Critical Delays in NSW Emergency Care as It Buckles Under Pressure

A general view of the ambulance entrance of St Vincent's Hospital in Sydney, Australia, on Dec. 28, 2021. Jenny Evans/Getty Images

Rising demand and systemic pressures have left paramedics and emergency departments in New South Wales (NSW) struggling to cope, with serious repercussions for patients across the state, revealed the latest Bureau of Health Information (BHI) Quarterly Health Report (July to September).

NSW paramedics responded to 385,873 incidents this quarter, a 6.2 percent rise from the previous year.

Life-threatening cases surged by 45.8 percent, but only 64 percent were reached within the critical 10-minute benchmark—a 2.5 percentage point drop.

Median response times for emergencies extended to 13.7 minutes, compared to 12.9 minutes last year, with some waiting over 32 minutes for life-saving care.

Brendan McIlveen, Australian Paramedics Association (APA) NSW Secretary, highlighted the human cost.

“Paramedics are doing everything they can, but the numbers show the cracks in the system are widening. Every delay is not just a statistic—it’s a patient waiting in pain, and it’s a paramedic pushed to their limit.”

ED Performance Hits Record Low

Emergency departments (EDs) reported record-breaking demand, with 787,590 attendances this quarter—up 2.1 percent from last year.

Treatment delays hit an all-time low, as fewer than 61.3 percent of patients began treatment on time. Only 49.2 percent of Triage 2 cases (requiring treatment within 10 minutes) received care within the recommended time, a 5.4 percentage point drop.

McIlveen described the resulting chaos: “Paramedics are stuck waiting with patients outside overcrowded EDs, unable to respond to new emergencies in the community. It’s a vicious cycle that leaves everyone worse off.”

He called for a review of the triage system, suggesting reforms to prioritise critical emergencies more effectively.

In rural NSW, the disparity in care deepened, with median response times for emergencies rising to 13.9 minutes—far higher than the 8.3 minutes seen in urban centres for such cases.

“Our rural communities are being left behind. This disparity is unacceptable and must be addressed with targeted investment,” McIlveen said.

A Call for Systemic Reform

APA NSW has urged policymakers to take immediate action. Proposed reforms include increasing the paramedic workforce, enhancing triage systems to better prioritise critical cases, and investing in rural and regional healthcare infrastructure.

“Our paramedics are committed to their patients, but they need support,” McIlveen said. “This isn’t just about statistics—it’s about saving lives and ensuring every community has access to timely, quality care.”

The report highlights the urgency for systematic change to ensure a fairer and more effective healthcare system. For patients, paramedics, and communities, every delayed ambulance or overcrowded ED represents a reminder of the need for reform.

Opposition Blames Labor for Cuts

Reacting to the report, Opposition Leader Mark Speakman said Labor’s real cuts to the health budget two years in a row have led to poorer patient outcomes and increasing pressure on hospital staff.

“Behind every one of those numbers is a patient trying to get better. They don’t want Labor’s buck passing; they want access to quality healthcare when they need it,” he said.

Shadow Health Minister Kellie Sloane said NSW Labor has tried to shift the blame to federal Labor, saying GP shortages were the reason for the failures of the public hospital system.

“Chris Minns and the health minister have decided to throw a weak Prime Minister Anthony Albanese under the bus to distract from their failure to adequately invest in our health system and their months of industrial chaos,” she said.

Government Rolls Out $600 Million Health Overhaul

The Minns government was quick to announce a suite of measures to alleviate the pressure on the state’s healthcare system, with over $600 million (US$383 million) in funding.

Key initiatives include expanding virtual care services to prevent 180,000 ED visits and investing $100 million to strengthen urgent care pathways for 114,000 patients.

Additionally, $70 million will be directed towards improving patient flow through expanded short-stay units, helping reduce ED wait times by nearly 80,000 hours.

The funding also includes $15.1 million for an Ambulance Matrix system, which will help paramedics transport patients to hospitals with greater capacity, further reducing wait times.

Another $31.4 million will expand the Hospital in the Home program, allowing over 3,500 patients annually to receive care in their own homes instead of occupying hospital beds.

To support timely patient discharges, $53.9 million will be allocated to improve patient flow and facilitate early identification of those ready to go home with proper support.

The government is also tackling primary care access challenges by offering $189 million in payroll tax relief to incentivise GPs to bulk-bill and empowering pharmacists to prescribe medications for minor conditions.

In surgical care, more than $200 million has been allocated to reduce overdue surgeries, exacerbated by industrial action and a harsh winter.

Health Minister Ryan Park attributed challenges to the “Commonwealth’s GP shortage crisis,” compounded by past Medicare rebate freezes.

“The NSW government is playing our part by making significant investments in alleviating pressure on EDs and creating alternative care pathways,” he said.