The management and operations of the Ambulance Service of NSW

245 Pages·2008·0.9 MB·English

LEGISLATIVE COUNCIL

General Purpose Standing Committee No. 2

The management and
operations of the Ambulance
Service of NSW

Ordered to be printed 20 October 2008 according to
Standing Order 231

Report 27 - October 2008
LEGISLATIVE COUNCIL
The management and operations of the Ambulance Service of New South Wales

New South Wales Parliamentary Library cataloguing-in-publication data:

New South Wales. Parliament. Legislative Council. General Purpose Standing Committee No.
2
The management and operations of the NSW Ambulance Service : [report] / General Purpose
Standing Committee No. 2. [Sydney, N.S.W.] : the Committee, 2008. – xxii, 223 p. ; 30 cm. (Report /
General Purpose Standing Committee No. 2 ; no. 27)

Chair: Hon.. Robyn Parker MLC.
“October 2008”.
ISBN 978192128285

1. New South Wales. Ambulance Service.
2. Ambulance service—New South Wales.
I. Title.
II. Parker, Robyn.
III. Series: New South Wales. Parliament. Legislative Council. General Purpose Standing Committee No. 2. Report ; no. 27

DDC 362.188 (DDC22)
ii Report 27 - October 2008
GENERAL PURPOSE STANDING COMMITTEE NO. 2

How to contact the Committee
Members of the General Purpose Standing Committee No. 2 can be contacted through the Committee
Secretariat. Written correspondence and enquiries should be directed to:

The Director
General Purpose Standing Committee No. 2
Legislative Council
Parliament House, Macquarie Street
Sydney New South Wales 2000
Internet: www.parliament.nsw.gov.au
Email: [email protected]
Telephone: [phone]
Facsimile: 9230 3416

Report 27 - September 2008 iii
LEGISLATIVE COUNCIL
The management and operations of the Ambulance Service of New South Wales

Terms of reference
The terms of reference for the Inquiry are:
That General Purpose Standing Committee No. 2 inquire into and report on the management
and operations of the NSW Ambulance Service, and in particular:
a. management structure and staff responsibilities,
b. staff recruitment, training and retention,
c. staff occupational health and safety issues,
d. operational health and safety issues, and
e. any other related matter.1

These terms of reference were self-referred by the Committee.

1 LC Minutes No. 14, 15 May 2008, Item 4, p 605
iv Report 27 - October 2008
GENERAL PURPOSE STANDING COMMITTEE NO. 2

Committee membership
The Hon Robyn Parker MLC Liberal Party Chair
The Hon Christine Robertson MLC Australian Labor Party Deputy Chair
The Hon Greg Donnelly MLC Australian Labor Party
The Hon Tony Catanzariti MLC Australian Labor Party
Ms Lee Rhiannon MLC The Greens
Revd the Hon Dr Gordon Moyes MLC Christian Democratic Party
The Hon Marie Ficarra MLC Liberal Party

Report 27 - September 2008 v
LEGISLATIVE COUNCIL
The management and operations of the Ambulance Service of New South Wales

Table of contents

Chair’s foreword xi
Summary of key issues xiii
Summary of recommendations xvii
Glossary xxii
Chapter 1 Introduction 1
Terms of reference 1
Terminology 1
Conduct of the Inquiry 1
Submissions 1
Hearings 3
Site visit 3
Recent reviews of the Ambulance Service of NSW 4
Report structure 6
Chapter 2 Workplace culture and management 7
Ambulance Service culture 7
Corporate culture surveys 8
Attrition survey 9
2001 Performance Audit 9
The Head Review 10
Ambulance Service Management 10
Criticism of managers 10
Old boys club 12
Factors influencing the culture of the Ambulance Service 12
The changing nature of ambulance work and increased demand 12
Emphasis on budget and key performance indicators 13
Generational differences 13
Conclusion 14
Chapter 3 Grievances, Bullying and Harassment 17
Terminology 17
Occurrence of bullying and harassment within the Ambulance Service 19
Impact on victims 21
vi Report 27 - October 2008
GENERAL PURPOSE STANDING COMMITTEE NO. 2

Causes of bullying behaviour 24
Management of complaints 25
Increased victimisation 25
Breaches of confidentiality 27
Complaints are ignored 29
Professional Standards and Conduct Unit 31
Role of the Unit 31
Perception of the Unit 31
Timeliness and communication 33
Matters dealt with by the Unit 34
Changes to the Unit 35
Transparency and accountability 36
External investigations 38
What is the Service doing about grievances, bullying and harassment? 39
Bullying and Harassment Taskforce 40
Training and simplification of guidelines and procedures 40
Management training in grievance handling 41
Which procedures apply 43
Increase in Station Managers 44
Other issues 44
What if the grievance is about the manager? 44
Adherence to policies 46
Conclusion 47
Chapter 4 Recruitment, Promotion and Training 49
Recruitment 49
Transparency and accountability 49
Appeals and reviews 51
Selection panels 52
Psychometric testing 53
Training 55
Overview of career progression 55
Supervision of trainee officers 55
Certificate to Practice 58
Clinical Training Officers 60
Frequency of recertification 63
Performance appraisals 64
New protocols 66
Registration of paramedics 67
Conclusion 69
Report 27 - September 2008 vii
LEGISLATIVE COUNCIL
The management and operations of the Ambulance Service of New South Wales

Chapter 5 Staffing and Award Conditions 71
Staffing levels 71
New South Wales 71
Central Coast 74
Planning capacity 76
Remuneration 78
Work Value Case 80
Professional rates 81
Fatigue management 82
Overtime 82
Rosters 85
Meal and rest breaks 86
Leave entitlements and flexible work practices 89
Annual and Long Service Leave 89
Suitable Alternative Duties 91
Family friendly hours 93
Conclusion 95
Chapter 6 Rural Issues and Transfers 97
Rural postings 97
Rural relief 99
Lack of incentives 100
Transfers 102
Local recruitment 104
Skills in rural areas 105
Intensive Care paramedics 105
Advanced Life Support paramedics 106
Rural on-call 108
Single on-call 109
Conclusion 110
Chapter 7 Occupational Health and Safety 113
Physical health and safety 113
Station conditions 113
Violence against officers 114
Physical injuries 117
Psychological health and safety 118
The level of suicide in the Ambulance Service 118
viii Report 27 - October 2008
GENERAL PURPOSE STANDING COMMITTEE NO. 2

Staff support services 119
Employee Assistance Program 119
Peer support officers 119
Chaplaincy 120
Review of staff support services 120
Management response after traumatic events 120
What is critical incident stress debriefing? 121
Officers need ‘time out’ after traumatic incidents 122
Comparison with other agencies 122
Concerns about the peer support officer system 123
Notification of peer support officers 123
‘Red flag’ incidents 124
Training and support for peer support officers 125
Conclusion 126
Chapter 8 Operational Issues 127
Rescue 127
Demand Management 130
Non-emergency patient transport 130
Inappropriate use of ambulances 132
Extended Care Paramedic Program 134
Hospital block 136
ProQA 137
Single officer ambulance crews 139
Station infrastructure 141
Sydney 141
Bundeena 143
Nelson Bay 144
Drugs 145
Theft of S8 drugs 146
Drug supply 147
Drug storage 148
Other issues 149
Satellite Navigation Units 149
Portable radios 150
Station administration 151
Conclusion 151
Chapter 9 Structural Issues 153
Management structure 153
Report 27 - September 2008 ix
LEGISLATIVE COUNCIL
The management and operations of the Ambulance Service of New South Wales

Top heavy management 153
Paramilitary style 153
Chief Executive 155
Reporting to NSW Health 157
Board of Directors 158
Health or Emergency Services? 159
Legislation 161
Conclusion 164
Appendix 1 Submissions 165
Appendix 2 Witnesses 173
Appendix 3 Tabled documents 175
Appendix 4 NSW Industrial Relations Commission decision 176
Appendix 5 Minutes 186
Appendix 6 Dissenting statements 218

x Report 27 - October 2008