelors degree in Paramedicine and gaining an ATP (authority to practice) level of an EMT (Emergency Medical Technician) I get paid a mere $20.40 per hour. I work 12 hour shifts. I do not receive penalty rates for weekend work and night shifts like other healthcare workers do. I do not receive an hourly rate that is consistent

with my current authority to practice although I am still expected to work under that ATP. Last year St John agreed to pay a penalty rate of T1.25 with the implementation this year. When the time came … they didn’t come through.

I have struggled through post traumatic stress disorder, anxiety and depression after a number of horrific things I attended because ‘it’s my job’. I weas pushed back into work before myself and my psychologist believed I was ready because we appeared understaffed.

To put it simply, they needed me back in my sear to avoid an ambulance being unavailable due to inadequate levels of staffing. It didn’t matter that my mental health was suffering. So I picked myself up, struggled through the anxiety attacks and the crippling depression, wiped

the tears from my eyes while no one was watching and I went to work and continued to care for others and to do my job … at my own detriment.

I love my job. I am passionate about my job. I love seeing the difference that we, as ambulance officers, make in. the communities where we work. I do not appreciate my employers treating me as a pawn in their chess game. I speak not only for myself, by my colleagues when I say we feel severely undervalued.

We shouldn’t have to fight so hard to get what we deserve. None of us take these strike actions lightly but everyone is exhausted and at the end of their tether.

We are sick of not being valued and respected by our employer.

AMBULANCE ACTIVE

#FIRSTUnion #StJohnOnStrike Ambulance Professionals First

#shiftourpay

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INDUSTRIAL REPORTS

LONG-SERVING PARAMEDIC SACKED FROM ST JOHN AS PAY NEGOTIATIONS REACH BOILING POINT A long-serving paramedic has been fired by St John, after sharing information found on the company’s intranet.

THE UNION SAYS THE DOCUMENTS, which were accessible by any employee, showed St John was not bargaining in good faith.

However, St John says the information was private and should not have been accessed or shared.

On top of one man’s dismissal, up to five other First Union members are facing their own fallout.

It comes as pay dispute negotiations between First Union, which represents almost half of the organisation’s workforce, and St John reach boiling point, ahead of unprecedented planned strike action next week.

“If you disagree with St John in any way, shape or form and you’re a First Union member, watch out,” an anonymous paramedic, with decades of experience, told 1 NEWS. She said workers love their job, but “hate” their employer.

First Union co-ordinator Sarah Stone said: “This is utterly shocking for someone in public health in New Zealand to treat its workers this way” 1 NEWS has seen parts of the document at the centre of this issue and it details a plan to offer a “sweetheart” pay deal to ambulance officers in two other unions, isolating and discriminating against First Union.

St John chief executive Peter Bradley says those who shared the document breached the organisation’s privacy.

“It was an internal document for our board to talk about, how we would work with our unions, and how we would fund our pay settlement,” he says.

But it was accessible to all members of the organisation. 1 NEWS has been told it was on the intranet for more than 50 days.

“Over 3000 people could have accessed

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First Union says the document, which could’ve been accessed by any employee on the company’s intranet, showed St John wasn’t bargaining in good faith. Source: 1 NEWS

that... It wasn’t marked confidential and sensitive,” said the paramedic.

Despite what was found, in writing, the ambulance service says there’s no plan to discriminate against First Union members.

“We have no desire or intent not to work with all of our unions, or to oust First Union. That’s never been part of our plan,” Bradley says.

The dispute over better pay for paramedics working unfavourable shifts is still not resolved, with some saying the organisation isn’t bargaining in good faith.

“It’s very difficult to prove bad faith unless you have a smoking gun, of something that is deliberately deceptive,” law expert Bill Hodge says.

“It’s pretty close but there is nothing in the statute that says you can’t offer a better deal to one union.”

Two 24-hour stop work strikes are set to go ahead next week.

“This is the first time in New Zealand history that ambulance officers have ever voted to withdraw their labour,” said the paramedic.

Stone said the workers “can’t take it anymore”.

“They will not put up with this behaviour from St John Ambulance any longer,” she said.

“I have to make it really clear: These workers do not want to strike. They just want to go to work and they want to be paid for the work they do at nights and weekends.”

Bradley said St John still wants to resolve the dispute.

“We want to find a way through all this... and, of course, we can always do things better.”

But Stone said the message the union is getting is clear: “St John doesn’t want to find a resolution.”

AMBULANCE ACTIVE

INDUSTRIAL REPORTS

LABOUR-LED GOV FUNDS BEING USED TO PENALISE AMBOS FOR PARTIAL STRIKE ACTION St John says it will use the funding freed up for Ambulance Professionals on just about everything but ambulance professionals.

IN A STAFF MEMO ST JOHN STATES the 21 million of funding over two years will address urgent needs such as, ‘moving our 111 Clinical Communications Centre people out of a leaky building in Auckland and into a fit-for-purpose space,’ ‘recovering and continuing to pay the unbudgeted costs associated with extra frontline paramedics recruited into Christchurch in February’ ‘recovering the $2m in revenue we’ve lost due to the industrial action’.

FIRST Union spokesperson for ambulance professionals, Sarah Stone, says that to state it wants to use the money to recover lost revenue from partial strike actions just adds insult to injury.

“This is nothing less than a penalty for ambulance professionals doing what they have a right to do. St John is spending money in the wrong places instead of easing the pressure off staff by agreeing to shift recognition, something which the rest of the health

sector, and ambulance professionals around the world, have.”

She adds resentment is growing among staff.

“The money provided is the same amount as the money ambulance professionals asked for to be able to temporarily fix their pay dispute. Ambulance officers believe that this is a punitive measure to stop them from taking action again. They campaigned for this money and it will now be used against them.”

GOVERNMENT MUST INTERVENE TO HALT MASS WAGE THEFT FIRST Union, the union representing 1200 Ambulance Professionals at St John, are calling on the Government to intervene in what can only be described as “Mass Wage Theft”.

FIRST UNION HAS FILED FOR urgency in the Employment Court for compliance with an agreement reached in 2019 that St John would introduce penal rates for night and weekend work of 1.25% per hour from July this year if agreement could not be reached on an alternative model.

St John wrote to FIRST Union in June 2019, claiming that they could not afford to pay the agreed penal rates, but did not provide an option for an alternative model or delay of the agreed rates.

St John have since received up to $30M in Government funding for this purpose - significantly more than the cost of the agreed rates - but they are still refusing to honour the agreement with FIRST Union, AMBULANCE ACTIVE

and ambulance professionals are still not receiving the agreed pay rates.

FIRST Union spokesperson Sarah Stone says St John’s refusal to honour the agreement amounts to mass wage theft from ambulance professionals and taxpayers.

“These workers reached a legally binding agreement with St John that covers their employment on the basis that from this year onwards, they would not be earning less than the agreed penal rates,” said Ms Stone.

“They’ve done their part - including working through the Covid-19 pandemic, the eruption of Whakaari and the Christchurch shootings - and now St John are withholding money from them in an

attempt to leverage them into agreeing to something else that suits them better.”

“This is wage theft of the worse kind.

We are likely talking in excess of $5M that has already been withheld from these workers.”

“Our ambulance professionals deserve better, and the New Zealand public deserve to know that this is how their ambulance service is being run by St John.”

“The Labour Government must not sit back and let this wage theft happen.”

FIRST Union ambulance professionals across New Zealand are withdrawing their labour on October 25th and October 28th in what is believed to be the first full strike in the ambulance sector in New Zealand history.

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INDUSTRIAL REPORTS

INDUSTRIAL REPORTS ACT ACT ELECTION The ACT election in October 2020 saw the return of 10 Labor MP’s, 6 Greens and 9 Liberals to the 25 seat ACT Legislative Assembly. The progressive Labor-Greens Coalition Government has a significant majority. The result has confirmed that the ACT is the most progressive jurisdiction in the country. The TWU looks forward to working with the new government to ensure that the ongoing reforms promised to ambulance services are delivered in full.

COMMUNICATIONS CENTRE REFORMS One area of reform that is still a significant ‘work in progress’ is the Emergency Services Agencies ‘One ComCen’ process.

This has now been going on for 5 years and by any measure is starting to look like a failed process. ACT Ambulance currently takes more emergency calls than ACT Policing and ACT Fire & Rescue combined.

It is time that this is reflected in the level of resourcing provided to the ambulance section of the centre.

The TWU has recently had a huge win in committing the government to providing a rolled-up composite rate for ACT Ambulance (ACTAS) ComCen staff.

There is however significant work still to be done to provide safe working conditions, adequate breaks, realistic relief factors, fit for purpose rosters, safe staffing levels and welfare and wellbeing improvements to our members in this vitally important centre.

ACTAS 2025 The TWU has now participated in 4 workshops with the ESA Commissioner and the ACTAS executive to hammer out what we see as the priorities in modernising the service over the next 5 years. A draft ‘transformation plan’, which proposes to address residual issues highlighted in the Blueprint for Change process has been received and is currently being assessed by delegates. The plan looks at how we can achieve a modernised service delivery model, a fit for purpose management and supervisory structure, leadership development as well as a focus on staff health and wellbeing in the AMBULANCE ACTIVE

medium term. As always, the devil will be in the detail and the timelines for achieving lasting change. TWU is committed to changing the culture in ACTAS and is actively participating in discussions and representing members interests.

MATERNITY UNIFORM Our newly elected diverse caucus delegates have achieved many significant wins so far. The timely provision of an adequate, fit for purpose operational maternity uniform has been one of the more notable victories. After we threatened to refer this issue to the ACT Human Rights Commission, the ESA and ACTAS executive met with the TWU to ensure that this issue is resolved once and for all. As an interim show of good faith, tailored, modified uniforms have been supplied to staff who need them, pending the arrival of the new kit in early 2021.

Picture: HSU delegate Kieran delivering individually signed letters calling for NSW Treasurer Dominic Perrot to fund realistic MOLs

NEPT COMPOSITE ROLLED-IN RATE Another significant victory has been the achievement of a Composite RolledIn Rate of pay for our Non-Emergency Patient Transport members. This, along with the provision of a new supervisory structure have been significant victories for our NEPT members that have occurred since the conclusion of our last Enterprise Agreement.

XMAS WISHES The TWU Ambulance Caucus wished all of our fellow unionists across Australia and Aotearoa New Zealand a safe and happy Xmas and a prosperous New Year.

Yours in Unity,

Jim Arneman

TWU Ambulance Caucus Secretary

NSW MOL CAMPAIGN One of the biggest and most pressing issues ADHSU members have faced this year is the critical under-resourcing of NSW’s ambulance service. Our minimum operating levels (MOL’s) are now over a decade old and the additional resources that we won in 2018 aren’t being maintained, rendering them obsolete.

This is an issue that affects all members from the road to the control centre

resulting in extreme work intensity and fatigue and blows out our response times to a dangerous level.

To fight this, delegates in metro Sydney began a ground campaign, recruiting many new activists in their areas. The objective of the campaign is to maintain rosters and increase operating levels to an adequate level for 2020 and beyond, which boils down to a matter of funding. As such, our target is the NSW Treasurer.

The first majority worker action of the campaign was for members to individually sign a letter to the treasurer. Over a third of all paramedics in Metro Sydney signed a letter and so approximately 700 letters were delivered to the Treasury by delegates.

We did not receive a response and so the next phase of the campaign will be to lobby MPs in target seats to force the Treasurer to fund the maintenance of our rosters.

As expected, COVID-19 is being used as the excuse In Solidarity

Courtney Thompson Organiser - Ambulance HSU NSW

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INDUSTRIAL REPORTS

NT NT Ambos – Enterprise Agreement negotiations ongoing It has now been 2 years since ambulance members in the NT – employed by St John Ambulance Australia (NT) Inc have had a payrise. Enterprise agreement negotiations have been ongoing since November 2018.

St John are refusing to recognise the significant efficiencies of paramedics, patient transport and Comms members have been providing St John over the years.

Members have been engaged in protected industrial action since late 2019.

St John continue to lodge applications in the Fair Work Commission for assistance with the negotiations and continue to either provide inferior counter offers or renege on already agreed in principle claims.

Members are standing strong against St John are just wanting a fair enterprise agreement which recognises their value to St John. Members will not be divided on this agreement. They have had enough of St John complete disrespect of their ambulance crews and Comms staff.

Erina Early

Organiser – UWU NT

Queensland UWU PARTICIPATION ON QAS RESPECT COMMITTEE United Workers Union welcomes the QAS RESPECT initiative which will focus on inappropriate behaviour in the workplace.

The initiative aims to foster a culture where employees at all levels of the organisation step up and be empowered to stamp out inappropriate workplace behaviours promoting a positive and safe workplace for all QAS employees.

UWU delegates advise and encourage members of their rights to a safe workplace which includes a zero-tolerance approach to Sexual Harassment.

UWU representatives are participating in a variety of ways to support the RESPECT initiative including becoming RESPECT officers and representing on working groups and steering committees.

STANDING UNITED RESULTS IN A POSITIVE WIN FOR UWU GPIPS A recent intake of QAS paramedic graduates found themselves with an issue that saw most of them not being able to qualify within the time frame of their temporary contracts.

Through a combination of the grads being rostered to do PTS shifts and only having 17 weeks to complete their required 800 hours of clinical practice, the figures just did not add up.

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The grads got together and contacted their union for help.

Discussions soon followed between the members, UWU and QAS. After being made aware of this predicament QAS realised the grads dilemma and were able to come up with a solution.

Our members were stoked when all 85 grads were offered extensions to their contracts so they would be able to qualify.

The grads were also offered additional support from management and mentors if needed.

By these members recognising a collective issue and coming together for support from their union, a resolution was soon achieved.

$1250 ONE OFF PAYMENT HITS PAY PACKETS United Workers Union negotiated a one-off $1250 payment from Government this year.

This payment has gone to all government employees who met the criteria.

The payment would have been paid with the successful negotiation of the QAS EB in September this year had negotiations gone ahead as planned.

MAJOR SICK LEAVE BREAKTHROUGH Responding to member feedback and agreeing these issues could not wait until 2022 EBA, UWU State Councillors have negotiated and won changes to two sick leave arrangements of long-standing concern to members.

• The cessation of reducing aggregate rate when sick on a weekend • Introduction and implementation of a new 10-hour cap on sick leave debits even when sick for a 12-hour shift These changes will last for at least the duration of the ongoing COVID-19 health emergency.

While these issues have been of concern for some time, State Council responding to member feedback argued that in the middle of a health pandemic any disincentive to front-line health workers staying home if sick needed an urgent review.

EMDS OCCUPATIONAL VIOLENCE Hearing from EMD members more and more regularly about the kinds of abusive, aggressive and clinically traumatic occurrences members are exposed to as part of their work has initiated UWU to conduct a survey to give members a voice and have their say on the subject.

The information gathered from the survey will be used in ongoing work being done between UWU and QAS in working towards improving and providing safer workplaces as well as ongoing training for our members in the Operation Centre environment.

PATIENT TRANSPORT CERTIFICATE IV PROGRESS United Workers Union representatives participated in the first meeting to discuss the implementation of Certificate IV Patient Transport Officers into the workings of QAS. It has been a long time coming since the first group of patient transport officers have been upskilled to Certificate IV and as has been the case with many things, the roll out of this initiative has been impeded by this year’s COVID-19 restrictions.

All things going well and once recognition of the new skills afforded to the Cert IV and the suitable equipment has been supplied, UWU will be calling upon QAS and their obligations to pay Cert IV Patient Transport Officers practising in this higher level of clinical practice the appropriate pay scale.

IMPROVEMENTS FOR FWA OFFICERS UWU has been working closely with QAS regarding equity and access to the same workplace entitlements for those staff on Flexible Working Arrangements.

The advocacy by United Workers Union members and delegates has gone a long way to help shape the kind of workplace QAS aspires to provide to its staff.

Many FWA members consistently reported being allocated as the first option to fill holes in lesser clinical roles, are being made to feel they should be grateful for their flexible work arrangements and are encouraged to not complain or rock the boat.

The Commissioner’s recent recommitment to FWA Officers has made it very clear as to what his expectations are: “In seeking to ensure all staff, whether flexible or non-flexible, work under similar conditions, these are the expectations I have laid out: • Flexible workers should be provided a full roster projection, which includes an allocated station to start at for each shift, with the same consistency in station being provided as is provided to our non-flexible staff (i.e. You should still receive a 13 week projection and there should be no expectation that signing a flexible agreement means you must, by default, move from your usual station or sign an agreement to work at multiple stations); • There should be equitable sharing of all types of shifts between all types of employees (both flexible and non) with the appropriate skill set where there is a need (i.e. filling of vacancies on PTS/ LARU etc. should be equitably spread around both flexible and non-flexible staff).”

AMBULANCE ACTIVE

INDUSTRIAL REPORTS

PRESUMPTIVE LEGISLATION FOR PTSD AND PSYCHOLOGICAL INJURIES ONE STEP CLOSER FOR QUEENSLAND AMBULANCE EMPLOYEES Since the 2014 launch of the CodeOne campaign, United Worker’s Union has had an ongoing commitment in making sure our Ambulance members are protected and looked after at work.

In 2017 United Workers Union funded a Griffith University research study focusing on how ambulance services organisationally deal with issues of psychological health and well-being of their staff.

This research identified the need for better education for the organisation which included PTSD prevention strategies, as well as to support normalising the practice of seeking treatment.

CHANGING THE CULTURE Member representatives from United Workers Union have participated on the QAS Mental Health Task Force which has spent time pulling apart the cultural barriers inside QAS and the general stigma surrounding these types of illnesses and injuries in society in general.

Advocacy in the space of member wellbeing has included the union writing to The Minister for Industrial Relations over the last three years to lobby for reforms in our state’s legislation to assess the benefits of presumptive legislation covering PTSD and other psychological injuries to first responders and emergency service workers.

WHAT IS PRESUMPTIVE LEGISLATION? A presumptive position would reverse the current onus for Ambulance officers to prove that they developed diagnosed PTSD as a result of their employment.

This would mean that the cause of the PTSD is automatically presumed at the first instance to be work related, for the purposes of claiming compensation under the legislation.

By removing this potential source of stress for those who are suffering with PTSD and highlighting the importance of helping people return to meaningful work would be a step closer to supporting our frontline workers.

It would allow our Ambulance Officers to be confident in putting their hands up and saying they are struggling, without fear of reprisal from their employer and insurers.

OUTCOME ACHIEVED After United Workers Union advocacy to government around this long-standing issue, a working party was established by the Minister for Industrial Relations.

For the past six months representatives AMBULANCE ACTIVE

from Ambulance, Police, Firefighters, Emergency Nurses, Child Safety, Corrections and their respective unions have met and developed an action plan around improvements to the whole claims process. This also included the barriers identified around the legislative test for injury.

The proposal was presented for consideration to the Minister for Industrial Relations Grace Grace.

We are pleased to have been advised by the minister that the government intends to legislate the presumptive workers’ compensation laws.

Debbie Gillott

Lead Organiser Ambulance Sector

SA In the early hours of 16th August 2016 one of our ambulance crews was involved in a vehicle accident with a patient and their family member on board. The crew had been contacted to commence their night shift early in order to be able to complete the long-distance non-emergency transfer.

The patient was in a regional town approximately two hours from Adelaide.

The crew started shift in Adelaide and drove to the patient’s location. Due to a difficult extrication process, it was several hours later before they mobilised back to Adelaide with the patient and a family member.

The crew stopped at a roadhouse at about 3am, half way into the journey, in order to buy refreshments as they had not had a break despite being eight hours into their 12 our shift. Approximately 15 minutes after resuming the case, it appears the driver, our member Matt McLean, had a microsleep. The bariatric vehicle left the road and rolled. The patient, Ms Karen Biddell tragically died at the scene. Her daughter was injured, as was Matt’s crew partner Andy who were both unrestrained in the back of the ambulance.

Matt was subsequently charged with Death by Dangerous Driving and lesser charges relating to injury of the other passengers. None of us could have predicted in those early days following this tragic incident that it would be four long years before the case would be heard before the Court. This wait was not only hard on Matt, his wife and young children, but also Ms Biddell’s family who were seeking justice for their devastating loss.

The Department of Public Prosecution alleged that Matt was fatigued at the time of the accident, and ought to have known he was fatigued to the point he would fall asleep but continued to drive

Pictured: Matt McLean (front right), wife Sascha, industrial and legal team.

anyway. Matt maintains that he did not feel fatigued or sleepy and would not have driven if this was the case. Some time after the accident and before the trial commenced in November this year, Matt had been diagnosed with sleep apnoea.

The Court heard from Matt’s specialist during the trial that in all likelihood Matt would have had the condition at the time of the accident, and would not necessarily have felt tired or displayed any signs of fatigue before falling asleep.

On 4th December 2020, Matt McLean was found not guilty of death by dangerous driving and the lesser charges.

Whilst we are ecstatic for Matt and his family, our thoughts are also very much with the Biddell family who we believe have not received justice. We maintain that the systems and practices that allowed this incident to occur are still prevalent today, and that a Coronial Inquiry would better serve in identifying these systemic problems. We have subsequently referred the case to the South Australian Coroner.

Our ambulance crews often work 9, 10, even 11 hours into a shift before receiving a break. There are an increasing number of members reporting no break at all in a 12 hour shift. This neither reasonable, safe or sustainable and has the potential to lead to other preventable tragedies without some intervention. We continue to advocate on this critical issue on a daily basis. The issue of members receiving late or no break in a high

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INDUSTRIAL REPORTS

workload environment is undoubtedly experienced in ambulances services across Australia, and we encourage all members and their unions to be aware of the significant risk of fatigue which Matt’s case has highlighted.

has refused to budge on ‘fit testing’ for P2/N95 masks for most of 2020, it’s simply not required to be done. Recently however that stance has changed, now all paramedics in Tasmania will be ‘fit tested’; the timing for the rollout of that is still to be determined.

including predatory behaviour, within Victoria Police. Through the review, Victoria Police has implemented a range of initiatives to help it achieve gender equality by 2020. The AEAV is hoping for the same results in its recently commissioned Ambulance Victoria review.

Industrial Officer – AEASA The judgement of the ‘R v McLean’ case can be accessed via the following link: http://www.courts.sa.gov.au/ Judgments/Pages/default.aspx

Chris Kennedy

WORKING GROUPS

Tasmania

On the back of the agitation around bullying and harassment that the AEAV started in Gippsland in August 2020, Ambulance Victoria made a formal request for the Victorian Equal Opportunity and Human Rights Commission to review discrimination and sexual harassment within Ambulance Victoria.

AEAV Secretary Brett Adie said “Ambulance Victoria’s culture around allegations like these has been one of cover up, inadequate investigation and protecting the people against whom complaints have been made. It is essential that we recognise that this is broader than just gender discrimination, it relates to management practices and a bullying culture across the organisation.”

VEOHRC recently released the Terms of Reference (ToR) for their review into Ambulance Victoria. AEAV members have expressed their concern about the fact that bullying is not listed in the ToR, which includes - “The nature, extent, drivers and impact of discrimination, sexual harassment and victimisation experienced by current and former staff and volunteers” The majority of the bullying cases that we have dealt with at the AEAV could also be viewed as bullying as a result of discrimination, whether because the person being bullied is young, old, female, male, has raised an issue in their workplace or so on. Most of these categories may be a relevant factor in whether or not the case could be dealt with under the Equal Opportunity Act. The first phase of the VEOHRC inquiry will take one year and examine: • the nature, extent, drivers and impact of discrimination, sexual harassment and victimisation experienced by current and former staff and volunteers • the adequacy of measures to prevent and eliminate discrimination, sexual harassment and victimisation within Ambulance Victoria VEOHRC has significant experience in conducting independent reviews. In 2019, it concluded a five-year review of sex discrimination and sexual harassment,

Leah Watkins

We wish all members of the union family a merry Christmas and a happy new year.

The last six months have posed some significant challenges in the paramedic world; especially on the front line, but there have been significant changes to how the back end works too.

Risk apparently is a real thing, that we must now consider. There is business as usual risk, which apparently does not need to be managed, then there is COVID Risks, which need urgent priority and additional resources and lots of $$$ to manage these new risks, even though the risks may be significantly less serious than the risks we naturally carry.

Fatigue and mental health resilience and recovery to trauma exposure are most likely to be front and centre in 2021; if your service is like ours, it will be a lip service approach to risk mitigation, presumably because these are known and business as usual risks.

I write this on the back of two serious MVA involving active trucks both on the Bass Highway; there of course is no apparent similarities between these crashes other than they occurred on the same (long road). But as always, the devil will be in the detail. HACSU is concerned about the apparent lack of concern by the employer, as these things happen from time to time.

Rosters will be a topic of ongoing debate, haven’t they always? How do you provide 24/7 cover without evenly dividing the 24 hours into a set number of shifts. Various shift structures exist around the country, 10/10/14/14 or 12/12/12/12 or 8/8/8/8/8 or 10/10/10/10 (with some overlap) and probably different rotations.

We are concerned that beliefs outweigh science and that includes assessments of risk of fatigue and active mitigations where we know people are working in the ‘orange or red zone’.

PPE has nearly always been available and in stock, but Ambulance Tasmania

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Victoria CLEAN UP AV CAMPAIGN

In the recently approved Ambulance Victoria Enterprise Agreement 2020, the parties agreed to establish a Working Group to discuss a number of claims that were left unresolved from the enterprise bargaining. Two of these issues were a Spares Trial and a review of the Ambulance Victoria Alcohol and Other Drug Policy.

SPARES TRIAL This was a significant win on an issue that has caused much angst and frustration.

We know that the current approach to Spares leads to people travelling a long way from their homes and paramedics working single officer in locations that they do not know and where there is no readily available back-up by VicPol or AV. This causes increased fatigue, stress and anxiety.

The AEAV has made it clear, since our new leadership stepped up, that a key focus would be to fix the Spares issue that has gone unresolved in rural Victorian ambulance since 2011. This issue was ignored for many years despite requests from rural staff. The result being an ad hoc system where controls do not exist and response performance is regularly prioritised over welfare.

ALCOHOL AND OTHER DRUG POLICY The recently approved Ambulance Victoria Enterprise Agreement 2020 states: The EA Implementation Group will discuss the Ambulance Victoria Alcohol and Other Drug policy and related procedures, including AV’s testing program and industry best-practice, including understanding environmental exposure, in order to identify opportunities for improvements to the current policy framework.

Although it was disappointing we were unable to get stronger safeguards for AEAV members in the Enterprise Agreement itself, the Working Group provides an opportunity for members to voice their experiences with AV’s flawed Alcohol and Other Drug Policy and advocate why AV needs to acknowledge occupational/environmental exposure when analysing positive drug results.

Both Working Groups are set to commence in early 2021.

Brett Aidie

AEA-V Secretary AMBULANCE ACTIVE

INDUSTRIAL REPORTS

WA It has been a mad rush to the end of the year, here in the West.

Bargaining for St John Ambulance Transport Officers new Enterprise Agreement began earlier this year, which ground to halt as most of the country did when corona virus hit. However, Delegates Scott Cahill and Adele Bromwich have worked tirelessly on behalf of United Workers Union members over the past couple of months, and we find ourselves almost at an end of negotiations.

St John have also notified the Union of their intent to commence bargaining for both the First Aid Trainers Enterprise Agreement, and the also the Ambulance Officers/Paramedics Enterprise Agreements.

We are currently in the process of consulting with the workforce and preparing members claims, with a view to commencing negotiating meetings late December, and in the start of the new year.

Paramedic and Ambulance Transport Delegates recently met with both the Deputy Premier, Roger Cook, and the Premier, Mark McGowan at Parliament House to speak directly to decision makers

United Workers Union Paramedic/Ambulance Transport Delegates, Rachel, Gary and Scott.

Premier Mark McGowan with United Workers Union member, Paramedic Lisa Munday.

about community health issues, and their perspective as first responders.

Finally, our own United Workers Union Paramedic member, Lisa Munday, has been pre-selected for the seat of Dawesville in the upcoming March 2021 State Election.

For the past 19 years, Lisa has served the WA community as an ambulance paramedic. She was one of two paramedics working at the Dawesville sub-centre when it opened in 2011, and is currently based at the Mandurah depot, which services Dawesville. As a paramedic Lisa became concerned with the emerging prevalence of mental health issues in

the community, and decided to go back to university to study psychology, and, until recently, has worked as a registered psychologist at a clinic in Halls Head.

Lisa is passionate about ensuring the people of Dawesville have access to high quality health and education services, and wants to ensure jobs are created for locals as WA recovers from COVID. Lisa is running against incumbent Liberal Zac Kirkup, who has recently taken over the leadership of the State Liberal Party.

We trust that the Ambulance community in Australia will get behind Lisa and support her campaign!

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PARAMEDIC FOUND NOT GUILTY OF CAUSING PATIENT’S DEATH IN AMBULANCE ROLLOVER A District Court judge has found a South Australian paramedic not guilty of causing a patient’s death by dangerous driving.

MATTHEW JAMES MCLEAN, 42, WAS transporting Karen Biddell, 48, from Port Pirie to the Royal Adelaide Hospital in 2016 when he crashed on Port Wakefield Road.

During the trial, the prosecution blamed fatigue, with Mr McLean having worked 11 shifts in 12 days after volunteering to work overtime.

But Mr McLean’s lawyers argued he was suffering from an undiagnosed sleep disorder at the time of the crash.

He had pleaded not guilty.

The District Court had heard that the bariatric patient was being transported from her home in Port Pirie to the Royal Adelaide Hospital for treatment when the accident occurred.

‘Justice has been done’ Ambulance Employees Association general secretary Phil Palmer expressed his condolences to Ms Biddel’s family and friends.

He said the long-awaited verdict brought four years “of hell” to end for Mr McLean and his family.

“First of all it’s a tragic situation, somebody has lost a mother, sister, friend, loved one, and our hearts go out to them,” Mr Palmer said.

“Mr McLean specifically asked me to pass on to the family of the deceased that he thinks of them every day and he goes through anguish.

“From our perspective justice has been served, this gives us faith in the justice system.”

He said paramedics in South Australia often struggled with fatigue on the job and did not get enough support from their employer or the government.

“We’re all worried about fatigue but in this case, at this time, we’re just relishing the moment that Mr McLean can walk free and know he’s not facing jail, go home and tell his kids that daddy’s going to be home from now on,” Mr Palmer said.

“Every ambo in South Australia was behind him, we’ve been getting messages all day — ambos from all over Australia will be relieved by this.

AMBULANCE ACTIVE

Ambulance officer Matthew James McLean pleaded not guilty over the 2016 crash.(ABC News: Rebecca Opie)

Ambulance Employees Association general secretary Phil Palmer told reporters justice had been done after the District Court found Matthew James McLean not guilty of causing death by dangerous driving.(ABC News: Mahalia Carter)

“We’re pursuing the issue of fatigue … and we’re hoping for a decision out of the arbitration commission that forces the Government to do something about it.”

PARAMEDIC TOLD COURT HE TRIED TO SHIELD PATIENT’S DAUGHTER Mr McLean broke down in the witness box as he gave evidence in his own defence last month, recounting how he rolled the ambulance and tried to shield a girl from witnessing her mother’s death.

“I put the daughter in the front seat to try and shield her from seeing her mother in that position and then I was physically

The bariatric ambulance rolled in August 2016.

(ABC News)

trying to pull the stretcher up because I needed to get her up and out of that position,” he said.

“I attempted to resuscitate her … but the patient was deceased. I was just devastated, and I still am.”

He told the court he did not feel fatigued and would have asked to swap positions with his colleague if he felt “at risk” of falling asleep.

“I felt as normal as I was driving at any other time,” he told the jury during the trial.

By Mahalia Carter 21

PARAMEDICS HAVE ONE OF AUSTRALIA’S MOST DANGEROUS JOBS – AND NOT JUST BECAUSE OF THE TRAUMA THEY WITNESS Allegations of widespread sex discrimination and gender-based bullying among Ambulance Victoria staff have highlighted just some of the problems faced by paramedics.

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SINCE THE ALLEGATIONS CAME TO light last month, Ambulance Victoria has engaged the Victorian Equal Opportunity and Human Rights Commission to investigate.

While these reports are reason enough for drastic action, they are just part of a broader pattern of poor physical and mental health among Australian paramedics. The profession needs to change, and rapidly.

Paramedicine is one of the most dangerous jobs in Australia, according to epidemiologist Brian Maguire, who has researched violence against paramedics.

Researchers at Flinders University, led

by Sharon Lawn (one of this article’s coauthors), published in July a systematic

review of research on paramedics’ health.

They found that, compared with other professions, paramedics have far higher rates of mental health disorders, workplace violence, workplace injuries, fatigue, sleep disorders and suicide.

There is a pervasive myth the impact of a career in paramedicine stems from unavoidable exposure to traumatic events. However, the researchers found paramedics say workplace culture – and how state and territory ambulance service management treat their staff – may play an even bigger role in the link between paramedicine and poor health.

Before looking at the changes needed, here are five key reasons why Australian paramedics often have poor health: AMBULANCE ACTIVE

3. THEY HAVE SIGNIFICANTLY POORER SLEEP Most paramedics work a mixture of day and night shifts in a single block, which is known to be one of the most damaging work patterns.

Researchers from RMIT surveyed 136 Australian paramedics and found they have significantly poorer sleep quality than the general population, and a significantly increased chance of developing sleeping disorders, which contribute to their already poor mental health.

4. THEY HAVE THE HIGHEST RISK OF WORKPLACE INJURY Paramedics have the highest injury rate of any profession in Australia, double that of police, and are seven times more likely to be seriously injured at work than the national average.

Alarmingly, the fatality rate for paramedics is six times higher than the general population.

5. MORE THAN HALF OF PARAMEDICS HAVE ‘TOTAL BURNOUT’

1. THEY ARE AT THE HIGHEST RISK FOR WORKPLACE VIOLENCE According to Ambulance Victoria, a paramedic is assaulted in Victoria every 50 hours.

And it’s getting worse. A 2018 study by Maguire found reports of assaults against paramedics tripled between 2001 and 2014.

One study of 400 Australian health-care workers in 2003 found paramedics were at the highest risk of experiencing workplace violence.

Another study, led by Malcolm Boyle (another of this article’s co-authors), found many paramedic students undertaking clinical placements experience workplace violence, including sexual harassment by colleagues.

2. THEY ARE TWICE AS LIKELY TO DEVELOP PTSD AND TO SUICIDE A national Australian study of emergency service workers found two out of five paramedics had been diagnosed with a mental health condition.

Just over 8% of paramedics suffer posttraumatic stress disorder (PTSD), which is double the national average, while 21% have anxiety and 27% depression.

A 2016 study showed paramedics are twice as likely to suicide compared with the general public.

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Burnout refers to a state of physical, emotional and mental exhaustion.

It’s linked to an increased intention to leave one’s career, poorer patient care, and developing depression and anxiety.

One study of 893 Australian paramedics found two-thirds had “work-related burnout”, and more than half had “total burnout”, meaning the burnout was impacting both their personal and work lives.

WHAT HAS TO CHANGE? The evidence paints a bleak picture of paramedicine in Australia. If anything is clear from the recent bullying revelations, it’s that ambulance services are not being proactive enough about their staff’s health and well-being.

Research is showing that potentially the largest threat to paramedics’ well-being is not the traumatic scenes they encounter at work, but rather a workplace culture that undermines their physical and mental health. A fundamental change is needed to how ambulance services management support and treat their staff.

There is a clear need for an independent review into the management of state and territory ambulance services. What has occurred in Victoria is just the tip of the iceberg nationally. These cultural issues have existed for a long time. The decision

by Ambulance Victoria to engage the Victorian Equal Opportunity and Human Rights Commission to investigate the allegations of bullying indicates

removing decision-making power from the ambulance services is needed and more independent oversight is required nationally.

High on the agenda for reform should be building ways of working that encourage healthy work-life balances.

We need to address the impact of the career on all aspects of paramedic well-being, including mental health, healthy eating, quality exercise, better sleep, and access to support services.

Some ambulance services have created positive change over recent years, but it’s clear this hasn’t been enough.

All forms of workplace violence, which includes bullying and harassment, must stop. There is a need to dismantle the punitive culture that punishes paramedics for speaking out. It’s clear many paramedics don’t feel supported or respected by their management.

CHANGING THE CULTURE IS IMPERATIVE We also need to acknowledge and address the gender bias in paramedicine and create inclusive workplaces. Female paramedics are at more risk of workplace violence, burnout, and bullying and harassment. Ambulance services need to ensure the safety of all paramedics, as well as fair and open recruitment and development opportunities that don’t disadvantage women.

Most importantly, a drastic change in culture is needed. Ambulance culture is often centred on meeting productivity goals, without acknowledging the human cost. A key performance indicator in ambulance services has long been incident response times, and paramedics are held to account for every delay.

We need to have indicators on workforce health, and chief executives and boards need to be held just as accountable.

We shouldn’t have to sacrifice the health of our paramedic workforce to meet productivity targets.

Simon Sawyer

Lecturer in Paramedicine, Australian Catholic University

Malcolm Boyle

Academic Lead in Paramedic Education and Program Director Paramedicine Programs, Griffith University

Sharon Lawn

Associate Professor in the Department of Psychiatry, Flinders University

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DON’T LET KETAMINE COST YOU YOUR JOB! AEAV is embarking on a campaign of education and advocacy about the risks of environmental exposure to Ketamine and drug testing. Paramedics are unwittingly risking their careers for simply doing their job correctly.

IMAGINE THIS: YOU ARE REQUIRED TO submit to drug testing. You are not a recreational drug user so no issue, right?

Wrong! Now you’re stood down and the subject of a disciplinary investigation surrounding allegations of drug use because you tested positive to Ketamine.

The result must be erroneous! You’re not a drug user, the only time you have been near Ketamine is when stocking your truck or administering the drug to your patient.

This is NOT a hypothetical scenario.

FACT! Ketamine is readily absorbed through your skin into the blood stream and can unwittingly be deposited and absorbed into your hair simply through touch.

When drug testing was introduced into Ambulance Victoria, concerns were raised by AEAV members that positive results may occur as a result of not only recreational drug use but also from occupational exposure.

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The Ambulance Victoria CEO was at pains to allay these fears by reassuring paramedics that occupational exposures could be distinguished from illicit use.

Ambulance Victoria have failed to make good on these assurances and have pursued paramedics with allegations of drug use falsely maintaining that the tiniest quantities of Ketamine detected can only be consistent with personal use.

“They (Ambulance Victoria) pursued members by maintaining an ill-informed and ignorant stance” said AEA-V Secretary Brett Adie, “Even after being presented with independent evidence suggesting a positive result is occupational exposure to Ketamine, Ambulance Victoria have bullied, intimidated and disciplined members over what effectively is a workplace accident with devastating psychological injuries as a result. Our members are charged with serious misconduct when it is Ambulance Victoria’s

stubborn and wilfully ignorant refusal to recognise this issue that is the serious misconduct.”

The danger to paramedics is about to increase by 10 to 20-fold with the introduction of intranasal Ketamine for pain due to a change in the clinical guidelines.

Two key measures of drug testing that paramedics need to understand are the difference between ‘the limit of reporting’ (LOR) versus ‘cut-off levels’ (COL) and the absence of metabolites.

In hair testing the smallest quantity of drugs can be detected. Hair testing can measure the presence of a drug to quantities as low as 0.2ng/mg Ketamine.

This measure is known as the LOR and records the minimum concentration of a substance in a sample that can be reliably detected in a laboratory.

COLs are the agreed levels that a quantity of detected drug should exceed AMBULANCE ACTIVE

before being reported as a positive finding and are indicative of abuse. COLs serve as a ‘safeguard’ for those being tested against spurious claims of drug abuse.

Ketamine does not have a universally accepted cut-off level. There has been much research into what a COL for Ketamine should be and suggestions are that it should be set in a range of 0.4 – 0.8 ng/mg. Note the LOR (ability to detect the drug) for Ketamine is 0.02 ng/mg, twenty times lower than the COL. The absence of a COL means any detection above the limit of reporting (0.02 ng/mg) is reported as a positive result.

Secondly, any drug that is metabolised by the body leaves residual metabolites.

Metabolites are routinely tested for with the same LORs as their parent drugs. If a drug has been deposited into hair environmentally, it has not been metabolised, therefore, no metabolites will be detected. Norketamine is a metabolite of Ketamine and is routinely tested for. It would be logical to conclude if Norketamine is not detected the drug has not been metabolised, thus the likely source is an occupational exposure.

Professor Olaf Drummer spoke at a recent FACTA (Forensic and Clinical Toxicology Association) conference

in Melbourne about interpreting hair results. Professor Drummer who is considered an expert in this field warned against reporting any positive findings in the absence of metabolites, especially when the concentration of the drugs detected is relatively low.

Ambulance Victoria continues to pursue AEAV members when there are detected levels of Ketamine barely above the LOR coupled with no evidence of Norketamine.

Ambulance Victoria proudly boast that they value Evidence Based Practice, yet they continue to ignore the evidence presented to them and continue to intimidate, bully, harass, and discipline members over this issue. This issue is only set to get worse with the expanded and increased administration of Ketamine to patients.

Ambulance Victoria must accept the uncontroversial science and follow the lead of Victoria Police. A simple policy change cognisant of the evidence provides realistic protection for paramedics simply doing their jobs.

AEAV are not against drug testing in the workplace, as long as it is done discretely and respectfully. It must be considering ALL the evidence for the protection of frontline workers delivering emergency patient care.

Until Ambulance Victoria adopt a sensible informed approach to drug testing and Ketamine, AEAV will continue to campaign on this issue to the highest levels available.

All paramedics must be informed and make this a live issue in your branches.

Raise the issue of occupational exposure with your HSRs, Team Managers and colleagues.

AEAV ask that you exercise extreme caution when administering Ketamine to your patients.

An interim measure, we advise is that you complete a ‘near miss’ on the HSCS (Health & Safety Complaint System) every time you administer Ketamine to a patient.

This will begin a paper trail to start to protect you from spurious allegations of personal drug use.

This issue will worsen with the reintroduction of drug testing in the workplace coupled with an expanded level of Ketamine administration.

DON’T LET KETAMINE COST YOU YOUR CAREER. JOIN THE CAMPAIGN.

Brett Aidie

AEA-V Secretary

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NSWA MOVES TO BLOCK ICP COURSE SELECTION OPPORTUNITIES IT’S NATURAL FOR MANY PARAMEDICS and other health professionals to want to be the best clinicians they can be.

Why put up with the long hours, extreme injury rate, abuse, and an employer who says you deserve a 0% pay rise because the fires and pandemic are unremarkable, unless you want to make a clinical difference in the lives of patients?

That is reflected in a late 2018 ADHSU survey on paramedic specialisation where 75% of P1 respondents wanted to advance clinically, 68% to ICP, 32% to ECP, and 5% ‘other’.

81% of combined respondents (all clinical levels including trainees) said that the NSW ICP scope of practice had stagnated and needs to expand.

This is great news for the NSW community as they can be satisfied that there are plenty of motivated clinicians who want to be highly and higher trained than they are now.

It should also be great news for an employer who doesn’t have to deploy cynical tactics to convince staff who want to continue to improve.

So what does NSWA do with all that?

Demotivate staff by moving to limit ICP

course applications/testing to once every 18 months.

ADHSU successfully pushed for HR numbers to be increased so these sorts of things would become more accessible to members, not to cut off hope to 75% of paramedic staff.

It only takes one tough night with the kids to underperform at an interview or exam, so limiting opportunities to once every one and a half years will have an effect on countless paramedics trying to get ahead.

We will engage management on this issue immediately and let members know the outcome.

UPDATE ON COVID TRAINEES AND DELAYED INSERVICE As everyone knows, 180 new grads were brought forward and trained in March this year to help tackle the COVID pandemic.

This was an extraordinary feat that was made possible because of the dedication of Ambulance Education staff and their ability to respond to an immense and dynamic workload this year.

However, an issue has now arisen – namely, the fact that this class of P1Ts all need to return for training to become and be paid as fully qualified P1s. Typically, this occurs after 12 months, but the COVID class is being split over a number of

AMBULANCE ACTIVE

months with some P1Ts not returning for their Inservice until as late as November 2021.

Ambulance’s excuse for this is because of the sheer number of P1Ts who need to be safely trained.

This creates an unfair divide between trainees, in which some members will be financially worse off than their colleagues with whom they began their Ambulance careers.

ADHSU delegates are still in discussions with Ambulance about this matter and has begun investigating industrial measures

to protect workers from this arbitrary unfairness that financially penalises workers who have to wait up to 7 months longer than their classmates.

There was also the matter of the COVID trainees being told they would not be able to access their Annual Leave entitlements until they have completed their Inservice.

Delegates have secured confirmation that all COVID P1Ts will be able to take their Annual Leave after 12 months of service as per the award.

We will endeavour to update affected members as the issue progresses.

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ARE THEY TRIPLE OK?

We’re always there to help.

Let’s make sure we help each other and ask R U OK? ruok.org.au/triple-ok

TRAINING VOLUNTEERS IS PAID DUTY TIME! HACSU WAS RECENTLY TOLD OF ongoing conflict about risk management involving fatigue and when fatigue breaks would or wouldn’t be provided, and the issue of volunteer training by single Branch Station Officers arose.

We agree that training volunteers is a Statement of Duties criteria but don’t agree it’s required to be done outside paid duty time - it counts as work and therefore should be paid time – on shift workloads and call out workload no longer justify the BSO ‘volunteering’ arrangements.

There may have historically been an expectation to conduct this training in your own time but recent industrial changes, such as calculating the time spent working in the on-call period for fatigue breaks, means this time can only be considered a paid work task.

Our view is that volunteer training should where possible be arranged within the normal working day. If it needs to occur during an on-call period: 1. The whole training time must be paid time, including any associated travel.

2. The whole training time in the on‑call period counts towards fatigue break accruals.

3. Scheduled volunteer training in an oncall period should be approved by a duty manager or the BSO Team Leader to remove any doubt that it will be paid time. Flexibility regarding 56 days’ notice is likely required for this allocation of work.

If you have questions please contact HACSUassist on 1300 800 032.

AHPRA RELAXES CPD REQUIREMENTS DUE TO COVID-19 In late September United Workers Union wrote to the Chair of the Paramedicine Board of Australia on members behalf regarding the requirements around demonstration of CPD hours accumulated during the 2020 registration period.A number of members from around the state have raised concerns regarding access to formal CPD learning during the restricted working environment experienced as a result of Covid-19.On 21 October 2020 your United Workers Union representatives and officials from across Australia met with AHPRA Paramedicine Board Chair Professor Stephen Gough ASM and Executive Officer Paul Fisher to discuss CPD requirements for our Paramedic members.AHPRA recognises the impact that Covid-19 has had on the ability of many to complete the required 30 hours of

AMBULANCE ACTIVE

CPD –including the 8 hours of Interactive CPD. To this end, AHPRA have advised that while there isstill a clear expectation that CPD be completed,”no action will be taken should a registered paramedic not meet these requirements due to the impactof the COVID-19 pandemic”.

You are still required to make an honest declaration in relation to the CPD you have completed, and this, along with your hours already logged, must still be submitted to AHPRA. There is no minimum CPD hours that you must complete in the 2020 registration period.AHPRA have also suggested that Paramedics think outside the box in terms of what the interactive component of your CPD looks like, i.e: • Interactive online events such as Skype calls, video conferences • YouTube videos

• Several paramedics read a journal article and discuss in a small group session • Accessing the union-providedTalisium learning portaland undertaking short courses The important element will be the reflection on the training that has been undertaken.AHPRA has also advised that for those with dual/multiple registration, if the CPD undertaken in the role of RN matches the scope of the paramedic role, then it can be counted as CPD for both roles. We have also asked for sufficient notice of any return to the normal CPD requirements, so that Paramedics can plan their CPD accordingly.United Workers Union will continue to meet with AHPRA to raise issues that are important to our members.

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IMPROVEMENTS FOR FWA OFFICERS UNITED WORKERS UNION WELCOMES the recent commitments made to FWA Officers by Commissioner Russell Bowles regarding equity and access to the same workplace entitlements as the non-flexible workforce. In recent times a lot of work has been done by QAS to address access to a fair and inclusive workplace for all QAS staff.

The advocacy by United Workers Union members and delegates has gone a long way to help shape the kind of workplace QAS aspires to provide to its staff. Many FWA members consistently report being allocated as the first option to fill holes in lesser clinical roles, are being made to feel they should be grateful for their flexible work arrangements, and are encouraged to not complain or rock the boat.

The Commissioner’s recent recommitment to FWA Officers has made it

very clear as to what his expectations are: “In seeking to ensure all staff, whether flexible or non-flexible, work under similar conditions, these are the expectations I have laid out: • Flexible workers should be provided a full roster projection, which includes an allocated station to start at for each shift, with the same consistency in station being provided as is provided to our non-flexible staff (i.e. You should still receive a 13 week projection and there should be no expectation that signing a flexible agreement means you must, by default, move from your usual station or sign an agreement to work at multiple stations); • There should be equitable sharing of all types of shifts between all types of employees (both flexible and non) with

the appropriate skill set where there is a need (i.e. filling of vacancies on PTS/ LARU etc. should be equitably spread around both flexible and non-flexible staff).”

With just short of 500 staff on flexible work agreements, this is a challenge the QAS is going to have to work through for solutions.

Your union, United Workers Union, will continue to participate in discussions around making the QAS a fairer and inclusive workplace. If you are working on a FWA and feel like you do not have access to the same opportunities or entitlements as other QAS employees, please contact your United Workers Union delegate or official so that your individual circumstance can be progressed.

AWARD AMENDMENTS Award Amendments for part-time employees and increment progression seek to remove gender-based barriers for public sector workers.

As a result of the Queensland government commissioned Bridgman Review [pdf] of public sector employment laws, a change in how part-time employees are treated in terms of increment progression has been made in order to remove barriers to gender pay equity.

The review was commissioned by the government to ensure Queenslanders have the most responsive, consistent and reliable public service possible – _a public service that is fair, an employer of choice, and a leader in public administration.

United Workers Union participated in providing information to the review and it is pleasing to see many progressive recommendations being taken on by the Government and its agencies like QAS. On 2 September 2020 the Queensland Industrial Relations Commission granted the State of Queensland’s application to remove provisions in public sector awards that impose hours-based

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barriers to increment progression for parttime employees.

The applications did not deal with increment progression for casual employees or the movement between classifications (i.e. progression from one classification level to a higher classification level) – there is no change to these arrangements.

These arrangements do not apply retrospectively. For QAS employees this means the following crossed-out sections of the Award and Certified Agreement no longer apply : • Ambulance Service Employees Award - State 2016 • Schedule 1 - Generic Level Statements - Section 1: Progression Page 37 of 52 Schedule 1 - Generic Level Statements • Section 1: Progression and maintenance arrangements - general • (d) The progression tables set out below outline the minimum timeframes for progression.

QUEENSLAND AMBULANCE SERVICE CERTIFIED AGREEMENT 2017 (as amended 2020) 18.4 Incremental progression timeframes outline within this agreement are the minimum timeframes for progression QAS LASNs have calculators to work through individual part-time employees’ circumstances.

If you don’t think you have progressed appropriately based on the information in this article, or the links provided, contact your local LASN HR in the first instance, so they can work through the process with you.

If you require further assistance contact the Union office.

If you have a co-worker who isn’t receiving these emails please contact qldambulance@unitedworkers.org.au to get them signed up.

AMBULANCE ACTIVE

PALASZCZUK GOVERNMENT MUST COUGH UP AMBULANCE FUNDING IN STATE BUDGET QUEENSLAND’S PARAMEDICS ARE calling on the newly sworn-in Palaszczuk Government to put their money where their mouth is and deliver on election commitments for more ambulance resources in the state budget next week.

United Workers Union ambulance member Rachelle Owen said the Labor Government had made a lot of promises during the election campaign, but now was the time to put words into action.

“As ambulance officers, we’ve been on the frontline through COVID-19, working around the clock to keep our communities safe and healthy across the state,” she said.

“We need to make sure we have proper resources and funding so we can continue to keep up with the growing demand for our essential services.

“During the election, we heard a number of commitments from Labor, including more paramedics, new and upgraded stations, and sufficient vehicle numbers.

“Now we want to see the funding for these commitments in black and white in next week’s budget.”

United Workers Union National Ambulance Coordinator Fiona Scalon said union members had been calling for more resourcing throughout the year, to build on boosted paramedic numbers over the previous term of government.

“Talk is cheap during an election, now it’s time for action,” Ms Scalon said.

“Our message to Queensland’s new health minister Yvette D’ath is simple: put your money where your mouth is and deliver on your commitments to fund our ambulance services.”

REMINDER:

YOUR RIGHT TO REPRESENTATION ALL STAFF ARE ENTITLED TO SUPPORT OR representation when participating in discussions with management regarding complaints or potential disciplinary action. Any formal request to meet regarding these types of issues should include information about your entitlement to support and provide detail of the information around what will be discussed. If what starts out as an informal chat then turns into something more significant,

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every member then has the right to pause the meeting and seek union support or representation. All QAS supervisory staff are educated in ensuring staff have access to their industrial entitlements.

If you are not being afforded this industrial entitlement, you have the possibility to challenge the processes for which you are being asked to respond. Every worker has the right to procedural fairness and natural justice.

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COVID-19 SLASHED HEALTH-CARE USE BY MORE THAN ONE-THIRD ACROSS THE GLOBE. BUT THE NEWS ISN’T ALL BAD It’s no secret the COVID-19 pandemic has changed many aspects of our lives. One is how often we access health care.

WE’VE CONDUCTED WHAT WE believe is the first systematic review on this topic, bringing together studies documenting changes to health-care use during COVID-19 from around the world.

We found a 37% reduction across all parts of the health system, from February to May this year, compared to the same period in previous years.

Many people will suffer as a result of having missed out on lifesaving care, such as for heart disease or cancer. But others may benefit, by avoiding care they did not need in the first place.

also been unable to access some types of health care, as services like elective surgery were suspended.

Rates have bounced back in many places, but some remain significantly lower than previous years. Total admissions to hospitals in New South Wales, for example, were still down in the most recently available figures (up to the end of June).

In a small number of studies we also found some things increased, including treatments for acute stroke. And future studies will likely find large increases in services such as telehealth.

DRAMATIC DROPS ACROSS ALL CATEGORIES

REDUCTIONS ARE GREATER FOR LESS SEVERE ILLNESS

Together with a global team of researchers and doctors, we identified 81 studies from 20 countries, including Australia. It’s important to note our work is currently undergoing peer review, although in keeping with much pandemic-related research, it’s available as a preprint.

Between February and May 2020, those studies reported on around 7 million health services, such as having a scan or an operation, compared to roughly 11 million in the same period the year before.

Overall, there was a 37% median reduction across all categories of health care. Visits to seek care, such as going to a GP or the emergency department fell by 42%; admissions to hospital dropped 28%; the use of diagnostic tests fell 31%; and the use of treatments, such as procedures to treat heart disease, dropped by 30%.

One of the biggest individual studies in our review found a 42% reduction in visits to all United States emergency departments during April. Weekly visits fell from 2.1 million in 2019 to just 1.2 million in 2020. For visits among children the drop was 72%.

A smaller study in Australia found a 37% fall in emergency department visits at two hospitals in Victoria during April.

There are many possible reasons for these trends. For example, people may have stayed away from hospitals for fear of contracting COVID-19. People have

Many of the studies in our review found reductions in use were greater for people with milder illness. That US study found the biggest fall in emergency department attendance was for people with abdominal pain.

Likewise, the Australian study found bigger falls among those with the least acute problems. For example, attendance was lower than expected for people with gastroenteritis and wrist fractures — but there was no change in category 1 triage patients (the most severe who require urgent attention).

Notably, several studies found larger reductions in admission for milder forms of heart attacks than for more severe forms.

A large English study in late March found national admissions for the more severe form dropped 23%, while admissions for the milder form dropped 42%.

In terms of mental health, a study from Paris found a 55% reduction in emergency visits in the first four weeks of lockdown, but with greater reductions in visits for anxiety and stress, and smaller reductions for psychotic disorders.

At the height of the pandemic, doctors in Northern Italy found a 68% drop in presentations to children’s emergency departments. The reduction in attendance for the “white” triage category, the minor conditions which don’t require a doctor, was 89%.

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AN OPPORTUNITY TO REDUCE UNNEEDED CARE Clearly many people will have been harmed by missing out on needed care.

As the authors of the English study on heart attack admissions made clear, public campaigns are important to assure people that visiting hospital is safe. Reluctance to call an ambulance when experiencing severe symptoms, they write, results in “unnecessary deaths and disability”.

But many experts around the world are also seeing this crisis as a potential opportunity to wind back unnecessary care, and to free up resources for those most in need.

The Italian doctors who found significantly fewer children presenting to hospital with mild complaints suggested this has freed resources to “provide critical services to patients suffering from medical emergencies in a timely manner”.

There’s already a lot of evidence about overuse of medical services and overdiagnosis, also known as low-value care. Examples include the inappropriate use of antibiotics and opioids, unnecessary diagnoses of prostate cancer, and the overuse of CT scans for children.

As health systems continue responding to the pandemic and deal with the urgent backlog of care, addressing this harmful waste becomes even more pressing.

Commentators in the British Medical Journal and the New England Journal of Medicine, and influential doctors’ groups, have echoed this view.

The tragedy of the pandemic has underscored the importance of reducing unnecessary and harmful care, and offers us a real opportunity to address this problem.

Ray Moynihan

Assistant Professor, Bond University

Loai Albarqouni

Postdoctoral Research Fellow, Bond University AMBULANCE ACTIVE

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