Media Release: National Distribution Union Wednesday, 3 March 2010
Looming workforce crisis in ambulance sector
Ambulance officers are warning of a crisis in the sector as overworked paramedics miss meal breaks because of heavy workloads.
“Very few employees have to wait seven hours to get a meal break, but in the ambulance sector this is becoming more frequent as paramedics struggle to manage the increasing demand on the current resource base,” says NDU Ambulance Sector Coordinator and former paramedic Craig Page.
“With an annual growth of between 6-8%, emergency call volumes are overwhelming the availability of ambulances.”
“Paramedics are suffering as they miss their meal breaks and constantly exceed their work time limits imposed by legislation.”
More double crewed emergency ambulances with well qualified staff were needed, he said.
“Everyone understands that from time to time workload peaks or a true emergency occurs, but when there aren’t enough resources at the best of times or when decisions are made not to cover vehicles, then our members say this just isn’t good enough.”
“Ambulance officers want St John and the government to acknowledge the issue and do something about it. Things briefly improved a couple of years ago when we implemented a penalty for non compliance, but the situation has got worse.”
“Put simply, if nothing improves the sector will lose experienced career Paramedics to Australia. Demand is just as great there, but the pay is better and their employers manage meal breaks significantly better with appropriate compensation to their workers when they can’t get breaks,” Craig Page says.
Ends. For further comment: Craig Page on (021) 776-026.
The National government has finally allocated the money promised by the former Labour government to try and improve ambulance services in New Zealand.
The following message is from Mark Woodard, Group Manager - National Ambulance Sector Office:
On Thursday June 4 Ministers Tony Ryall and Pansy Wong announced the following measures to advance the ambulance service in New Zealand:
100 new paramedics. NASO will be working with providers to assure that these new staff will be located to result in the greatest reductions in single crewing and on-call responses.
Support for rural volunteers to upskill to the Basic Life Support (BLS) level. We will be working with existing providers to organise the details of this programme.
Support for a registration process for ALS and ILS paramedics to achieve recognition under the Health Practitioner Competency Assurance Act (HPCA).
Additional support for the air ambulance sector in recognition of declining community support in this recession.
In addition, the Ministers also announced the release of the New Zealand Ambulance Service Strategy. This revised strategy reflects the input we received from 57 submissions and the 419 people that participated in sector engagement meetings. For example, one of the things that you may note in the final Strategy is the inclusion of a phased work programme, which identifies which initiatives will be actioned first. The final strategy and a summary of both the written submissions and the sector engagement process is posted on our website (http://www.naso.govt.nz).
We have commented to media outlets in response to this announcement.
The draft sector strategy document from the National Ambulance Sector Office (the combined ACC/MoH body) is continuing to be reviewed by sector stakeholders. Facilitated meetings around New Zealand are attracting reasonable audiences to participate in the prioritisation and general discussion of the ten initiatives in the strategy.
Initiative
Key Components
Importance
1
Provide accountable strategic management to deliver leadership to the sector, the form of which is yet to be defined.
***
2
Develop transparent sustainable funding models to meet the total cost of providing ambulance services.
***
3
Monitor audit and publish contractor performance through relevant KPI's, mandate NZS 8156, QA, rural/urban variance.
***
4
Develop a framework for community and key stakeholder involvement in the sector including resource allocation.
*
5
Lift clinical standards, register Paramedics, determine the optimal clinical workforce, and improve career pathways.
***
6
Improve the ability of the sector to meet MCI/CD events, emergency service integration and community resilience.
**
7
Improve and incentivise health care pathways of integration, expanded role Paramedics and improve clinical leadership.
**
8
Improve the research data set, integrate health care information, improve quality assurance activities.
*
9
Review the configuration of ambulance services including the models used and rural/urban variance.
**
10
Establish an independent national clinical advisory group, improve EACC triage abilities and establish international links.
*
Some Thoughts on Prioritisation All the identified initiatives are relevant, logical and necessary steps for the sector to take. We think that above all else we need to work out what we want/need to provide to deliver effective services. When we have the answers to the perfect system, we need to have an effective system to sustainably fund ambulance services. Once we have the funding to deliver our ideal system we need to make sure it is performing, constantly looking at ways to improve and is accountable to the funders and the public ultimately. We have initially ranked initiatives 2, 3, 5 and parts of 9 and 1 as the highest priority for the sector.
Our Concerns
The ambulance sector is full of groups with vested interests. This skews the viewpoint of the relative importance of each of the initiatives. The feedback we are receiving suggests that the NASO meetings have highlighted the need for sector coordination and leadership, well beyond individual organisational leadership. We think the most important initiative has not been identified - the need to develop a structure and a new independent entity to deliver all the initiatives. More commentary will be placed online shortly.
What Do You Think?
We want your feedback on how we should comment as a representative organisation. Do you agree with our initial commentary? What are your thoughts? What do you want us to promote? We need to know your feedback by no later than Friday December 5.
Add a comment specifically about the strategy and your concerns to this thread. We will use your feedback to construct a submission on behalf of NDU Ambulance Professionals.
Remember you can access the strategy and comment directly at http://naso.govt.nz/consultation as an individual by no later than December 12.
The last 12-18 months has seen some major changes signalled for the ambulance sector. Years of union pressure and member commitment to the improvement of their workplace and ambulance services provided to the community have finally been recognised.
Union pressure resulted in the government announcing a Health Select Committee review into ambulance services during 2007, which outlined some major recommendations for change to the sector mid 2008. These critically included the need for greater consistency and cooperation, recommended nationalised training and clinical governance, the professional registration of Paramedics and target timelines for the double crewing of emergency ambulances in metropolitan and large urban centres.
Ambulance NZ (the employer lobby group) began work in a collaborative manner with the sector participants to investigate a newly proposed education curriculum and work together on progressing the professional registration of Paramedics under the HPCAA.
St John (lead employer provider) developed and is about to begin the release of a proposal for major education and qualification/skill level change which should provide national alignment of practice levels pending registration through stakeholder endorsement
The government continued to fund additional positions in response to "hot spot" funding requests from some of ambulance service providers, most notably in response to St John requests for an additional 400 Paramedics over a number of years.
The MoH and ACC established the National Ambulance Sector Officer (NASO) to cooperate on funding arrangements and provide funder led national consistency.
The draft National Ambulance Strategy was released for public and other stakeholder consultation.
NZTA Work Time rule was implemented that theoretically imposed more clarity on the driving related expectations of Paramedics in the performance of their emergency and non emergency roles.
Media pressure from Unions resulted in the issues of ambulance funding and service deficiencies being raised to the wider attention of the public, but more critically to the attention of politicians.
Commitment to national terms and conditions through union pressure to develop multi-employer collective agreements and the lead provider St John agreeing in principle to work towards national parity.
Despite all the changes, the critical missing link is the commitment of central government to adequately fund emergency ambulance services. Most elections the NDU raises the awareness of general issues that impact workers without intentionally showing party preference. Whilst we are cognisant that our members are free to make their own decisions, we wanted to use this forum to identify key party policies in regard to the ambulance sector. In this period of high public interest in ambulance services, we expect comprehensive policies on the ambulance sector from the lead parties.
We have reviewed the literature that is publicly available on the respective parties website about ambulance services, focussing on recent comments in the last 12 months. This generally includes all public statements includind media releases. Additionally, Iain Mackay (a WFA Intensive Care Paramedic and CAWU Head Delegate) also sent three questions to the main parties for comment. The questions were:
Do you share the view of ambulance officers that all emergency ambulances should be staffed with two qualified ambulance officers?
Do you believe that ambulance services muct be adequately resourced and able to comply with NZTA work time regulations?
Do you believe that by comparison the response time requirements in NZ are too low and should be the same as other developed countries?
The statements and/or answers to the questions stated above are detailed below, including any specific policies about ambulance services.
Some of the more interesting comments are provided below:
Volunteers are a strong and vital part of many communities, and as such, are an extremely valuable resource. Any move to have ambulances only crewed with a salaried workforce is bound to undermine our rural and provincial communities (Jo Goodhew - National Party)
The Green Party will look into replacing the current largely voluntary system with a professional ambulance service that is an integral part of the public health system. We will increase funding for the provision of ambulance services, and integrate funding into one single provider. (Sue Kedgley - Green Party)
I think fire and ambulance services in NZ are complimentary frontline service activities that should be contracted out professionally to private enterprise, regulated by one health authority in a similar way to the reserve bank with one Governor. (Kevin Campbell - ACT Party)
Recent Vote Health increases in funding (for St John, Wellington Free Ambulance and Emergency Communication Centres) has consisted of:
A 19% increase for 2006/07 on the 2005/06 base funding
A 25% increase over two years on the 2006/07 base funding
A one-off 5% payment, to St John and Wellington Free Ambulance, on the 2006/07 baseline funding in 2007/08.
A $47 million dollar increase announced going forward from 2008.
(Labour Ministers of Health & ACC - Labour Party)
We are not making any recommendation either way about who you should vote for, either party wise or local politician wise. The only request we would have is that you do actually vote, having contemplated the effect of your vote on the future of New Zealand and how it might impact on you and others going forward.
Unfortunately time constraints have limited our ability to comprehensively review each political parties policies or commentary. The collated results are the product of a quick investigation. If you know of any additional policies or viewpoints, use the comment function to update this article.
