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ABC News
20-07-2025
- Health
- ABC News
Health unions in pay talks with SA government speak out about ongoing healthcare challenges
Standing outside the Royal Adelaide Hospital emergency department, nurses' union secretary Elizabeth Dabars did not mince her words. Three-and-a-half years after Labor was elected on a promise to fix the ramping crisis, one of the state's key health unions had a message for the South Australian government. "We are sick and tired of being placated and told that people are working on things," Ms Dabars said, flanked by a group of members in scrubs. The union this week went public with concerns over what it calls "internal ramping" — the practice of caring for patients in makeshift areas because no bed is available. Asked about what had prompted her to speak out about the issue, Ms Dabars said she had spent months trying to work with the government behind closed doors — to no avail. "We have tried every single avenue humanly open to us to resolve this concern," she said. Health Minister Chris Picton fired back, responding "we don't accept that terminology from the trade union" — while SA Health claimed it was standard practice to care for patients in alternative spaces while they wait for a bed. The nurses are not the only health workers to have aired their concerns publicly in recent weeks. The unions representing doctors and paramedics have also criticised the government over its handling of issues including ramping, hospital overcrowding and safety. Ambulance Employees Association secretary Paul Ekkelboom this week raised issues of ramping and resourcing in the wake of the death of a man involved in a car crash at Sellicks Hill. SA Salaried Medical Officers' Association (SASMOA) chief industrial officer, Bernadette Mulholland, has highlighted safety concerns over working conditions inside hospitals. In most cases, a union boss calling out the government is hardly remarkable. Yet, for much of Labor's term, health unions faced criticism for keeping too low a profile as ramping hours climbed and the system struggled to cope under enormous strain. The relative silence was most stark in the case of the Ambulance Employees' Association, which had played a key role in helping to turf out the previous Liberal government and get Labor into office. The union helped the then-opposition to humanise the ramping crisis — raising the cases of victims and speaking out about the toll ramping takes on paramedics. "Ash the Ambo" became the face of the campaign, issuing a powerful warning to "vote Labor like your life depends on it". Following the election, the union faced accusations it was failing to hold Labor to the same standard it had the Liberals. Even as ramping continued to reach eye-watering levels, former secretary Leah Watkins showed a more sympathetic approach to the new government — insisting in interviews it would take time for Labor's funding boost to alleviate pressure on the system. Mr Ekkelboom was installed last year as union secretary, thoroughly defeating Ms Watkins after promising to re-establish the AEA's "political independence" and take a "stronger stance" on ramping. The increasing union loudness comes at a time where doctors, nurses and paramedics are all in the midst of pay negotiations, some of which are threatening to turn hostile. The Australian Nursing and Midwifery Federation said discussions with the government are continuing, while the doctors have already held a stop-work meeting and are planning a strike later this month. SASMOA wants 10 per cent annual pay increases over the next three years — a demand the government has called untenable. Bosses have been quick to shut down any link between their recent criticism and the ongoing pay talks. "Let me be very clear. This is nothing to do with that," Ms Dabars said on Wednesday. Mr Ekkelboom said it would be disrespectful to make any comment on his union's wage negotiations while he was speaking out about the death of a patient. But public commentary is one of the most powerful tools at the unions' disposal — and one some are using now more than at any other point in this term of government. It's been a quieter couple of weeks for the Health Services Union, which earlier this month reached a deal with the government on their new enterprise agreement. Eight months out from the next state election, Labor is widely considered by politicians and pundits to be overwhelming favourites to win another term in office. With a popular premier and an opposition struggling to land punches, there seem to be only a small handful of issues with the potential to inflict real damage on Labor between now and March. Whether the difficulty the government has faced to deliver on its promise to fix the ramping crisis is one of those potential banana skins remains to be seen. Public concern around the state of the health system is not at the same level it was in 2022, when Labor was swept to power on the back of its ramping pledge. But the state's health unions hold the power to change that — and, whatever their motivation, they're looking ready to use it.
ABC News
14-07-2025
- Health
- ABC News
Ambulance union raises response time concerns after man's death at Sellicks Hill
Concerns about ambulance ramping and resourcing have been raised by the state's ambulance union in the wake of the death of a man involved in a car crash at Sellicks Hill, south of Adelaide, on Saturday morning. The Ambulance Employees Association (AEA) said it took 17 minutes for an ambulance crew to arrive at the scene of the category one case — which in metropolitan areas would require a response within eight minutes in 60 per cent of cases. Health Minister Chris Picton said the patient was "outside the Adelaide metropolitan area". South Australia's Ambulance Service (SAAS) chief executive Rob Elliott said the patient was seen as soon as possible "on our most urgent priority", with multiple resources sent to the scene He said it was "not very sensible" to aim for an eight minute response time in regional areas where towns could be sparsely located and that SAAS instead endeavoured to "make sure that we have good regional coverage, good access to resources". He extended his sympathy to the man's family, and praised the "extraordinary" efforts of the bystanders and paramedics who attended the scene. AEA general secretary Paul Ekkelboom said the case was initially triaged as a category two but within two minutes was upgraded to a category one case where "every minute counts". He said the "number one thing" affecting ambulance response times was available crews. "When we don't have crews sitting on station or actively free to respond then it's going to be a delay to get a crew to respond to a patient," he said. "When they're stuck on a ramp, then obviously we can't free them up to respond to the community. "The real effect is obviously when we can't get to our patients in time to administer life-saving care." When asked if the man in this case would have survived if the ambulance response time was faster, Mr Elkkelboom said he was "unsure" but added that he did not have all the patient's medical history. "What we do know is if we can get there in a timely fashion, oxygenate the brain, and keep that blood pumping and give them the life-saving care that [is] needed, there's a good opportunity that we might be able to get a favourable outcome," he said. He said bystanders at the scene did their best to help while awaiting the arrival of paramedics. While he said demand on the health system was high, Mr Ekkelboom acknowledged the government had planned to open more beds later in the year. "I don't want to see another patient in the community experience what unfortunately happened to that gentleman over the weekend," he said. Mr Picton said at the time, the ambulance from the closest station "was at another job in the community, assisting someone else". "Our crews did everything they could to get to that case as soon as possible," he said. Mr Picton said that because the case occurred outside the metropolitan area, the eight minute response time goal applicable to metropolitan areas did not apply. When asked, he said ramping did not play a role in this case "based on the regional location". Last month's ramping numbers were the second highest on record, with ambulances spending 5,387 hours waiting. Mr Picton said the state's health system — including the ambulance service — was currently dealing with the highest number of influenza cases in the state for the past decade. He said while 2,000 influenza cases had been recorded in the past week, the numbers were "vastly underestimated" because not everyone with the flu had a PCR test. There were 164 hospital admissions due to the flu. "Our health system is under pressure, we know that the flu numbers are up, we know that admissions to hospitals are significantly up, but our doctors, nurses and ambos are working as hard as they can — particularly to see the most urgent cases — to make sure that people can get the care that they need," he said.
ABC News
16-06-2025
- Health
- ABC News
Ambulances queued outside Mount Gambier Hospital 'not ramping', SA premier says
South Australia's salaried doctors and paramedics unions say reports of potential "ramping" and staff shortages at the Mount Gambier Hospital need to be taken seriously. In the past week, photos of up to seven ambulances waiting outside the hospital, in the state's largest regional city, have been posted to social media. The photos ranged in time from 2024 to as recently as Wednesday and Thursday of last week. When asked about the images, SA Premier Peter Malinauskas told ABC South East SA his advice from the Limestone Coast Local Health Network was that the incidents were not ramping. He said patients were waiting for treatment on stretchers inside the hospital building and not in the back of ambulances. "Ramping is when someone arrives at a hospital in the back of an ambulance and then isn't able to get out of the ambulance into the hospital in the appropriate time frame." The premier added some of the ambulances in the images were transferring patients between health facilities and were not undertaking an emergency response. "But that's the advice that I've received and I've got no reason to discount it." Mr Malinauskas campaigned heavily on addressing the state's ramping crisis in the lead-up to Labor's 2022 state election win. Ambulance Employees Association SA general secretary Paul Ekkelboom said the premier was arguing semantics over an exact definition of ramping. "Either way, it ties up the ambulance and it makes it unavailable to respond to the community. "Our members have had multiple reports that both forms occur, whether that be internal or external." Mr Malinauskas denied differentiating between patients waiting inside or outside the emergency department was arguing the semantics of ramping. Prior to the 2022 election, Labor MPs raised concerns in state parliament about "internal ramping", including in 2019 by Member for Wright Blair Boyer regarding the Lyell McEwen Hospital in Adelaide. In 2021, Light MP Tony Piccolo talked about the prospect of "internal ramping" at the Gawler Health Service. Mr Ekkelboom said ambulances not being able to leave the hospital was "genuinely scary". "The last thing we [want to] see, and it's happened before, is that there's no ambulances to respond to people in the community," he said. "You take a cardiac arrest — seconds means the difference between potentially life-sustaining treatment. "If we have ambulances ramped for an hour, we can't respond to anyone." The South Australian Salaried Medical Officers Association (SASMOA) completed a site inspection of Mount Gambier Hospital's emergency department in February and told ABC News ramping was "common" and raised concerns about staffing levels. Speaking in response to Mr Malinauskas's comments, chief industrial officer Bernadette Mulholland said staffing remained an issue. "What we are looking for is medical workforce reviews of the ED there and the other clear request from members is more senior staffing in that ED to be able to assist with the patient presentations." Construction on a $24 million upgrade to the Mount Gambier Hospital is ongoing, which will increase the number of beds and expand the emergency department. It will also include upgrades to a dedicated mental health unit.
