The variable psycho-social demands of the public, constitute a sufficient demand on the working life of operational paramedics; without the contending with the inconsistency, dysfunction and incompetence of its management.
The prevalence of this institutional trauma is such that the new breed of paramedics is given a working life expectancy of between 5 to 7 years. Thereafter, the effects of the physical and moreover mental stresses will present NSW Ambulance with circumstances beyond their limited abilities to manage, let alone resolve. The primary option (for organisational convenience and cost savings), then “offered” to staff is separation from the organisation i.e. resign, and so speed the process of detachment.
Many unfortunately find themselves with Post Traumatic Stress Disorder (PTSD) brought about first by trauma and then aggravated by the moral injury of institutional betrayal and lack of appropriate support.
Institutional betrayal can involve both acts of omission and commission. Retaliation and persecution are the most obvious act of commission by the organisation i.e. a person complains and suddenly the organisation turns hostile towards them. Passive forms of betrayal include, institutional tolerance for bad behaviour, investigations lacking transparency, untimely complaint resolution, inadequate or inconsistent sanctions, and other forms of effective indifference. Filing a complaint carries the risk that you will be doubted, blamed, refused help and denied protection. People take that risk because they trust the institution to “fix it and make it right.”
In 2005, and in the face of overwhelming bullying and harassment, wife, mother and Paramedic Christine Hodder took her own life. Her protests to NSW Ambulance senior management went largely ignored.
The management that should have protected and supported her, instead treated her complaint with contempt and were complicit in the perpetuation of a bullying culture. The status quo was maintained and the culprits survived without reprimand or sanction. Following this tragedy, a Parliamentary Inquiry was held in 2008, from which the recommendations made were intended to stimulate NSW Ambulance to make positive changes within the Ambulance Service culture. Their efforts in response (although full of promises) were feeble, pathetic and without any honourable motivation. Changes seen by operational paramedics was more policies, loaded with rhetoric to appease the recommendations and give the appearance of insight into their own toxic culture.
This fundamental failure, posturing and lip service only served to heighten the effect of the moral injury. There was never the necessary oversight and no real accountability. Frustratingly, the attitude of senior management of entitlement and being “untouchable”, not only prevailed but flourished.
In the last State Budget, some $30m was granted to NSW Ambulance to “improve” the mental health and well-being of its staff. Unfortunately, this is $30m that tax payers will see little benefit and no fundamental improvement in the attitude of the organisation. The perpetrators of this toxic culture still reside in their positions of authority (making the same inept decisions) and their only legacy is to ensure their blinkered perceptions are upheld by the next generation of managers. Notional policies have been “revised” and sealed with the statement “compliance is mandatory”. Ironically, those making the policies and demanding compliance, are those who have consistently failed to uphold their own words. Policies, rather than a genuine attempt at cultural change are constructed to provide managers with more tools to control, harass and bully staff, without accountability or procedural fairness.
At the most recent Parliamentary Inquiry, the CEO, Dominic Morgan, appeared with an impressive entourage of “supporting” (defence) staff (including lawyers and barristers, all paid for by the tax payer); armed with boxes of policy. Despite this preparation, his testimony was contemptible and insulting to the Committee and staff of NSW Ambulance. He floundered when asked even the most rudimentary questions about the organisation which he leads. He demonstrated a complete lack of insight (an observation made multiple times by the Parliamentary Committee). Instead, he merely re-stated the same old pattern of tiresome rhetoric i.e. that with policy and titled people in place, everything was “under control”.
The reality, (and what is carefully hidden from the public) is that, everything is not “under control” or even OK. In fact, the suggestion that NSW Ambulance (and its CEO) have any insight or motivation for positive change adds insult to his failure and speaks volumes about the impotency and corruption within his own organisation.
NSW Ambulance act as self-appointed gatekeepers, judges, jury and executioners of the process of raising a complaint or grievance from within the organisation. What they have created is a complex bureaucracy to thwart anybody but the most determined to seek justice and report misconduct. These processes have no independent oversight, no transparency and no right of appeal. It is for all intents and purposes an organisational dictatorship.
NSW Ambulance behaves as if it is exempt from the legislation and codes of conduct, expected of Government, taxpayer funded organisations. Work Health and Safety Legislation and codes are consistently and deliberately flouted, and the rights of injured workers (physically and/or mentally) disregarded.
The public of NSW has a right to know how their tax dollar is being spent, and this knowledge will only come from placing NSW Ambulance under greater scrutiny and in a transparent manner, holding to account those who choose to mis-manage an organisation on which the public depend, each day. There is no choice of service provider when 000 (Ambulance) is dialled, and unlike a commercial body with competitors, NSW Ambulance has a ready supply of funds from the public purse. The truth would show they have a long-standing reputation for wasting public money on ill-conceived campaigns and projects, without actually resolving the long-standing issues. NSW Ambulance rely on the apathy, complacency and lack of power of the public, NSW Health and the NSW Parliament, to avoid the difficult questions and avoid making the necessary changes.
Despite the investment and the promises, NSW Ambulance is not in the premier league of pre-hospital providers in the world or even Australia. Skills and equipment which are proven, tried and tested throughout many other services across Australasia, and the world, are woefully absent here. Instead money has been thrown into a new uniform and fresh new logos on vehicles; but these do not constitute the changes required. Due to mismanagement, and except for Tasmania, NSW Ambulance has the slowest metropolitan (@ 23 mins), emergency response times in Australia. This is not an acceptable level of service for the people of NSW and has nothing to do with the work ethic or determination of Paramedics at the coal-face.
Aided by diminishing moral, dysfunctional, incompetent management and a prevailing culture of nepotism and “incestuous” behaviour with insurers and other entities, NSW Ambulance does not possess the will nor the insight required to change itself into a worthy and acceptable organisation.
NSW Ambulance needs to be put on notice, that the people of NSW will not tolerate the mismanagement and failure any more.
Based on the words of an anonymous source…