Private Members Statement: Regional Paramedics

Legislative Assembly Hansard – 07 May 2025 

Private Members' Statements

Regional Paramedics

Mr JUSTIN CLANCY (Albury) (20:16): Our paramedics are highly skilled professionals—the backbone of our emergency response system, delivering critical care to patients in often challenging and time‑sensitive situations. Their unwavering service, professionalism and ability to respond under pressure keep our communities safe. Regional communities rely heavily on the expertise of NSW Ambulance paramedics, yet we see stark disparities between metropolitan and regional services.

One of the most pressing concerns is the limited availability of Extended Care Paramedics [ECPs] and Intensive Care Paramedics [ICPs] outside metropolitan areas. Those advanced models of care have been proven to improve patient outcomes, reduce unnecessary hospital admissions and ease the pressure on emergency departments. The benefits of the ECP model are clear. A regional pilot program is currently underway where Extended Care Paramedics work alongside nurse practitioners, registered nurses and allied health professionals in a multidisciplinary urgent care team, responding to non-life‑threatening cases in patients' homes. This approach prevents avoidable hospital presentations and keeps paramedics available for true emergencies.

ECPs can manage wound care, catheter changes, dispense certain medications and provide advanced clinical assessments for elderly or mobility‑impaired patients who struggle to access GP appointments. The introduction of ECPs in communities like Corowa, Holbrook and Tumbarumba would improve patient care and alleviate pressures on hospitals. A practical example from our own region demonstrates the need. Recently, a patient presented at a small regional hospital with a dislocated shoulder. Under normal circumstances this would have meant a painful, hour-long transport to a larger hospital. Fortunately, one of the responding paramedics was a trained ECP on secondment, who, under clinical guidance, was able to safely reduce the dislocation onsite. This not only spared the patient significant pain and stress, but also kept local ambulance crews available for other emergencies and saved hospital resources.

Currently, there are no NSW Ambulance‑funded ECP positions outside the greater Sydney region—a limitation that is actively holding back regional health care. Worse still, paramedics who have undertaken ECP training are forced to relinquish their specialist position if they wish to transfer back to a regional or rural station, reducing those paramedics to general duties. It is a policy that not only disadvantages patients but also actively disincentivises senior paramedics from working in regional New South Wales.

The situation for intensive care paramedics is equally concerning. Albury station is the only Category A station in our electorate that is enabled to have an ICP. Yet, of the 12 required ICPs, currently only nine are available, with two on long-term work cover and one in a clinical training role. When ICP-trained paramedics are sent to smaller regional stations, they too must relinquish their title and scope of practice, despite our communities' desperate need for those life-saving skills. Finding 23 of the New South Wales Legislative Assembly inquiry into regional health services found:

NSW Ambulance is restricting Intensive Care Paramedics to large stations and limiting training for Extended Care Paramedics outside of metropolitan areas, which is disincentivising senior paramedics from working in remote, rural and regional NSW and effectively de-skilling the paramedic workforce.

It recommended urgent reforms to lift those restrictions and enable regional expansion of those specialist roles. It is not because our paramedics are not willing; it is quite the opposite. A local paramedic told me recently:

I love working as a paramedic in a regional community. What I find most rewarding is also what makes this work so important: the opportunity to serve people I know and care about. However, one of the most significant challenges we face is the lack of access to specialist paramedic resources such as Extended Care Paramedics. It's incredibly frustrating to know that expanded scopes of practice exist within metropolitan areas but remain out of reach for regional communities like ours. Aspects like this contribute to the decreased life expectancy of our regional, rural and remote communities. I want to keep learning, keep growing and keep serving my community right here, where I belong. But, right now, continuing to develop my skills often means leaving the very place I'm committed to. My goal is to provide the highest standard of clinical care to my patients, and I believe regional communities deserve access to the same advanced care opportunities as metropolitan areas.

The reality is we are asking those highly skilled professionals to choose between career progression and staying in the communities they love. It is a false choice. There exists a capable, passionate pool of paramedics eager to upskill and serve their communities at a higher clinical level. Our paramedics are ready. The New South Wales Government needs to deliver the resources, support and career pathways they deserve.