Stephen Pearce knows only too well the hour-by-hour, day-to-day realities of being an experienced Sydney metropolitan paramedic.
He and the other dedicated men and women on the front line often work 16-hour days with no meal breaks. There is a huge and ever-growing workload caused by staff shortages, together with the stress of waiting in hospital emergency bays to offload patients because of congestion. They say it all contributes to anxiety and burn-out.
"There is also our concern for our patients," Mr Pearce tells North Shore Living.
"They are frequently traumatised and often in need of urgent medical treatment. We are always wondering - can we get there in time before a tragic death takes place or a child is unable to be resuscitated?"
He says it is not a profession for the faint-hearted. Mr Pearce, who is also president of the Australian Paramedics Association, is critical of a new NSW government initiative which will drastically revamp the ambulance network and alter working conditions for ambulance officers and paramedics.
In May, NSW health minister and North Shore MP Jillian Skinner announced the ambulance service would be boosted by four more superstations - including a new base at Reserve Rd, Artarmon and the addition of 27 extra paramedics to service the metropolitan area. Mrs Skinner said the announcement was part of the new Sydney Ambulance Metropolitan Infrastructure Strategy (SAMIS) and represented an Investment of $150 million.
Following the state budget in June, Mrs Skinner announced that a total of 85 extra paramedics would be employed in both metropolitan and regional NSW centres. Mrs Skinner said the new investment would allow Ambulance NSW to "meet the demand placed on its services now and Into the future and allow our paramedics to respond faster from strategically based locations”.
The changes wlll be dramatic on the North Shore. There will be a superstation at Artermon and former stations located at Naremburn, Lane Cove and Chatswood will become what the government describes as “standby points”.
But Mr Pearce insists there is "no evidence” that the new network will improve response times under a system that is already struggling to meet demand without the necessary increase in staff.” It's not about building a new superstation," he says in frustration. "It is always going to be about getting more paramedics and human resources in the field. We need at least another 500-600 staff - not 85 as the minister has proposed.
"We are concerned that residents on the North Shore and the Sydney metropolitan area are being misled by the NSW government about the value of these so called superstations," he tells North Shore Living.
"What we need is hundreds more paramedics - not an unproven system of centralised ambulance hubs with a few extra paramedics to work from them.
NSW Ambulance has continued to support the changes although new figures indicate a blow-out in response times and hospitals, including the Royal North Shore Hospital, being swamped by emergency patients and those clogging up the system arriving in ambulances.
The Health Services Union says "resource shortages" within the ambulance sector means in some cases paramedics are not arriving for more than 30 minutes after the 000 call, and they are struggling to meet the category one deadline. During August, hospital emergency departments recorded being flooded with patients as the flu season gripped the elderly, the young and those with compromised immune systems.
Health Services Union state president Gerard Hayes tells North Shore Living the government's superstations, including Artarmon, will fall because they simply do not have enough staff to operate them effectively.
"Gaping holes will be left in ambulance cover," he maintains. "It's a dangerous experiment - it's the Swiss cheese strategy. It will fall because you have to resource these superstations effectively and secondly you have got to get through traffic, which is not easy in Sydney."
Mr Hayes says he looks forward to seeing exactly what "response points" actually mean. "I would be thinking many of these will be sold if they are in a good area for resale."
Health professionals on the ground say the long-term implications of the changes have not been thought through. They say Sydney's population is projected to grow by 1.5 million by 2030 and the city will take on greater traffic problems and density.
In August, the Paramedics Association reported several instances where the ambulance service came close to meltdown, with many emergencies waiting close to an hour for treatment.
Mr Pearce reported at the time there were simply not enough paramedics or vehicles to attend to 000 calls.
The state government maintains the new ambulance centre at Artarmon will be "strategically placed to meet emergency medical needs, with metropolitan paramedics responding from one patient to the next and staff starting and ending their shifts there".
Paramedics tell North Shore Living that when they arrive at an emergency they can already be subject to a range of emotions from the people they encounter at the scene.
“Patients are distressed and paramedics know they may need to save a life.
“When we do not arrive on time, through no fault of our own, the odds will often be stacked against the patient. This workload has just been increasing for the past 10 years. We understand that people are upset and angry if the response times are blowing out," Mr Pearce says.
“We are all really frustrated and sick of the band-ald solutions.”The only real solutions are not superstations but more professionals and ambulances.”