The SAAS request – obtained by the opposition through freedom of information and seen by InDaily – was mentioned to SA Health CEO Dr Chris McGowan by the organisation’s former Executive Director of Operational Service Improvement Lyn Dean in an internal memo dated February 14, 2019.

The memo recommended that McGowan swiftly approve the contracting of a consulting firm to develop a preliminary assessment of the SAAS’s request and the “economic impacts relating to rebalancing the South Australian health system”.

“This contract is in response to an urgent government policy decision,” Dean wrote.

“The urgency is in regards to the consideration of a significant policy and budget commitment for the SA Ambulance Service.

“It therefore must be considered within the broader roadmap of service planning and reform being prepared by SA Health and is required urgently.”

Dean noted the SAAS’s funding submission was so urgent that “if an open market procurement process was used for this preliminary narrative report … then the immediate needs of government to make an informed decision about the SAAS proposal could not be met”.

McGowan approved the preliminary report four days after the memo was submitted. Later that year, InDaily revealed the details of a broader report the government commissioned from consulting firm PwC relating to the “economic analysis narrative for rebalancing the South Australian Health system”.

The PwC report, worth $93,671, outlined plans for a revamped out-of-hospital and non-government health services sector – criticised at the time by union groups who raised concerns about privatisation.

It comes as the Ambulance Employees Association this morning entered into mediation with the government to resolve an ongoing industrial dispute over ambulance resourcing and rostering reform.

Since Wednesday, paramedics have not been identifying ambulance patients for billing purposes if they experience prolonged wait times outside hospitals.

The union has indicated it may expand this action to cover all patients, which could cost the government hundreds of thousands of dollars given transport fees accounted for 117.2 million dollars in revenue last financial year.

Opposition Health Spokesman Chris Picton said the government could have avoided industrial action if they responded to the advice received in 2019.

“The Marshall government has had advice for two years that they need to put more money into ambulance services,” Picton said.

“It was a request that was made to the government, and likely to the cabinet level, which was listed as urgent and significant from SA Ambulance Service about the need for additional resources.

“If that funding in that request had been approved at the time, then we may not be in the serious situation we’re in right now.”

Picton called on the government to “release all the details of that request” and “explain why it is that they decided not to meet [it]”.

A state government spokesperson defended the government’s resourcing of the ambulance service in 2019, pointing to an increase in full-time paramedics.

“As the Budget papers show, the SAAS workforce was boosted by 76 FTE in 2019/2020 – part of a 25 per cent increase in the SAAS budget under this Government,” the spokesperson said.

“The State Government has shown its commitment to give SAAS the resources it needs and will continue to do so.”

The spokesperson criticised union industrial action.

“The union bosses are holding back both the resourcing and much-needed reform of the ambulance service and doing a disservice to both their members and the South Australian community,” the spokesperson said.

“We urge them to come back the table so we can together build an ambulance service fit for the 21st century.”

SA Employment Tribunal President Justice Steven Dolphin ordered the union into mediation late Thursday.

Treasurer Rob Lucas, who is also responsible for industrial relations, said an agreement in mediation would require “compromise from both sides” and the cessation of all industrial action from the union.

“We welcome this development and hope that, ultimately, it leads to sensible discussions, which is something the Government has long been calling for,” Lucas said.

“The Government has always been willing to negotiate fairly and sensibly with the union, in the interests of hardworking paramedics and all South Australians, as we strive to further improve our ambulance service.

“As we have indicated publicly, the Government remains willing to provide further additional resources to the ambulance service so long as the union agrees to sensible industrial reforms, including in relation to rosters (shorter shifts) and meal breaks, and the cessation of all industrial action.”