Nine ambulances backed up at Geelong Hospital on Wednesday, unable to transfer patients
Victoria's accident and emergency system has been accused of acting in disarray, with worsening ambulance response times, demoralised paramedics and a lack of hospital beds prompting concerns that patients' lives could be at risk.
In angry exchanges in the state parliament on Thursday, the government was accused of ignoring a crisis that resulted in nine ambulances backed up at Geelong Hospital on Wednesday, unable to transfer patients to the emergency department.
State opposition leader Daniel Andrews told Guardian Australia he believed "lives could be put at risk" if the delay in transferring patients was not remedied.
The issue, known as 'ramping', has been exacerbated by a long-running paramedic pay dispute that has seen ambulances across Victoria daubed with messages lambasting state premier Denis Napthine.
Ambulance Employees Australia, the paramedics' union, claims ambulances now spend 13,000 hours a month parked at hospitals in Victoria waiting for beds to become available.
The union said that the problem is partially responsible for flagging response times.
A freedom of information request by Labor found that barely one in four ambulances arrived within 15 minutes for critical emergencies in the first half of last year. In some cases, substantial areas of Victoria have been dangerously short of ambulance cover, especially along the state's Surf Coast.
The paramedics' union is embroiled in pay negotiations that have seemingly stalled. The government has offered a 2.5% pay rise on the base salary of $57,000, in return for paramedics giving up certain allowances. The offer has been rejected.
According to the union, Victorian paramedics are among the lowest paid in the country, with their counterparts in South Australia paid $23,000 more a year. However, the Victorian government points out that South Australian paramedics have been stripped of some basic benefits in return for their pay deal.
Steve McGhie, general secretary of Ambulance Employees Australia, said that around half of Victoria's 3,000 paramedics have indicated they want to leave the profession within the next five years.
"Morale is at the lowest it has ever been," he said. "It's a real battle for paramedics. They work for 10, 12 or 14-hour shifts and then can be forced into overtime for 15 hours straight with no meal breaks. On top of this, they deal with death and dying every day.
"We have offered productivity trade-offs but the government's view of productivity trade-offs is to just take things away like sick leave and annual leave. Sick leave is very important as paramedics have a very high injury rate as they are in close proximity to patients all the time.
"We've had slogans on the ambulances for several weeks now, even though Ambulance Victoria threatened legal action if we didn't remove them.
"The public response has been overwhelming. They hold paramedics in very high esteem."
Deficiencies in the ambulance system have been blamed on various underlying factors, including a dispatch system that assigns vehicles for 000 calls that aren't necessarily emergencies. The union also wants paramedics to have the option to treat patients with minor injuries at home, even if they demand to go to hospital.
More broadly, Victoria is facing the challenge of providing healthcare to a rapidly growing and ageing population.
The Victorian government denied that there is an ambulance crisis, with health minister David Davis telling Guardian Australia that the system was "very strong".
"We have the best survival rates in the country, the best outcomes in the country," he said.
"We are focused on clinical targets and they are getting better year on year. There are 10 big country towns that never had MICA (Mobile Intensive Care Ambulance) units before we put them in there. What's important isn't the yapping of Daniel Andrews, it's the clinical results we've achieved.
"Daniel Andrews himself has said that around 40 to 50% of the problems bowled up by the union aren't true and we agree with that.
"Ambulance Victoria has one of the lowest turnover rates in Australia, only 4% of people leave a year. It's a job that people want to keep."
Davis added that the messages displayed on ambulances, which have labelled Napthine as 'Denis the Menace', were "scurrilous graffiti".
"The community doesn't respect the untruths on the graffiti and it's not exactly wise for paramedics to be putting things on their windows which obstruct vision," he said.
Andrews said the "arrogant" Napthine government should take responsibility for the issue of ramping.
"I hear horror story after horror story from doctors, nurses, patients and their families," he said.
"Mr Napthine needs to acknowledge the problem rather than arrogantly denying it. The only person not accepting there is a problem is the premier. All he can do is throw political dirt.
"Instead of blaming everyone else, he should be a leader for once and take responsibility, sit down with paramedics and look at what can be done to improve the situation."