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Maxwell welcomes emergency action budget

Media statement

May 3, 2022

Victorian Budget 2022-23

Tania Maxwell MP has welcomed the state government’s $457 million budget commitment towards improving ambulance response times.

The Derryn Hinch’s Justice Party Member for Northern Victoria said she had pushed successive emergency services ministers since 2019 to fix performance problems that can be life-threatening in regional Victoria.

The government today announced spending of $333m to recruit another 400 call-takers and despatchers to the Emergency Services Telecommunication Authority and $124m to recruit and train another 90 paramedics, improve ambulance fleet management and staff rostering, and reduce bottlenecks at hospital emergency departments.

“I’ve been raising ambulance service issues consistently with the government across the past three years,” Ms Maxwell said.

“I’ve brought to ministers’ and parliament’s attention many times the challenges my communities face with Emergency Services Telecommunications Authority call-handling, ambulance emergency response times, hospital ramping and how community paramedics and first-responder services could be supported to reduce the strains on our health system.

“But the COVID-19 pandemic and its aftermath seem only to have made things worse.

“When every second counts, the latest Ambulance Victoria performance data shows Northern Victorians had to wait 50 seconds longer on average in the three months to the end of March than they did for an ambulance to arrive at a code one call-out in the previous quarter.

“Across 27 local government areas in my electorate, people wait on average 20 minutes 16 seconds for an ambulance called to an emergency, almost two minutes more than they did a year ago.

“And in Indigo in the North East, one of our smallest shires by population and area, the latest data shows the average emergency response time has blown out three minutes in the past quarter, to 24:51 minutes, and more than 2:12 minutes in the past year.

“At the same time, there’s been good news for Mansfield residents, where code one call-out average response times have improved 2:18 minutes in the past quarter and 4:24 minutes in the past year.

“But in so many areas, like Towong (31:08 minutes), Yarriambiack (25:27), Buloke (27:23), Loddon (26.20), Hepburn (20:20), Murrindindi (24:43) and Strathbogie (24:00) the wait is still way too long.

“So, I’ll be asking the government for detailed assurances about the benefits my communities can expect from the extra funding announced in today’s budget after Parliament resumes next week.”

Ms Maxwell said hospital ramping – where patients wait on-board in hospital emergency ambulance bays for medical attention – was still critical last week with reports of 30 ambulances ramped at emergency departments and delays at 12 major hospitals of up to seven hours.

“The additional budget money directed at reducing emergency department bottlenecks, more resourcing for emergency call and despatching staff and $698m for the ‘Better at Home’ health program is welcome, but is it enough?” she said.

“Regional hospitals have been at code yellow alert levels for months and the strain on staff is really biting.

“I’ve also recently requested a briefing from the Minister for Emergency Services about the recommendations from the ESTA review made by former Victoria Police chief commissioner Graham Ashton and, while I am yet to hear back, I look forward to this discussion taking place as a priority.”

$10 million ambulance rostering project stalled?

Adjournment speech

Victorian Ambulance Union says digital problems mean Ambulance Victoria shifts are regularly unfilled

February 8, 2022

Tania MAXWELL (Northern Victoria) (21:07): (1707)

My adjournment is to the Minister for Ambulance Services (Hon. Martin Foley MP), and it is regarding the ever-deepening crisis facing our ambulance services. The action I seek is for the minister to provide an update on the enterprise resource planning project to manage rostering for ambulance services.

We recognise that COVID-19 has placed enormous strains on our health system, and I think there is an inherent learning from the pandemic that we must bolster our health services for the long term to ensure we can meet the challenges of the future. In this digital age, our government agencies, particularly those relating to critical service delivery, should be leading the way in how they utilise technology.

The Victorian Ambulance Union secretary was recently reported as saying that problems with an IT system result in ambulance shifts regularly going unfilled. With staffing issues a recurrent challenge for Ambulance Victoria, system issues should be supporting and not hindering efforts to ensure that every shift is adequately staffed.

The enterprise resource planning project was due to start in 2019, and the planned delivery end date is June this year. The Ambulance Victoria strategic plan progress report of June 2021 had this project marked as being on track, yet the government’s digital strategy and transformation website indicates that the $10 million project seems to be stalled and is undergoing an internal review. There was no mention of the project in Ambulance Victoria’s most recent annual report.

In the last year 700 additional paramedics have been recruited. If we have an extra 700 paramedics on the books, I think the general public and our paramedics, who are working so incredibly hard, deserve an explanation of how rostering systems have such regular gaps, why the development of an IT system that would be intended to make rostering easier has been delayed and when it will get back on track.

Government should explain ambulance roster delay

Media statement

February 8, 2022

Tania Maxwell MP has welcomed Ambulance Victoria’s improved emergency response times in Wangaratta, Towong, Indigo and Mount Alexander local government communities in the quarter ending December 31, 2021.

The Derryn Hinch’s Justice Party Member for Northern Victoria said code one call-out performance year-on-year improved 38 seconds in Wangaratta to 13:08 minutes, on average, in response to 506 calls.

In Indigo Shire, performance improved 1:22 minutes, to 21:50 minutes, for 180 calls, and 4:32 minutes in Towong Shire, to 25:48 minutes, for 75 calls.

In Mount Alexander Shire, another of the 27 local government areas Ms Maxwell represents, performance was better by 48 seconds, to 18:24 minutes, for 217 calls.

“But I’m very worried about the worsening performance shown by the latest data for Alpine, Campaspe, Gannawarra, Loddon, Macedon Ranges, Mansfield, Mitchell, Moira, Moorabool, Murrindindi, Nillumbik, Strathbogie, Swan Hill and Yarra Ranges shires, Wodonga and Whittlesea city council communities, and other areas,” she said.

“I acknowledge that emergency call-out demand has ballooned as a result of COVID-19.

“It’s up 9.6 per cent for the year across Northern Victoria, and there’s no doubt this has contributed to a 1:33-minute blow-out in average performance times.

“A year ago, it took almost 18 minutes, on average, for an ambulance to arrive at a code one emergency call-out in Northern Victoria.

“Now that average response time has expanded to 19:26 minutes.

“These outcomes prompt me today to ask Ambulance Services Minister Martin Foley MP to update Parliament about the government’s $10 million enterprise resource planning project, due for completion in June, to improve ambulance rostering.

“The Victorian Ambulance Union recently said that a problem with information technology results in ambulance shifts regularly going unfulfilled, yet the government should be leading the way to fix such vital system management issues.

“But the government’s digital strategy and transformation website indicates that the enterprise resource planning project to resolve ambulance rostering problems is under internal review.

“Since last year, an extra 700 paramedics have been appointed and I think that they and their colleagues, who are working so hard, deserve an explanation about why there are rostering gaps, why the IT development repair project has been delayed, and when it will get back on track.

“So does the public.

“We must learn from the COVID-19 pandemic to bolster our health services and ensure that we can meet future challenges.”

Vote defeats public agency scrutiny

Media statement

December 9, 2021

Tania Maxwell MP was last week prevented by two votes from giving Parliament and government the power to request a Victorian Equal Opportunity and Human Rights Commission review of public agency compliance with equal opportunity law and authorise it to publish findings.

The Derryn Hinch’s Justice Party Member for Northern Victoria moved in the Legislative Council on December 3 to amend the Equal Opportunity Act 2010 during debate on the government’s proposed changes to equal opportunity exceptions[1] for religious organisations.

“Victorians have been shocked this week to read about VEOHRC findings into the extent of bullying, harassment and gender and sexual identity discrimination in Ambulance Victoria,” Ms Maxwell said.

“But in 2018 we were prevented from knowing if there was similar behaviour in the Metropolitan Fire Brigade and Country Fire Authority when Victoria’s Court of Appeal upheld action brought by the United Firefighters’ Union against the VEOHRC’s power to conduct exactly this type of review.

“The Court found that the VEOHRC had exceeded the powers of review given it by Parliament.

“So the only way to ensure that the VEOHRC is properly equipped to do its work is to change the Equal Opportunity Act, and I look to the support of my parliamentary colleagues to do that.”

Ms Maxwell’s amendment would have authorised Parliament or a Minister to request a VEOHRC review of programs and practices of any government department, public authority, state-owned enterprise or municipal council.

It would also authorise the VEOHRC to release a report and related documents under this process subject to a public interest test.

Government response

But Attorney-General and Legislative Council leader Jaclyn Symes MP told the House the government was unable to support Ms Maxwell’s amendment “because I do not have an appreciation of what the outcome will be”.

“I know what you are trying to achieve, but because of the time I have not had the opportunity to get advice on whether there would be unintended consequences and the like and how it would change the VEOHRC’s practices,” Ms Symes said.

“Have you got any advice from the commission or otherwise about how that would be implemented? You do not do things unless you know exactly what they are going to do, and I am not in a position to know if there would be other consequences for your amendment.”

Ms Maxwell said she had requested a meeting with the Equal Opportunity Commissioner.

“In my speech in the second-reading debate I said it is clear that the Equal Opportunity Act 2010 needs to change in order for VEOHRC to review matters that may be referred to it by a government minister or the Parliament,” she said.

“As Ms Symes noted in response to my question yesterday, the government cannot table a review that it does not have and VEOHRC cannot provide the minister with a copy of a particular review because of a court order made by the Court of Appeal in 2018.

“The court order was enforced in direct relation to section 151 of the Equal Opportunity Act. It clearly demonstrated that if the government requests a review of a public entity by VEOHRC, that entity may simply say, ‘No, thanks’, and block the review.

“If there are systemic human rights issues within a public authority, a government department, a state-owned entity or council and they do not self-refer, the government or the Parliament should, we believe, be able to refer this to VEOHRC.

“The commission’s role is executed through researching systemic issues; reviewing organisations, programs and practices for compliance; and conducting investigations under the Equal Opportunity Act.

“So these amendments provide for VEOHRC to exercise some discretion. VEOHRC can consider a referral and determine not to review an organisation; however, there is a public interest test for the release of reports and documents. I believe these are reasonable amendments—ones that advance the protections for workers and public transparency—and they would provide the opportunity for those reports to be accessible by changing section 151 of the Act.”

Opposition supports amendment

Shadow attorney-general Matthew Bach told the House the Opposition was “very understanding” of Ms Maxwell’s amendments.

“From our perspective, given the seriousness of the issues which she has hit upon both in her contribution here but also in the very helpful explanatory note that she circulated some time ago, we will be supporting her amendments,” Dr Bach said.

Liberal Democrats’ David Limbrick MP and Independent Catherine Cumming MP also indicated support for the amendments.

“I would like to thank Ms Maxwell’s team for briefing my team on what she is intending to do here,” Mr Limbrick said.

“I appreciate some of the concerns raised by the Attorney, but I do appreciate the intent of what Ms Maxwell is trying to do and the Liberal Democrats will be supporting this.”

On division, the move to amend the bill was defeated 19-18, with the Reason, Animal Justice and Greens parties voting with Labor. Two more votes would have passed the amendment.

Ms Maxwell used Question Time yesterday to ask the Emergency Services’ Minister Jaclyn Symes MP if the government itself would initiate changes to the Equal Opportunity Act, or conduct a fresh review of workplace culture in Victoria’s fire services.

Currently S.151(1) of the Equal Opportunity Act 2010 says:

Commission may conduct review of compliance

S. 151(1) amended by No. 26/2011 s. 22(1)

(1)  On request of a person, the Commission may enter into an agreement with the person to review that person’s programs and practices to determine their compliance with this Act.

Ms Maxwell’s proposed amendment to Bill:

(2) On request of the Parliament or government, the Commission may review the programs and practices of any public agency or authority.

(3) The Commission may disclose a report or documents that relate to the review of programs and practices of an agency or authority under (2) if the Commission considers it in the public interest to do so.



[1] Equal Opportunity (Religious Exceptions) Bill 2021

Equal the opportunity to see fire services’ review

Question without notice

December 2, 2021

Tania MAXWELL (Northern Victoria) (12:33):

My question is to the Minister for Emergency Services.

Minister, this week the Victorian Equal Opportunity and Human Rights Commission (VEOHRC) released the report of its independent review of Ambulance Victoria. It was noted to be both painful and confronting and uncovered entrenched disrespect, victimisation and bullying. To the credit of Ambulance Victoria, this report is transparent and it has accepted all the recommendations from the review.

With respect to the similar review of fire services and the stubborn position of the union to block its release, will you once again seek to gain access to this report or make changes to the Equal Opportunity Act 2010 so future taxpayer-funded reviews cannot be blocked?

Jaclyn SYMES (Northern Victoria—Leader of the Government, Attorney-General, Minister for Emergency Services) (12:34):

Ms Maxwell, in relation to your question where you mentioned the VEOHRC report into Ambulance Victoria, it is compelling reading. It is an important review and I want to commend the management of Ambulance Victoria for taking that seriously. I also want to thank every single member of Ambulance Victoria who came forward to share their experience with the commission, and I encourage those members to continue those conversations. They are important conversations to have.

We should not have workplaces that are not inclusive, respectful and safe.

I have talked about the culture of the emergency services agencies that I have responsibility for in relation to the emergency services portfolio. You have asked for specific information on the VEOHRC review into workplace culture in relation to the fire services. I have answered this question on several occasions. I cannot table a review that I do not have. The VEOHRC have advised me that they cannot provide me with a copy of the review, not because of their legislation but because of a court order made by the Court of Appeal in 2018. So I do not have the capacity to force them to break a court order. That would be inappropriate in any sense but particularly in my other portfolio of Attorney-General.

I guess what I would say to you, Ms Maxwell, is that rather than focusing on a report from five years ago that I have not seen and I do not have access to, the government is focused on cultural change.

We are investing in and delivering in partnership with all of our emergency services organisations, and you have referenced Ambulance Victoria. There are other organisations where issues have been raised, and I think it is important to acknowledge that. I think I have said also, on the record, that the agencies that I deal with do not shy away from their responsibilities to address this. They do not deny that there are problems, but we are all working together to ensure that all of our agencies are safe and inclusive, and we really want them to be a welcoming place, particularly for women. That is something that I am particularly passionate about, and I know you share that passion.

As I meet more and more people in the organisation, I am really confident that everyone is focused on that end-goal.

Ms MAXWELL (12:37):

Thank you, Attorney.

Attorney, the VEOHRC report into Ambulance Victoria noted 52.4 per cent of surveyed respondents reported experiencing bullying. An internal review of the fire services revealed similar statistics. If the government seems unable to obtain this report for tabling in the Parliament, will the government initiate a new similar review of the fire services that will be more transparent?

Ms SYMES (12:37):

I think I addressed the issues that you spoke about. I meet with our emergency services agencies on a regular basis and always on the agenda is workplace culture. I will continue to have those conversations with them, and as I meet more and more staff and volunteers in the organisations as well I will be focused on outcomes.

As I said previously, I believe that our agencies are well on their way to understanding their culture and have in place some really ambitious objectives to ensure that they are one of the best places to work in the state.

Image: Guardian Australia

Resourcing regional paramedic demand

QUESTION WITHOUT NOTICE

September 14, 2021

Tania MAXWELL (Northern Victoria) 11:37:

My question is to the Minister for Emergency Services, Ms Symes:

Minister, congratulations on your new portfolio. As you know, Northern Victoria has some of the greatest gains to make in the state to improve ambulance response times.

We know our ambulance workforce is committed to the care of their patients, but regional services are challenged by increased demand, hospital ramping and geography.

Minister, in a meeting with the Health and Community Services Union last week, my office was told there are approximately 1000 paramedics in Victoria who are trying to obtain work in the system. 

Ambulance Victoria has only allocated 56 more paramedics for rural Victoria as part of the 300 committed (new) positions in the past 12 months. This is despite a 26 per cent increase in code 1 callouts for local government areas in Northern Victoria, compared with the same time last year.

Minister, will the government allocate more paramedics to regional Victoria to help meet this massive increase in demand?

Ms SYMES:

I thank Ms Maxwell for her question. I am the Minister for Emergency Services, but I act for Minister Foley, who is the Minister for Ambulance Services. So I will seek an answer in relation to the provision of paramedics from Minister Foley. I do thank you for your question, and there has been record investment and recruitment of paramedics. I recognise the same issues that you do in our shared electorate in relation to areas that are seeking to have additional resources, so I would be quite interested in the answer as well. So I will seek those details and provide them to the house.

Ms MAXWELL:

Thank you, Attorney. Ambulance Victoria is currently in talks with the CFA about delivering a first-response program in partnership with a number of regional brigades. This will be welcome news to Kiewa CFA, who have put their hand up for a pilot as first aid responders. Could the minister please update the house on those talks, if possible?

Ms SYMES:

Thank you, Ms Maxwell, for your supplementary question, which crosses more over into my portfolio as opposed to the Minister for Ambulance Services, but I might take that on notice and get you an update of the emergency medical response rollout, because I have only received preliminary briefings and I am not in a position to provide specific locations of where that might be rolled out to. I can assure you that I have heard that many brigades in regional Victoria are very keen to take on that role, but in terms of specific locations I am more than happy to provide you some more information in relation to that matter.

Thank you, President, and thank you, Minister. Ambulance Victoria is currently in talks with the Country Fire Authority about delivering a first response program in partnership with a number of regional brigades. This will be welcome news to Kiewa CFA, which has put its hand up for a pilot as first aid responders. Could the Minister please update the house on these talks?

Revamping ambulance ramping

Media statement

Tania Maxwell MP has again asked Health Minister Martin Foley about state government action to improve ambulance response times and overcome ramping at hospital emergency departments.

The Derryn Hinch’s Justice Party Member for Northern Victoria last week told Parliament she did “not expect to be happily surprised” by the latest ambulance response time data for the April-June quarter.

It shows average response times[i] to code 1 call-outs, compared with a year ago, increased two minutes in Alpine, Campaspe and Mitchell shires, 2:41 minutes in Hepburn , one minute in Benalla, 3:21 minutes in Loddon, and 4:21 minutes in Mansfield, while there were improvements in Gannawarra and Indigo – all areas under the spotlight in the past year.

Ms Maxwell said practice of ambulance ramping, which occurs when hospital emergency departments are extremely busy and instruct paramedics to keep a patient on board until given the go-ahead to deliver them, was also affecting patient care.

“The July report of a patient with a spinal injury who was in a corridor at Sunshine Hospital for 14 hours is simply despairing,” she said.

“This patient was ramped outside the hospital for hours and then waited and waited for a bed. The Victorian Ambulance Union reports that patients are regularly waiting for 12 hours in ambulances outside hospitals or being treated by paramedics in corridors while they wait.

“I have spoken numerous times in this Parliament about the pressure on ambulance services in northern Victoria, including a very sad, recent case in my electorate where an aged-care resident waited 90 minutes for an ambulance, a delay which was attributed directly to hospital ramping.

“These bottlenecks are placing enormous strain on our health workforce.

“Speaking with healthcare workers, they tell me of the challenges of staff shortages and trying to find ways to discharge more patients safely to free up beds.

“They do an incredible job in an already pressured environment.

“The Australian Medical Association warned in July that our hospital systems cannot cope with a flu epidemic, let alone a COVID epidemic, in what was described as an ‘acute public health disaster’.

“Yet the point of Victoria’s first lockdown early last year was to prepare our health system to cope, and 18 months later we seem to be in no better position.”

Ms Maxwell said ramping was not isolated to state hospitals or Victoria.

“The Royal Australian College of General Practitioners has called for a whole-health-system approach across both state and federal governments, including utilising general practice and community health,” she said.

“Other states, such as Tasmania, are rolling out policy to take pressure off emergency departments with extended care centres through general practices, extending hours, and weekend operation.

“I expect such a prospect would be welcome in many regional centres also, if you could indeed resource them, given the wait time to see a GP.

“I thank our healthcare workers, and I encourage the government to share with our communities what work they are doing in Victoria and with other levels of government to address these concerns.”


[i] https://www.ambulance.vic.gov.au/wp-content/uploads/2021/08/2020-21-Q4-Ambulance-Response-Quarter-4-FY2020-21.pdf

Ambulance ramping threatens healthcare

Adjournment speech

August 4, 2021

Ms MAXWELL (Northern Victoria) (18:06): My adjournment matter is for the Minister for Health in the other place, and the action I seek is for the minister to detail how the government intends to address the persistent ramping issues that are affecting hospital admissions and creating further delays in ambulance responses.

The latest report, last month, of a patient with a spinal injury who was in a corridor of Sunshine Hospital for 14 hours is simply despairing. This patient was ramped outside the hospital for hours and then waited and waited for a bed. The Victorian Ambulance Union reports that patients are regularly waiting for 12 hours in ambulances outside hospitals or being treated by paramedics in corridors while they wait.

I have spoken numerous times in this Parliament about the pressure on ambulance services in northern Victoria, including a very sad case recently in my electorate where an aged-care resident waited 90 minutes for an ambulance, a delay which was attributed directly to hospital ramping.

These bottlenecks are placing enormous strain on our health workforce. When speaking with healthcare workers they convey the challenges of staff shortages and trying to find ways to discharge more patients safely to free up beds. They do an incredible job in an already pressured environment. The AMA warned in July that our hospital systems cannot cope with a flu epidemic, let alone a COVID epidemic, in what was described as an ‘acute public health disaster’. Yet the point of lockdown # 1 was to prepare our health system to cope, and 18 months later we seem in no better a position.

Now, this is not just a state hospital matter, nor an issue isolated to Victoria. The Royal Australian College of General Practitioners has called for a whole-health-system approach across both state and federal governments, including utilising general practice and community health. Other states are rolling out policy to take pressure off emergency departments—such as Tasmania, with extended care centres through general practices including a Medicare match scheme, extending access to GP hours and weekend operation. I expect such a prospect would be welcome in many regional centres also—if you could indeed resource them, given the wait time to see a GP.

The latest ambulance response time data is due for release, and I do not expect to be happily surprised by it. But I hope—I sincerely hope—I am wrong. I thank our healthcare workers, and I encourage the government to share with our communities what work they are doing in Victoria and with other levels of government to address these concerns.

Kiewa CFA seeks ‘first-responder’ pilot

Kiewa CFA wants to pilot first-aid responses to serious incidents, and I’ve asked the government to consider this proposal.

Ambulances response needs rapid fix

Adjournment

Ms MAXWELL (Northern Victoria) – Tuesday, May 25, 2021 (19:59):

My adjournment is for the Minister for Ambulance Services, and the action I seek is for the minister to detail how – specifically for my electorate – he will address the immediate and urgent issues relating to ambulance response times and mitigate lengthy delays.

Last week I was contacted by an aged-care facility in my region. One of their residents waited two hours for an ambulance after a fall and later died in hospital. The paramedics did a wonderful job when they got there, but they were ramped and no other units were available to respond. This is not the only story; it is just the latest.

The issues in our ambulance system are regularly reported and frustrating for my electorate, including lengthy response times, staffing shortages and fatigue, hospital bypassing and ramping. It is distressing for patients, their families and the healthcare responders who are working each day in this environment. According to the latest performance data released by Ambulance Victoria, response times that were already poor in my vast electorate became worse. Alpine shire went from 49 per cent of call-outs meeting benchmark to 40 per cent, and it was 34.1 per cent in Buloke, 41 per cent in Gannawarra, 32 .4 per cent in Mansfield and 27.6 per cent in Indigo shire. It goes on and on.

Paramedics and other health professionals in our regional areas work exceptionally hard to deliver care in their communities. This is not a slight in any way on them, because they do an incredible job. We know COVID-19 has had an impact, with restrictions delaying people seeking medical care and PPE requirements adding another element of delay, but health workers tell me the issues are deeper than this, such as attracting staff to regional areas, having resources to fill shifts and manage fatigue rates and addressing the bottlenecks that leave paramedics ramped and emergency departments under pressure. Law reforms such as to public drunkenness may place further demands on emergency departments.

Prevention and early intervention work in community health are critical to reduce demand at the acute end. I am working proactively with Ambulance Victoria to promote the GoodSAM app and other community-based responses, and I congratulate them on this work.

I still believe we need substantially more paramedic teams on each shift in the pool for northern Victoria. Paramedics tell me that themselves. The overwhelming feedback that I get is there are not enough resources to meet the demands on the system.

Last week’s budget delivers more than $759 million for change, and constituents in my electorate need to know the specifics of what will be delivered for them, when and what difference this will make.