Wollongong paramedics say they are routinely delayed by up to five or six hours while waiting to transfer patients to the hospital emergency department, and will join a statewide protest highlighting this issue.
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From Tuesday morning until just after the election, paramedics who have to wait longer than 30 minutes will leave low-risk patients unsupervised at the ED instead of following health department orders.
The Health Services Union says the decision is being taken to address the ongoing issue of ramping - also called bed block - when full beds inside the ED stop patients being transferred from ambulance stretchers and leave paramedics stuck in hospitals supervising these patients.
But quizzed on his health policies when he was in Nowra on Monday to campaign for the Liberal Party's candidates in the South Coast and Kiama, Premier Dominic Perrottet said ramping did not occur in NSW like it did in other states.
"We have the strongest health system in the country," he told reporters.
"The issues that you're seeing in other states in relation to ramping don't occur in NSW, because what we are seeing here in our country is health ministers from around the country asking NSW how it's done."
Paramedic and HSU delegate Tess Oxley said the Premier's comments showed he was not listening to paramedics.
"I also think it's insulting, not only to the health workers that are caring for these patients in hospital corridors but also to the patients," she said.
"To say that it doesn't happen when someone knows they have sat there being very unwell for five or six hours in a hospital corridor really diminishes what they have experienced."
Ms Oxley said bed block was entrenched in the day-to-day work of Illawarra paramedics.
"On a day to day basis, cars can be delayed anywhere between one or two hours, which is no longer really even considered a delay by local paramedics, up to five or six hours," she said.
"It's very busy - Mondays especially are known to be very busy - and that's when you see huge numbers of cars lined up in the streets, because there's just so many outstanding jobs and only a limited number of cars."
Last month, paramedics at Wollongong Hospital were forced to park in the nearby 7-Eleven car park after all the ambulance bays and street parking outside the ED filled up.
The latest statistics from the Bureau of Health Information show that paramedics in Wollongong waited an average of 22 minutes for their patients be transferred to hospital care in the last quarter of 2022.
One in 10 patients waited at least an hour and 40 minutes, and only two out of five were transferred to hospital care within the state benchmark time of 30 minutes.
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During this week's industrial action, Ms Oxley said paramedics would not be leaving patients younger than 18 or older than 85, or those who required constant medical attention.
"The patients we are regularly delayed with can be patients with active chest pain, people with severe unrelieved pain, patients who are very unwell who have to wait for hours," she said.
"From tomorrow, after 30 minutes, it's going to be the low acuity patients that we will leave within the hospital - so we can get to those other patients who are calling Triple-0 who might be having that chest pain or other issues."
Ms Oxley said union members had resorted to the unprecedented action ahead of the election as their calls to address bed block and deliver professional recognition for paramedics were being ignored by the government.
"We have not taken this action lightly, and we are taking it with the patients' best interests in mind because all we want to do if our job. We want to be able to respond to these patients when they need us," she said.
In the Nowra press conference where he said ramping was not an issue for NSW, Mr Perrottet also said his government has promised to hire 10,000 new health staff and highlighted the Coalition's spending on new hospitals.
"We continue to invest, and we continue to invest only because we have strong financial and economic management," he said.
NSW Labor says ramping has become a serious problem, and has promised to hire an extra 500 rural and regional paramedics and an extra 1200 nurses on top of the Coalition's commitments, if elected.
It has also promised to change the staffing system in hospitals, starting with mandated shift-by-shift ratios in emergency departments.
Labor has also agreed to abolish the Coalition's public sector wage cap, which HSU boss Gerard Hayes says has left "12000 vacancies across the hospital system because people with skills and experience simply can't afford to live in NSW and work in health".