Today’s correspondent raises issues of employee management. They say:

Clause 45 of the Ambulance Victoria Enterprise Bargaining Agreement specifies that:

“a) Subject to clause 45.1(b), the Employer may require an employee to work reasonable overtime (including incidental and full shift overtime) at applicable overtime rates of pay.

(b) An employee may refuse to work overtime in circumstances where the working of such overtime would result in the employee working hours which are unreasonable.”

Subsection(c) of this clause further stipulates that:  

“In determining whether the requirement to work overtime hours is unreasonable for the purposes of 45.1(b), the following must be taken into account by the employee and the Employer:

(i) any risk to the employee’s health and safety from working the overtime including previous overtime worked;

(ii) the employee’s personal circumstances including any family responsibilities;

(iii) the needs of the workplace or enterprise including the Employer’s primary function to provide pre-hospital care and transport in an emergency setting;

(iv) the notice (if any) given by the Employer of the overtime;

(v) the notice given by the employee of his or her intention to refuse to work any required overtime;

(vi) the usual patterns of work in the industry, or the part of an industry, in which the employee works;

(vii) the nature of the employee’s role, and the employee’s level of responsibility;

Ambulance Victoria frequently uses this section of the EBA to justify dispatching ambulance crews to call outs close to the end of the paramedic’s shift, likely resulting in overtime for the paramedics. In my experience, most paramedics do not mind attending to emergency cases close to end of shift. However, once paramedics are on scene they will find that whilst these patients require transport and assessment in hospital, the patients are not critically unwell and therefore paramedics may end up ramped at hospital waiting to transfer the patient well beyond their scheduled shift end time.

My question relates to whether these paramedics would have an argument to refuse to remain with the patient whilst ramped at hospital beyond the end of their shift (especially given that under sub-section (viii) above, the paramedics will have satisfied the employer’s primary function of providing pre-hospital care and transport). Could the argument be made that it is unreasonable for AV to expect the paramedics to be forced to remain at hospital beyond their shift time ending, given the fact that the patient has now been transported to hospital and their ongoing care should be a hospital responsibility. In my mind it seems more reasonable to expect that the ongoing care (post triage) of a patient who has been transported to hospital should be the responsibility of the hospital and not the paramedics who brought them there (and as such government should be funding sufficient nursing staff and equipment to care for patients whilst they’re awaiting for transfer to the ED, rather than expecting paramedics to do this)?

Of course, it would be better if the care of patients was transferred to the hospital, but clearly that is not a problem that is easily fixed, or governments would have fixed it, nor is it a solution that ambulance Victoria can implement. Ambulance Victoria runs the ambulance service, not the hospitals.  Ambulance Victoria cannot direct hospitals what to do but could do things like have crews report to the hospital to relieve overtime crews etc.  That, of course, requires resource allocations and I cannot comment on what factors AV considers when trying to deal with what is an identified and common issue across Australian health services.  It would also be better if governments (federal and state) fully funded adequate health services, but the allocation of resources are policy, not legal issues. Governments have many competing demands and it is up to them to decide how the government’s resources are allocated.

Given then that there is ambulance ramping could a paramedic refuse to do further overtime? That would depend on ‘the needs of the workplace or enterprise including the Employer’s primary function to provide pre-hospital care and transport in an emergency setting’.  They may have transported the patient, but they are still giving ‘pre-hospital care’.  It would also depend on ‘the notice given by the employee of his or her intention to refuse to work any required overtime’.  If you contacted co-ord and said ‘I’m going home’ that would not be reasonable; but it might be if you contacted co-ord and said ‘I have a commitment I have to be somewhere by [time]’ and that gave AV time to find someone to come and take over that might be reasonable. It would also depend on how long you are asked to stay, refusing to stay 15 minutes is probably not reasonable; refusing to stay 15 hours probably is.

For further discussion see:

This blog is made possible with generous financial support from the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.