“Despite concerns being well known within SJANT, the voices, concerns and the frustrations of front-line clinicians are not being heard, or are being ignored, by those who are responsible for the provision of safe ambulance services within the Territory,” they said. “All Territorians need to be made aware that SJANT are failing in their responsibility to deliver high quality healthcare on several fronts.”

St John Ambulance NT would not comment for this article, nor would Chief Minister and Health Minister Natasha Fyles, but United Workers Union NT secretary Erina Early said even before COVID-19, the workload in the NT had been increasing significantly, with no extra resources being made available.

“Currently, crews will often work a 12-plus hour shift without a single effective break in that period,” she said.

“Our NT ambulance service is at crisis levels and government does not care as our ambulance service is not run by government.

“Our paramedics, patient transport and ambulance officers deserve better, it is time for government to intervene in the NT Ambulance service before it is too late.”

In early May, the NT Independent reported that a UWU NT survey found more than three quarters of NT paramedics said St John Ambulance puts profits ahead of the welfare of workers and nearly half say they had been bullied and harassed by management for engaging in protected action during bargaining negotiations.

The survey also found that 86 per cent of paramedics feel that the “NT government and opposition does not care about the issues facing the NT Ambulance service and its employees”.

It also revealed that 78 per cent of staff who responded feel their welfare is ignored in regional centres due to the current on-call rosters and the lack of fatigue management, while that 78 per cent also said they have not been provided training or professional development which they have been paying for over the last two years.

Nearly 150 staff members took part in the survey, the union said.

‘No confidence’ in executive management team: Ambos

In late June, the NT Independent reported the Ms Early had said student paramedics and ambulance volunteers had been used in St John ambulances to deal with critical patients, including a person who had hanged themselves, and those who were suffering seizures or needing resuscitation, without supervision of an experienced paramedic.

The students and volunteers known as “ambulance assist” staff were being used without professional paramedic backup or delayed backup, Ms Early said, and had a minimum advanced responder level (which is the same level as a patient transport officer). Most have advanced first aid training, and were supposed to have been moving COVID-19 positive patients and selected close contacts in Darwin, as funded by the NT Government.

At the time, St John director Andrew Thomas declined to comment but the whistleblowers said this practice had now stopped.

The group of ambulance workers said this week that no confidence in management remains a key issue.

“Similar to the NT Police, SJANT employees and volunteers speak freely of an increasing lack of confidence in the outgoing chief executive officer, director of ambulance services, and the remainder of the executive leadership team, the majority of whom have recently resigned,” they said.

‘Stopping the clock’: Ambulance drivers instead of paramedics sent to emergencies

One of the stark examples of problems provided by the employees was the “every day” use of non-emergency patient transport officers, who hold a Certificate III in Ambulance Transport, being used as “clock stoppers” to meet key performance indicators on Triple-0 calls.

“This means that if your relative has a heart attack, they may not get a paramedic,” they said.

“Many times, on the most serious of calls, the ‘Priority 0’ calls, no paramedic, critical response unit or duty manager are available to attend.

“Every day we still see the patient transport unit drive lights and sirens to emergency jobs where the community are expecting a paramedic.

“Paramedics have four years of training between university and then on the job training before getting their authority to practice. Patient transport officers have three weeks of training and are being sent to emergencies they do not have the education or tools to manage.

“Reports released by SJANT to government, may appear to indicate SJANT is meeting contractual requirements, but what Territorians are not told is that patient transport officers continue to be sent under lights and sirens to emergencies to impact statistics by stopping the clock.”

Ms Early backed the employees’ account that the “clock stopping” practice happened daily and said there was a lack of transparency around it.

“St John NT do not provide the stats on how many jobs patient transport officers go to, which should be high acuity jobs for first responders,” she said.

“Our members tell us at least two to three per shift a day. St John is intentionally misleading the public.”

An attrition rate far larger than the rest of Australia

The whistleblowers said the ambulance drivers being sent to emergencies could be caused by a “horrible attrition rate”, an outdated and inefficient recruitment process, dropped paramedic shifts, and paramedics being used to cover events who pay SJANT for the service at expense of the emergency ambulance service.

“We are burning out. We have been so tired for so long that a lot of people don’t do overtime to cover vacant shifts anymore. It leaves the shifts busier and the next group of people fatigue too. It is a vicious circle,” they said.

Mr Early said that according to a Federal Government Productivity Commission report published in February, NT ambulance services consistently reported the highest staff attrition rate of any service in Australia, and by a very significant margin.

For the 2020-21 financial year, that figure was 16.6 per cent, with the next highest being Western Australia at 5 per cent. In the 2019-20 financial year it was 20.2 per cent, with the next highest being the ACT at 4.3 per cent, and for the 2018-19 financial year it was 12.6 per cent, again compared to the ACT at 6.2 per cent.