Women and people of diverse backgrounds who work at Ambulance Victoria face attitudinal barriers that are preventing them from rising through the ranks, a report released by the state's human rights watchdog has found.
The report said the attitude was in part due to the "continued influence of the stereotype of paramedics as white, male, of able-body and mind, confident, stoic and the family breadwinner".
It is the second instalment of a Victorian Equal Opportunity and Human Rights Commission review into the organisation's culture.
The first part, released late last year, found an entrenched culture of harassment at Ambulance Victoria, with more than half of paramedics reporting experiences with bullying, and almost a fifth reporting sexual harassment.
The second report found men were over-represented in managerial and senior roles at the organisation.
"Power imbalances, including those related to gender inequality, are affecting career advancement opportunities for certain groups of employees, particularly women and those not part of the so-called 'in-crowd' or 'boys club'," it stated.
Paramedic Rasa Piggott, who wrote to Ambulance Victoria chair Ken Lay calling for the inquiry, said the review was an accurate reflection of her experiences regarding career advancement at the organisation.
"The most clear-cut statement I've received from a person in management is that if I were a six-foot-four, white, blond male, I wouldn't be having these problems," she said.
"It's a pervasive culture that's been around for a very long time and that's been proven through the commission."
Across the entire workforce, women's representation was slightly higher than men's.
The commission found Ambulance Victoria had a gender pay gap of 10.8 per cent, which was in line with the Victorian public sector pay gap.
Ro Allen, the Victorian Equal Opportunity and Human Rights Commissioner, said Ambulance Victoria should develop a "robust complaints system" to ensure accountability in the future.
"It's not about band-aiding and sticking on things on the structure... it's about pulling down the structure and starting again," they said.
They said the report focused on issues with equality, respect and inclusion, and contained 19 recommendations — all accepted by Ambulance Victoria.
In the first report, a dozen Ambulance Victoria staff members reported being the victims of either rape or attempted sexual assault.
Ambulance Victoria said it enacted all 24 of the recommendations listed in the first volume of the commission's report.
This week the organisation's executive director of people and culture, Rebecca Hodges, tendered her resignation after more than six years in the role.
On Wednesday, acting CEO of Ambulance Victoria Libby Murphy denied the timing of Ms Hodges's resignation was linked to the publication of the commission's report.
Ms Murphy said significant organisational cultural change took a long time.
"We've come from an era where we've only had women, many whom have given their stories, in the organisation for 35 years," she said.
"The simple fact is that we do need to get better. We need to have equality, we need to have diversity, and we need to understand our workforce needs."
The commission will audit Ambulance Victoria's response to its recommendations in late 2023.
Union labels Ambulance Victoria 'toxic'
Brett Adie, secretary of the Ambulance Employees Australia Victoria, said a "major shake-up" was needed at Ambulance Victoria.
"Ambulance Victoria not only failed to protect staff, but failed to listen to them when they have reported harm," he said.
"As we said when the first report was released: a fundamental shift in culture will require an equally large shift in the senior leadership, and the workforce who have tolerated years of inaction deserve that."
Since the publication of the commission's first volume, the Victorian Ambulance Union has said it is aware of recent allegations of bullying and sexual offences within the organisation.
Despite previous audits, the commission found Ambulance Victoria's board and executive committee "did not fully anticipate … or systematically address the substantial and unacceptable lawful and harmful workplace conduct" identified in the independent review.
Victorian Ambulance Union secretary Danny Hill said the culture at Ambulance Victoria was "incredibly toxic".
"We have people who are genuinely harmed, unwell, distressed, leaving the job as a result of what they've experienced," he said.
"I think it's quite telling that the board weren't aware of just how bad things have become."
Code red blamed on staff shortages
Meanwhile, staff shortages have continued to place strain on the state's ambulance service, with around 500 paramedics currently furloughed after being infected or exposed to COVID.
Ambulance Victoria was forced to call a code red for two hours on Tuesday night, after high workloads and hospital ramping led to just 1 per cent of the organisation's ambulance fleet available to respond to calls, according to the Victorian Ambulance Union.
Acting Premier James Merlino said the impacts of COVID-19 were to blame.
"Across our health services more than 2,000 people yesterday were being furloughed, so the pandemic continues to be a challenge for our health system in Victoria and right across the nation," he said.
Shadow Health Minister Georgie Crozier attributed the crisis to the state government, saying it had underfunded and understaffed the sector for years.
"You cannot blame this crisis on COVID, this is years in the making," she said.
Danny Hill from the Victorian Ambulance Union said he was concerned the staff shortages, combined with the workplace issues identified by the Commission's review, would have a "flow-on effect" on services and patient care.
"At the moment, we have high levels of absenteeism, we have people who are burnt out and traumatised, and who are off on Work Cover long-term.
"We need people feeling welcome at work, wanting to come to work and feeling safe at work."
