‘Patients are going to die’: Compo claims deplete paramedic workforce

One in 12 NSW Ambulance employees has, or has had, a WorkCover claim for a psychological injury in the past two years, with those on the road saying it is the “guilt of patients dying” due to “an overburdened health system” that is making them sick.

Documents obtained by the Herald exclusively under freedom of information laws reveal that there are 351 open claims for psychological injuries against NSW Health by ambulance staff sustained in the 24 months until the end of September 2023, while a further 160 have been finalised in the past two years. A psychological injury can be post-traumatic stress disorder (PTSD), anxiety, depression or other stress-related illness.

Among the 8 per cent of NSW Ambulance staff forced off the job with a psychological injury, this paramedic says the “feeling of guilt” of not being able to save lives as a result of an overburdened health system, is making him sick.Credit: Danielle Smith/SMH

NSW Ambulance employs 4952 paramedics and a further 486 call centre staff, with 535 people in corporate and support roles. When asked as part of the information request how many ambulance employees had been medically terminated in the past two years, NSW Health said it did not hold that data.

A veteran paramedic, who spoke to this masthead on the condition of anonymity for fear that being identified would impact his WorkCover claim, said he had been left with a “moral injury” as a result of an exhausted system.

“A lot of ambos get very caught up on the life-threatening, critical, life-in-the-balance type case and unfortunately response times are as such, particularly outside urban areas, that lives hang in the balance. You’re going to get an ambulance late and there’s a psychological impact [on officers] because of that,” he explained.

“It’s guilt of not being able to save the life, and there are factors at play that are beyond our control.”

He said often, regional paramedics were used as patient transport and would be “forced” to drive hours out of town while listening to radio calls for help.

“You hear a cardiac arrest and you just know that person is going to die because no one will get there in time to bring them back,” he said.

For the life of their employment with NSW Ambulance, paramedics get only 10 paid-for private psychologist or psychiatrist sessions.

‘You hear a cardiac arrest and you just know that person is going to die because no one will get there in time to bring them back.’

Veteran NSW Ambulance paramedic

Demand for NSW Ambulance is the highest it has ever been, according to the latest Bureau of Health Information statistics, with only 52.9 per cent of ambulances arriving within 10 minutes to regional call-outs for the highest-priority cases in the quarter from April to June 2023. For urban areas, 69.4 per cent of ambulances arrived within 10 minutes for highest-priority cases, which include people who are not breathing, in cardiac arrest, unconscious and not responding.

The paramedic said officers were forced to take overtime shifts to make ends meet, and that left them more susceptible to trauma. The average university-trained paramedic in their first year takes home about $76,000 a year; their counterparts in Queensland and Victoria can command up to $20,000 more.

More than 1500 NSW paramedics have pledged not to renew their national registration from Friday and say they will remain unregistered until the state government ensures a 20 per cent pay boost. The industrial action means ambulances will be left critically short-staffed.

Ben Fisher, an intensive-care, flight-trained paramedic with 27 years’ experience, told the Herald he was in the process of “separating” from the service.

“I can drive the local school bus for $40 an hour … without the associated stress and trauma. I’m on $45 an hour now. Tell me, what would you choose to do?” Fisher said.

“At 2am … when me and my partner – who may well be a 21-year-old trainee – go to a car rollover, it’s dark and raining and two people are trapped; all the decisions about what drugs can be given, how to save their lives, that’s on me.

“I do all of that in the space of five, 10 minutes. No one else except a doctor has the authority to do that, and at the hospital there are teams of people making those decisions. So tell me, why are we so undervalued?”

NSW Ambulance paramedics have the highest rate of WorkCover claims for physical and psychological injuries of any services across Australia, according to the Australian Paramedics Association (NSW). The rate of occupational violence is also higher than most other states, the union told the Herald.

Steven Tougher’s family gather in Campbelltown where he died. The paramedic was only an hour or two from finishing his shift when he was allegedly murdered.Credit: AAP/Nikki Short

Paramedic Steven Tougher was stabbed to death in the back of an ambulance in Campbelltown in April while he and his workmate took a food break towards the end of their night shift. The 29-year-old’s alleged killer remains before the courts.

APA (NSW) president Brett Simpson said the number of psychological injuries was underreported as many paramedics were reticent to make a claim for fear of repercussions.

“The lengths our members are forced to go to to prove a psychological injury is damaging to their mental health. Some have private investigators following them, taking photos. I have a colleague who has lost a house trying to prove his injury in court,” Simpson said.

Health Minister Ryan Park said the Hunter bus tragedy and the death of Tougher were reminders of the harrowing nature of paramedic work.

“Every day a paramedic goes to work they could very well attend to someone experiencing the worst day of their lives,” he said.

“NSW Health provides a comprehensive suite of supports for our paramedic workforce.”

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