PROUDLY SUPPORTING AMBULANCE ACTIVE
VOLUME 11 ISSUE 2 2020 Australasian Council of Ambulance Unions Elected Office Holders 2020
REGULARS 05 From the President 07 From the Secretary 08 Industrial Reports
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)
What does Australia’s bushfire smoke mean for your health?
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FEATURES 15 Keep our paramedics safe at work 16 Underwhelming and insulting 20 ACT Ambulance Service Enterprise Agreement 2018-2021
mean for your health?
28 Paramedics and emergency service workers enduring assault daily
30 The voluntary assisted dying
legislation passed in Western Australia
Paramedics enduring assault daily
26 What does Australia’s bushfire smoke
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The voluntary assisted dying legislation passed in WA
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the PRESIDENT I AM PLEASED TO GIVE THIS SHORT message as the new president of the Australasian Council of Ambulance Unions. It is a changing time and we are entering areas we have never experienced before. We have seen some amazing ups and downs over the last 18 months, including National registration for paramedics in Australia, inclusion of New Zealand paramedic representatives in the National Council of Ambulance Unions, which is now appropriately called the Australasian Council of Ambulance Unions. We have also witnessed a pandemic, which most of us never imagined we would see in our lifetimes, that has changed the way we work and introduced incredible difficulties and stress onto our front line paramedics National registration for Paramedicine has been with us in Australia for just over a year now and we are coming to terms with our roles as professionals and the responsibility and accountability that go with that. The ACAU has been and is still, supportive of registration and recognition of paramedics as professionals. Now it is here, we must, as both paramedics and unionists ensure that while paramedics do hold responsibility and accountability they are also given the protection that other professionals receive through their associations and representative bodies.
Information sharing, resources and support given between unions represented in the ACAU will help paramedics across Australia maintain the highest level of care for our community. The ACAU will also be able to use our common ideals and community to lobby all governments for wages that are comparable to the responsibility and accountability that paramedics hold in their day-to-day work. It is up to us to make sure that paramedics don’t just quietly bear the responsibility of being professionals. The ACAU must ensure they are given the recognition earned by health professionals. I take this opportunity to welcome our sisters and brothers from across the Tasman as members of the Australasian Council of Ambulance Unions. Paramedics in New Zealand face the same issues and challenges as paramedics in Australia. It has been wonderful to share information and ideas at our recent conferences which the New Zealand contingent attended as observers. It was at our last conference and with an immense amount of pleasure that we were able to welcome First Union New Zealand as a member of the ACAU, after unanimous endorsement by our member unions. We have entered unprecedented times with the current COVID-19 pandemic
sweeping across the world. It has changed the way we must conduct ourselves on the front line of health, particularly in the field of Paramedicine. At best, our working environment is volatile and unpredictable. Now it is more so with the constant threat of this virus facing our members. Shortage of PPE and the risks of overloading hospitals as well as concern for our own family weighs heavily on all our paramedics. Still, we go out there every day and continue to provide the service to our community. I am truly proud to call you all my colleagues and I am proud to be part of a family that continues to care in the face of adversity. The ACAU will continue to do whatever we can to ensure that our paramedics across Australia and New Zealand will have all the backing we can muster. I encourage all paramedic members to utilise your union support during these difficult times. Stay vigilant and safe In solidarity
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 PARAMEDICS, COMMUNICATIONS centre staff and patient transport union members, we are currently facing the biggest health challenge of the past 100 years. Our training has prepared us well for this challenge. Our jobs have always been about creating order out of chaos. About making incredibly important decisions as quickly as we can. About using scarce resources wisely to get the greatest benefit for the largest numbers. About adapting to and overcoming left field problems, unexpected challenges and less than optimal workplaces, equipment and work systems to achieve great outcomes for those for whom we care. As I write this, ambulance services nationally are scrambling to mount an effective response to COVID-19 whilst continuing to address business as usual. One thing being highlighted in this crisis in a range of industries, not just ours, is that it is the front line workers who hold things together in these situations: paramedics,
call takers, dispatchers, their supervisors, transport workers, ED staff, teachers, cleaners in hospitals, factory workers producing vital medical supplies, our food producers, workers in aged care facilities. In the past few days, two hospitals have been closed in Tasmania and thousands of people, including health workers and their families, have been quarantined and isolated. It’s a timely reminder that we must be vigilant in keeping safe ourselves, in practicing good hygiene, using PPE and not bringing COVID home. We’ve included a great resource with tips on minimising these risks for paramedics who may be in contact with COVID-19 positive patients in the following pages. A number of jurisdictions are coping well with the pandemic. Some services have set up single points of truth for information for staff with modified management guidelines and updated infection control procedures and PPE guides to assist staff. These are best practice approaches and we encourage all services to adopt them or something similar, in consultation with
your local union, to ensure staff have timely access to up to date information. Standards for PPE, supply of PPE and access to leave for isolation are all live issues for our members, as is the provision of alternate accommodation for staff who are required to self-isolate after a potential exposure and who don’t want to endanger family or housemates. I encourage all our member unions to pursue these issues with their jurisdictional ambulance services and discuss outcomes at our regular teleconferences. More than ever we need consistent standards across states, territories and in NZ to ensure our members can continue to safely care for affected patients and not endanger our loved ones. The ACAU will continue to coordinate the fight for standardised safe approaches to equipment and procedures we need to see this pandemic through. Stay safe out there!
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.
INDUSTRIAL REPORTS ACT COVID-19 The TWU is engaging directly with the ACT government to ensure that all steps possible are being taken to ensure the safety and wellbeing of paramedic and ambulance members. • The government has announced that members will not have to access annual or personal leave for the purposes of isolation, if required. • Alternate work arrangements are being negotiated for members who have vulnerable health status. • We are also negotiating for the provision of accommodation for members who may wish to self-isolate away from family and loved ones to protect against transmission. • The TWU is fighting to ensure appropriate PPE is available and supply is assured for the foreseen duration of the pandemic. These are clearly unprecedented times. The TWU is continuing to engage constructively with ACT Ambulance to ensure good communication, safe work practices and wellbeing are at the core of all decision making.
ENTERPRISE AGREEMENT A detailed separate report on the recently concluded EA negotiations is included elsewhere in this edition of Ambulance Active. The ballot on the proposed agreement closed on April 15th 2020 with 97% voting in favour. Highlights include a pay rise of 10.85% over 4 years, with backpay to October 2017; a partial composite pay rate for Non-Emergency Patient Transport (NEPT) and CommCen members; a revised classification structure for NEPT and a new Ambulance Paramedic (AP) 2 pay classification, which will allow ambulance paramedics access to a range of higher duties and promotional positions.
AGM AND ELECTION A new updated constitution has recently been endorsed by the Caucus for implementation following the 2020 AGM. An election will be held in the coming month for an expanded caucus and executive, with the objective of ensuring increased inclusiveness and more empowering of delegates under the new structure.
HEALTH AND SAFETY Our health and safety reps are particularly active at present. All members are encouraged to raise safety issues, especially those related to COVID-19, with their Block HSR’s as soon as they arise. Stay safe out there!
NSW THE HEALTH SERVICES UNION New South Wales has had amazing evolution over the last year with 12% growth, making us one of the fastest growing unions in Australia. The Ambulance Division of our union has been active with campaigns with a particular focus on a professional wage that reflects the role of the modern paramedic in the frontline of health care. National registration requires paramedics to take responsibility for our actions and be accountable for the treatment and the safety of our patients. We, as paramedics have embraced that responsibility and provide life-saving care to our community that is second to none. Unfortunately New South Wales state government, the major employer in health, has not chosen to give that recognition to paramedics in terms of professional wages. The government has hidden behind an archaic wages policy that requires public sector workers to trade off entitlements in order to achieve a fair pay rise. This terrible policy precludes paramedics from conducting a true work value case. Forcing workers to trade off entitlements in order to pay for their own wage increase. The Ambulance Division of the Health Services Union (ADHSU) has joined in a coalition with police, fire fighters and public sector prison officers to create a powerful lobby group that will continue to push politicians in New South Wales for front line emergency workers to be given an exemption from this draconian wage policy. The Emergency Services Coalition, with the HSU, is lobbying New South Wales’ members of parliament for support in this fight. The ADHSU is also conducting its own ‘Value Our Service’ campaign. This campaign is encouraging New South Wales communities to engage with paramedics and work with them to get support for these health professionals
to be recognised for the value that they provide to the communities in which they work. This value has never been more evident than during the current COVID-19 pandemic, where paramedics have continued to go above and beyond at risk to themselves and their families. The response has been awesome with the public obviously recognising the true value that paramedics bring to the community. Another campaign that is linked to the ‘Value Our Service’ campaign is a member driven push for intensive care paramedics to be available to work across all of New South Wales. Currently the government is trying to restrict intensive care paramedics to metropolitan areas of New South Wales while rural communities with limited health facilities who would benefit greatly from an advanced level of pre-hospital and community care are left out. Our members have recognised this need and have driven the campaign to push for equity in prehospital care across New South Wales. It is very much the view of the paramedics in the Ambulance Division of the Health Services Union of New South Wales that your postcode should not dictate the level of paramedical care you receive. The push by the Health Services Union for additional paramedics over the last two years has paid dividends with 700 new paramedics being brought on board. It has been incredibly lucky that the majority of these extra staff were in place prior to the COVID-19 pandemic. These extra paramedics, combined with a push to bring forward the remaining staffing enhancements scheduled for the next two years will help ease the burden on current staff who face this crisis every day at work. However the HSU is not resting on these laurels. These enhancements are not enough! The HSU is still calling for another 700 paramedics to be employed in New South Wales. These numbers are just enough to meet the normal day-to-day workload, let alone the challenges brought about by the current pandemic. We will continue to pressure for more staff until we have the resources required to give the community the service they deserve and our paramedics the safety that they earn. Delegates from the Ambulance Division have also been involved in a protracted battle in the NSW Industrial Relations Commission in order to force New South Wales Ambulance to utilise their resources in the AMBULANCE ACTIVE
way that provides a pre-hospital service that is safe for both the community and paramedics. The delegates have been working to ensure that New South Wales Ambulance maintain roster levels, particularly in metropolitan Sydney where paramedics are consistently missing crib breaks and working extension of shift overtime almost every day. Our delegates have identified that the current rostering levels are outdated and do not meet the requirements of the current workload. The action in the NSWIRC has led to a review of these staffing levels but there is more work to do as our delegates push for better staffing practices and more crews on the road at every shift. The Ambulance Division has had an active and effective Women’s Committee in place over the past 18 months. This Committee is comprised of frontline members who are some of our brightest and most enthusiastic women. The committee has been successful in addressing many issues that not only affect our female paramedics but impact on all workers in NSW Ambulance. The group has been particularly successful in assisting our members understand and interpret policy relating to domestic violence and have provided support and advice to victims of this unacceptable situation. The Ambulance Women’s committee has also established itself as a fantastic access point for our female members to get assistance to navigate and implement aspects of policies related to women’s issues such as maternity leave and flexible working arrangements. The COVID-19 pandemic has come upon us in a way that few imagined possible. This crisis highlights the true value of frontline health professionals such as paramedics. The stress and dangers faced by paramedics in their daily job has increased dramatically. The ADHSU has continued to work to ensure that members are safe and properly supported with appropriate PPE and we are constantly confirming that all possible safety measures are in place. The HSU, as part of our COVID response, has purchased hand sanitisers and masks for supply to members who cannot be supplied by the employer. While the union recognises this difficult time for government and employers, we are continuing to campaign for paramedic safety and are constantly vigilant for any lapses or changes in work practice by employers that may put our members at greater risk. Paramedics are on the frontline and are putting themselves in harm’s way. Our Union is standing with them and will fight to make sure they are safe physically, financially and emotionally. In Solidarity. AMBULANCE ACTIVE
NT WIN FOR NT EMERGENCY SERVICE WORKERS DIAGNOSED WITH PTSD In a big win for the Northern Territory’s dedicated emergency service workers, the Northern Territory Government has tabled amendments to the Return to Work Act. Most importantly, these amendments include presumptive post-traumatic stress disorder recognition for paramedics and fire fighters. Erina Early, United Workers Union NT spokesperson says, “This is the right thing to do for our paramedics and firefighters. It will help bring about the cultural change needed in the territory’s emergency services. It will allow our
paramedics and firefighters to be confident enough in putting their hands up to say they are struggling, without fear of any reprisal from their employers and insurers. “Claiming PTSD through workers compensation is stressful and challenging. For too long our paramedics and firefighters are made to feel worthless when they lodge a worker’s compensation claim. “The union never wants to see another one of our paramedic and firefighter members go through a rejected PTSD claim again. “Just recently a paramedic was refused a diagnosed PTSD claim. They were called a liar, greedy and accused of wanting to have time off work. Throughout the
claim process they were made to relive traumatic workplace events. This member was a broken person – they would vomit hearing ambulance sirens, become agitated and distressed. It was a heartbreaking situation. It has to stop – these changes to legislation will ensure this won’t happen again.” Further amendments to the Return to Work Act will ensure world-leading rules for occupational cancer coverage for the NT’s firefighters. Erina Early reported that the Return to Work Act amendments also tabled additional presumptive occupational cancers for firefighters – asbestos-related disease, skin cancer, liver and lung cancer. With these additions our NT firies which includes career firies, volunteers and auxiliary staff will have the best coverage in Australia and internationally.
New Zealand KIA ORA FROM LOCKDOWN NEW Zealand …. we hope you are being looked after and have been keeping yourselves safe. In New Zealand the two ambulance providers, St John Ambulance and Wellington Free Ambulance both receive around 72% of public funding with the rest of the costs made up by donations, charges for callouts, membership subscriptions and other paid services. This July we are back in bargaining with both organisations and it is not looking promising with St John. At the end of last year they decided they do not want to pay the agreed 1.25% for shift pay (due to commence on 1 July) but instead have decided on 1.15%. They have refused to provide a copy of an ‘independent’ workforce review to staff and have not applied for enough funding (again) to meet the signed collective agreements. It is troubling behaviour as Peter Bradley (the CEO) promised the bargaining team last year that, although he had not included pay rises for staff in previous funding rounds he would do so in the future. It is also worrying as last year frontline officers voted to walk off the job and, as we went into COVID19 morale had never been lower with officers still very angry from the last bargaining round (only concluded last May). St John have always claimed insufficient funding as a reason for depressing the salaries of their frontline staff and now both the workers and the New Zealand public are suffering. Every day, all over New Zealand, ambulances
are left in stations or staffed with a person of a lower ATP to the government contract because St John cannot attract new staff. Newly qualified paramedics are heading overseas, tempted not only by better wages but quicker ATP pathways. What this staff shortage can mean is long wait times after an ambulance is called and the Fire service are responding to more and more calls to prop up the service, with people even calling them direct. COVID19 has brought to the forefront the differences of healthcare provision around the world. Here in NZ we have seen the disparity in PPE for those contracted out services such as aged care and community workers, hospital orderlies and catering staff. For the ambulance service we have seen St John ‘interpret’ government directives and information for those who are immunocompromised and try to insist that workers are obliged to only be signed off work through their internal Occupational Health. Initially staff were told to ignore the advice from Healthline and ED and some staff who have been stood down under the government guidelines have been harassed by St John to divulge their private medical information and make them use their annual leave. Because of our Lockdown St John have told us that calls to the service are down by 25% but this doesn’t mean that all around the country the pressure has eased off. In our main metropolitan areas we have been so understaffed for so long that there is still an endless list of waiting
jobs, especially at night. If NZ had not started early with closing our borders and going into lockdown then the staff shortages in St John could have been catastrophic. So what does this mean for the future of the service? At the end of last year, we asked ambulance members the same question, with a variety of options. Should the ambulance service be run by another provider? Should ambulance combine with a service such as Fire Fighters? Workers at St John said they would prefer to be back under the running of the government as a core emergency service and perhaps this is the best option. For over a decade they have consistently failed to ask for enough funding from government (they fully acknowledge this) and the workers and the public have been paying the price. When money does go into the service it is taken away from frontline staff into new streams of work and many more positions in administration, management and human resources. Some MPs have made a pledge to increase the funding to 90% (St John doesn’t want 100% as it would alter their charity status) but if they still won’t pass it onto to ambulance officers then nothing will change. Perhaps a positive change from Covid19 could be to bring back our contracted out ambulance service to where it should belong – fully funded and government run - so that both the public and the workers are treated fairly. Sarah Stone National Ambulance Sector Co-ordinator Ambulance Professionals FIRST Union AMBULANCE ACTIVE
SA ON MONDAY 3RD FEBRUARY THE AEASA commenced its ‘Safe Staffing’ arbitration case in the SA Employment Tribunal, over: • insufficient staffing, • an over-reliance on overtime to fill shifts, • fatiguing on-call rosters still used in many country locations, • the increasing number of crews receiving very late or no crib breaks, and • the practice of ramping across SA Hospitals Numerous Paramedics and Operational staff gave compelling, and at times emotional, evidence on the current dire situation in the SA Ambulance Service which is undoubtedly putting lives at risk every day. Clinicians are worked to the point of fatigue, sometimes their whole 12 hour shift without a break. Over 40% of Metropolitan Crews are not receiving a crib break within the first 6 hours of shift. In some Metropolitan regions, this has been as high as 70% of crews. Dedicated shifts of Extended Care Paramedics (ECP’s) are being rostered on overtime in the Emergency Operations Centre (EOC) to ring patients back and apologise for not receiving an ambulance within timeframe targets, often many hours outside of criteria. His Honour Judge Dolphin, heard these ECP’s are often subjected to verbal abuse and some have left the role as a result of the stress this role places on them. One of our EOC members recalled at times having seven crews dropped and up to seven Priority 2 Emergency cases pending, with no crews to dispatch. One recalled being routinely short staffed in the EOC and being required to perform multiple roles, potentially putting patients at risk due to the overwhelming workload imposed.
A Paramedic recalled asking for back up for a patient in cardiac arrest, however there were none to send. Despite making an emergency trip to the nearest hospital with the Paramedic performing CPR in the back of the ambulance on their own, the patient later passed away. Response times have continued to decline over the last few years. Only Priority 1 KPI’s are being met, although it’s worth noting that the target for Priority 1’s is set much lower than for other Priorities. We receive anecdotal reports from members that response times for Priority 3 cases have blown out to 8 or even 10 hours. These are often elderly patients who have fallen or who are suffering in severe pain. As part of discovery, the SA Ambulance Service ‘Risk Register’ showed that there is an ‘Extreme’ and ‘Deteriorating’ level of organisational risk, which only validates our concerns. In response, SA Ambulance Service and the State Government are fixated on taking away members’ current crib entitlements as a solution, as opposed to implementing appropriate staffing levels to meet the rising demand. Hospital and Ambulance avoidance strategies introduced, such as Priority Care Centres and Secondary Triage, are only having very minor impact to date. Despite demonstrating an inability to reduce the scourge of ramping across SA Hospitals over many years, the Central Health Network containing the new $2.6 Billion Royal Adelaide Hospital has boldly committed to eradicating ramping by 30th April 2020. Whilst we would welcome such an achievement, this seems an unrealistic goal given the amount of time and effort which has been expended to achieve very little improvement over the last 8 years. We are understandably sceptical Jan 2018
Priority 1 (KPI 60% within 8 mins)
Priority 2 (KPI 95% within 16 mins)
Priority 3 (KPI 92% within 30 mins)
this is just another PR exercise in direct response to the case currently before the Tribunal and the damning evidence which is being revealed in this public forum. The case before the Tribunal continues. It is due to conclude on 26th March 2020 and we will then await His Honour’s deliberations and judgement. All information relating to the case will be made public via our website in the near future. In the meantime we continue to run our ‘Safe Staffing, Safe Community’ campaign, and have launched a Parliamentary Petition where we are encouraging SA residents to join our fight.
Queensland 2020 HAS SEEN MANY CHALLENGES for United Workers Union members in Queensland, but also significant gains. In January, after months of advocacy from the United Workers Union, the Queensland Ambulance Service (QAS) implemented a new policy in regards to placing crews out of service in order for members to finish on time. One of the most common issues raised by members in the south east corner of Qld was the inability to finish work at the end of their shift. It was not unusual for crews on 10 hour shifts to work 12+ hours and for those on 12 hour shifts to work 14. This makes it incredibly difficult for anyone to plan their lives outside of work, whether it be child care commitments, missing celebrations or the ability to make appointments any time following the end of their shift. The new procedure places crews out of service at the end of their shift and only respondable to cases 1A or 1B. If crews are dispatched to respond to these urgent cases after the end of their shifts there is a process in place to request relief in order to reduce the amount of time after shift end these crews are on duty. It is only early days and there was some confusion about how the policy was being applied initially, but delegates are hopeful we’ll see some positive change in regards to staff wellbeing and the ability to plan ahead into the future.
COVID-19 Like every service around the country the QAS have been stepping up their response and preparedness to the COVID-19 Pandemic. United Workers Union delegates have been vigilant in terms of ensuring members access to a safe work environment during these unprecedented times. Delegates and members have been actively working within their local structures to ensure a reliable and appropriate supply of PPE stock is available for all staff. Delegates have been proactive in AMBULANCE ACTIVE
encouraging responsible conduct amongst their peers in order to keep everyone safe. United Workers Union delegates have come out publicly about ensuring the safe use of PPE. UWU delegates have provided essential feedback from the ground in regards to adjustments to clinical practice and transport guidelines in the COVID-19 environment. The disciplined use of the Local Consultative Committee structures by United Workers Union delegates has ensured all QAS LASN’s have been required to respond consistently as issues arise across the state.
COVID -19 LEAVE ENTITLEMENTS The QAS has applied the whole of Health Department directive around pandemic leave entitlements to operational staff. This includes access to 20 days paid pandemic leave if personal leave entitlements have been exhausted and access to special directive leave if staff are required to self-isolate as a result of exposure to COVID-19. While delegates have welcomed the additional leave provisions the UWU position is that no worker should be disadvantaged if impacted by COVID-19, the requirement to exhaust personal leave before pandemic leave being accessible and the loss of aggregate rate if special directive leave is access is not good enough. United Workers Union representatives continue to advocate with government to acknowledge the different circumstances members in the Ambulance Section face as part of the front line of the response to managing this pandemic in the community.
Industrial Commission for approval was signed on April 16th 2020. The bargain includes pay rises since Dec 2018 of up to 10.25% until Dec 2021. (including an extra increment for the majority of members, and longer-term access to them for all current and future employees. There are improvements to parental leave up to 16 weeks paid time and partner leave of 3 weeks paid time. Casual employees have secured conditions in line with the hospital award, where there were previously no specific terms for casuals. Introduction of paid family violence leave, changes to carers leave, changes to compassionate and bereavement leave have also been won. We have been in dispute about WHS with the ‘regulator’ cancelling a PIN in Dec 2019; we don’t believe they had the appropriate authority to do this and have raised this to government. The response was at best confusing, the head of WorkSafe Tasmania recently resigned; we are not implying the two things are related but it’s an awful coincidence! Our response times remain the worst in the nation, we believe our utilisation rates
would be also the worst, if they tracked that data. One bright note has been the recent agreement to increase Duty Managers coverage to 24 hours across the state. This will occur progressively, with appropriate consultation and agreed timeframes being applied to roster changes. See the Joint AT/HACSU Statement for further detail. We are pushing for improved safety and better contingency plans, currently both are at breaking point. We have a high use of WC claims, and many more long-term users of sick leave (who don’t want to enter the WC system). The key focus on safety is about resources, equipment, fatigue, workload and roster structures and the over-reliance on volunteers to provide clock stopping responses. We are engaging with members, the hospitals and the DOH about our COVID-19 responses and we have huge concerns about AT’s ability to get their response right given the lack of resources, which has been evident now for some time. Chris Kennedy
PRESUMPTIVE LEGISLATION United Workers Union Qld Branch has been advocating with State government for the introduction to presumptive legislation in regards to emergency service workers, PTSD and other mental health conditions. After formal representations to the Minister for Industrial Relations on behalf of Ambulance members a reference group has been convened to discuss the handling of mental health injuries by the Workers Compensation system. This is another in what is likely to be many more steps to have government recognise the link between those diagnosed with a serious mental illness and their work as a first responder.
Tasmania WELL IT APPEARS WE HAVE RESOLVED the everlasting bargaining process. We concluded the 2018 EBA in August 2019 with a single year agreement which on the dates had already expired when approved. We’ve commenced bargaining again for the2019 EBA without a break. A final position was put to members in early January 2020, the application to the
mental healthcare for first responders. Currently, emergency service workers who need to claim workers’ compensation for post-traumatic stress disorder must prove that this came from their work.
AEAV SECRETARY ANNOUNCEMENT The AEAV is pleased to announce that in April 2020, Ambulance Victoria paramedic Brett Adie has been appointed as the Secretary of AEAV. Brett had a long history as an active State Councillor with the AEAV, was heavily involved in the Code Red campaign and has represented numerous members in industrial matters. As well as bringing his experience as an operational paramedic, Brett worked for the last 4 years as a Senior Team Manager. Brett has 25 years’ experience in Emergency Services including 11 years as a police officer. The addition of Brett to the AEAV team compliments the operational State Council and the expertise of the union officials.
BARGAINING In early March 2020, the AEAV reached an in-principle enterprise agreement with Ambulance Victoria. Wins for members included: DRUG TESTING Members wanted recognition of environmental exposure and for AV to treat Paramedics with dignity when drug testing. AEAV refused to sign off on the deal unless AV agreed to the creation of a working group with specific parameters to improve drug testing, and we won! These parameters will include, industry best practice testing and acknowledging - and understanding - the risks associated with environmental exposure. SPARES The strength of the AEAV membership allowed us to hold the line and refuse to sign off on a heads of agreement until we got a formal commitment to address Rural Spare. In the first year of the agreement a working group will be established and a trial developed in one rural region to test alternative spares rostering arrangements. This trial was proposed and the parameters stipulated by your AEAV representatives. AEAV’s involvement in the working group will ensure that Paramedics concerns regarding safety and work-life balance will be at the forefront. If Rural Spare has been an issue for you, we encourage you to get in touch and find out how you can be involved. SENIOR TEAM MANAGER 2% INCREASE (SEPARATE FROM OTHER INCREASES) The STM role has radically changed with AV’s recent restructure – and the pay had not changed to reflect this. AMBULANCE ACTIVE
Northern Territory Firefighter and UWU members Royle Salt, UWU President Jo Schofield and AEAV Secretary Brett Adie outside Parliament House in Canberra.
Because AEAV think every AV employee counts, we fought hard to get an immediate increase. In year 3 of the Agreement, to address classification relativities, an independent third party will review AV operational employee wages. We have put AV on notice that FMOs, TMs and STMs will be our key focus for that review. AEAV will continue to support all members in having their voice heard. Moving forward, there is much preparation to be done to ensure the best possible outcome from this review. Other key settlement points: • The classification structure had been proposed to introduce year 6 and year 9 levels. The original proposal was for a 1% increase between these new levels. AV agreed to a 2% increase between year 3 and year 6, and a gradual increase of 2%-3.3% between year 6 and year 9. • The 2% annual wage increases were maintained. They will take effect from 1 February 2020 and will run for the 4-year term of the agreement. If you want more information or to be involved, contact us at AEA.VIC@ unitedworkers.org.au or 9235 7777.
EMERGENCY SERVICES SUMMIT IN CANBERRA In February 2020, AEAV Secretary Brett Adie attended a union-wide emergency services summit in Canberra, convened by the ACTU. The summit was called as a response to the intensity and devastation of the bushfires, which has claimed at least 3 million hectares of bushland, over 2000 homes and properties, at least a billion animals, and 28 lives. Brett joined the United Workers’ Union President and UWU Firefighter members from the Northern Territory to talk about the importance of first responders. One of the resolutions raised was to support changes to the workers’ compensation scheme and to prioritise
The COVID-19 pandemic has presented Ambulance Victoria and other health service providers with unprecedented challenges. AEAV understands that we have a critical role in this response – to ensure a safe workplace for our members and to assist in developing processes which improve safety for all Victorians. Subsequently, AEAV representatives have been in consultation with the AV Executive to raise matters of concerns to our members and to discuss changes that could increase safety of health workers. Key issues covered during these discussions have so far included: • Pre-shift voluntary overtime to provide time for operational staff to review current COVID-19 guidelines, ensure sufficient PPE and to prepare your vehicle • COVID-19 location alerts to inform dispatchers, DM’s and operational staff of status of premises, ie. COVID-19 confirmed, COVID-19 suspected • Specific COVID-19 Treat and Refer guidelines to empower and support staff to make decisions on scene regarding requirement for transport • Fast-track training of appropriate staff for REFCOM duties with COVID-19 specialisation to minimise exposure of operational crews These discussions have been very productive and the AEAV will continue to work with Ambulance Victoria to improve the safety of its members and the Victorian public. It is the UWU position nationally that no worker should be worse off as a result of COVID-19. As such, the AEAV is demanding Ambulance Victoria provide sufficient paid special leave if: • Staff contract COVID-19 • Staff are required to self-isolate • Staff have been in close contact with someone who has COVID-19 • Staff have caring responsibilities as a result of COVID-19 Ambulance Victoria have made some concessions to the granting of special leave. The AEAV believes more work needs to be done and will continue to advocate that no worker should have to utilise their own leave entitlements when battling the pandemic on the frontline. Brett Aidie AEA-V Secretary
TO MY FELLOW AUSTRALIAN AND NEW ZEALAND PARAMEDIC AND AMBULANCE UNION MEMBERS I sought and included this report in this edition of Ambulance Active in the interests of providing vital information to as many paramedic and ambulance union members as possible. We are facing unprecedented challenges at present. A united
front and sharing our collective COVID-19 inspired issues, solutions and wisdom is in the best interests of all paramedic and ambulance union members, their safety and wellbeing. Jim Arneman – ACAU Secretary
SINCE THE FORMATION OF THE Victorian Ambulance Union Incorporated (VAU) in July 2019 we have been focused on building a new union from the ground up that is ambulance specific and provides members with excellent services. The work has paid off as we have now recruited over 4520 financial members. We have a current staff of ten and will soon be growing to thirteen. We have a leadership committee of 40 State Councilors as well as over 120 delegates across the state.
• at RFDS the VAU has been meeting with the employer to finalise a new agreement and we expect that this will occur shortly; and • we waiting for the new agreement with ESTA to be approved by FWC which should happen shortly; and • we have started bargaining with Health Select and were successful getting orders issued by the Fair Work Commission after they published inaccurate information.
The VAU have continued as bargaining representative for members within in the private and public sectors.
Recently the VAU have pushed for strengthening of legislation criminalising assaults on emergency workers in light of the recent Haberfield decision. It was disappointing to see another case of a violent offender let off without any time in prison after assaulting one of our members. We campaigned publicly for the laws to again be overhauled. New legislation was passed to tighten special circumstances which have allowed offenders to be released.
AMBULANCE VICTORIA NEGOTIATIONS The VAU closed a wage deal with AV and Government representatives in early March 2020. Members will move into a new structure that will provide for increases above the Victorian Government wages policy of 2% per year. Members will have incremental progression that recognises up to nine years of service in operational roles. There are also over 50 other improvements to conditions such as increased parental leave, paid defense force leave, improved relieving arrangements and an excellent new disciplinary clause that allows us to protect members involved in investigations and disciplinary outcomes. We have also strengthened our union facilitation clauses with paid union secondment, delegate training and State Council release provisions all increased significantly. We also managed to get Milo on the stores list for all branches (one of the great industrial barriers has fallen).
NEPT BARGAINING UPDATE In the NEPT sector: • An agreement negotiated with NPT was approved by the Fair Work Commission after over 2 years of bargaining; and
NEPT INDUSTRY The VAU have also been consulting with the Department of Health and Human Services Victoria in relation to NEPT sector. As part of this consultation process, we have provided a written submission about how the NEPT Act 2003 (Vic) (which governs the way employers operate in this sector) needs to change to strengthen accountability of employers working in this space.
MENTAL HEALTH ROYAL COMMISSION In July 2019 we also lodged submissions on behalf of members before the Royal Commission into Victoria’s Mental Health System regarding the impact on the mental health of workers responding to emergencies within the Ambulance & Patient Transport Industry.
AV 10 HOUR ROSTER GRIEVANCES After a long consultation process with AV and following the commissioning of a report from fatigue expert Professor Drew Dawson we were able to assist all Super Resource Center as well as Donnybrook & Mernda branches to move off fatiguing and universally disliked 10-hour rosters. AV ultimately removed those rosters.
COVID-19 At the moment the only game in town is ensuring our members are safe during the COVID pandemic. We have been dealing with AV, DHHS and the Government at all levels to ensure members have access to paid isolation leave, hotel accommodation, access to PPE including full length overalls, priority testing and dealing with hundreds of individual enquiries related to the virus. The flow of information has been rapidly changing and at times confusing and members have been coming to the VAU to get the information they need. Everyday something new arises that has to be dealt with quickly. For example we recently found out that a new cleaning chemical used to clean ambulance floors and another chemical used to clean ambulance dashboards and surfaces, when mixed create chlorine gas. The fast pace of change has meant risk assessments are skipped and hazards are missed. Finally we have been busy dealing with hundreds of day to day individual member matters and have attended the Fair Work Commission on nearly twenty occasions since our formation. So work wise, not much has changed – just a lot more of it! Danny Hill General Secretary
KEEP OUR PARAMEDICS SAFE AT WORK EACH MEMBER OF THE COMMUNITY plays an important role in helping to keep our paramedics and ambulance drivers safe at work. By keeping our paramedics safe, you are also protecting your own safety in situations where there may be violence and aggression present. Below are some ways you can keep paramedics and ambos safe at work.
AVOID CROWDING THE PATIENT It is crucial that paramedics receive the space they need to work. Please ensure you are actively aware of where you are standing, and ask others that may be crowding the situation to step back.
LET TRIPLE ZERO (000) KNOW IF VIOLENCE OR AGGRESSION IS PRESENT OR PREDICTED If you call Triple Zero (000), it is imperative that you tell the operator if violence or aggression is present at the scene, therefore they can arrange police to attend if necessary.
STAY CALM Emergency situations can be quite distressing, especially if it is you or your loved one that is receiving treatment. Always remember that becoming angry, aggressive or irrational will not help the patient and will make it difficult for paramedics to do their job.
OFFER ASSISTANCE It you are able bodied and have the correct skills, let paramedics know that you are able to help if needed. Paramedics sometimes appreciate or require help keeping crowds away from the scene or carrying equipment.
PUT YOUR OWN SAFETY FIRST If you are in a situation where violence is present, keep back. Do not do anything to worsen the situation.
The Health and Safety Strategy was implemented to bring awareness to the safety of Paramedics over a three year period. The strategy’s aim was to create a culture where paramedic safety is front and centre to all thinking and actions, ensuring that better care is taken for Paramedics in the workplace. The strategy is focused on improving Ambulance Victoria’s safety culture, aiming to move on from a culture that has been primarily focused on patient safety first and paramedic safety second, with injuries being accepted as part of the job. Ken Lay, Chair of Ambulance Victoria Board says, “we simply can’t continue to trade health and safety performance for good performance in other areas. We must become an organisation in which outstanding clinical performance and safety go hand in hand.” Over the three year period, the Health and Safety Strategy aimed to improve the safety issues Paramedics were facing daily. The first key issue addressed in the strategy being manual handling. The handling of patients and stretchers were two of the highest reported causes of manual handling injuries, being over 67 per cent of injuries at Ambulance Victoria. The strategy aims to minimise manual handling risks, including the ongoing design and equipment improvements. The second key issue addressed is psychological injury. The safety and wellbeing of paramedics also covers their psychological health and wellbeing. First responder employees have higher chance of developing depression, anxiety, post-traumatic stress disorder (PTSD), stress and fatigue. Paramedics tend to experience higher levels of stress in comparison to those in other occupations, factors including: • Long work hours • Repeated exposure to death, trauma and violence
• High levels of responsibility • Shift-work • Frequent shift extensions The third key issue addressed in the strategy is occupational violence. This has remained a pressing issue over the years for paramedics nationwide. The Victorian Auditor General’s Report Occupational Violence Against Healthcare Workers found that paramedics, as well as emergency service workers, faced a high risk of occupational violence, as they often deal with people in stressful, unpredictable and potentially volatile situations. In Victoria, metro regions have the highest rates of incidents, with the top five suburbs with the highest incident rate being within 5kms of Melbourne’s CBD. The Health and Safety Strategy is divided into four focus areas. The first being Safety Culture, Leadership and Engagement. This area of focus introduces clearly defined expected safety roles, responsibilities and accountabilities. The second focus area is centred around Risk Management, the focus being as mentioned above; manual handling and occupational violence, as well managing alcohol and drugs. The third focus area is Injury Management, focusing on offering quality support services are provided to paramedics when they are injured in order to promote recovery and return to work. The fourth focus area is the continuation of safety improvement. Tony Walker, acting CEO of Ambulance Victoria says, “we will build a safety first culture where everyone is committed to AV’s (Ambulance Victoria) safety expectations and has the knowledge and skills to do their jobs safely. “Providing the best care for our patients and the safest possible workplace for our staff must be the foremost priorities for all of us at AV.”
UNDERWHELMING AND INSULTING ACAU slams the Federal Government reply to “The People behind 000: Mental Health of our First Responders” ON FEBRUARY 25, 2020, IN THE MIDST OF THE EVOLVING COVID-19 crisis, the Morrison Liberal-National Government finally responded to the report of the Senate Inquiry into the Mental Health of Emergency Services Workers and First Responders. Underwhelming and insulting are the words that best describes the government’s response. The report of the Senate’s Education and Employment References Committee on its inquiry into the mental health of first responders, emergency workers and volunteers was only replied to after a joint motion, sponsored by Senator Ann Urquhart from Tasmania and Senator Tony Sheldon from NSW, calling on the government to table a response or be held in contempt of the Senate. ACAU Secretary Jim Arneman slammed the governments response. “This response is a disgrace” said Jim Arneman. “It has taken the Morrison government over a year to table this response, which they only did after being forced to so by Labor Senators from Tasmania and NSW”. “The Senate Committee’s original recommendations were detailed. They addressed the most important areas that need reform if we are to seriously address the horrendous toll caused by mental health impacts of their work on paramedics” Mr Arneman said. The ACAU’s Report Card for the governments reply is as follows:
REPORT CARD ON THE 14 RECOMMENDATIONS: RECOMMENDATION 1 The committee recommends that the government work with state and territory governments to collect comprehensive data on the occurrence of mental health injuries and suicide in first responders.
RECOMMENDATION 2 The committee recommends that the federal government work with state and territory governments to collect data on the cause of death for first responders who die while employed or die within 10 years of leaving their service. Morrison Government Response: Support in principle MARK: F for FAIL VERDICT: The collection of accurate data and evidence on which to base funding decisions affecting lives has to be a priority. By reverting to the old chestnut “it’s actually a state or territory issue”, the government shows they have either no idea or do not care about the fact that the lack of consistent data collection, because it’s not standardised across jurisdictions, is why we have the problem that we cannot measure in the first place.
Jim Arneman, NCAU and Terry Savage, Mick Callinan, Mick Grayson and Steve Fraser HSU NSW at the Canberra Session of the Inquiry
The committee recommends that federal, state and territory governments work together to increase oversight of privately owned first responder organisations.
The committee recommends that compulsory first responder mental health awareness training, including safety plans, be implemented in every first responder organisation across Australia.
Morrison Government Response: Noted
MARK: MF for MASSIVE FAIL VERDICT: This recommendation specifically referred to the WA and NT jurisdictions where St John sub contract to provide ambulance services to the government. The Senate Report was scathing about the lack of accountability in these arrangements and the impact this was having on the mental health outcomes of paramedics and ambulance employees in these jurisdictions. Clearly the WHS provisions referred to by the government are not working, hence the need for this recommendation.
The committee recommends that compulsory management training focusing on mental health, such as that developed by the Black Dog Institute, be introduced in every first responder organisation across Australia.
RECOMMENDATION 7 The committee recommends that mental health support services be extended to all first responder volunteers. Morrison Government Response: Support in principle MARK: F for FAIL VERDICT: This response is classic Sir Humphry double speak, providing a funding list that doesn’t address the issues the Senate Inquiry raised. Training and support are fundamental areas that need to be addressed urgently in a consistent and nationally focussed response. The Morrison Government is not addressing the problem or the solution in this response.
The committee recommends that a Commonwealth-led process involving federal, state and territory governments be initiated to design and implement a national action plan on first responder mental health. Morrison Government Response: Support
MARK: CONDITIONAL PASS
The committee recommends that the Commonwealth Government establish a national stakeholder working group, reporting to the COAG Council of Attorneys-General, to assess the benefits of a coordinated, national approach to presumptive legislation covering PTSD and other psychological injuries in first responder and emergency services agencies. This initiative must take into consideration and. work alongside legislation already introduced or being developed in state jurisdictions, thereby harmonising the relevant compensation laws across all Australian jurisdictions.
VERDICT: This response is potentially the only acceptable one to any recommendation in the Senate Report. The proposed National Action Plan for First Responder Mental Health has the potential to be a positive step forward. The devil will be in the detail though: who is invited to participate in the preparation of the plan and how binding any recommendations are on states and territories who’ve often dodged the hard decisions, which is why we needed a Senate Inquiry in the first place. An early concern is that the response appears to be shaped by the Bushfire Crisis and not the Senate Inquiry’s recommendations.
Morrison Government Response: Support in principle MARK: F for FAIL VERDICT: This is a key area that needs harmonising across jurisdictions. The Senate Recommendation was based squarely on an ACAU call to coordinate a national approach to presumptive legislation. A number of states and territories have already gone it alone in this area. We need to ensure consistency so that no paramedic is disadvantaged.
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The committee recommends that the Commonwealth Government, 1n collaboration with the states and territories, initiate a review into the use of independent medical examiners (IME) in workers’ compensation.
The committee recommends that early intervention mental health support services be made available to all employees of first responder organisations with the aim of preventing or reducing the severity of mental health conditions.
The committee recommends that the Commonwealth Government establish a national register of health professionals who specialise in first responder mental health.
The committee recommends that ongoing and adequate mental health support services be extended to all first responders who are no longer employees of first responder organisations around the country.
Morrison Government Response: Noted Morrison Government Response: Support in principle
MARK: MF for MASSIVE FAIL VERDICT: This response is insulting for all of those paramedics who displayed immense courage to front the inquiry and share their horrendous experiences with IME’s. Even the Psychiatrist College testified in the course of the inquiry that many of the IME’s were re-traumatising or increasing the injury of vulnerable workers. The proposed national register was about establishing a body of dedicated health professionals with a genuine understanding of and interest in treating psychologically injured paramedics and first responders. The government is showing contempt for the injured paramedics and responders who highlighted a serious policy flaw, only to be dismissed by the government’s response.
RECOMMENDATION 11 The committee recommends that a consistent approach to referrals to rehabilitation counsellors be developed across, states and territories, requiring referrals to be made by general practitioners not associated with employers or insurers. Morrison Government Response: Noted MARK: F for FAIL VERDICT: This response notes that a Nationally Consistent Approval Framework (NCAF) for workplace rehabilitation providers has been in place since 2010 and that a Principles of Practice for Workplace Rehabilitation Providers was developed to better support workplace rehabilitation providers in the delivery of services to injured workers in 2019. The facts are that consistent referral processes are still not occurring. Strict accountabilities need to be introduced and enforced to address this problem.
MARK: F for FAIL VERDICT: Similar to their response to recommendations 1 & 2, the government reverts to the old chestnut “it’s actually a state or territory issue”. By doing so they show they have either no idea or do not care about the problem. Again, it’s the absence of standardised early intervention and support services across jurisdictions, that was the raison d’etre for this recommendation. Coordination is the key – the federal government appears to have no interest in taking a leadership role on this issue.
RECOMMENDATION 13 The committee recommends that the Commonwealth government make funding available for research in the prevalence of mental health conditions in retired first responders. Morrison Government Response: Noted MARK: F for FAIL VERDICT: The government response notes the importance of this issue, then fails to address it directly. Again, it shows a lack of willingness to show leadership. The Senate focussed on the fact that many psychological issues manifest after retirement from emergency services. In its response, the government shows no inclination to support research into the prevalence of mental health issues for many who spent a life time caring for others.
The ACAU will not rest until the most important of these recommendations are satisfactorily addressed. We are currently in discussion with a range of Labor and Cross Bench Senators who are sympathetic to our cause and want to see genuine action. The ACAU will continue to campaign on this important issue so that our members who are psychologically injured in the course of their work are given the best support and care available. We’ll also continue to fight for nationally consistent legislative frameworks and regulatory provisions to ensure no paramedic or emergency responders are left behind, and that there are consistent approaches to treatment and prevention across state and territory boundaries. For further information on the government response or our planned campaign contact Jim Arneman email@example.com
ACT Ambulance Service
ENTERPRISE AGREEMENT 2018-2021 A successful Enterprise Agreement Ballot has been held to endorse the ACT Ambulance Service Enterprise Agreement 2018-2021. THE BALLOT CLOSED ON APRIL 15, 2020. 97% of staff voting endorsed the agreement. Consistent with ACT government policy pay increases will be paid immediately following the successful ballot, effective May 28th 2020 with back pay scheduled for the June 11 pay run. The EA contains a number of centrally agreed provisions that apply to all ACT Public Sector Agreements. The most important of these for TWU ACT Ambulance members are as follows:
PAY OFFER Pay increases totalling 10.85% over a period of four years duration with percentage increases being provided at regular intervals. The TWU and Unions ACT negotiated for the pay increase to be back-paid to the first full pay period on or after 1 October 2017. The full offer is: • 2.25% from the first full pay period on or after 1 October 2017; • 0.5% from the first full pay period on or after 1 June 2018; • 1.35% from the first full pay period on or after 1 December 2018; • 1.35% from the first full pay period on or after 1 June 2019; • 1.35% from the first full pay period on or after 1 December 2019; • 1.35% from the first full pay period on or after 1 June 2020; • 1.35% from the first full pay period on or after 1 December 2020; and
ALLOWANCES All allowances in Annex C will be increased by the same percentage amounts as the pay increases outlined above.
SUPERANNUATION Members of preserved schemes like the CSS and PSS will continue to receive the contributions they do currently. Members of Superannuation Guarantee Funds are
currently receiving 10.5% (9.5% Super guarantee + the current additional employer contribution of 1%). This will increase to: • 10.75% on 1 July 2018; • 11% on 1 July 2019; and • 11.5 % on 1 July 2020. The Government will continue to offer 1% additional employer contribution for members of Superannuation Guarantee Funds who choose to contribute at least 3% of their salary to their superannuation.
Patient Transport (NEPT) by creating a specialised Patient Transport Officer 1-3 classification. • The introduction of an automatic pay out of Accrued Days Off at single time (no penalties) in excess of 6 days rather than a cap of 6 days for employees engaged in the role of Call Taker/ Dispatch as Ambulance Support Officers within the Emergency Services Agency (ESA) Communications Centre (ComCen).
SIGNIFICANT ACT AMBULANCE SPECIFIC CHANGES INCLUDE:
OTHER SIGNIFICANT ‘CORE’ AGREEMENT CHANGES INCLUDE:
• The establishment of a bipartisan workforce planning committee to oversee the development of workforce planning including consideration of rostering a component of annual leave, roster variation and modifications, overtime allocation and flexible working arrangements and other items as agreed by the committee. • The introduction of the new classification level of Ambulance Paramedic 2 (AP2), which will allow ambulance paramedic access to a range of HDA and promotional opportunities. • A commitment to the development of a partial composite allowance for employees working in the Communications Centre (ComCen) and (Non-Emergency) Patient Transport. • A review of Training and Development Officers and Team Leader positions will be undertaken. Following completion of the review, positions will be filled permanently on merit. • From the date of commencement of the proposed Agreement, employees acting as Flight Intensive Care Paramedic (ICP) 2 positions, that meet the requirements of the role, will be permanently translated to the ICP2 classification. • The introduction of a new classification structure for Ambulance Support Officers 1-3 within (Non-Emergency)
SUPERANNUATION ON PARENTAL LEAVE The Government will extend superannuation contributions to the unpaid portion of the first 12 months of parental leave. This includes birth leave (aka maternity leave) and unpaid parental and grandparental leave. CLASSIFICATION/ WORK VALUE REVIEW The clause dealing with an employee’s or group of employees’ right to request a review of their classification and the work value of their position(s), is being strengthened to ensure that genuine reviews will be undertaken where warranted. The ACT Government is committed to employees being classified appropriately, and is also intending to undertake a larger scale classification review, outside of the Agreement process, to identify categories of classifications that may need to be adjusted based on work value changes. WORKPLACE FLEXIBILITY The Agreement significantly simplifies and strengthens the ability for employees to access a range of entitlements in the Agreement to ensure they can balance their work and personal commitments. The clauses provide flexibility well above the minimum requirements of the Fair AMBULANCE ACTIVE
“This EA has taken a considerable time period to
finalise, however, the provision of back pay to October 2017 as well as a number of significant changes and enhancements to working conditions are a testament to the tenacity of the those involved in the negotiations.
Work Act, while incorporating the concept of ‘Reasonable Business Grounds’ into the Agreement to allow any disputes to be raised through the Dispute Avoidance/ Settlement Procedures of the Agreement, an avenue currently more restricted in the existing Agreement. Any employee, may for any reasons request a Flexible Working Arrangement. This may be a part-time or job-sharing arrangement, or varied start and finish times, flexible access to leave and any number of other arrangements. Requests can only be refused on reasonable business grounds, and AMBULANCE ACTIVE
those business grounds are listed in the Agreement, and are more restrictive than those under the Fair Work Act. These arrangements will be recorded in writing and can be for a period of up to three years, at which they will be reviewed. If the employee so requests, a new arrangement can then be entered into unless there are reasonable business grounds for refusing the request. Other agreed “core” changes cover NAIDOC, Bonding, Family Violence and Concurrency Care leave entitlements, as well as changes to provisions dealing with misconduct and underperformance.
This EA has taken a considerable time period to finalise, however, the provision of back pay to October 2017 as well as a number of significant changes and enhancements to working conditions are a testament to the tenacity of the those involved in the negotiations. TWU delegates are already turning their attention to the next round of negotiations, with the new agreement being due to expire in only 18 months.
TWU ACT Ambulance Caucus
EXTREME DEDICATION! Queensland paramedics made sure that they were keeping themselves safe and protected on the job by shaving off their beautiful beards.
A SHAVED FACE ENSURED THAT THEY can keep their face masks on nice and secure. Whilst there is no evidence to suggest coronavirus can be carried in strands of beards or thick facial hair, it became apparent that beards and thick moustaches prevented face masks from sealing properly against the skin. If face masks cannot be sealed properly, airborne COVID19 droplets could pass through incorrectly secured masks. Most paramedics had no issue shaving off their beards all in the name of keeping themselves and loved ones safe from the spread of the virus. To some it was a little harder to part with but soon admitted the least of their worries during these extraordinary times.
CORONAVIRUS DISEASE (COVID-19) INFORMATION FOR PARAMEDICS AND AMBULANCE FIRST RESPONDERS This information sheet should be read in conjunction with the ‘What you need to know’ and ‘Isolation guidance’ information sheets. Go to www.health.gov.au/covid19travellersfor the current list of higher risk countries and these other information sheets.
ADVICE ON CLINICAL CARE OF A PATIENT WITH POSSIBLE COVID-19 When a person in quarantine or selfisolation develops symptoms of concern, particularly difficulty breathing that requires emergency treatment, they have been advised to: • Call 000 and advise operators that they are in self-isolation because of possible COVID- 19;and • Advise paramedics and ambulance first responders on arrival of their travel or close contacthistory. Paramedics and ambulance first responders are advised to follow specific personal protective equipment (PPE) requirements (outlined below) while assessing and treating patients in selfquarantine or isolation, regardless of whether or not respiratory symptoms are present.
General guidance: • Contact and droplet precautions are recommended for routine care ofpatients. • Contact and airborne precautions are recommended when performing aerosol generating procedures, including intubation and cardiopulmonary resuscitation(CPR). • Provide advance notice to the receiving destination to clarify transfer of care arrangements.
PRECAUTIONS DURING ROUTINE CARE The following contact and droplet precautions are recommended during routine care of a patient with possible COVID-19. 1. Place a surgical mask on the patient if they have not already done so, unless this will aggravate breathingdifficulties. 2. Perform hand hygiene before donning a gown, a surgical mask, eye protection and gloves. 3. After the encounter - remove gloves, perform hand hygiene, remove eyewear and gown, then perform hand hygieneagain. 4. Apply clean PPE and clean any contacted/contaminated equipment and surfaces with detergent/disinfectant.
AEROSOL-GENERATING PROCEDURES Aerosol-generating procedures (AGPs) include tracheal intubation, non-invasive ventilation, tracheotomy, CPR, manual ventilation before intubation, and bronchoscopy. Care should be taken when performing AGPs. Information for Paramedics and Ambulance First Responders – Version 2 (25/02/2020) Coronavirusdisease (COVID-19) Note: Nebuliser use should be avoided and alternative administration devices (e.g. spacers) should be used if possible. Airborne precautions should be used routinely for all persons in the vehicle during high-risk AGPs. These precautions include: • Performing hand hygiene before donning a gown, eye protection, a P2/ N95 respirator (which should be fit checked) andgloves; • Having the driver don a P2/N95 respirator and protectiveeyewear; • After the AGP, remove gloves (perform hand hygiene), eye protection and gown (perform hand hygiene) and P2/N95 respirator (perform handhygiene); • Not touching the front of any item of PPE duringremoval; • Disposing of used PPE in a clinical waste bag;and AMBULANCE ACTIVE
• Cleaning ambulance equipment and surfaces with disinfectant wipes by a person wearing clean PPE (i.e. gloves, gown, protective eyewear and surgicalmask). AMBULANCE AIR FLOW During transport, vehicle ventilation in both compartments should be on nonrecirculated mode to maximise air changes that reduce potentially infectious particles in the vehicle. If the vehicle has a rear exhaust fan, use it to draw air away from the cab, toward the patient care area, and out the back end of the vehicle.
USE OF PPE IN LIFE THREATENING SITUATIONS In circumstances where paramedics or ambulance first responders are providing clinical care in life threatening situations (for example, CPR upon arrival) for a patient with suspected COVID-19, officers may not have sufficient time to adequately apply full airborne precautions. In these circumstances, officers are advised to ensure their own safety including: • Use of a surgical mask and eye protection as a minimum precaution, or a (fit-checked) P2/N95 respirator and eye protection ifavailable; • At completion of the episode of care, removal of gloves (perform hand hygiene), removal of eyewear, gown and mask (perform hand hygieneagain); • Notification of your employer if you have had a close contact with a suspected or confirmed case of COVID-19 without using appropriate PPE e.g. if COVID-19 was not suspected at the time;and AMBULANCE ACTIVE
• Seeking advice from your local public health authority regarding any need to be isolated and monitored for symptoms of thevirus.
HOW CAN WE HELP PREVENT THE SPREAD OF COVID-19? Practising good hand and sneeze/cough hygiene is the best defence against most viruses. You should: • wash your hands frequently with soap and water, before and after eating, and after going to thetoilet • cover your mouth and nose when you cough and sneeze, dispose of tissues, and use alcohol-based hand rub,and • if unwell, avoid contact with others (touching, kissing, hugging, and other intimatecontact.
WHERE CAN I GET MORE INFORMATION? Clinicians: • Follow jurisdictional guidance and local procedures and if unsure, ask your managers or Infection Prevention and Controlpersonnel Organisations: • For the latest advice, information and resources go towww.health.gov.au. • Call the National Coronavirus Health Information Line on 1800 020 080. The line operates 24 hours a day, seven days a week. If you require translating or interpreting services, call 131 450. • The telephone number of your state or territory public health agency is available on the coronavirus page at www.health. gov.au/state-territory-contacts
WHAT DOES AUSTRALIA’S BUSHFIRE SMOKE MEAN FOR YOUR HEALTH?
WITH THE CATASTROPHIC AUSTRALIAN bushfires creating overwhelming smoke in not only New South Wales and Victoria, but all across Australia. Residents of Sydney and Melbourne have endured some of the worst smoke through December 2019 and January 2020. The air quality in both cities have exceeded ‘hazardous’ levels on several occasions. As our trees burn, they release particles of carbon and gases, including carbon monoxide. Particles of less than 2.5 micrometres in length, referred to as PM2.5, are the biggest risk to health as they can bury deep into the lungs and in some cases, enter the blood stream. This can cause irritation, infection and cause an increased chance of lung disease and heat attacks. Because the PM2.5 particles found in bushfire smoke are so small, they can travel huge distances in the wind; and with the smoke expected to
make at least one full circuit around the globe, this poses an even greater threat for Australia and the rest of the world. Studies have found that exposure to these particles are linked to a wider range of conditions than previously thought. The known effects being on the lungs and heart, new diseases include urinary tract infections and renal failure. Breathing this bushfire smoke can cause irritation to the lungs, throat, eyes and nose. In more serious cases, for people with pre-existing conditions, breathing bushfire smoke can lead to hospital visits. The most vulnerable to the smoke shrouding our country are children, elderly and smokers. People with heart and lung problems can experience heightened symptoms such as difficulty breathing and chest tightness. With bushfire smoke, issues with overheating become present. It is important that anyone responsible
for someone in this ‘vulnerable group’ should make sure they are well hydrated. The effects of heat exhaustion and heatstroke can be a life-threatening medical condition. With this rise in smoke, hospitals across NSW and Victoria have seen a 10% rise in hospital admissions, with paramedics treating hundreds of people for breathing problems. Standard face masks are ineffective when it comes to blocking the hazardous PM2.5 particles. The air quality in Sydney has been as high as 734 micrograms in the PM2.5 particle – equivalent to smoking roughly 37 cigarettes. More than 100 extra paramedics were put on duty late December of last year as the NSW government declared a state of emergency over bushfire risk and soaring temperatures. Ambulance Victoria Acting Director of Emergency Management, Justin Dunlop, AMBULANCE ACTIVE
released a statement on January 7th saying, “yesterday we saw a 51 per cent increase in the number of people reporting breathing problems, and we think that’s largely due to smoke. Breathing problems calls increased from an average of 187 per day to 282 yesterday… many of those callers were taken to hospital.” The Royal Australian College of General Practitioners has urged people to call their doctor with health concerns in relation to bushfire smoke that are not life‑threatening. “If it’s not life-threatening, call your local GP…” said collage president Dr Harry Nespolon. “We know paramedics have seen a spike in calls from people suffering from respiratory concerns related to bushfire smoke. Emergency lines should be used when there are genuine emergencies, it’s important that they are not tied up.” AMBULANCE ACTIVE
Ambulance Victoria has recommended people to guard against exposure to smoke by taking some simple precautions, being: • Stay inside your house if possible; close all windows and doors • If you use an air conditioner, switch it to ‘recycle’ • Avoid exercise • Ordinary paper dust masks and handkerchiefs wont filter out particles from bushfire smoke- use a special ‘P2/ N29’ filter mask, which you can get at a hardware store but be sure they fit properly and you have no medical issues that would prevent use In spite of this, bushfire smoke and pollution does not cause as much lasting damage to the body as traffic or industrial pollution. It is very common to experience a range of emotions if you are directly or indirectly affected by bushfires.
24/7 telephone services offering counselling and support: • Lifeline Australia: 13 11 14 or www.lifeline.orn.au A crisis support service that provides short-term support at any time for people who are having difficulty coping or staying safe. • Beyond Blue: 1300 224 636 or www.beyondblue.org.au Available by phone or online via chat or email, to provide support on a range of mental health issues. • MensLine Australia: 1300 78 9978 or www.mensline.org.au/ A telephone and online counselling service for men. • Kids Helpline: 1800 55 1800 or www.kidshelpkine.com.au A free, private and confidential 24/7 phone and online counselling service for young people aged 5 to 25 years.
PARAMEDICS AND EMERGENCY SERVICE WORKERS ENDURING ASSAULT DAILY ASSAULTS ON PARAMEDICS IS AN occurrence which is too often heard about. In no career is violence expected, so why shouldn’t paramedics and emergency service workers feel the same? Paramedics do not come to work to get assaulted, and they should not have to worry about their safety; paramedics need to be able to do their job, uninterrupted and in a safe environment. Abuse of paramedics and first responders is so frequent, that it has almost become desensitised, with verbal abuse being almost a weekly occurrence.
In the Northern Territory (NT), assaults on paramedics have become so common that many incidents are going unreported, causing urgent care to be delayed out of severe safety concerns. Amy McCaffrey, Alice Springs paramedic said, “there is absolutely no excuse for abuse but, because we are subject to it so often, we become really desensitised to it and we often don’t report it. “What is really sad about all these incidents, is that we are just here to help, and it takes away from what we really got into the job to do.”
In 2019, there were 50 reported cases of assault on St John Ambulance NT paramedics, but it is thought that that number would be considerably higher if every attack was reported. Of the 50 reported assaults, 34 were physical and resulted in multiple staff members requiring treatment, therefore needing to take time off work. Paramedics have been forced to flee scenes where violence is unbearably apparent and overwhelming. Emergency service workers are also experiencing increasing amounts of violence while at work, with an emergency department nurse saying, AMBULANCE ACTIVE
“St John Ambulance NT workers have
endured a rise in physical assaults during the December holiday period. Paramedics have issued a plea to the public to try and stop the downpour of abuse.
“… I don’t think I know a single person who works in ED (emergency department) who has not been at least verbally abused.” This is not an issue exclusive to the Northern Territory, but is a prominent issue across Australian ambulance services. While multiple campaigns have run to put an end to this violence, such as the It’s never OK campaign, we are still seeing assaults occur across the country. Additionally, the NT Hands Off! Campaign aims to keep paramedics safe. The campaign is centred around giving paramedics space to save lives, as well AMBULANCE ACTIVE
as striving for the notion that paramedics should be able to go out in public in their uniform and wear it proudly without the idea that they might be attacked. Andrew Thomas, ambulance services director said, “it’s becoming almost a culture within paramedics that it [is] almost seen as being accepted. “Across the Northern Territory we had a number of assaults where our paramedics received physical blows to the face and the head, some of them have been when their back was turned, and we’ve all seen the information around one-punch hits.”
Thomas says St John NT paramedics have been spat on, threatened and had rocks thrown at vehicles while they are driving. The rise in violence and aggression is occurring with both ambulance staff and health care professionals. The consistency of assaults and issues with violence have taken a huge impact on paramedics, Thomas saying, “we’re probably now starting to see some of the psychological impacts on staff. “They might not feel as comfortable to respond at night-time or certain types of cases might bring back some sort of memory. “We’ve told people before, for their own safety, to pull back and wait for police to come and support them.” St John Ambulance NT workers have endured a rise in physical assaults during the December holiday period. Paramedics have issued a plea to the public to try and stop the downpour of abuse. The NT government introduced harsher penalties in 2019 for people who assault health care workers. The changed introduced now apply the same penalties to those who have assaulted the police.
THE VOLUNTARY ASSISTED DYING LEGISLATION PASSED IN WESTERN AUSTRALIA THIS WAS NOT LEGISLATION THAT was put in place overnight, with the Joint Select Committee on End of Life Choices being established by the Parliament of Western Australia in 2017. The Committee undertook an inquiry into the need for laws in Western Australia, to allow citizens to make informed decisions about their own end-of-life choices. The Committee handed its report, ‘My Life, My Choice’, to both Houses of Parliament in August of 2018. The report outlined 52 findings and made 24 recommendations in relation for Western Australian citizens end-of-life choices. In August 2019 the Voluntary Assisted Dying Bill 2019 was introduced into the Western Australian Parliament. On December 10, 2019, the Bill was passed by Parliament to be enacted upon Royal Assent which occurred on December 19, 2019. Following Royal Assent there will be an 18 month implementation period led by the Department of Health.
In the Bill’s foreword, it says, “Overwhelmingly, people want to live. For those left behind, the protracted death of a loved one from a terminal or chronic illness can be devastating… “The Committee received hundreds of submissions from people who watched on- powerless- while a family member or friend experienced a protracted and painful death. “How we die has changed over the last 60 years. Medicine and the law have not kept pace with this change, now with the changes in community expectations.” Health Minister Rodger Cook said, “we are at the end of a very long process, a momentous process for the Western Australian Parliament and the Western Australian public. “Everyone knows what this legislation is about. It’s about reflection. And to reflect that we’ve chosen compassion and the right to choose.”
Not everyone is eligible for voluntary assisted dying, with there being more than 100 safeguards in place. To go through the process, the person in question must meet all of the eligibility criteria, being: • Over 18 years of age. • An Australian citizen or permanent resident who has been ordinarily resident in Western Australia for at least 12 months. • Diagnosed with at least one disease, medical condition or illness that is advanced to the point that it will cause death within a period of six months, and is causing suffering that cannot be relieved in a manner that the person in question considers tolerable. • Must have decision making capacity in relation to voluntary assisted dying. • Must be acting voluntarily and without persuasion. • Must have an enduring request for access to voluntary assisted dying. AMBULANCE ACTIVE
“… the ultimate act of
compassion is surely to allow someone to choose to end their suffering, even when we want them to stay with us.
To access voluntary assisted dying, the person in question must be independently assessed as being eligible by at least two medical practitioners. Those medical practitioners must meet certain requirements themselves, and have undergone mandatory training. AMBULANCE ACTIVE
Once passed the requirements, the person must make three separate requests for voluntary assisted dying; the initial request, a written declaration, which must be witnessed by two people who meet specific requirements, and a final request. Throughout the process, the person must be informed of the many different aspects relating to voluntary assisted dying, as well as their treatment options. Voluntary assisted dying may be through self-administration or administered by a practitioner. This decision is made in consultation with the co-ordinating medical practitioner. If the person chooses self-administration, they must appoint a Contact Person who has responsibilities under the Act, including the return of any unused substance. If the person chooses practitioner administration, it must be done by a medical or nurse practitioner, who, again, meets specific requirements.
Medical practitioners are able to refuse to participate in voluntary assisted dying for any reason. The death certificate must not include any reference to voluntary assisted dying. In addition, healthcare workers are not to initiate or suggest voluntary assisted dying to a person they are providing health care services. The unnecessary suffering at the end of life is what formed the basis for the Committee’s recommendation that the Western Australian Government introduce a Bill for Voluntary Assisted Dying. The Government then instructed the Department of Health and the Department of Justice to develop the legislation. State Premier Mark McGowan said, “to everyone who helped make this happen, thank you. “Thank you for your unwavering support, your contribution, your stories, your consultation and for entrusting us with this task. “We did it for you.” This legislation was strongly supported by the Western Australian Paramedic Delegate group, as well as the Western Australian United Workers Union. Matt Sim, a paramedic in Western Australia for over 20 years, said that paramedics are exposed to people in their end of life stage moreso than the wider community. “Speaking to other paramedics, there is an overwhelming consensus that these laws need to be passed. It is the humane thing to do. We don’t want to see people needlessly suffering.” He says that “if people can choose can opt out of medical assistance, which is effectively ending their life in a much longer and more painful process, then people should be allowed to choose when they want to end their life.” He further says that, “People can opt out of receiving medical assistance, effectively ending their life in a much longer and more painful process. People should be allowed to choose when they want to end their life”.
This can be a very sensitive topic. If any of this information has raised distressing thoughts or emotions, please contact: LifeLine WA on 13 11 14 or www.lifelinewa.org.au LifeLine are available 24/7 via phone or email.
THANK YOU, HENRY
HENRY SIENKIEWICZ HAS BEEN A member of the United Workers Union for 47 years. He has committed his whole working career to the people of Western Australia, helping them in their times of need. Henry joined St John in 1972, after witnessing a horrific incident. “I was working at the steel works,” Henry recounts, “and a guy was on the roof above us and he jumped down to the next level, but there was no wire meshing and [he] landed on the steel plates behind me. “That was around a 15 metre fall, there were bones hanging out; he was moaning and groaning and bleeding and I thought, ‘holy crap… I don’t know what to do for him’, so I raced to the first aid room and told them to call for an ambulance. I watched the guys as they picked him up and, we had one son at the time, I went home and thought, imagine if something happened to David, I wouldn’t have any idea what to do. “So, I learnt first aid, but I still wasn’t confident, so I got in touch with St John and asked if they had any advanced first aid training. They said no, but are you interested in becoming an ambulance officer. I just thought, I’m not that smart. “I then went through the induction school, which you did in your own time back in those days, and I’ll be damned I actually passed. They offered me a position and I took it. That was on the 6th of June 1972, 47 years and 7 months ago.” Working as a paramedic for this amount of time is truly an incredible feat, and one that should not be taken lightly. Spending your entire working life helping the community when they are in their greatest times of need, is one of the most honourable things a person can do.
For those aspiring to become a paramedic, he recalls something he would always tell himself before going to a job. “Have a good look around when you’re walking in, and take note of the quickest, safest exit strategy. More importantly, especially these days with drugs and other things, some people might have the attitude, oh it’s just another druggy and not take the situation as seriously as they should. “I never had a preconceived idea of a situation before I got there. I always think, I’m going to a job, we’ll assess it when I get there. I haven’t made any decisions at that stage. “Always be calm. People have these preconceived ideas and walk in with an attitude, and people can sense it, which can cause other situations to erupt.” Henry says, without hesitation, “if you want to be a paramedic, go for it, because it is a fantastic job. “There is nothing more rewarding than a job like this. I love the job and I enjoyed going to work every day.” Paramedics across Australia and the world serve their communities with everything they have, but sometimes, some people or situations cannot be saved. “The hardest part [of being a paramedic]? Telling someone that you could not save their partner, child or loved one.” In his career, Henry recounts some of his most memorable moments, one being becoming one of the first four ambulance officers to become an aero medic with the St John air ambulance. Henry assisted Don Fewster in setting up the air ambulance. Additionally, he was also a tutor to other aero medics, and undertook over
400 hours flying time, which led him to later take on the role of air ambulance coordinator. June Congdon, Member Engagement Officer at the Western Australia United Workers Union, says, “to achieve such longevity in the paramedicine field is quite remarkable. Henry has committed his working career to helping the people of Western Australia when they have been at their most vulnerable and in urgent need of care. “Henry has also been a staunch supporter of the union movement, and has been a member of the United Workers Union for 47 years. As a Union Delegate, Henry was most passionate about the safety and care of patients, and the safety of his colleagues. Even in retirement, he still makes himself and his extensive knowledge of St John Ambulance available to the Union. “We want to wish Henry the very best for his retirement, and to thank him for his service to both the people of Western Australia, and the United Workers Union.” Henry truly is one of the humblest people I have ever met, and I am thankful that I had the opportunity to interview him. When I asked him to tell me something about himself, he said, “not much to know … just an old average joe who enjoyed what he did.” From all of us at Ambulance Active, we would like to congratulate you for your 47 years at St John, working as a paramedic, saving countless lives, and loving it every day until you retired. May your retirement years be filled with fishing and spending time with friends and family. You are an incredible man, and we thank you.
Savannah White 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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Proudly supporting the paramedics
The official journal of the Australasian Council of Ambulance Unions.