Hunter paramedics will defy an Industrial Relations Commission order and hold strike action on Friday, escalating their campaign for "equitable wages and improved working conditions".
On Thursday afternoon, the Industrial Relations Commission sensationally blocked the action, planned from 7am to 7pm on Friday.
However, more than 90 per cent of Australian Paramedics Association [APA] members voted on Thursday night to defy the orders.
The Hunter workers will join colleagues across the state in "partial strike action" to fight for fair pay, amid concern about increased workloads, burnout and the rising cost of living.
APA NSW president Brett Simpson said "It is utterly disgraceful that Premier Chris Minns has taken 2500 paramedics and their union to court instead of following through on his own promise for a pay increase at least in line with inflation".
"This is the second time in just over six months that this government has tried to silence paramedics under threat of massive fines.
"We've been stabbed in the back by the Minns government every day since the election."
Brendan McIlveen, a paramedic based at Hamilton Ambulance Station, said the 12-hour action on Friday would mean "we'll only respond to sirens and lights cases and the highest priority non sirens and lights cases".
"We won't be doing any routine transfers. The only exemptions will be palliative patients requesting to have their last hours at home. We will happily facilitate that."
Mr Simpson added: "We want to assure the public that emergencies will still be attended to, with our focus on life-threatening cases."
Mr McIlveen - an association assistant secretary - said "ultimately we're asking for an acceptable pay rise".
"There is money set aside in the budget for public sector wage increases, yet every time we ask about it we get crickets," he said.
NSW Health Minister Ryan Park said "discussions with the union movement are progressing".
"We are working through what is a challenging issue. We do have a budgetary challenge. We are still at the negotiation table," Mr Park said.
He was concerned that "any strike action" would affect health services, but said workers had "a right to take industrial action".
Mr McIlveen said paramedics had "worked tirelessly, especially over the last number of years during the pandemic".
He said it had been more than a decade since paramedics received a decent pay rise.
"We've been under the wage cap for years, which the Liberals put in. That meant we were locked in at a maximum of 2.5 per cent a year. At one point, we got 0.5 per cent during COVID."
He said paramedic wages were "not even meeting CPI [consumer price index]".
Annual CPI had been 5.1 to 7.8 per cent since March last year, ABS data shows.
"We want a fair pay rise - at least inflation. They offered us 4 per cent. That was what every health employee was offered," Mr McIlveen said.
Paramedics in NSW earn a typical wage of about $79,000, but their take-home pay depends on shift penalties and overtime.
Mr McIlveen said paramedic work was "increasingly challenging".
"A lot of paramedics are experiencing high levels of burnout due to the increased workload," he said.
"We're experiencing extended shift times and heightened emotional and physical demands due to the constant workload."
He said a lot of paramedics had moved to Queensland to work there.
"If we could get similar wages to Queensland paramedics that would retain more staff."
He said some NSW paramedics were "struggling to even pay their rent".
The Health Services Union [HSU], which also represents paramedics, is seeking a 20 per cent immediate pay-boost for paramedics to align them with Queensland.
An HSU spokesperson said the paramedics it represented won't be involved in the association's action.
However, about 1900 of its paramedics had signed a pledge to "boycott their professional registration" from Friday.
"Paramedics are sick of being treated like ambulance drivers," the HSU spokesperson said.
The boycott meant that in a month, paramedics who had not signed their registration would be banned from the "higher order clinical work they now do".
"It will have a significant impact if it's not sorted by early January."
Shadow Health Minister Matt Kean said the government was "putting patients across NSW in potential danger if they allow paramedics across the state to boycott their professional registration".
