Ambulance Active Winter -Spring 2020

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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.

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VOLUME 11 ISSUE 3 2020 Australasian Council of Ambulance Unions Elected Office Holders 2020 PRESIDENT Steve Fraser (HSU NSW) 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)

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

REGULARS 05 From the President 06 From the Secretary 08 Industrial Reports FEATURES 13 Leon Cartledge 15 My day starts the night before 17 Time for the government to take over New Zealand Ambulance Services

18 19 20

Pandemic Kindness Movement The politics of a COVID-19 vaccine I’m an ambo and I’ve got symptoms

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


TWU caucus meeting

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Reflecting on 26 Years as a Proud Union Member

A return to ramping

Peter’s story

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

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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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REPORTS

the PRESIDENT COVID 19 HAS CHANGED THE FACE of emergency care dramatically. That is not because it is covered up by masks and goggles. Worldwide, the scope of paramedic practice has become broader through necessity. The epidemic has forced the recognition that the out of hospital provision of both emergency and nonemergency medical service is well within the bounds of the professional paramedic. Paramedics are taking on exponentially expanding responsibilities as the strain on medical systems around the world increases. Testing and medical retrieval of ventilated patient transfer duties are being handed over as hospitals struggle with the massive ICU load. While Australia and New Zealand have yet to face the full impact of an overloaded health system, paramedics are taking on extra roles and responsibilities with the expectation of working in mixed crews, extra training loads as new graduates are pushed through as a workforce planning strategy. New skills and practices are introduced under the guise of COVID response and working in stifling and restrictive PPE is a necessary normality. The expectation that we as paramedics will step up in this time of crisis, unwilling to speak out against changes in work practices, is valid. We do it! We accept these changes for the greater good and feel that we must not object in these tough times. However, what was the reward in the good times? We continually had to fight for recognition of our professional value, we were constantly told that wages could not grow in case inflation got out of control. We were undervalued.

Now, the call is to take on greater responsibility and staff the frontline of the fight against an invisible and surreptitious disease. We are expected to accept any role or practice that will protect the community from ‘COVID’. While some thanks from the community appears through social media and members of the public regularly offer a “thank you for you service’, The Ambulance providers across Australia and New Zealand offer nothing more than lip service and wage freezes. We will continue to step up and we will continue in our role of community protectors. However, we must remember

to constantly remind the government and the community that we deserve better. Better professional recognition, better professional wages and better safety systems to protect ourselves in this volatile work environment. Regardless of the epidemic, Ambulance Services across the Australasia must recognise the service value of paramedics and reward us in kind. Stay safe. 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.

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the SECRETARY AS I PEN THIS ARTICLE THERE appears to be no end in sight to the COVID-19 pandemic and the challenges it is presenting. For a time, it looked as if Australia and New Zealand had successfully combatted the worst of the crisis with lock downs and border closures and rigorous quarantine requirements. Unfortunately, the recent resurgence of the disease in Victoria and NSW is undoing many of the early wins and returning us to more challenging times.

THANK YOU I want to pay tribute to paramedics in Australia and New Zealand who have responded so professionally to the pandemic and the additional pressures it has place on our clinical practices. Simple cases have had layers of complexity added by the addition of PPE and additional COVID related policies and procedures. At the present time, Victorian Paramedics are battling spiralling caseloads in that state as a result of the outbreak in Melbourne. We wish you all the best in your continuing fight and hope that ‘the curve’ can once again be bought back under control.

AGED CARE AND THE EROSION OF WORK CONDITIONS I’ve been reflecting on the incredibly sad situation affecting patients and residents in Aged Care Facilities as the virus spreads to these sites. As a result of successive governments winding back industrial laws and protections for vulnerable workers, this largely casualised and underemployed workforce has inadvertently become a vector for the spread of the virus. I have the utmost respect for aged care workers. They are generally poorly paid, on minimum part time and casual ‘contracts’ and often have to work at multiple facilities to make ends meet. The vast majority care for their residents like they are family. The lack of employment security for these workers has facilitated the spread

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of the disease as they have unwittingly transported the virus between facilities. Many of the carers who have felt they had to turn up to work when unwell were driven by economic necessity. For me, the governments who have destroyed the protections these workers once had are complicit in the spread of the virus in these circumstances.

“ I want to pay tribute

to paramedics in Australia and New Zealand who have responded so professionally to the pandemic and the additional pressures it has place on our clinical practices.

MENTAL HEALTH AND WELLBEING The Mental Health and Wellbeing of paramedics and other ambulance staff has been a big focus for the NCAU and now the ACAU over the course of our existence. In these challenging times it is more important than ever to look after ourselves and each other to ensure we maintain a work-life balance that supports good mental health and wellbeing. In this edition of Ambulance Active there is a page dedicated to a new web-based resource called the Pandemic Kindness initiative. Mike Palmer, an RN and Project Manager with South Australia’s Clinical Excellence Commission, spoke to a recent ACAU Executive meeting on this resource.

It is set up as a one stop shop for COVID-19 information for health professionals to look after ourselves in the pandemic. It’s intuitive and based on Maslow’s Hierarchy. I encourage you to have a look at the material on the link. It’s a mix of easy to read and listen to podcasts, written material and other resources designed to assist us in maintaining our own health and welfare in this fight.

SENATE INQUIRY RECOMMENDATIONS Speaking of mental health, there is still no sign of the Morrison Government implementing any of the recommendations of the 2019 ‘Answering the Call’ Senate Report on the Mental Health and Wellbeing of Emergency Services and First Responders. ACAU is continuing to lobby Labor and Cross Bench Senators to continue to pressure the government to follow through on these recommendations and take genuine steps to improve mental health in our sector.

RORTING OF WORKERS COMPENSATION BY INSURERS AND EMPLOYERS In the last few days, a shocking report on collusion and rorting in the Workers Compensation system in NSW has been revealed by ABC Four Corners. Some who watched Monday’s ABCTV Four Corners program may have been shocked at the revelations about workers’ compensation insurance. It shouldn’t have been too big a surprise, since Victoria’s Ombudsman in late 2016 found that insurance agents working for WorkSafe Victoria were “gaming the system” by unfairly denying payments to injured workers as well. These were issues extensively highlighted by unions, the NCAU and others in the Senate Inquiry mentioned above. The Morrison Government needs to front up and hold these mavericks to account by pursuing the recommendations of the bipartisan Senate Report. AMBULANCE ACTIVE


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WH&S – FACE MASK NONCOMPLIANCE WITH AUSTRALIAN STANDARDS Some members have recently raised concerns that some ambulance services are not complying with Australian Standards when it comes to face masks being used in the pandemic. The ACAU will shortly be forwarding correspondence, though our member unions, to state and territory ambulance services requesting evidence of their compliance with this imperative standard.

A SHOUT OUT TO UNION OFFICIALS AND DELEGATES Finally, I’d like to pay tribute to all the union officials and delegates in the

ambulance space who are continuing to fight for members rights and entitlements as well as addressing the myriad of industrial issues that have arisen that are unique to COVID-19. Some employers are taking the opportunity afforded by the pandemic to subvert normal consultative processes and cut corners when it comes to work health and safety and other provisions in the name of expediency. I think we all can appreciate that by and large we are in a very fortunate space compared to many workers and industries who have been decimated by the pandemic, and some give and take can sometimes be applied. That however is not an excuse to ignore rights and conditions, many of

them hard won and designed to protect health and safety of our members so that they can look after the health and safety of the public. Keep safe out there and continue to provide the excellence in care for which paramedics and ambulance employees generally are renowned!

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 a current ACT TWU Ambulance Executive Member and was elected unopposed as the inaugural Secretary of the Australasian Council of Ambulance Unions in 2019.

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AMBULANCE ACTIVE

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INDUSTRIAL REPORTS ACT COVID-19 The ACT has so far avoided the second wave of COVID-19 infections being experienced by some other jurisdictions. The TWU is continuing to consult and engage constructively with ACT Ambulance to ensure good communication, safe work practices and wellbeing continue to be at the core of all decision making.

ENTERPRISE AGREEMENT The ACT Ambulance Service Enterprise Agreement 2017-2021 has now been stamped by the Fair Work Commission. Members have received substantial back pay dating from 2017. As sometimes happens, a provision relating to meal allowances on overtime was removed without consideration of the impact on shift workers from the ACT Public Service ‘Core’ agreement. This is impacting on paramedics and steps are being taken by the TWU and other unions representing shift workers in the ACT to reverse this measure by consent. If this is unsuccessful, a formal dispute will be lodged in the Commission.

NEW CAUCUS Following the endorsement of our updated ACT Ambulance Service Delegates Constitution an election has been held for an expanded caucus and executive. Pleasingly, the new caucus has lots of new faces and is increasingly representative

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of the diversity across our general membership in ambulance. Our new activists have hit the ground running with campaigns initiated around a fit for purpose maternity uniform and WHS compliant ambulance equipment already underway.

MEETING WITH THE MINISTER The Minister for Police and Emergency Services, Mick Gentleman, met with the newly elected caucus on Monday July 20th. Delegates raised grave concerns about the lack of meaningful progress on the Blueprint for Change Transition and the serious infrastructure challenges faced in terms of inadequate station facilities and vehicles. The most serious issue raised was around an increasing trend towards lack of consultation on major and minor change at both ACTAS Chief Officer/Operations level and from the office of the Emergency Services Commissioner around structural changes. The Minister has committed to address these issues with the government as well as the ESA Commissioner.

TRAINING AND DEVELOPMENT DAYS Two Training and Development Days will be run for all members of the new Delegates Caucus on July 30 and 31 2020. A range of skills will be covered. The intent is to put together a strategic plan for the Caucus for the next three years, prioritising campaigns and the negotiations around the new EA. Jim Arneman Caucus Secretary

NSW Like every other state, New South Wales has undeniably been put through the ringer this year. We had barely recovered from defending our homes and communities against Australia’s worst bushfire season to date when we were swung head-first into COVID-19. While responding to crises like this comes with the territory of the job, we didn’t quite expect the Government to thank us for our hard work in the form of a public service pay freeze. The Wages Policy that has been in place in NSW since 2011 restricts our wages to 2.5%. Recently we were given certainty in the IRC that 2.5% is not a given either, confirming that the Government can offer us any amount between 0 and 2.5% in any year. We still don’t know what figure they think we are worth this year. This doesn’t really matter though, as 2.5% is not a win for us or our members when we know our work is worth more. The professional rates of pay we are campaigning for will be a ball-park figure of a 35-40% rise without trading off conditions. NSW paramedics are the lowest paid in the country, and we will continue to fall behind the wages of our colleagues in other states for as long as this policy stays in place. Since its inception, the Value Our Service campaign’s focus has been on removing the wages policy as a first step towards professional pay. This year’s 2.5% debacle is symptomatic of a larger issue of statewide wage suppression and a devaluation of our skills and profession in NSW. Moreover, the move to cut our pay this year shows the Government’s calloused devaluation of our compassion and commitment to our communities. In June, we had our first big campaign action and began liquid chalking ambulances around the state. This has been ongoing for over a month now, garnering interest and a warm reception from members of the community. Our messaging has been centred around valuing our service as well as our community, who will also be hit hard by a public-service wage freeze. We are now gearing up for our next action, which will involve gathering community signatures on a petition in AMBULANCE ACTIVE


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support of removing the wages policy to present to parliament. As well as the Value Our Service campaign, members in Metro Sydney have begun a campaign to raise the Minimum Operating Levels (MOLs). While we have seen welcome (yet still insufficient) staffing increases in the service, this has made little difference when we still have the same number of cars on the road as we did in 2010. While countless densely populated apartments and estates have sprouted up across metro Sydney over the past decade, we still do not have the resources available to properly support such community growth. For our members, the current inadequate operating levels result in high levels of fatigue, frequent missed cribs, low opportunity for overtime and staff consistently being sent to other stations for relief while leaving their home station a car down. An initial campaign committee of delegates was formed to create a survey to present to members. From the responses on the survey, we have managed to identify a strong hunger for changes to current MOL levels, as well as a large cohort of new activists. This has been an important campaign in building union numbers, strength, and activists within metro stations. From this, we will form a final campaign committee that will be responsible for coordinating action. In Solidarity HSU NSW

New Zealand KIA ORA Bargaining has started here in NZ with St John Ambulance but despite four days at the table we still do not have an offer to take back to staff. We are looking, amongst other things, at: • 3% base pay increase for all members • Emergency Medical Technicians (EMT) who progress to Paramedic to have their pay backdated to their provisional ATP date to encourage true (not slowed) progression • Emergency Medical Assistants to be paid at their ATP (currently we have many who are EMT qualified) First Union has had to lodge a noncompliance legal action with the Employment Relations Authority because St John are still refusing to pay the shift rate that they signed for in the last round of bargaining (payment was due to have started on 1 July 2020). The employer seems to believe that the rate can be rebargained this year (without paying it) but AMBULANCE ACTIVE

we are confident the employment court will find in our favour. The ‘new rate’ that St John would like is a reduction to T1.15% and a shortened night shift stating at 2000hrs not 1800hrs. Both their Chief Financial Officer and Chief Executive Officer have said in union meetings, and in the media, that the government have told them to settle this round of bargaining and come back to them for financial assistance. In addition, Peter Bradley (CEO) recently released a podcast on Radio NZ, on which he said … “We have failed to pay our staff the recompense that is due … I am absolutely committed to giving the staff the pay that they deserve as soon as possible … making that happen come what may. “We are absolutely committed to giving staff the pay catch-up that is needed and the MOH have acknowledged that the pay correction needs to happen … they have said that once this round of bargaining has been completed they will give the appropriate level of funding support.” However, they disappointedly closed the bargaining saying … “We can’t ask the government for money because they are facing an increasing Covid debt and now is not the time”. Peter Bradley (CEO) has never said that he will make the pay correction this year. The St John’s bargaining team does not have the authority to respond at the table. They finished by asking us not to communicate with members or, at the very least, to keep any feedback neutral. It really is quite beyond belief that “The Priory in New Zealand of the Most Venerable Order the Hospital of St John of Jerusalem” can’t bring itself to ask the government for about $50m when the COVID debt is predicted to be billions. An anonymous ambulance officer was recently interviewed on our national radio show Checkpoint and said of St John and its ability deliver the ambulance service … “If you are a charity that can’t afford it and can’t run it as it needs to be run then maybe it’s time you don’t run it. Maybe the government needs to step in so that it can be run as a proper emergency service.” He is by no means alone in thinking this, as last year when surveyed, the rest of our membership also chose to be government run. We hope this will lead to a wider public debate on the future of the ambulance service in NZ. Sarah Stone National Ambulance Sector Co-ordinator Ambulance Professionals FIRST Union.

Queensland 2020 COVID-19 WAGE POLICY United Workers Union and other public sector unions have been in discussions with government since the Premier announced on 2 April that public sector bargaining and wage increases would be on hold. Ambulance Section State Councillors were briefed on the situation including the financial position of the state and potential impact on upcoming bargaining for their next enterprise agreement. Delegates expressed they understood the environment we were working with and navigating to achieve the best outcomes in. Along with Ambulance members who had enterprise bargaining due to commence, other United Workers Union Public Sector members such as health professionals, operational clinical staff in hospitals and home care workers would all be impacted by a change of government policy on wages. UWU Queensland Health members reached ‘in principle’ agreement with government at the end of 2019 after voting to take industrial action, these agreements were not yet certified and consequently members had not had a pay rise since 2018. Ambulance State Council delegates authorised discussions with government acknowledging the unprecedented circumstances created by the pandemic. State Councillors endorsed the call for pay parity for health workers through payment of 2019 increases and for any deferral of 2020 increases to be consulted about and consistently applied. After weeks of consultation with UWU and other public sector unions, the government finally announced a package that secured wages and conditions for ambulance members during and after the COVID-19 crisis. The current certified agreement will be extended by two years and will protect the entitlements for that period. The wages policy 2.5% increase due this coming September will be deferred to September 2021 and a further 2.5% be paid in March 2022 in the lead up to negotiating a new agreement to be in place by 1 September 2022 where a further increase in line with wages policy at that time will be negotiated. State Council believe this was the best possible outcome for members under these challenging circumstances.

UNFILLED SHIFTS/SINGLE OFFICER Members and delegates had recently reported instances of unfilled business as usual shifts. Delegates were incorrectly informed that the Union had signed off on the process of letting shifts go unfilled, and

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for officers to run as single officers when they would normally be part of a crew. Whilst there had been regular briefings from QAS to United Workers Union regarding the arrangements that have been put in place to bolster the system in preparation of work in the COVID-19 environment, at no point has the United Workers Union “signed off” on any short fall of resources as part of this response. There was no agreement that officers who would normally work as part of a two person crew be deployed as single officers. Delegates raised these concerns to QAS senior managers who had provided assurances that there was no intention that officers who would normally work as part of a crew operate as single officer responses. However, inconsistencies of processes across LASNs had members taking action by reporting to their union, unfilled shifts and single officer deployment in real time so action could be escalated and best practices followed without impact to neither service nor officer core shift conditions.

CONTINUING PROFESSIONAL DEVELOPMENT Meeting registration standards this year will be a bit more challenging for paramedics due to the COVID restrictions placed around some of the group training usually provided by the employer. UWU members have taken this opportunity to access the professional development courses available from UWU partnered health e-learning platform Talisium. The platform was launched in November 2019 and offers free subscription to all UWU Ambulance members. It gives access to paramedic specific courses as well as providing a chance for members to contribute and share their own appropriate specific content for on line CPD.

SA COVID-19 We have been fortunate in South Australia that our COVID-19 case numbers remain very low, to date. Our members continue to remain vigilant in their use of PPE as we are well aware how quickly that situation can change. Several of our Paramedic members travelled to Victoria recently to lend a helping hand as COVID-19 takes a different trajectory in our neighbour state. We hope to not need the favour returned in the future. We believe a key factor in controlling the outbreak is paid pandemic leave for all workers, including casuals. The South

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A return to ramping.

Australian Government has confirmed only recently that casual employees are not included in the new COVID-19 leave provisions. This is a disappointing decision given the introduction of such leave is intended to address the inherent disincentive for casual staff to take shifts off due to illness. We will be seeking a review of this decision in light of the risks posed. In the initial stages of COVID-19, the workload and extent of ramping dropped somewhat, but has since returned with a vengeance. This has meant our members are right back in the situation of receiving very late or no crib, and our patients are waiting hours and hours for an ambulance.

ENTERPRISE BARGAINING The AEASA agreed to pause Enterprise Bargaining negotiations during COVID-19 but have since recommenced this process. Despite being 18 months past the expiry of the old Agreement, we are still in the very early stages of negotiations, and are yet to be provided with the Government’s full agenda. What we have seen of their agenda so far includes cuts to members conditions including allowances and penalties. It is hard to contemplate a Government failing to see the value of the vital work our members do, particularly as we are still very much in the midst of a global pandemic. We will continue to negotiate strongly to uphold, and improve on, our members conditions.

‘SAFE STAFFING’ ARBITRATION CASE As reported in the previous edition, the AEASA commenced its ‘Safe Staffing’ arbitration case in the SA Employment Tribunal. This was due to conclude on the 26th March however was adjourned due to COVID-19. The Government argued that the reduction in workload and ramping due to COVID-19 addressed the core issues of our dispute, and called for the case to be adjourned for six months. They were provided six weeks. We are now in the process of submitting

supplementary affidavits and evidence that the workload and practice of ramping has returned to near ‘pre-COVID-19’ levels. From members’ perspective, they are right back to facing an overwhelming workload, very late or no cribs, late knock offs, and pending high priority cases with no resources to send. Our witnesses are scheduled to appear in Court in August, with final submissions due September. It can’t come soon enough. Leah Watkins Industrial Officer – AEASA

Tasmania The EBA and Award changes went through on 5 May 2020; members have now received the back pay for 6 months of wages owed from December 2019. The bargain locks in terms and conditions for the Period Dec 2018-June 2022, wages improvements of 10.5 - 11.5% pay rises with 2 remaining pay rises 2.3% and 2.35% are due in Dec 2020 and Dec 2021. Big structural changes to family violence leave, bereavement leave (when on another form of leave), the way recreation leave is managed (hour for hour debits instead of weekly deductions), improvements to parental and partner leave, casual employees’ terms and conditions. COVID-19 has put a massive strain on the Tasmanian Health System, with 2 public hospitals of 4 closing their doors to Ambulance Arrivals in various capacities. This has added to long driving times, high utilisation and slower than normal response times (starting from the position of “worst in the nation”). COVID-19 has certainly highlighted the flawed resourcing model that exists in Tasmania. We remain concerned that the government will walk away from COVID promised responses as soon as the can without addressing the fundamental issues. The Tasmanian Government announced 40-50 new paramedics in April to add to the AMBULANCE ACTIVE


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approximately 350 operational staff. What is not clear is will all the positions actually be filled, where they will be based, if any new equipment, such as Ambulances, will be purchased for them to use, let alone capital works issues like can any existing station accommodate more staff? Like always we continue to push for improved safety and better contingency plans. Our WC stats remain at high levels with about 1 out of 10 workers in the WC system, some very long term. There are many others using sick leave to avoid the WC system. The unions key focus remains on safety due lack of resources, equipment, fatigue management, workload management and roster structures, high levels of overtime and the over-reliance on volunteers to provide clock stopping responses. Chris Kennedy

Victoria PSYCHOMETRIC TESTING AND COACHING In recent years Ambulance Victoria has begun using Psychometric Testing, conducted online by a third-party provider, as a component of its internal promotion and Graduate Paramedic appointments. Applicants who fail the Graduate psychometric component are told they can retake the testing in 6 months’ or 12 months’ time. In the past, Ambulance Victoria has refused to provide some applicants with feedback on their results, which would allow them to better prepare for next time. AEAV has been successful in receiving psychometric testing feedback for both internal and external Ambulance Victoria applicants who had initially been refused. The AEAV has dealt with numerous member issues regarding the psychometric testing and believes that the current procedure does not consistently identify the most suitable candidates for recruitment and internal promotion. The AEAV is also concerned that Ambulance Victoria has created an inconsistent and non-transparent process that has harmed the career and advancement opportunities for our suitably qualified members. AEAV is excited to announce a recent partnership with the Institute of Psychometric Coaching (IPC) to assist our members in preparing for the psychometric component of Ambulance Victoria’s internal and external recruiting process. The partnership between the IPC and AEAV means our members will receive a 15% discount for coaching services. The IPC resources are delivered by experienced Psychologists either face to face or via Skype online. AMBULANCE ACTIVE

IPC Resources available include but are not limited to: • Experienced Psychologists administering psychometric testing similar to that used by Ambulance Victoria; and • Advice and guidance on how to ensure that you demonstrate your full potential during the testing. AEAV will continue to fight for a fairer recruitment process so that an online psychometric test administered by a third party does not unilaterally derail anyone’s application.

AEAV CLINICAL REVIEW SPECIALIST In response to concerns raised by our members, the AEAV has sourced and recruited its very own Member Clinical Review Specialist. Former AV employee, Russell Nelson, has been engaged to ensure members have access to the highest level of expertise, in relation to Ambulance Victoria Clinical Reviews. The clinical review procedure is meant to be fair to all involved parties and be conducted without prejudice in a ‘Just Culture’ environment. Sadly, this is not always the case and the AEAV has had to represent members to ensure they are afforded procedural fairness.

Russell has extensive experience as the Clinical Review Specialist for Ambulance Victoria and a MICA paramedic. Russell’s experience will be invaluable in ensuring that Ambulance Victoria is held to account on modern Clinical Review philosophies and that AV’s own procedures and policies are followed. Russell will also use his expertise to assist our comrades in affiliated ambulance unions in other states. Having this level of expertise to support our members is something that has never been offered to Victorian paramedics before. The AEAV is proud to provide this level of protection to our members and we look forward to using Russell’s expertise to ensure Ambulance Victoria abides by its own policies and procedures and also those of Safer Care Victoria.

NEW INCOME PROTECTION SCHEME AEAV have led the development of a new Income Protection Scheme for ambulance sector members with additional benefits not offered before in Victoria. This scheme is available to all AEAV members and is being offered to UWU members across Australia. Brett Aidie AEA-V Secretary

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LEON CARTLEDGE Reflecting on 26 Years as a Proud Union Member UNITED WORKERS UNION DELEGATE Leon Cartledge has been a union member for over 26 years. Leon has represented members through many EB negotiations, arbitrations, industrial actions, continuing changes to the health system, clinical practices and paramedic registration to name just a few of the ever evolving ambulance service in Queensland. We are proud to have Leon on the UWU team! He recently sat down with QAS media to reflect on his long time career as a paramedic in the North Queensland region of Cairns. The year was 1984 – when a loaf of bread was 60c and a beer was $1.50. It’s also the year that Leon started his Ambulance journey with the QATB as a volunteer in Mossman. Clearly taking to the job, later that year, Leon moved rapidly to a full time Ambulance Officer. He is now into his 37th year on the job, having spent most of his time in Queensland’s beautiful far north, currently as the Officer in Charge of Kuranda Station. Leon was asked what makes his job so memorable. In true fashion, he said there are too many to choose from as he often experiences a memorable moment on every shift rotation, but there is one thing in particular that stands out that makes Leon proud and that is to see his daughter, who grew up at various Ambulance Stations with her dad, join him in the ranks of the QAS as an Emergency Medical Dispatcher in our Triple Zero (000) call centre. Leon said “I feel a little swell of pride when I hear her on the dispatch radio, but it feels a little weird have her wake me up in the middle of the night to go to a call-out.”

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When reflecting on his career Leon said, “I really feel this career chose me! In 1981, I found myself at the scene of an accident that involved my girlfriend at the time (now my wife Belinda of 34 years) and her older brother Russell. The car had rolled over and while Belinda’s injuries were only

minor her brothers proved fatal. At the time, I was working with a guy who was applying for the Ambulance service and I felt that it was absolutely what I had to do. It has turned out to be the best decision I ever made as it has given me far more than I could have imagined at the time.”

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NATIONAL POLICE REMEMBRANCE DAY

29 SEPTEMBER


MY DAY STARTS THE NIGHT BEFORE Peter’s Story MY DAY STARTS THE NIGHT BEFORE, I have a shave to save time in the morning. I put a sign up on my door as a reminder “nil by mouth after midnight”. At 20:30 I take my night medication then off to bed at 21:30. Pretty good sleep until 01:30, then up for more pills. At 06:30 I am awoken by the night nurse. Observations have to be taken and patient wrist and ankle bands have to be on. I follow this up with a shower, my hair has to be dry! At 0715 me and another guy leave the ward with a nurse escort for the short walk to the operating suites. Here, we go through admissions then into the transit room where we hop onto operating suite trolleys. A short time later the anaesthetic registrar and an anaesthetic nurse come down and take more obs, they also check identification. Still on the trolleys we are moved up to theatre. I am greeted by staff in the theatre. Monitoring gear is put on me as well as EEG monitoring leads, gel is applied to my right temple and to the top of my head… Yep, this is ECT day. The psychiatric consultant and the anaesthetist re check my ID and if I fasted. A cannula is inserted. When everyone is ready, Propofol is administered followed by suxamethonium.

I am out to it by the time sux is administered. The aim is to produce a one-minute seizure. I am sent to recovery post ECT. Waking up is pretty slow due to the PTSD drugs I have onboard. When we have both recovered enough to mobilise we get our priorities right and head to a coffee shop, then back to the ward for breakfast and our morning meds. This is the routine every Monday, Wednesday and Friday.

I am an inpatient at Heidelberg Repatriation General Hospital, in the Post Trauma Recovery Service, Ward 17. I am down for 12 sessions of ECT but with a maximum of 26. Why am I writing this?? I don’t want to see other Paramedics go through this. Look after yourself, speak up (there will always be others that criticise you for asking for help, they are brain dead, don’t worry about them!) Cheers Peter

EDITOR’S NOTE I first met Peter James in Hobart in 2008 at the gathering held to discuss whether we should form a nationally coordinated group to represent paramedic unions across Australia. The National Council of Ambulance Unions, (NCAU), was formed later that year. Peter is quietly spoken, dignified, but with a mischievous sense of humour. He is a committed unionist and a professional and highly respected paramedic. Over the years I gradually appreciated Peter’s career had taken him to many difficult and challenging cases and places, some of them gaining national and international attention. As with many of us, these cases have taken their toll, whether we realise it or choose to acknowledge it. In 2017, Peter literally became the face of paramedics

AMBULANCE ACTIVE

struggling with PTSD when his image was used on the cover of the HACSU Tasmania submission to the Tasmanian State Governments Inquiry into the need for Presumptive Legislation to cover workers compensation claims for psychological injuries arising from Paramedic employment. This push was ultimately successful, due in no small part to the passionate advocacy of ordinary paramedics like Peter and his colleagues trying to get a better deal for all paramedics. Thankfully over the careers of long serving paramedics like Peter, much of the stigma surrounding help for our mental health and wellbeing has receded. But it hasn’t disappeared entirely. His advice about seeking help is as important now as ever. Thanks, Peter, for your ongoing service and advocacy on behalf of paramedics in Tassie and beyond.

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Road Trauma Support for WA Every year in WA, thousands of people are impacted by road crashes. The result of a crash can have a devastating impact on those involved, witnesses or those attending the scene, as well as those around them. Road Trauma Support WA provides information, support and counselling to Western Australians affected by a road crash. We support anyone who has been affected by a road crash from those involved in a crash to first responders, emergency services, witnesses, their families and friends. It can be common to experience a range of upsetting thoughts, feelings and physical reactions after road trauma. Free information and tools are available to help guide you through some of the concerns and emotions you may have after experiencing a road crash at www.rtswa.org.au. After a crash, often the most important things for recovery are time, understanding and support from family and friends. You may find it helpful to talk to a health professional, particularly if you are struggling with everyday activities, your work, or connecting with your friends or family.

Supporting Western Australians after a road crash www.rtswa.org.au 1300 004 814

Road Trauma Support counselling is free and can be provided in person at our Leederville office, via telephone or online for those living regionally. Road Trauma Support WA is delivered by Injury Matters and funded by the Road Trauma Trust Account with contract management through the Road Safety Commission of WA. If you or someone you know is in need of support, call 1300 004 814 or email admin@rtswa.org.au

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OPINION PIECE

TIME FOR THE GOVERNMENT TO TAKE OVER NEW ZEALAND AMBULANCE SERVICES AFTER YEARS OF LOW OR NO PAY rises, despite an ever-expanding scope of practice, St John Ambulance in NZ has finally admitted its frontline officers need a huge salary jump to reflect their true worth. Last year St John undertook a remuneration review. It came as no surprise to workers that the review found a pay gap that needs to be urgently closed. As the review stated, the role of a paramedic has changed dramatically in the last twenty years with some staff seeing their ability to deliver drugs expand by up to 180 per cent and an overall increase in skills for others of 80 per cent. 20 years ago, the role of a paramedic was to give immediate life-saving treatment - such as defibrillating lethal heart rhythms in the case of a cardiac arrest - and then transport to hospital. Today the role has advanced exponentially. NZ paramedics can administer intravenous, gold standard pain relief such as morphine, fentanyl and ketamine. Glucose is routinely administered to hypoglycaemic diabetics, medication to stop seizures, to treat agitated patients and support people with anything from nausea and vomiting to psychosis is routinely administered now, when once such interventions were the realm of emergency departments. There is also an expectation now that Intensive Care Paramedics are Rapid Sequence Intubation trained, an extremely high-risk procedure, that has conveniently not been recognised via increased pay, despite the recent recommendations to do so.

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In fact, 20 years ago, the number of drugs that could be administered were fewer than five but now, including drugs and skills the total is 65. These procedures are supported by a 533-page guideline book which has also had to grow exponentially! It is not just the road staff who jobs have expanded. Emergency call takers generally had some ambulance experience, but today more specialist skills are needed and calls have increased to well over half a million per year. The role has now been divided with separate call takers to identify the clinical skills needed and ambulance dispatchers managing geographical and resource challenges. It has long been clear to the workers that their increased scope in practice should see an increase in pay. Instead St John has overseen years of paltry and unfair wage increases that have resulted in these big gaps. The skills and expectations on modern paramedics simply haven’t been matched by a professional rate of pay. St John Ambulance, who operate as a charitable trust, have allowed this gap to develop and widen over the years. Frontline staff have typically subsidised operations via their low wages, keeping this charitable trust afloat. It is not just a case of not enough funding, as their CEO has admitted that he has always received the money he has asked the government for. Unfortunately, it appears that is as far as it gets. Last year we surveyed our paramedic and ambulance members, asking

who they thought should deliver ambulance services in New Zealand. Even with an option of full government funding for St John being one of the choices, frontline workers opted overwhelmingly for a government run model of ambulance services. More and more people are asking now if St John Ambulance is a good fit for running an emergency service for New Zealanders. Is this the business model we want – a contracted out health and emergency service that forecasts it’s spending and costs whilst ignoring the needs and worth of its workers? By Sarah Stone

Sarah Stone is an organiser with New Zealand’s First Union. She coordinates campaigns for paramedic and ambulance service members. Sarah was elected as an inaugural Vice President of the Australasian Council of Ambulance Unions in 2019 when First Union was accepted as a full member of the ACAU.

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Basic needs

Safety

Love and belonging

Esteem

Contribution

Leadership actions

PANDEMIC KINDNESS MOVEMENT PANDEMIC KINDNESS MOVEMENT WAS created by clinicians across Australia to support and enhance the health and wellbeing of all health-workers during the pandemic. Supported by the Commission on Excellence and Innovation in Health in SA, the Agency for Clinical Innovation in NSW, Safer Care Victoria, and the Queensland Government, it has collated respected, evidence-based resources that are curated by teams of clinicians and wellbeing experts. The Pandemic Kindness Movement website https://aci.health.nsw.gov.au/ covid-19/kindness has resources organised under the domains of Maslow’s hierarchy of needs to reflect potential challenges on the health workforce, plus leadership actions. In the initial stages of the COVID-19 pandemic, resources in ‘basic needs’ (such as those addressing fatigue, sleep, nutrition and hydration) were the most accessed consistently across Australia. However, since July there has been variation between states, with Victorians accessing ‘basic needs’ and ‘safety’, New South Wales and Queensland prioritising ‘basic needs’ and ‘leadership’, South Australians prioritising resources in the ‘safety’ and ‘love and belonging’ domains. Michael Palmer RN Project Manager – Consumer and Clinical Partnerships South Australian Commission on Excellence and Innovation in Health e: mike.palmer@sa.gov.au

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PYRAMID OF NEEDS

The model for organising the health worker support is based on Maslow’s hierarchy of needs. The pyramid representing these needs has been adapted to reflect the potential challenges of the COVID-19 pandemic on the health workforce. Effective leadership is critical at all levels of the pyramid and is an additional layer represented in this model. The aim of the Pandemic Kindness Movement is to provide health workers with easy access to curated resources to enable them to access the support they need. You can explore the pyramid by selecting the different needs: basic needs, safety, love and belonging, esteem, contribution and leadership actions. Health worker wellbeing Contribution

Achieving one’s full potential

Leadership actions and behaviours

Esteem

Respect, recognition, gratitude

Love and belonging

Kindness, community and social connection

Safety

Physical and psychological

Basic needs

Air, food, water, shelter, sleep

Connecting health workers and communities

AMBULANCE ACTIVE


THE POLITICS OF A COVID-19 VACCINE By Richard N. Haass THE GLOBAL TOLL OF THE COVID-19 pandemic is enormous: more than half a million lives lost, hundreds of millions out of work and trillions of dollars of wealth destroyed. And the disease has by no means run its course; hundreds of thousands more could well die from it. Not surprisingly, there is tremendous interest in the development of a vaccine, with more than 100 efforts under way around the world. Several look promising, and one or more may bear fruit—possibly faster than the several years or longer it normally takes to bring a vaccine on line. But even if one or more vaccines emerge that promise to make people less susceptible to COVID-19, the public-health problem will not be eliminated. As any medical expert will attest, vaccines are not panaceas. They are but one weapon in the medical arsenal. No vaccine can be expected to produce complete or lasting immunity in all who take it. Millions will refuse to get vaccinated. And there is the brute fact that there are nearly 8 billion men, women and children on the planet. Manufacturing 8 billion doses (or multiples of that if more than one dose is needed) of one or more vaccines and distributing them around the globe could require years, not months. These are all matters of science, manufacturing and logistics. They are sure to be difficult. But the politics will be at least as challenging. For starters, who will pay for any vaccine? Companies will expect to recoup their investment in research and development, along with the costs of production and distribution. That is already tens of billions of dollars (and possibly much more)—before the question of profit is even introduced. There is also the related question of how companies that develop a vaccine will be compensated if they are required to license the patents and know-how to producers elsewhere. The toughest political question of all, though, is likely to concern access. Who should receive the initial doses of any vaccine? Who determines who is allowed into the queue and in what order? What special advantages accrue to the country where a vaccine is developed? To what extent will wealthier countries crowd out poorer ones? Will countries let AMBULANCE ACTIVE

geopolitics intrude, sharing the vaccine with friends and allies while forcing vulnerable populations in adversary countries to the back of the line? At the national level, every government should start to think through how it will distribute those vaccines it produces or receives. One idea would be to administer it first to healthcare workers, followed by police, firefighters, the military, teachers and other essential workers. Governments must also consider what priority to give those at higher risk of developing serious complications

every government “ … should start to think through how it will distribute those vaccines it produces or receives. One idea would be to administer it first to healthcare workers, followed by police, firefighters, the military, teachers and other essential workers.

from COVID-19, such as the elderly and those with pre-existing conditions. Should a vaccine be free to some or all? At the international level, the questions are even more complex. We need to make sure that production can be scaled rapidly, that rules are in place for availability and that sufficient funds are pledged so that poorer countries are covered. Gavi, the Vaccine Alliance, the World Health Organization, several governments, and the Bill and Melinda Gates Foundation have formed the COVID-19 Vaccine Global Access, or Covax, Facility. Its creators propose that any effective vaccine that emerges be treated as a global public good, to be distributed equally around the world, regardless of where it was invented or of a country’s ability to pay for it. The WHO has put forward a global allocation framework that seeks

to ensure priority for the most vulnerable populations and healthcare workers. But such approaches may be unrealistic. It’s not just that the Covax effort lacks adequate funding, the participation of the United States and China, and clear authority. It’s that all governments are sure to come under enormous pressure to take care of their own citizens first. Vaccine nationalism is almost certain to win out over vaccine multilateralism. Recent history reinforces this scepticism. COVID-19 emerged in China and quickly became a worldwide problem. Responses, though, have been mostly along national lines. Some countries have fared relatively well, thanks to their public health systems and political leadership; with others, it’s been just the opposite. Continuing this national-level approach to a vaccine is a recipe for disaster. Only a handful of countries will be able to produce viable vaccines. The approach must be global. The reasons are not just ethical and humanitarian, but also economic and strategic, as global recovery will require collective improvement. In Iraq, when military progress outpaced planning for the US-led war’s aftermath, the result was chaos, or ‘catastrophic success’. We cannot afford an analogous outcome here, with success in the laboratory outpacing planning for what comes next. Governments, companies, and nongovernmental organisations need to come together quickly, be it in the Covax initiative, under the auspices of the United Nations or the G20, or somewhere else. Global governance comes in all shapes and sizes. What’s essential is that it comes. The lives of millions, the economic welfare of billions and social stability everywhere hang in the balance. Richard N. Haass is president of the Council on Foreign Relations and author of The world: a brief introduction. Article courtesy of The Strategist: https://www.aspistrategist.org.au/thepolitics-of-a-covid-19-vaccine/

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I’M AN AMBO AND I’VE GOT SYMPTOMS

NOW WHAT? HACSU HAS BEEN ASKED TO comment on Service Update No. 8/2020 COVID-19 Special Leave that was issued last Thursday by James McManus but left people with a few questions - with some of the info being contrary to the outcomes negotiated between HACSU and the State Service Management Office. If Ambulance Tasmania sends you home because of an expected exposure to COVID-19 it’s done so on full pay, no leave required, and you get tested and when negative you follow public health’s advice about returning to work. If you have symptoms you mustn’t go to work or go out in public and you need to inform work and contact public health. As healthcare workers it’s our view that symptoms are work related - you shouldn’t be using personal leave and should be paid normally while on pandemic leave. If public health tells you to get a COVID test, you stay on pandemic leave until the results are back, and when cleared by public health to return to work if you test negative you can only return to work when you no longer have symptoms. If you continue to have symptoms because it’s a cold etc then it becomes personal leave, but please don’t go to work with a cold.

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IF YOU TEST POSITIVE FOR COVID-19 If positive you must follow public health advice about quarantine/isolation and inform your employer, get medical treatment as needed, and it’s likely additional testing will be required later. You’ll then have to work out whether you got it from transmission at work or in the community, and if you suspect from work then you should make a workers compensation claim.

WORKERS COMPENSATION To make a workers compensation claim you should get advice from us first, and definitely don’t be talked out of making a claim by a manager or other workers because in a worst-case scenario your family could get death benefits from the workers comp system. The employer or insurer may insist you didn’t get it from work so the paperwork must be done right, including the details on the workers compensation certificate you get from your doctor. Your work environment is vast, and transmission could be from contact with a confirmed or suspected case, from visiting a worksite such as an aged

care facility with a cluster, from visiting a hospital, from contact with other healthcare workers or from visiting a home or a motor vehicle accident.

INFORMATION FOR WORKERS To make a workers compensation claim you must be diagnosed with COVID-19 and your employment must have contributed to a substantial degree. You should provide evidence of pathology testing confirming your diagnosis.

CONFIRMATION ABOUT COVID SPECIAL LEAVE - ONLY APPLIES TO PUBLIC SECTOR WORKERS The pandemic leave should be automatically approved if public health tells you to enter isolation or quarantine. If you have no personal leave credits but are symptomatic after a negative COVID test result you should get leave on account of COVID-19 approved in lieu of accessing personal leave

If you have any questions please contact your delegate or call HACSUassist on 1300 800 032.

AMBULANCE ACTIVE


Not all heroes wear capes! They wear jumpsuits, boots, protective gear, helmets and their hearts on their sleeves. Your job is high risk. It’s relentless, intense and dangerous. You are brave beyond measure and we are all grateful every day for your skill and kindness in the face of adversity. But even the strongest amongst us don’t live forever. Introducing Your Wills: an Australian first: a fast, hassle free online Will platform that allows you to create a simple, straightforward, legally binding Will online, anywhere, anytime. To show our gratitude to all emergency services workers and their families, Your Wills would like to offer Countrywide Austral magazine readers 10% off when completing your Will online. Use promotional code COUNTRYW10 at check out. Jump onto www.yourwills.com.au and complete your Will from $59.95* Use promotional code

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