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'Implied' ICAC threat as paramedics speak out over hospital ramping

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The state’s ambulance boss today warned paramedics they could face trouble with ICAC if they speak publicly about long enforced waits outside full public hospitals, prompting accusations that the government is trying to “gag” comment about an ongoing health issue.

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The SA Ambulance Employees Association and members went on a media blitz on Tuesday after all metropolitan hospitals went “code white” on Monday night, with 88 patients waiting for a bed and 15 ambulances ramped at the Royal Adelaide Hospital at around 8pm.

One member, paramedic Josh Cox, told reporters he worked a 12-hour shift with no break on Monday, with one case ramped for four hours while there were “uncovered lights and sirens jobs that we just did not have the resources to send”.

SA Ambulance Service Chief Executive David Place sent a letter to paramedics on Tuesday, warning employees they “may commit misconduct” if they speak out in violation of the public service code of ethics.

Place this morning rejected suggestions he was threatening paramedics, but then went on to say ICAC may become involved if the public sector workers speak out.

“I’m just trying to put out a call to them to say be careful, because when you breach that code of conduct, there may be implications of that,” Place told ABC radio this morning.

“Not that we’re intending to do that, I fully support our people being able to say what they need to say as a member of the public, but what we find sometimes in a heated situation like we’ve got at the moment, some people say things with incorrect information.

“My fear is that they will, firstly, maybe scare the public into not ringing for an ambulance believing that it won’t attend.

“The second issue is the ICAC commissioner has made it pretty clear that public sector employees need to adhere to that code so once they breach that code, I can’t necessarily protect them.”

Place added that he has not spoken to any individual paramedics about their decision to speak out, and whether he would depended on “how outrageous the claim”.

SA Ambulance Employees Association industrial officer Rob Leaney said Place’s comments about ICAC carried an “implied threat”.

“Obviously it’s trying to silence other members from standing up, and voicing their concerns,” Leaney told InDaily.

“He’s portrayed it as just advice and just a reminder, but there’s an implied threat in there which we’re not happy with at all.”

Asked whether the latest threat would dissuade members from speaking out, Leaney said: “I suspect it may with some … a threat from the chief executive they won’t take lightly.”

“But what we’re hearing is it’s buoying others up that wouldn’t have come forward now to come out and speak,” he said.

“So we’ve pretty much got a queue of members that are now actively saying … we’re prepared to speak up on radio and television because something needs to stop and something needs to change here.”

Leaney also rejected the ambulance boss’s concern that paramedics making public comments about ambulance call outs could pose a risk to patient confidentiality.

“They would never breach patient confidentiality, they’re health professionals, they would never do that,” Leaney said.

“Patient-first is their mantra, and they see that this (speaking out) is putting the patient first.

“It’s a very unusual circumstance, I don’t think I’ve seen this in thirty years where our members have been so compelled to stand up and say these things.”

Opposition Health Spokesperson Chris Picton echoed the union’s criticism, and called on Place to retract both his email on Tuesday and his comments on radio today.

“This is a startling escalation, and this is a sign that the government is at war with their own staff,” Picton told reporters this morning.

“The threats that were made on radio this morning need to be retracted, and the government should listen to these paramedics and invest the resources needed.”

Health Minister Stephen Wade said he would be meeting with Place on Friday to discuss the issue, and reiterated his opposition to gagging health workers.

“I’ve consistently made it clear to health leadership that I do not believe it’s acceptable that health officials be gagged,” Wade told reporters today.

“I’m sure that CEO Place is aware of that.”

The minister clarified that he wants patient confidently to be respected, but would not support gagging employees for discussing the provision of healthcare.

“There are certainly constraints on health professional in terms of the revealing of patient details, so certainly I don’t think it’s inappropriate for Mr Place to remind people of their public sector ethics,” he said

“But we are in a free society, and as health minister, I respect my health professionals being part of a conversation about how to improve services.”

The increased attention towards ramping this week comes amidst a nearly four-year industrial dispute between the government and the ambulance union.

Place revealed on ABC radio this morning the workload of paramedics has been growing on average by 4.5 per cent each year, but resource funding for the agency – tied to the consumer price index – has only grown from 2 – 2.5 per cent annually.

“I actually do believe that we need more resources but the resources we need to be more effective,” Place said.

“We’ve got a 1990s ambulance service model trying to solve a 2020 problem.

“The union believes it’s very simplistic it’s just about resourcing, we believe it’s much more complex than that.”

Premier Steven Marshall told reporters on Tuesday that the government takes ramping “very seriously”, and said they were looking at a range of solutions – from ambulance resourcing to hospital patient flow – to solve the problem.

“The ramping is unacceptable, it’s not something that we are sitting on our hands about,” Marshall said.

“But there’s no simple solution to the situation that we inherited from the previous government.”

He added that ongoing upgrades to the Flinders Medical Centre had temporarily reduced the facility’s emergency department capacity.

“One of the things that is compounding the problem at the moment … is that there has been a slight contraction at the ED capacity at the Flinders Medical Centre which is putting some pressure on the overall system at the moment.

“But we are working to get that stood up as quickly as possible.”

The premier also pointed to the more than 180 paramedics his government has hired, and the upgrades completed on 46 ambulances across the state’s health network during his time in office.

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