The Victorian government was warned of the “precarious financial position” at the state’s triple-zero call-taking agency about six years before Covid-19 overwhelmed the service and caused delays linked to 33 deaths.
A report by Victoria’s inspector general for emergency management (Igem), Tony Pearce, released on Saturday, identified 40 “potential adverse events” linked to triple-zero delays, lengthy ambulance waits and command decisions at the Emergency Services Telecommunications Authority (Esta) between December 2020 and May 2022.
Of the 40 events, 33 patients did not survive. Pearce did not make any findings about whether faster intervention would have prevented the deaths, noting it will be a matter for the coroner.
The review found Esta “simply did not have sufficient ambulance call-takers to meet incredible demand” during the pandemic, with fewer than 70% of triple-zero calls answered within the agency’s five-second target by late 2021.
In January 2022, as the Omicron variant spread through the state, just 39% of calls were answered within the target. One caller waited 76 minutes for assistance.
According to the review, the Andrews government was aware of Esta’s “precarious financial position” as early as 2015, through an auditor general’s report that gave the agency a “red light” for its financial sustainability.
Esta is predominantly funded by a levy on emergency services organisations, which was set in 2004-05 and increases by 2.5% a year. Since 2014-15 this has been topped up with additional funding, through the state budget.
Pearce’s review described Esta’s existing fee and funding model as “insufficient”, as it doesn’t account for demand growth and increases in wages.
“The ad hoc nature of the year-to-year supplementary funding arrangements limits Esta’s ability to recruit to meet demand,” the review found. “It also limits Esta’s ability to plan beyond 12 months or implement longer-term investments to improve the service during business-as-usual and surge events.”
An independent report, commissioned by Esta in 2018, made similar findings, according to Pearce.
The review noted the Department of Justice, the Department and Treasury and Finance, Emergency Management Victoria and Esta began working on a sustainable funding model “more than 10 years ago and [it] is yet to be completed”.
“It is critical that an agreed and sustainable funding model is put in place for Esta as soon as possible,” the review found.
“The agreed funding model should not only consider and reflect the increasing demand due to Victoria’s changing demographics, but also consider the increasing frequency and severity of emergency events and the need for a surge workforce.”
The emergency services minister, Jaclyn Symes, said Esta has been provided with more than $333m in funding over the next four years, including to hire 400 additional staff, with work on a sustainable funding model to be completed by the end of 2023.
“If Esta require anything different before the end of that four-year period, I’m sure that they will let us know and respond appropriately,” she told reporters on Saturday.
The review found Esta did not have the required budget and contingency funding to recruit significant numbers of additional operational staff for periods longer than three-to-six months in early 2020.
It said the agency “missed an opportunity” to seek urgent funding to begin hiring more staff in anticipation of increasing triple-zero demand.
By comparison, the New South Wales Ambulance (NSWA) service “recruit[ed] aggressively” in June and July of 2020.
“NSWA acknowledged that overspend occurred, however cited that it was willing to overspend to avoid fatiguing its staff and to reduce reliance on overtime,” the review read.
Similarly, the Queensland ambulance service recruited emergency medical dispatchers from 1,000 graduate paramedics.
Ambulance Union state secretary, Danny Hill, said the report laid bare Esta’s ill-preparedness for the pandemic.
“Every other state was upscaling, hiring extra staff and preparing for the worst and [the Victorian service] weren’t,” he said. “By the time they realised … it was too late.”
