When Red Cliffs local John "Bugs" Bunney was struggling to breathe, he knew he was in trouble, but he wasn't sure how much.
The 78-year-old had heart surgery in 2017 and lives with a chronic lung condition, but out in the Mildura region he might have had to wait three weeks for a GP appointment.
He didn't want to trouble an ambulance or place pressure on the local hospital.
But he knew he could turn to Ebonee Dowdy.
She is one of two community paramedics working in the district to bring much-needed healthcare to people who have been falling through the cracks.
"We have lots of problems, but when you get to our age, you don't express your problems," John explains.
"You want to talk to somebody but you don't know where to go."
"And the paramedic is the perfect person. She understands."
Helping people out before health problems become a crisis
Ebonee worked for Ambulance Victoria for 12 years as a paramedic, before starting this role in July.
Rather than chasing the emergency, she's now working to get ahead of it, in a Victorian first.
She and a colleague are travelling to different community centres in the region each day, meeting locals, delivering health checks and connecting them with other health services.
Often under the guise of a morning tea, or a walking group, they're delivering healthcare to those who need it most.
Ebonee says when she was working as a paramedic, a lot of her workload would be people with chronic health conditions that hadn't been managed properly.
"If you could have intervened a few steps back and refer them into the right health services at the right time, you might have been able to prevent them getting to the point where they required an ambulance in the first place," she says.
"And so that's what we're trying to do. "
Tens of thousands more healthcare workers needed
Australia was facing a major healthcare worker shortage before the pandemic, but now it has reached crisis levels.
According to Victorian government data, 14,000 people left the healthcare workforce in 2020.
It's estimated Victoria will need an extra 65,000 health and community care workers in the next five years to keep up with demand.
Recruiting more people from overseas and training more locally are part of the solution.
But Juan Paolo Legaspi, from the Victorian Healthcare Association, says even with the best efforts — it will be an almost impossible job to catch up.
"I don't think that the workforce shortage will be alleviated anytime soon, it'll be a multi-year project, even if we could do it," he says.
"And so we need to start thinking, how can we do things better as well."
Mr Legaspi, who advocates for public health services, says there's been more than $20 billon thrown at hospital builds from both sides of politics this election.
But he says bigger picture issues need to be on the table — including redesigning health systems and changing the traditional "lanes" and roles of healthcare workers.
And a pressing one — making sure we retain the workers we already have.
Enter paramedics.
While all the other health professions are in short supply, there are actually 6,500 more trained paramedics in Australia than there are ambulance positions, according to government data.
Simone Heald, CEO of Sunraysia Community Health Services, says after speaking with experts at La Trobe University, she realised paramedics were an untapped resource.
"Look, if you could bring in more GPs, absolutely [you would]," she says.
"But we're a rural area, it is really difficult to attract any workforce to a rural area. And so what we have to do is just be innovative."
The pilot is based on a Canadian model which found after 10 years at 100 locations, there was a 20 per cent decrease in ambulance call-outs, an increase in service user's quality of life, and reduced chronic disease risk factors.
The goal is to target older people who are not connected to health care.
"The way our system is set up, is the people with the most resources generally get the best health care, whereas in actual fact, the people with the least resources, they need to get the best health care," Ms Heald says.
"We need to balance that out."
It also offers paramedics an alternative career outside the acute sector, that can help ward against burn out, and keep them in the health sector.
Ebonee, who's a mother of three, says she was looking for change and a better work-life balance.
"Expanding into a different role will allow much greater career longevity for me," she says.
'I could have a chat about how I feel'
For Patty Pullman, 82, the program has completely changed her life.
She first walked into the Red Cliffs Community Centre two months ago, to get her blood pressure checked.
But as she talked and as Ebonee probed more deeply, Patty confessed there was more going on.
Living alone, the anxiety was getting to her. She was really anxious actually. About everything.
She says she doesn't usually open up, but a space had been created where she "felt comfortable".
"I just found that I could have a chat about how I feel," she says.
"And out of it they said, 'oh, we can help you with that'."
The community paramedics have connected Patty with a counsellor, as well as a respiratory specialist for her lungs and exercise classes.
"Doors have opened everywhere for me, so it's just been wonderful," she says.
Plans to widen scope of care for community paramedics
Due to legislation, community paramedics are currently limited in the scope of healthcare they can offer.
Advocates hope over the next few years, that will change, and they'll be able to fix up minor wounds, offer vaccinations, order X-rays and diagnose minor ailments.
It's hoped if successful, the program will be rolled out all over regional Victoria with 100 community paramedics.
John Bunney first met Ebonee two months ago — and that's why that day he couldn't breathe, he knew he could trust her.
"You go into a doctor, you tell them what's wrong, they go 'brrrrrrrrrr'," he sounds while motioning, tapping on an imaginary computer keypad.
"Here's your prescription, Bye!
"I come in at the paramedic and she sits down, she talks to me, she asks me questions that no one's ever bothered to ask."
He's now joined a program for his chronic obstructive pulmonary disease (COPD) at the paramedic's urging.
As Ebonee hands John a spacer and explains how to use it, he turns and gives her a hug.
"You've put me into a program that might save me life. Thank you."
