'Deeply disappointing': Government ignored key recommendations, says Gilgandra paramedic

"Regional Paramedics know better than anyone how healthcare standards lag outside the city, and we've spent years drawing attention to the need for more investment in our communities," said Scott Beaton, an Intensive Care Paramedic and Station Officer in Gilgandra Station.

"In my time as a paramedic I have seen the New South Wales health system let down patients, let down communities and let down the paramedic workforce on countless occasions. We're concerned the government is shying away from a once-in-a-generation opportunity to really address the root causes of health inequality across our region."

Giving evidence at the parliamentary inquiry via video call in September last year, Mr Beaton - who is the Vice President of the Australian Paramedics Association (NSW) - spoke of the challenges facing paramedics in rural and regional towns across the state.

One issue - he said - was ambulances being treated as taxi services and often being used for non-acute patient transfers. In one instance, he and his partner were the only two people in the area who were qualified to use a bariatric ambulance - required in the transfer of larger patients - and were called to transport a patient from Broken Hill to the Royal Adelaide Hospital for treatment.

The pair had to pick the ambulance up from Wellington, then drive to Broken Hill to collect the patient and drive the patient to Adelaide. The whole ordeal meant Mr Beaton and his partner were out of Gilgandra for three-and-a-half days, leaving other station staff to fill in their shifts on overtime or on days off.

Travelling long distances for non-acute patient transfers isn't rare, Mr Beaton said, with paramedics at his station often being tasked with bringing patients to Dubbo for x-rays since the local hospital's x-ray unit is out-of-action on weekends.

"These transfers mean there's no ambulance in town until you get back. My mother is 82 and lives here in town and I often worry about what happens to her if something happens and there's no ambulance in the town - it is concerning and plays on your mind," he said.

"In my last week at work we had waits of one-and-a-half hours to two to three hours at Dubbo hospital, just to get a patient offloaded. That's four hours where there's no ambulance cover in Gilgandra."

In a win for regional ambos - as part of their response to the inquiry, the NSW Government will be reviewing the use of ambulance vehicles for patient transfers and explore extending the hours of operations of other patient transfer vehicles to provide 24-hour coverage.

"This change will come as a relief to all regional staff. We're glad to see some movement on this issue from the Government, and pleased to see years of continued advocacy beginning to pay off," he said.

But not all of the concerns raised by paramedics were appropriately addressed in the government's response.

Mr Beaton said one of the most disappointing aspects of the NSW Government's response to the inquiry is the fact they didn't take on board recommendations to invest in more specialists like Extended Care paramedics, which he says are desperately needed in regional areas.

Extended care paramedics have the ability to treat common minor illnesses and injuries in patients homes and perform tasks like changing catheters, putting stitches in and giving antibiotics so a patient doesn't have to present to a hospital, relieving the burden on emergency rooms and reducing bed-blocking.

While he welcomes the government's commitment to boosting numbers of Intensive Care Paramedics in regional centres, he said this doesn't address the problems faced by more rural communities.

"Somewhere like Dubbo getting new Intensive Care Paramedics doesn't help the problem in somewhere like Walgett or Lightning Ridge or Bourke, or any of those locations. That's where we'd need more of them," he said.

Intensive Care Paramedics - like Mr Beaton - have a broader clinical skill set and can perform advanced medical interventions and procedures and administer life-saving drugs. In towns where there are no doctors available, they can be called upon to assist at the hospital.

"The same thing happens in all of rural towns where paramedics are called to assist when there is no doctor or even called to assist the doctor due to a lack of nursing staff," he said.

"I can't get another Intensive Care Paramedic to Gilgandra because they won't be paid as one. Ideally we'd want two, so we had one on at any one time - and we need to get more funding to train them."

"It's deeply disappointing that the Government would choose not to endorse actions directly recommended by a Parliamentary process, and which frontline workers have spent years telling them are needed in our regional communities."

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