St John rejects state control push

A wages stoush with the Liquor Hospitality and Miscellaneous Union has shone the spotlight on the operations of the not-for-profit St John Ambulance Australia WA.

The state's largest union has threatened industrial action against WA's ambulance service if it doesn't commit to a 15 per cent pay rise for paramedics over three years and the restructuring of working conditions to bring paramedics in line with registered nurses.

Adding fuel to the dispute, LHMU state secretary Dave Kelly called on the state government to take over the ambulance service, accusing St John of profiteering by overcrowding emergency departments.

He said that St John was complicit in ramping, which occurs when ambulances are diverted to another hospital and forced to wait in a queue.

WA is unique compared with other states in that its ambulance service is run privately by St John, while in all other states the service is under government control.

St John WA chief executive Tony Ahern vehemently refuted the union's claims, saying the organisation's operations were the most cost-effective in the nation and that its paramedics were some of the best paid.

"This is not a grab-out-of-thin-air type statement that we're the most cost-effective, there's no question about that," he told WA Business News.

"We operate much more efficiently because the government in this state, and rightly so, gives us the freedom to do that...and doesn't interfere with how we run the organisation."

Mr Ahern said the annual cost of services to the government was $34 million in WA, while in Queensland, where the ambulance service is "in financial crisis", the cost was $300 million.

"If we were a for-profit, cold-hearted ruthless business it wouldn't actually be better with our fee structure to transport you to hospital so we could ramp up," Mr Ahern said.

"We charge you a fee whether or not we take you to hospital, so this nonsense that we're drumming up business shows he [Mr Kelly] doesn't understand business, he doesn't understand our fee structure."

"If we we're complicit in doing this, we wouldn't be the best performer in the country."

However, Mr Kelly said the government could reduce patient transfers if it had control of the ambulance service.

"St John has no solution to ramping and encourages hospital attendance due to their fee for service mentality," Mr Kelly said.

"A government-run service could moderate this."

According to a St John 2006-07 performance report, WA and the ACT have the lowest number of patient transfers to hospital per capita.

WA transports seven patients per 100 people and the ACT transports six in every 100.

Queensland, on the other hand, has the highest patient transfers with 14 in every 100 people. In the Northern Territory it is 13 in every 100 people.

Mr Ahern said during the past financial year, WA accumulated almost 6,000 hours in ramping, while in Calgary, Canada, which has a population two-thirds the size of Perth, there was 29,000 hours of ramping.

St John Ambulance Australia is a federal incorporated association located in every state and territory, which operate independently of each other.

The national organisation owns the name and logo and is responsible for developing the broad humanitarian principles.

St John took over formal control of the Perth metropolitan ambulance service from the fire brigade in July 1922 and has controlled the ambulance service since.

The organisation's corporate structure is much the same as a for-profit business, comprising an eight-person board, a chief executive, and six team directors overseeing the ambulance service, finance, human resources, technical services, medical provisions and business services.

In WA, St John's contract with the state government accounts for 30 per cent of its funding, with a further 20 per cent derived from business activities like first aid training. and 50 per cent from its fee for service.

The organisation receives about $120 million a year from all three sources and is expecting to record an operating surplus of $7 million this past financial year.

Although St John WA has $10 million in cash reserves, Mr Ahern said the money would be used to fund capital works and only equates to about six to eight weeks of operating expenses.

St John has agreed to the pay increase; however the union wants St John to bring its members' wages in line with nurses first and then include the 15 per cent.