BP2004/4285, Transcript of Proceedings [2005] AIRCTrans 610 (10 March 2005)

1800 534 258

TRANSCRIPT OF PROCEEDINGS

---

Workplace Relations Act 1996 10709

VICE PRESIDENT LAWLER
SENIOR DEPUTY PRESIDENT WATSON
COMMISSIONER HOFFMAN

BP2004/4285,BP2004/4286

s.170MW(8a) - power of the commission to suspend or terminate bargaining period

Metropolitan Ambulance Service
and
Liquor, Hospitality and Miscellaneous Union
(BP2004/4285)

s.170MW(8a) - power of the commission to suspend or terminate bargaining period

Rural Ambulance Victoria
and
Liquor, Hospitality and Miscellaneous Union
(BP2004/4286)

MELBOURNE

10.05AM, TUESDAY, 01 MARCH 2005

Continued from 28/2/2005

PN9466
VICE PRESIDENT LAWLER: Yes, Mr Friend.
PN9467
MR FRIEND: Thank you, your Honour. I call Mr Vincent Luppino.

<VINCENT LUPPINO, SWORN [10.06AM]
<EXAMINATION-IN-CHIEF BY MR FRIEND

PN9468
MR FRIEND: Is your full name Vincent Luppino?---That's right.
PN9469
Do you live at (address supplied)?---That's right.
PN9470
You've prepared two statements in this matter; is that correct?---Yes, I have.
PN9471
The first one has some 13 paragraphs and two attachments?---Yes.
PN9472
Are the contents of that statement true and correct?---Yes, they are.
PN9473
I tender that, if the Commission pleases.

EXHIBIT #48 STATEMENT OF VINCENT LUPPINO
EXHIBIT #49 REPLY STATEMENT OF VINCENT LUPPINO

PN9474
MR FRIEND: Yes, the second statement is also correct, is it?---That's correct.
PN9475
Yes, thank you. If the Commission pleases.

<CROSS-EXAMINATION BY MR PARRY [10.07AM]

PN9476
MR PARRY: If the Commission pleases. Mr Luppino, you're a member of the State Council of the union?---I'm a AEA representative in the Geelong area.
PN9477
Does that entail also being a member of the State Council?---No, it doesn't.
PN9478
When you say you're an AEA rep in the Geelong area, is that sort of like a shop steward, is it?---Shop steward, that's right.
PN9479
Your statement, if I could take you to your first statement. You're a clinical specialist and you say in paragraph 6 you oppose the proposed removal by RAV of the provision that there be one clinical specialist to every 20 ambulance paramedics and MICA paramedics which is currently contained in the RAV certified agreement 2001; and you attach that provision, and you attach it as Luppino 1 and if I could take you to that. I think (i) deals with what a clinical specialist is and (ii) says, and I quote:
PN9480

The formula for the number of clinical specialists appointed shall be based on the ratio of one clinical specialist to every 20 operational on-road ambulance paramedics and MICA paramedics. This ratio shall be an approximation as close to 1:20 as possible provided that the parties accept that the ratio may not be exact at all times.

**** VINCENT LUPPINO XXN MR PARRY

PN9481
End of quote. Right?---That's correct., yes.
PN9482
Do you accept that the position is that on occasions within RAV, on occasions the particular branches the ratio may go above or below 1 in 20?---That's possible, yes.
PN9483
Indeed that occurs on occasions doesn't it?---It's possible that it can occur, yes.
PN9484
Well, you're aware of it occurring aren't you?---I don't know exact - the exact ratio at this stage.
PN9485
I see. Because RAV is an organisation where there is significant variation in the size of branches and workload, isn't there?---Yes, that's correct.
PN9486
If I could take you on in your statement and it's to deal with, as you say, developments in MICA training?---Mm.
PN9487
The first is - you've dealt with rapid sequence intubation; are all MICAs trained in this procedure in RAV?---No, they're not.
PN9488
The trial - you're aware there's a trial taking place with regard to this procedure?
---Yes. That's recently commenced in the Geelong area where I work.
PN9489
It's also in Bendigo and Ballarat?---That's correct.
PN9490
And not outside those regions in RAV?---That's correct.
PN9491
You have set out the drugs administered in RSI and I think your second statement in respect of the drugs Hartmanns - sorry, Hartmanns fluid; Hartmanns fluid in 8.2, that is not new in MICA practice is it?---No, it's not.
PN9492
And Fentanyl is referred to; that is not new in MICA practice in RAV?---No, it's a recent drug but not new for this particular procedure.
PN9493
It replaced - well, I withdraw that. Does it replace morphine in RAV?---It did replace morphine for the sedate and intubate protocol.
PN9494
Right, and Midazolam, it was a drug that was used before RSI in RAV?---That's correct.

**** VINCENT LUPPINO XXN MR PARRY

PN9495
Suxamethonium is a new drug for RAV?---It is a new drug specifically introduced for the RSI procedure.
PN9496
Atropine is also part of MICA - I withdraw that - has been in MICA practice in RAV for some time prior to RSI?---That's correct.
PN9497
You have attached the clinical practice guideline for RSI and you have given that a number, Luppino 2, and if I could take you to that. If I could take you to page 4 of 4 and the second paragraph there - I'm sorry, the first paragraph:
PN9498

The use of the CPG is restricted to mass RAV MICA paramedics with greater than 12 months post-qualification experience.

PN9499
Is that the practice that this procedure is restricted to those paramedics?---Yes, it is.
PN9500
And the second paragraph refers to:
PN9501

A MICA paramedic operating alone regardless of seniority does not have to use the CPG to use intubation even though its use may be indicated.

PN9502
In RAV, on occasions, MICA paramedics do end up operating alone?---That's correct.
PN9503
I take it from this CPG that a MICA paramedic may choose to use alternative methods of intubation rather than RSI?---If intubation was possible to start off with, yes.
PN9504
Right, and the next paragraph:
PN9505

The use of the CPG outside approved patients must be authorised by prior consultation with a medical director, medical adviser of RAV or specialist physician of a designated regional or metropolitan trauma centre.

PN9506
Is this practice followed in respect of use of RSI in RAV?---It is. Usually we will consult with our receiving hospital and in Geelong it's Geelong Hospital, so we'll consult with whoever's on at A and E.

**** VINCENT LUPPINO XXN MR PARRY

PN9507
Have you yourself conducted an RSI procedure?---I've been involved in up to about five or six RSIs. But these have been with Air MICA or in A and E department. I've actually - senior medical personnel have actually run this RSI whereas I've actually intubated the patients.
PN9508
So at A and E, when was that?---Over the past 3 or 4 years.
PN9509
Where were you working then?---In Geelong.
PN9510
That's what, two or three?---At least two or three.
PN9511
And you've been there with a - I withdraw that. In Air MICA, when have the other two or three occurred?---Yes, probably a couple with regard to road traffic accidents whilst the chopper was on its way to the scene, I assisted with RSIs.
PN9512
Who did you assist?---The Air MICA - the MICA paramedic on the chopper.
PN9513
This was when working for?---This was still working with RAV.
PN9514
Right?---Yes.
PN9515
Now, you go on in your statement, your first statement in paragraph 8.4 you refer to there being:
PN9516

At least two MICA paramedics and one or two other experienced paramedics should be involved in RSI.

PN9517
And your second statement gives as your authority for that paragraph 5 of your second statement, you say - and I quote there:
PN9518

I say that more than one MICA paramedic should be involved in a field RSI as demonstrated in an RSI training video presented by Dr Stephen Bernard and supported by RAV and MAS. This shows the extensive RSI procedure carried out by four paramedics in important defined roles.

PN9519
I end the quote. Mr Walker, you've seen Mr Walker's statement here at paragraph 155; he says in paragraph 155 of his statement that - and I quote:

**** VINCENT LUPPINO XXN MR PARRY

PN9520

RAV requires a minimum of one qualified MICA paramedic and appropriately briefed second person. RAV will not necessarily have the four people referred to in this paragraph available or responding.

PN9521
Now, you take issue with Mr Walker when he says what RAVs requirements are for the performance of RSI; one qualified MICA paramedic and an appropriately briefed second person?---Well, I don't know what an appropriate brief other person is, whether it's a qualified paramedic or not. All I'm saying is that for optimum conditions, the more MICA officers there are on the scene the better, because it is a complicated procedure.
PN9522
Your position is the more that are there, the more optimum the procedure is?
---That's correct.
PN9523
Also Mr Walker's second proposition that RAV will not necessarily have the four people referred to in this paragraph above all responding, well, that's probably correct, isn't it?---It's possibly correct.
PN9524
Further on in your first statement, paragraph 8.5, your indications for RSI detail a Glasgow Coma Score and the second dot point refers to patients with cerebral injuries such as a stroke with a GCS of less than 10. Now, are they people that would be outside the RSI trial?---That's correct.
PN9525
So for them that would need to be done on consult?---That's correct.
PN9526
In accordance with the CPG?---That's right.
PN9527
With regard to the contraindications in the next paragraph:
PN9528

A patient who had suffered massive facial trauma would not be able to be ventilated by conventional means, bag and mask if RSI fails. A clinical judgement has to be made as to whether RSI is appropriate.

PN9529
Wouldn't a clinical judgement need to be made in respect of a patient who had suffered massive facial trauma if one was to use a sedation and intubation technique?---Sedation isn't - yes, that is correct. But it's specifically designed as a contraindication for an RSI protocol because you're stopping this patient from breathing so you really need to be able to ventilate this patient if the RSI protocol fails.

**** VINCENT LUPPINO XXN MR PARRY

PN9530
I think in paragraph 8.10 you say:
PN9531

The trial of RSI on head injured patients has not yet commenced in RAV but this is envisaged in the near future.

PN9532
I think you said earlier that the trial had commenced at Geelong?---Yes. At the time this statement was written it hadn't commenced as yet and- but it's now underway.
PN9533
Now, your next statement - I'm sorry, your next paragraph refers to the 12 lead monitor; you have before - I withdraw that. Your statement says that:
PN9534

MICA paramedics in Geelong are currently trialling 12 lead ECG monitors.

PN9535
How long has that trial been going on for?---Well, I don't work at the actual MICA station on a regular basis but at the time that the statement was written, the MICA paramedics at that station were trialling a particular monitor and- but I'm not sure whether that trial is actually going on at this stage. It's still used at times on the truck and in the branch environment.
PN9536
When you say it is still used on the truck, which truck are we talking about?---The MICA ambulance. So the regular ZOLL monitor, the normal three lead monitor is in place and there is an option to use the 12 lead monitor as well. But I'm not sure how long that trial's been going on for.
PN9537
During your training as a paramedic back in 1989 into presumably 1990 and 1991 you were trained about the operation of ECGs?---That's correct.
PN9538
You were trained to set them up?---Yes.
PN9539
You were trained to read the printouts from ECGs?---Yes.
PN9540
As a MICA, in your MICA training, you were trained about 12 lead ECGs?
---That's correct.
PN9541
You were trained how to put them on?---Yes.
PN9542
You were trained how to read a 12 lead ECG printout?---That's correct.

**** VINCENT LUPPINO XXN MR PARRY

PN9543
You say in this part of your statement that the advantages of the new monitor to the patient is that some previously hospital-based equipment such as the use of thrombolytic drugs with the patient experiencing a heart attack, may be commenced earlier in the pre-hospital environment thus resulting in better patient outcomes. Now, the thrombolytic drugs you there refer aren't used at Geelong?
---No, not the thrombolytic envisaged for the trial.
PN9544
The trial you refer to is one that's taking place at Bendigo MICA?---That's correct.
PN9545
How long has that been going on for?---I don't know.
PN9546
All right, and you're not aware of there being any results from that trial yet?---No, no.
PN9547
You have referred next to the clinical instructor's allowance and I just want to understand this:
PN9548

Clinical instructors are provided with an allowance when training student ambulance paramedics in stage two in their course of study.

PN9549
Now, just to deal with that; you've seen the statement of Mr Walker where he deals with clinical instructors at paragraphs 25 and 26?---Yes, I recall that.
PN9550
Do you recall him going through the stages in training when clinical instructors are paid that allowance?---Yes, I do recall that.
PN9551
It's a bit beyond just stage 2, isn't it?---It is.
PN9552
You say:
PN9553

Clinical instructors have a responsibility to provide training and feedback to students during other stages of the course but are not provided with an allowance for doing the course.

PN9554
You, I think, would accept that the allowances paid to clinical instructors at periods of stage 4, stage 6 and stage 8?---I believe so, I can't recall.
PN9555
That is when clinical instructors are rostered to work with student ambulance paramedics?---Specifically.

**** VINCENT LUPPINO XXN MR PARRY

PN9556
Yes?---But clinical instructors actually do work with paramedics beyond these times and my point being is that training doesn't actually stop after those paid periods. It continues well, as an ongoing event.
PN9557
Yes, but when you say it continues as an ongoing event; you have the formal time when the clinical instructor is rostered with the student paramedic, right? You're paid the allowance for that?---Yes.
PN9558
There's other times outside that where a student paramedic might ask questions of or seek guidance or advice on something from a clinical instructor?---Yes, the clinical instructor can still work with the student for instance. But what is required specifically within those timeframes are cyber reports and progress reports and that's pretty much the significant factor that is - that varies between the paid period and the non-paid period. Other than that, training actually does continue, does extend to those stages.
PN9559
You see it could be said that that's what clinical instructors are actually paid for, to actually instruct clinically student paramedics; you see that?---Absolutely.
PN9560
It seems a bit much that you ask for an instructing allowance on top of what could be said to be are normal duties; what do you say to that?---I would say that training does extend beyond that particular paid period.
PN9561
Yes, I see. I think some of the sign-offs actually are done by the clinical educator, aren't they?---That's correct.
PN9562
That's a different position than clinical instructor?---That's correct.
PN9563
Right. Now if I could go to the next part of your statement that deals with overtime. You have other employment apart from being a MICA paramedic?---I have been a casual lecturer at VUT.
PN9564
At the VUT, where's that?---Victoria University in St Albans.
PN9565
In St Albans?---That's right.
PN9566
St Albans seems a fair way from Ocean Grove; that must take a bit of a drive to get there?---It's not longer than today's drive.
PN9567
Well it must take - - - ?---About an hour.

**** VINCENT LUPPINO XXN MR PARRY

PN9568
An hour?---That's correct.
PN9569
What do you lecture in?---I just do sessional tutoring lecturers - lectures.
PN9570
That's - I'm sorry?---When asked to come down around assessment time.
PN9571
You're paid about $80 an hour for that?---I believe so.
PN9572
How often do you do that?---I think I did it twice last financial year.
PN9573
Only twice?---Yes, thereabouts, yes.
PN9574
Would you do it more if you could?---No.
PN9575
I see. With regard to overtime, you say in your statement:
PN9576

It's common for me to work incidental overtime at the end of my shift for three out of four shifts each week.

PN9577
Mr Luppino, I think you were off in the 4 week period in January?---I did have 4 weeks off, yes.
PN9578
In the month before that I suggest that for the 4 week period in the month before that you did overtime hours at the end of your shift on three occasions?---I don't have the records with me, sorry.
PN9579
You don't have the records but would that surprise you, to know you had done three occasions of - - - ?---No, it wouldn't surprise me.
PN9580
That was a total overtime hours of 9.5?---It's possible.
PN9581
I imagine that that time at Torquay is a bit busier than normal?---Not necessarily. It depends, weekends are usually the busiest time but you really can't tell what times are busiest.
PN9582
Torquay is a beach resort?---That's correct.
PN9583
It just would seem to me more likely that it's busier over the summer months or is that not so?---It's difficult to say. Like, in population it is definitely busier but I couldn't tell you exactly when the most jobs occur, over what period. I don't have any information with me.

**** VINCENT LUPPINO XXN MR PARRY

PN9584
From figures going back before that I suggest that it's around about three overtime shifts a month before that as well?---It is possible, yes.
PN9585
That's quite possible, isn't it?---Yes.
PN9586
I suggest that the suggestion of incidental overtime for three out of four weeks' shifts each week is a bit of an exaggeration?---I don't think so because over the year it would average out to about that amount.
PN9587
So you're telling me if we go back for the last year that it will average out to three or four overtime shifts?---No, incidental overtime.
PN9588
I'm sorry, yes? I apologise for that?---After a shift or before a shift.
PN9589
I suggest to you if we go back for a year we will find a continuation of the pattern in December, that there's three or four extension overtime sheets - I'm sorry, extension overtime worked; do you have any comment on that?---For what period?
PN9590
Back for the - well, I withdraw that. For the 3 month period before 29 November I suggest again we will have a similar pattern of three or four overtime shifts - I'm sorry, three or four extension overtime periods worked per month?---It's possible but I believe I was acting up in a regular position prior to that period so that meant 8 until 4, so regular hours.
PN9591
Right?---But if I was on the road I would commonly work incidental overtime. For instance, if whenever I'm asked to work at the MICA Unit in Geelong, I need to go to Torquay and grab my gear and then go up to the MICA Unit in Geelong and work and then often work after my shift at that location.
PN9592
Yes, I'm here, concerned with overtime at the end of a normal shift?---That's correct, yes.
PN9593
So we need to go back and look at the month periods when you've actually been on the road?---Mm.
PN9594
I suggest, number 1, you were on the road in December weren't you?---Yes, I was.

**** VINCENT LUPPINO XXN MR PARRY

PN9595
I suggest that if we look at the 3 month periods before then that you were on the road, we will find similar amounts of extension overtime, that is around three or four periods per month. Is that possible?---It's highly unlikely from my point of view.
PN9596
You haven't done this exercise yourself?---No.
PN9597
In the period in December when you were on the road I think your statement says:
PN9598

I am frequently asked to work full shift overtime.

PN9599
I suggest in December you worked three overtime shifts for the month, would that be fair?---It could be fair, yes.
PN9600
That people ring up and ask you to do that?---That's correct.
PN9601
You accept that, don't you?---That's correct.
PN9602
Sometimes you say no?---That's correct.
PN9603
I suggest again if we go back over the month periods when you've been on the road we will find a similar amount of overtime shifts worked, that is around three or four?---That's correct.
PN9604
That's correct?---Yes.
PN9605
You say that - I'm sorry, in the last financial year I think you've told us about doing two - a couple of times you worked at Victoria University; is that during the days that you're not at work, obviously, but during your days off in the roster cycle?---That's correct.
PN9606
What about in the financial year before July 2004; with what regularity?---It was quite irregular, so extremely casual basis and only if I was asked by the lecturer at VUT at the time, because there was a need of extra staff to cover a session.
PN9607
Well, how up on in the previous year?---It wouldn't be more than three or four maybe, thereabouts.

**** VINCENT LUPPINO XXN MR PARRY

PN9608
You also say in paragraph 11 - I withdraw that. Your earnings in the last financial year to July 2004, about 101,000 in total?---I couldn't tell you off the top of my head.
PN9609
The year before, about 97,000?---Again, I couldn't tell you.
PN9610
Those figures don't sound out of the ballpark?---They seem excessive to me because I don't know where it's gone, but.
PN9611
You're not Robinson Crusoe.
PN9612
MS MACLEAN: You're not alone there.
PN9613
MR PARRY: Just to deal with the branch at Torquay, that's an 11-person branch?---That's correct.
PN9614
On the 10/14 roster?---That's correct.
PN9615
Two people on day shift, two on night shift?---That's correct.
PN9616
The average calls per day about five?---That's correct.
PN9617
In RAV offcourse the five calls are going to be a mixture of Code 1, Code 2 and Code 3 aren't they?---That's correct, yes.
PN9618
The figures I have are about 1.4 Code 1 per day, 2.5 Code 3 - I'm sorry, Code 2 and 1.1 Code 3. Does that sound about right?---That's about right.
PN9619
This is not a particularly busy branch you wouldn't say?---It's actually got busier just recently. We've introduced a transport component to our roster at Torquay so the number of cases that Torquay does has actually increased. Plus we actually do spend a significant amount of time out of the branch, even though we only do our, you know, five jobs per day. They are extremely long transport times so for instance we actually travel from Torquay to Colac on a regular basis, down the coast to Aireys Inlet, Lorne. We have been to Apollo Bay and we do a lot of work in Geelong so the times out of the branch are quite extensive.

**** VINCENT LUPPINO XXN MR PARRY

PN9620
You express a concern in paragraph 11 of your statement about three-quarters of the way through that RAV will require you to go on standby on some of your days off. You understand that they can do that now, presumably?---Well, it depends on my personal situation if - whether I agree or not.
PN9621
It hasn't been raised at your branch has it?---I've been asked to standby after a shift.
PN9622
Yes, and have you accepted or declined that?---At time I've accepted, at times I've declined just due to personal circumstances at the time.
PN9623
That's at the end of a shift?---That's correct.
PN9624
That hasn't happened on your days off?---No, not at this stage.
PN9625
The next part of your statement deals with ALS and I think you say in paragraph 12.1 the clinical educator is responsible for organising ALS training. Isn't it the position that the - I think Mr Walker says in paragraph 122 of his statement that this is not correct and he says:
PN9626

A clinical educator delivers and coordinates elements of ALS training under direction of the senior operations officer, clinical education and support.

PN9627
Does that sound correct?---The clinical educator in Area 1, and I've acted in this role, we look at ALS training and see where there are significant gaps and we made advances or we try and tend to those gaps in education by teaching, by auditing, by communicating with an ALS trainees' clinical instructor and filling in those gaps. So as clinical educator, he actually - well, he or she will actually organise day-to-day training of particular ALS trainees and that's - that was my point.
PN9628
I see. The reference to - I think in the next paragraph you refer to ALS trainees are required to have I think completed at least 10 IV cannulations. That would be a fairly difficult target to achieve in RAV wouldn't it?---No, I don't think it is.
PN9629
Is that a formal requirement?---It was a formal requirement with external ALS programme that commenced in Geelong about 2001, 2002 and it's part of their practicum, the ALS trainees' practicum, they had to show that 10 IV cannulations were carried out and these were often done on the road under MICA supervision; apart from these particular ALS trainees working with a clinical instructor and this is done on a regular basis.

**** VINCENT LUPPINO XXN MR PARRY

PN9630
You go on in 12.3 and refer to MICA paramedics writing the fortnightly progress reports on ALS trainees. Isn't it the position that clinical educators are the ones that perform and are responsible for these fortnightly progress reports?---No, I was in particular speaking about the clinical instructor reports. So if a MICA paramedic was a clinical instructor of an ALS trainee.
PN9631
I see?---And it just demonstrates MICA involvement in ALS training.
PN9632
Yes, their involvement as an appointed clinical instructor?---That's correct, plus in a non-paid role as well, with regard to the supervision of IV cannulations and other ALS skills.
PN9633
You say MICA paramedics are often crewed with paramedics or undertaking their ALS training and play a clinical instructor role. You are there referring to the MICA paramedics passing on their knowledge and giving advice to paramedics going through this training?---That's correct and when an ALS trainee wasn't paired up with a MICA paramedic as a clinical instructor, they often meet MICA paramedics at a particular job and the MICA paramedics were able to supervise IV cannulations carried out by the ALS trainee and this was included as part of their practicum.
PN9634
Yes. When the cannulation was taking place the MICA paramedic would give advice and guidance as to the performance of the technique?---That's correct.
PN9635
You go on and deal with rosters and you say it's difficult being a rotating shift worker, "as my periods of duty change each week". This is the 10/14 roster, isn't it?---That's correct.
PN9636
Do you oppose any change to the 10/14 roster?---Well, it has changed at Torquay because as I've said previously, we've actually introduced a transport component and for those 2 weeks of transports we don't do 10/14 shifts. We do other length shift.
PN9637
For 2 weeks?---For 2 weeks.
PN9638
Per year?---No, every 10 weeks.

**** VINCENT LUPPINO XXN MR PARRY

PN9639
With regard to paragraph 13.2, "changes to work locations in RAV should occur by negotiation and agreement". Your position is that following the negotiation and agreement, if agreement is not reached there should be no change?---Well, that's correct.
PN9640
RAVs proposal, you say at the end, to change work locations unilaterally is unfair and very unreasonable. Why is a right for RAV to direct a change of work location following negotiation and failure to agree, unfair and very unreasonable?
---Well, there are two points. One is a clinical point of view. I feel that each RAV station needs a core branch of paramedics that know the branch, that know the area and it's only beneficial to other paramedics who work at that branch and that it's only beneficial to the community in terms of getting to a location quite quickly, so they know the particular area so they - the other thing is paramedics come to a new branch, a new branch environment, would benefit from the core paramedics being at the branch and showing them the ropes just say. The other point was that if someone's been working at a particular branch for a long period of time, to change a branch and to make them possibly travel a significantly further distance to work may actually interfere with their family responsibilities, childcare for example, picking up kids after school. Things that have been taken for granted and be quite reasonable in the past may change dramatically.
PN9641
Let's go through each of those, particularly the last one first?---Yes.
PN9642
Changing travel arrangements, from Torquay you have a branch at Bellarine?
---That's correct.
PN9643
How far away is that?---From Torquay to Bellarine?
PN9644
Mm?---It's about 25, 30 minutes, 30 minutes travel.
PN9645
How far from Ocean Grove?---Is what?
PN9646
Is Bellarine?---It's about 10 minutes.
PN9647
It's closer?---That's correct.
PN9648
To where you live?---That's correct.

**** VINCENT LUPPINO XXN MR PARRY

PN9649
It might suit you to be transferred to Bellarine better, mightn't it?---Not necessarily.
PN9650
It can't be harsh and unfair on your family and other arrangements to be transferred to Bellarine, can it, when you live at Ocean Grove?---Well, I chose to work at Torquay and that was by negotiation.
PN9651
Right, Norlane? How far is that from where you live?---That's about 35 minutes.
PN9652
How long does it take you to get from Ocean Grove to Torquay?---About 20 minutes.
PN9653
It's hardly going to be unfair and unreasonable to transfer you to Norlane is it?---It really depends. Being at Torquay and being on that peninsula, things are a lot easier with regard to child pick-up versus Norlane where, like, it's a completely opposite part of town.
PN9654
Your second point about showing the ropes, having people in the branch that could show the ropes. There's always going to be people in a branch that know generally about an area that could show the ropes, isn't there?---No.
PN9655
Right?---Well, for example, 7 o'clock shift. If the night shift are out and two new - two officers come into a branch and they've never been there before, which does happen, does occur, then it is of great benefit for a person that's actually worked at the branch to indicate where and - the wheres and the logistics of the particular branch.
PN9656
What, the logistics of the branch? How the branch is set up?---Yes.
PN9657
Or are you talking about the area as well?---Both, so where the safe is, where the drug safe is, how to access it
PN9658
Mr Luppino, you can't seriously suggest that working out where the drug safe is, how a branch itself, the building works and where things are is going to be something that would be complicated for a paramedic to pick up?---No, it's the simple logistics that could benefit.
PN9659
With regard to knowing an area, you've already told the Commission yourself you often travel outside your own area, don't you?---That's correct.

**** VINCENT LUPPINO XXN MR PARRY

PN9660
You need to find out - part of the job of a paramedic is finding his or her way around, isn't it?---That's correct but I can give you an example of where me, working from Torquay if I travel down the Great Ocean Road, there are some black spots where there is little or no radio communications and an officer who has not worked at Torquay may not be aware of these particular locations. So a great benefit for an officer that's regularly worked at Torquay to show this person the circumstances of that - of those black spots.
PN9661
Do you sometimes - I think you told us you travel down to Colac?---That's correct.
PN9662
Who sits in the car with you at that time, the person from the Torquay branch?---It may be.
PN9663
Where else did you say you went? You said you went to Colac?---We travel- we do jobs at Colac, Mitchelsea, Aireys Inlet, Lorne, Apollo Bay into Geelong.
PN9664
You might be travelling with a person from Torquay?---That's correct.
PN9665
You might be travelling with a person from Geelong branch?---That's correct.
PN9666
You accept that there's a very large amount of travel that RAV paramedics and MICA paramedics do outside their branch?---That's correct.
PN9667
Your second statement, you say in paragraph 2 about the role of paramedics and the ALS programme, isn't it the position that the ALS programme in RAV was really designed around a limited involvement of MICA paramedics?---It was designed to promote and for particular life threat situations to be resolved by certain skills.
PN9668
But with limited involvement by MICA paramedics?---Well, it was where MICA paramedics were probably not situated permanently, on a permanent basis.
PN9669
Some MICA paramedics in RAV didn't want to be involved in any aspect of the ALS programme, did they?---Well, I don't know of any. In fact in Geelong it's been taken aborad by many paramedics, MICA paramedics as a positive thing.
PN9670
If the Commission pleases.

**** VINCENT LUPPINO XXN MR PARRY

PN9671
VICE PRESIDENT LAWLER: Thank you, Mr Parry. Any re-examination,
Mr Friend?
PN9672
MR FRIEND: Yes, thanks.

<RE-EXAMINATION BY MR FRIEND [10.56AM]

PN9673
MR FRIEND: You were asked about 12 lead ECG training in your MICA training. Do you recall that?---That's correct.
PN9674
Yes, and I just want you to tell us - you've mentioned in paragraph 9.4 of your first statement, the 12 lead ECG; could you tell us what that training you refer to there involved?---Yes. The training on that particular day involved how to use that particular monitor. That was presented that MICA station so MICA paramedics would have an awareness of that particular model of monitor.
PN9675
Thank you. You've said that you would not do more sessional tutoring if you could. Why is that?---Probably for two reasons. One is highly taxed so in the end it hasn't been financially of benefit to me.
PN9676
Yes?---And secondly because of the travel and I just felt that I'd rather stay at home with the kids a bit more.
PN9677
You mentioned a roster change at Torquay?---That's right.
PN9678
When did that happen?---That occurred in the last - within the last 6 months.
PN9679
And how did that occur?---Via negotiation so we've had - it was part of a roster group and the area managers and the roster group got together with the branch members as well and we all nutted out an agreement and a transport component to our roster.
PN9680
Okay. Nothing further, if the Commission pleases.
PN9681
Thank you, Mr Friend. Thank you, Mr Luppino.

<THE WITNESS WITHDREW [10.59AM]

PN9682
MR FRIEND: I call Mr Barry Phillips

<BARRY RAYMOND PHILLIPS, AFFIRMED [11.00AM]
<EXAMINATION-IN-CHIEF BY MR FRIEND

PN9683
MR FRIEND: Is your full name Barry Raymond Phillips?---That's correct.
PN9684
You live at (address supplied)?---That's correct.
PN9685
You are an ambulance paramedic?---I am, yes.
PN9686
Employed by Rural Ambulance Victoria?---Yes.
PN9687
You prepared two statements in this matter?---Yes.
PN9688
Would you have a look at these. The first of those statements is 84 paragraphs long, is that correct?---Yes.
PN9689
Are the contents of that statement true and correct?---Yes.
PN9690
I tender that, if the Commission pleases.

EXHIBIT #50 FIRST WITNESS STATEMENT OF BARRY RAYMOND PHILLIPS

PN9691
MR FRIEND: The second statement, 15 paragraphs long?---That's also correct, yes.
PN9692
Are the contents of that true and correct?---Yes, that's correct.
PN9693
I tender that as well, your Honour.
PN9694
SENIOR DEPUTY PRESIDENT WATSON: In which folder is that to be found,
Mr Friend?
PN9695
MR FRIEND: Which folder?
PN9696
VICE PRESIDENT LAWLER: BF2.
PN9697
SENIOR DEPUTY PRESIDENT WATSON: Yes.
PN9698
VICE PRESIDENT LAWLER: BF2.
PN9699
MR FRIEND: Thank you, your Honour.

**** BARRY RAYMOND PHILLIPS XN MR FRIEND

EXHIBIT #51 SECOND STATEMENT OF BARRY RAYMOND PHILLIPS

PN9700
MR FRIEND: If the Commission pleases. Wait there, Mr Phillips.
PN9701
SENIOR DEPUTY PRESIDENT WATSON: Mr Phillips, for the benefit of Vice President Lawler could you tell us where Larpent, Victoria is?---It's about - it's an area of Colac, it's just outside Colac.
PN9702
Thank you.
PN9703
MR FRIEND: Where's Colac?
PN9704
MS MACLEAN: Not only for the Vice-President. Thank you, Mr Phillips.

<CROSS-EXAMINATION BY MS MACLEAN [11.02AM]

PN9705
MS MACLEAN: Colac is inland from the Great Ocean Road, Vice President, about an hour and a half from Melbourne, would that be about right, Mr Phillips
?---Closer to 2 hours.
PN9706
Closer to 2 hours? Right. Mr Phillips, you have spent some time in London in the 90s?---That's correct, yes.
PN9707
You undertook your ambulance paramedic training in the United Kingdom, didn't you?---That's correct, yes.
PN9708
You haven't undertaken any undergraduate ambulance paramedic training in Australia?---No, my qualifications were recognised.
PN9709
You became accredited to work as an ambulance paramedic in the rural ambulance service by a recognition of prior learning programme?---That's correct, yes.
PN9710
You're now stationed at Colac?---Yes, that's right.
PN9711
Which is an on call branch?---Yes.
PN9712
How many people are stationed at Colac?---Five at this present.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9713
Yes. So that means there's two of you on duty at any one time?---Yes, that's correct.
PN9714
You work an 8/6 roster?---Yes.
PN9715
Which means you're on duty for 8 days?---Yes.
PN9716
That's eight day shifts?---Eight 10-hour days except for the final one which is
8 hours.
PN9717
Which is an 8 or 6-hour day?---Maybe just rephrase that. The first one is an
8 hour day and the last one is an 8-hour day.
PN9718
Right, so you've got a period of 8 days during which you work day shift?---Yes.
PN9719
For the evenings of seven of those days you're on call?---That's correct.
PN9720
Following the last day shift, you have six consecutive days off?---That's correct, yes.
PN9721
Now if I could take you to your first statement; you've got copies of both your statements there?---Yes.
PN9722
It was your choice was it not, Mr Phillips, for family and other reasons to be stationed at Colac?---Yes, that's correct.
PN9723
You had worked on a fixed term fill-in arrangement at Colac prior to being permanently appointed there?---That's correct.
PN9724
So you knew the nature of the work of the branch?---Yes.
PN9725
And how busy it was?---Yes.
PN9726
Or wasn't and the sort of work that the paramedics stationed there were required to do?---That's correct.
PN9727
Yes, and you then - did you apply for a permanent appointment to that branch?---I did, yes.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9728
That was granted, I think, in about 2001?---That's correct.
PN9729
You are on the State Council for the union?---I am.
PN9730
So were you responsible for - as part of that State Council function, the formulation of the claims being advanced in this case?---I was, yes.
PN9731
Also as part of that role, in the formulation of the campaign of industrial action that was taken by the union last year?---Yes, that's correct.
PN9732
That includes, does it, protected and unprotected action?---Yes, I was.
PN9733
In relation to the comments you make generally about the advanced life support skills that you talk about in your statement; it's the case isn't it, Mr Phillips, that you have no knowledge at all of the undergraduate ambulance paramedic training that is undertaken in Victoria?---Only what I've been told but no, I don't.
PN9734
Yes. You haven't yourself, as I think we've already discussed, undertaken any undergraduate qualification in Victoria?---No, that's correct.
PN9735
You undertook the advanced life support training under a scholarship from RAV and you did that at the Victoria University of Technology?---That's correct.
PN9736
How long did that take?---It was prior - it was given out as a package of prior learning and then I think it was a week at the training centre and then they threw exams after that.
PN9737
You had some pre-reading to do, I think you said ?---Yes, yes.
PN9738
You know that the ALS package if I can refer to it that way, is now taught as part of the undergraduate training course for ambulance paramedics?---I believe it is but I have no firm knowledge of it. I don't work with students.
PN9739
All right. Now, your training in London, where was that undertaken?---At the Paramedic Training College in Fulham.
PN9740
Is that similarly to here, a university accredited programme?---It's actually a National Health Service accredited training course.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9741
I see, and the instruction in that course is undertaken presumably by clinical instructors of one kind or another and medical practitioners?---That's correct, yes.
PN9742
How long does that course take?---Eight weeks.
PN9743
Eight weeks?---Yes.
PN9744
Are there advanced levels of that or further components that one returns to by way of post-graduate study?---I believe you were clinically audited every year so that your skills were - yes, every year you had to go back to the Paramedic Training College to be audited on the amount of work you'd done, the quality of work that you'd been doing.
PN9745
I see, all right and that audit was undertaken by medical practitioners or clinical paramedics?---That was undertaken by clinical instructors for the London Ambulance Service.
PN9746
You started off in the London Ambulance Service in 1988, that's about right?
---Yes, that's correct.
PN9747
You started in the area of patient transport?---That's correct.
PN9748
Did that involve any particular paramedic training?---No.
PN9749
Had you undertaken any training at that stage?---Just a 4 week basic ambulance or basic first aid course.
PN9750
Then you moved onto undertake a role as a technician between 1989 and 1993; what did that involve?---That involves a 12-week school based, road based theory and practice.
PN9751
So when you said before that you undertook 8 weeks' training in the paramedic context, that's in addition to the 12 weeks that you're telling us about now for your technician training?---Yes, the London Ambulance Service works a little bit different than RAV. To get onto a frontline vehicle or to get onto an emergency vehicle you undertook a basic course which was defibrillation, not unlike the AOs here but probably a bit less than the AOs here.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9752
There are grades of paramedic training required before you get to the end stage which is the paramedic first response vehicle ?---Yes. That's correct, yes.
PN9753
All right, well let's just take your technician course for a moment. What did that cover?---That included things like defibrillation, GTN glucagon and basic life support.
PN9754
That was between 1989 and 1993 that you worked in that role?---That's correct.
PN9755
Then you moved onto a paramedic response unit in 1995; does that sound right?
---Well, I undertook the paramedic course which was the 8 week course at the Royal Free Hospital in Hampstead and the Paramedic Training College at Fulham and then I went on to work in the paramedic response units in 95, yes.
PN9756
From 1993 to 1999 you were working as a first response paramedic in an emergency vehicle?---You couldn't do first response all the time because they said it was too stressful so they broke it up between emergency vehicles and you couldn't work on the response unit at all times.
PN9757
No, that's - - - ?---So I was basically on the road as an operation paramedic then, yes.
PN9758
Yes. And a fair amount of that time was spent, was it, on an emergency first response vehicle?---Yes, that's correct.
PN9759
Yes. And as part of the duties that you performed on that vehicle, Mr Phillips, you undertook the intubation of patients requiring airway ventilation, didn't you?
---I did, yes.
PN9760
You also undertook a number of other responses that might be in the Victorian context said to be confined to a MICA paramedic?---Yes, that's correct.
PN9761
When you say in paragraph 12 of your statement that:
PN9762

From taking the advanced life support course I learnt the skill of insertion of an intravenous canula.

PN9763
That's just not right, is it?---No, that is I knew how to cannulate before I
joined - - -

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9764
You most certainly did and in addition to knowing how to cannulate, you also knew how to intubate a patient?--- I did.
PN9765
You knew about the administration of fluids for hypovolaemic shock?---I did, yes.
PN9766
You knew about chest needle decompression?---I did yes.
PN9767
And had performed that skill?---Yes, I have.
PN9768
You knew about paediatric advanced life support including intubation and intraosseus, that is the administration of drugs into the bone marrow tissue of a paediatric patient?---That's correct, as well, yes.
PN9769
You knew about that?---Yes.
PN9770
That's a MICA skill here, you know that don't you?---Yes.
PN9771
You see I'm puzzled, Mr Phillips, as to why you would understate so dramatically the skills that you held before you came to Australia?---Why? Because they're not recognised here so that wasn't - it was pointless understating something that I can't do here anyway. So they're not recognised here, so.
PN9772
Mr Phillips, when you say that it was in the context of the advanced life support course that you learnt the skill of the insertion of an intravenous canula that is not right, is it?---No, I will say again it - - -
PN9773
You had held and practised that skill for a period of some 6 years in the United Kingdom?---That's correct, yes.
PN9774
Similarly, with respect to the needle decompression of a potential pneumothorax, you had that skill and has used it?---That's correct, yes.
PN9775
Also in paragraph 28 where you talk about the administration of crystalloid fluids, that's Hartmanns solution. I think we've been referring to it as that; is that what you're referring to there?---Yes, I believe so.
PN9776
Hartmanns fluids?---Yes.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9777
When you say that the ALS also taught skills in relation to the administering crystalloid fluids. That's true, the ALS course did teach that?---Yes, that's true.
PN9778
But that is a skill that you had and had practised for a period of some 6 years, is that right?---That's correct, yes.
PN9779
Let's move to paragraph 23, the administration of adrenaline. You had used both intramuscular and intravenous adrenaline before you came back to Australia?---I did, yes.
PN9780
The component of the ALS course that concentrated on the use of adrenaline was in connection with the administration of intravenous adrenaline?---Yes, that's correct.
PN9781
Were you aware that ambulance paramedics had been administering intramuscular adrenaline prior the introduction of the ALS package?---Not that I can recall.
PN9782
Similarly, in respect of morphine, morphine was a drug which you had administered both intravenous to patients with pain of one kind or another, when you were practising in London as a paramedic?---No, morphine's not used in London.
PN9783
Don't use morphine?---No.
PN9784
What do you they use as a pain-killer?---They use a synthetic opiate called Nuvaine.
PN9785
Is that used in Australian paramedic practice as far as you know?---I have no idea. I have no idea.
PN9786
Would it be similar to Fentanyl?---I have no idea.
PN9787
Don't know. What was it called again?---Nuvaine.
PN9788
Nuvaine?---Yes.
PN9789
Is it what would be described as an S8 drug; is it a narcotic?---It's a synthetic based opiate that doesn't have the addictive qualities or supposedly doesn't have the addictive qualities of morphine or the S8 drugs.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9790
During the course of the ALS process you were taught, were you, about the qualities and indications for the use of morphine?---Yes. I was, yes.
PN9791
How to deliver that drug consistently with the clinical practice guidelines?---Yes, that's correct.
PN9792
In respect of morphine, you say at paragraph 18 of your statement that it has potentially a number of side effects which you set out there. Do you know Mr Walker?---Yes, I do.
PN9793
You know who he is, don't you?---Yes, I do.
PN9794
The clinical and education manager operations at RAV?---Yes, that's correct.
PN9795
You've read his statement, haven't you?---Yes, I did.
PN9796
He says at paragraph 97 that in respect of morphine, the 18 month audit conducted by RAV after morphine was introduced showed no adverse patient outcomes associated with its use; are you in any position to shed light on any adverse patient outcomes of which you are aware?---No.
PN9797
The identification of the pain score which you refer to in paragraph 20, that is part of base ambulance training is it not?---That's correct, yes.
PN9798
The administration of morphine because of its status as an S8 drug requires a bit of paperwork to be filled in about its transportation and methods of keeping it locked away?---That's correct, yes.
PN9799
That sort of thing?---Yes.
PN9800
You talk in paragraph 32 of the use of Maxolon. In your experience, Mr Phillips, Maxolon is most commonly used as a drug given with morphine to prevent nausea?---Yes, and nausea associated with chest pains.
PN9801
Yes, and as part of your training when you were in London, Maxolon is given intravenously as well, isn't it? Only intravenously?---Only intravenously, yes.
PN9802
Or by tablet which would be a bit slow. You were giving Maxolon or some other anti-nausea drug intravenously in London?---No.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9803
No anti-nausea drugs?---No.
PN9804
So if you had a patient who was feeling nauseous or experiencing vomiting what would you do?---Use a vomit bag.
PN9805
Sounds like a good idea. All right?---The drug Nuvaine didn't have the side effects - - -
PN9806
It didn't induce nausea?---It didn't induce nausea.
PN9807
Morphine doesn't induce nausea in everybody either, does it?---No.
PN9808
Now Ceftriaxone, you say that the level of responsibility in the administration of that drug is not as high as the others you've discussed. The administration of Ceftriaxone, is that something that you've actually undertaken?---No, never.
PN9809
No, a pretty rare event one would hope?---Yes.
PN9810
The side effects from Ceftriaxone, any known as far as you know?---It's more of an antibiotic to fight the infection.
PN9811
Yes. So if it's given when perhaps it turns out hopefully it's not a meningococcal episode, the side effects to the patient are minimal or none aren't they?---That's right.
PN9812
And similarly in respect of Maxolon, the side effects that you refer to in paragraph 33, apart from the dry mouth and thirst, are very uncommon?---Yes, that's the case.
PN9813
More common in children but you don't administer Maxolon to children, that's part of the clinical practice guidelines, isn't it?---That's correct, yes.
PN9814
Now chest needle decompression we've discussed, that was a skill that you held and you don't have any understanding of the chest anatomy, physiology instruction that may have been undertaken by undergraduate ambulance paramedics in Victoria, do you?---No, no.
PN9815
Defibrillation you talk about in paragraph 46, that I think you refer to as part of your base ambulance training, that is the first component of the training you undertook in London?---That's correct.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9816
Would you agree that it is part of base ambulance training; it's one of the first skills that would be taught?---Yes, that's correct.
PN9817
Similarly would you agree that advanced spinal management or spinal management at all that you refer to in paragraph 52 is also part of base ambulance training?---Yes, that's correct.
PN9818
If we can just turn then to the on call issues that you discuss then in your statement. I've already asked you this but Colac is an on call branch?---That's correct, yes.
PN9819
You chose to work at Colac knowing that it was an on call branch?---Yes, that's correct.
PN9820
Yes. Right, and you say in paragraph 61 that Colac handles about a hundred on call cases per month; can I suggest to you that the position is that for the past 12 months an average of 41 cases per month have shown in the on call period, a hundred might be a tad overboard?---Yes. That wouldn't be unrealistic, yes
PN9821
That the average time these cases take, the on call cases, is about an hour and a half?---I'd dispute that.
PN9822
Some might be longer, some might be shorter?---Yes.
PN9823
Can I take you to some - you talk about at paragraph 63 of the percentage of - you say:
PN9824

All officers have children at school, kindergarten or young children of one age group or another.

PN9825
You say there's a high percentage of callouts between 6 and midnight?---Yes,
27 per cent of Colac's cases are between 6 and midnight.
PN9826
And after midnight, what do you say the figures would show there?---I don't know. I only know the figures for 6 and midnight because there was talk of putting an afternoon shift on at Colac and that's the figures that were- - -
PN9827
You say that's about 24 per cent?---Yes, 27 per cent.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9828
I'm sorry, 27 per cent. And that averages over a year, can I suggest to you, between 6 and midnight is point 8 of case not one case per night, point 8 of a case during that period of the 6 to midnight timeframe?---I don't doubt it. I don't think you're taking into consideration there that sometimes we end up going to a job at quarter to six at night and not get home till 10 o'clock that evening. You're not taking into consideration continuous overtime.
PN9829
All I'm putting to you, Mr Phillips, at the moment and we'll come back and deal with continuous overtime in a moment, is that for a year period the caseload between 6 and midnight on an on call basis is less than one case per night?---If that's the maths, yes.
PN9830
That's the maths. Then in the post midnight to the commencement of the day shift period what's your sense of the rate of callout in that period. So midnight to what time does the day shift start?---The day shift starts at 8 o'clock and I have no idea of the percentage.
PN9831
Well, what's your experience of being called out in that period?---All I know is it makes me tired. I don't know.
PN9832
I don't doubt that but does it happen every night, every second night, every month?---Generally the staff at Colac go out twice in a call period.
PN9833
Yes. More often in your experience in the 6 to midnight than in the midnight to 7.00am say?---Again I have no idea. I have no idea of figures.
PN9834
You then have, as we've already discussed, at the end of your callout period a period of six consecutive days off?---That's correct.
PN9835
How many weeks' annual leave do you get, Mr Phillips?---Eight.
PN9836
Pardon?---Eight.
PN9837
Now, as you understand it and I think you said before that you have some familiarity and indeed involvement with the formulation of the claims of the union in this case. What is the claim of the union with respect to the on call issue that you're identifying in this part of your statement?---As regards to?

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9838
Well, you say the amount at paragraph 66, "the amount paid per hour for paramedics to be on call is insufficient to compensate for the inconvenience on the disrupted family life", et cetera. What is being sought here that will have a beneficial effect on the disruption that you there identify?---That was the increase in call allowance.
PN9839
It's not going to change the frequency with which you're called, is it?---No.
PN9840
No, not going to change the disruption to your family life?---No.
PN9841
You're not going to see your children any more during the daytime?---No.
PN9842
At paragraph 69 you give a number of examples of callouts that you had and you refer to one fortnight earlier this year, I take it obviously that's 2004. Any idea when that fortnight might have been. Have you got the dates perhaps that might assist us with those?---I'd have to look on the timesheet to get the dates.
PN9843
Yes. Did you do that when you prepared the statement or did you do that from memory or recall or perhaps information that someone else had?---No, I probably took it from my timesheet.
PN9844
Right, and you could look at - - -
PN9845
VICE PRESIDENT LAWLER: Probably or did?---If I recall correctly, I did take it from the timesheet, yes.
PN9846
MS MACLEAN: But you didn't think to put the dates in?---No.
PN9847
No, all right. Would you care - - -
PN9848
VICE PRESIDENT LAWLER: And you've got no idea when it was?---No, I'd have to look on the sheet.
PN9849
MS MACLEAN: Perhaps, Mr Phillips, you wouldn't be prepared to have a stab at when this might have been?---No, again, I'd have to look at my sheet.
PN9850
SENIOR DEPUTY PRESIDENT WATSON: You refer there to Thursday, Friday, Saturday, Sunday, Monday and Tuesday within a fortnight. Do you recall whether that was for example the first Thursday and the last Tuesday or whether that was within a week one period within the fortnight?---That would be a weekend during the fortnight. I only work one weekend a fortnight.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9851
But the one, two, three, four, five, six?---The instance is given - - -
PN9852
Six instances?---Yes.
PN9853
Were they within a week or within the whole fortnight?---No, they'd be - - -

PN9854

Over the whole fortnight?---Yes.
PN9855
MS MACLEAN: So Mr Phillips, just taking up on the question that his Honour just asked you, would it be safe to assume that on the other nights in that fortnight you weren't called out?---I probably wasn't called out with that much consistency. I daresay there are other callouts on the sheet.
PN9856
But you don't know?---No.
PN9857
VICE PRESIDENT LAWLER: Well, why would you include some and not all of them?---The - it was to show the frequency which was - which we are called out.
PN9858
But that doesn't show the frequency if it's a mixed sample. Well, it misleads us to the frequency, it undersells the problem if you omit some of them?---Well, if I was to sit there and write out my whole timesheet you'd have a huge document. I mean, I could have quite easily done that. I wasn't requested to do that.
PN9859
SENIOR DEPUTY PRESIDENT WATSON: But it's only dealing with the callouts, that's the only element that's given.
PN9860
VICE PRESIDENT LAWLER: Who physically prepared this statement?---I did.
PN9861
You sat down at a computer and typed it up?---Yes.
PN9862
Where was the computer?---At home.
PN9863
What happened to the file when you left home? I mean, sorry, what happened to the computer file when you finished with it? You just printed out the statement?
---I just printed out the stuff that was on there.
PN9864
Look at the bottom of your statement, see the footer?---Yes.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9865
CG:/AEAV. Isn't that a footer that indicates the G drive on the Association's computer?---That - the statement itself was printed up on their computer. I was asked to prepare a statement and email it to them.
PN9866
Well, why did you say a moment ago that the statement was printed out at home if it was printed out on their computer?---The initial statement was printed out - the initial statement that I prepared was prepared at home and then emailed off to the people who prepared this.
PN9867
If you wanted to take that any further that is a matter for you, Ms MacLean.
PN9868
MS MACLEAN: Just a couple more things, Mr Phillips. You said in answer to a question his Honour asked you a little earlier that you weren't requested to - and I may have misheard you - but you weren't requested to put in your whole timesheet, something like that; do you recollect saying that?---Yes, that's correct.
PN9869
Yes, can I suggest to you that what you were requested to do was to put in the instances and find as many examples as you could, of extreme levels of callout or overtime?---I can't remember exactly what the request was but it certainly wasn't for my whole timesheet.
PN9870
No, and can I suggest to you, that it was to find the most extreme examples you could, of incidences of callout and overtime?---Again, I can't recall what the request was.
PN9871
No, but you can recall, though, that you were requested not to put in instances where you weren't called out?---I don't know whether that request was made.
PN9872
Well you - - - ?---If there was a request to be made for my timesheet, I would have produced my timesheet.
PN9873
No, no, well who was making the request in relation to the statement?---The AEA.
PN9874
Who?---The people at the barristers prepared the - or the legal people who prepared the case.
PN9875
The legal people or the union people?--- I have no idea.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9876
Somebody spoke to you, did they, Mr Phillips, and asked you to prepare a statement?---Yes, they did.
PN9877
Who was that?---The AEA.
PN9878
Who was that?---I believe Brenda.
PN9879
Ms Forbath?---Ms Forbath.
PN9880
Yes, and she told you didn't she the sort of things that, from the union's point of view you might consider including in that statement?---That's correct, yes.
PN9881
Yes, and one of the things that was discussed in the context of that conversation was, can you put some examples in of the times that you've been called out for long periods or over long periods, wasn't it?---Quite possibly, yes.
PN9882
Quite possibly?---Well, again, I can't recall the exact conversation itself but that
- if that's what's in there then that's - - -
PN9883
Well, all that's in your statement, Mr Phillips, are the times that you were called out over this fortnight for which we have no dates?---Yes.
PN9884
And you complain in paragraph 70 about the restrictions as you describe them, on on call officers put in place by the Rural Ambulance Service?---That's correct, yes.
PN9885
Yes, you say that you are not to convey family members in the ambulance?
---That's correct, yes.
PN9886
Do you have a family car?---I do, yes.
PN9887
The only restriction that's placed upon you, can I suggest Mr Phillips, when you're on call is to be contactable by the operation centre?---I would say that statement was incorrect.
PN9888
You are required to be able to respond to a call if you're required to?---Yes, that's one of the stipulations, yes.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9889
If you're leaving your home you are to inform the call taker that you can be contacted on X number, a different number?---That's correct, yes.
PN9890
You are paid for the use of your home telephone, are you not? Your phone bill's paid?---That's correct, yes.
PN9891
That is so you can be contacted at home?---Yes, that's correct.
PN9892
And it's the nature of being rostered on call, for which you receive an allowance, that you are ready to respond?---That's correct, yes.
PN9893
SENIOR DEPUTY PRESIDENT WATSON: Mr Phillips, what is the process with the ambulance? You take the ambulance home, do you?---Yes, that's correct.
PN9894
You are obliged if you want to go anywhere to take the ambulance with you?
---Yes.
PN9895
So if you want to go to shop down at the local shops you take the ambulance?
---Basically if I need to go to the local shops then I take the vehicle. If I need to go, I take the vehicle and my wife follows in the car.
PN9896
So any time you leave the house you're required to have the ambulance with you?
---Yes, that's correct, and I would then be ready to respond.
PN9897
I see?---Yes.
PN9898
MS MACLEAN: The period during which you're on call, Mr Phillips, commences at 6 in the evening?---That's correct, yes.
PN9899
COMMISSIONER HOFFMAN: Mr Phillips, in terms of your mobile phone, is that purely for you to receive calls to respond to?---It's used for a lot of different reasons. It's used sometimes when there are dead spots within an area then we have to use it to contact the communications centre if we can't get through on the radio, or if we need to talk to them confidentially about an issue then we use it for those. So it's not specifically just for on call purposes, it is used for other things.
PN9900
MS MACLEAN: All right, now you refer in paragraph 71 to the rate of pay for callout duty, and I think we've established already that the person on callout is paid an allowance, a per hour rate for being on callout?---Yes.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9901
That's whether you're called out or not?---Yes.
PN9902
You receive that allowance. Is that the rate you're describing as appallingly low?
---Yes, that's correct.
PN9903
Was it also part of your instructions when preparing your statement to employ phraseology like, disastrous and appallingly low, and adjectives of that kind?
---No, I don't believe it was.
PN9904
What's appallingly low about being paid $3 odd an hour for sitting at home watching telly?---It's not the - it's the inconvenience of being ready to respond. We - again, we're a busy branch at Colac and you, you know, you're forever on the hooks waiting to go out the door so I think the call rate is low.
PN9905
Is it your understanding that as a part of this case the call rate is to be increased, or that's one of the claims, is it?---I believe so, yes.
PN9906
Now, you talk about single officer crewing from paragraph 77 and onwards in your statement. It's not the case, is it, that there is single officer response to emergency calls at Colac?---As a routine or as a - - -
PN9907
Ever, now, ever?---Yes, well, yes basically because the main day car and on call car are busy. The paramedics get recalled to duty and have - and invariably work on their own.
PN9908
No, no, you misunderstand my question, Mr Phillips. It is not the case at Colac that there is ever, on normal duty, a single response - a single respondent to an emergency call?---Only if the on call crew are on a break and it's a changeover day and there would be one officer at the branch.
PN9909
Only if the - just go through those circumstances again?---On a Thursday and a Monday there's three officers on at Colac.
PN9910
Yes?---If the two officers who have been on call that night are on a fatigue break or on an 8-hour break - - -
PN9911
On a fatigue break?---Yes.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9912
Yes, we'll come back to that in a moment?---Or an 8-hour break then that officer will be responding on their own.
PN9913
Does it happen a lot?--- I couldn't give you figures on how often it happens.
PN9914
You say that Colac branch rostered single crewing up until January 2001?---Yes.
PN9915
By that I take it you mean single all the time?---One paramedic on duty, yes.
PN9916
Yes, but that's not the case now, is it?---No, there are two paramedics.
PN9917
Thank you. In the circumstances that we were discussing just a moment ago, the Thursday and Monday, and if somebody's on a fatigue break and matters of that kind, there would be - if that person had to leave the station on their own to respond, that would be a backup, there would be a backup call made wouldn't there? Another unit would be sent to assist that officer?---Yes, generally Camperdown or something like that would be responded.
PN9918
Yes, right. Now, you also refer there to loading the patient into the ambulance vehicle by a single paramedic, that's not something that you would have to undertake terribly often is it, Mr Phillips?---Not now, no.
PN9919
On your own?---No.
PN9920
No, not now and not for some time?---No.
PN9921
The occupational health and safety coordinator that you refer to at paragraph 83 of your statement, you say that you find out about OH and S issues that have been satisfactorily resolved at branches other than Colac. Is it the position -correct me if I'm misunderstanding you - that you have then identified similar problems at Colac but have been unaware of this issue being dealt with at another station, is that what you're referring to here?---No, what I'm referring to there is that I'm actually HSO at Colac as well, the Health and Safety Officer at Colac.
PN9922
Yes, yes?---And there are issues that go on throughout that I'm not aware of that perhaps I should be aware of and there are issues sometimes at Colac that other HSOs should be aware of and the communication between the HSOs needs to be not unified but there needs to be more communication between them.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9923
Are you familiar, Mr Phillips, with the RAV intranet?---I am, yes.
PN9924
Something that you would have recourse to at the station?---Yes, I do.
PN9925
And you know, don't you, that there are area occupational health and safety committees?---I know there's one for Area 1. I get regular minutes of that one, yes.
PN9926
Do you know that the occupational health and safety minutes of all of those area committees are posted on the intranet?---No, I did not.
PN9927
If I could just take you to the attachment to your statement, BP1; do you have that there? No? I'm sure I've got something that says BP1. I withdraw that. Don't worry Mr Phillips. If you could turn to your reply statement. Just a couple of things I want to deal with in your reply statement. Was it also part of your instructions to prepare this statement to have a go at the ACOs and their level of competency and assistance to RAV paramedics?---No, I wasn't.
PN9928
You chose to do that off your own bat, did you?---No, I didn't have a go at the ACOs.
PN9929
You have included at paragraph 11 - one, two - and paragraph 12 a number of examples where you attempt, I suggest, to highlight the lack of training assistance and competency of the ACOs?---That's my experience, yes.
PN9930
It has never been the case, has it, that you have had a positive experience with ACOs; is that what you're suggesting?---I have no problems with ACOs.
PN9931
You have found them to be of assistance to you from time to time in the performance of your duties?---Yes, I have.
PN9932
You haven't included an example of that kind, why not?---Because that - the - I was asked to show ACOs.
PN9933
Thank you. You were asked by whom to show ACOs?---The AEA.
PN9934
Yes, Ms Forbath again?---Quite possibly, yes.
PN9935
Yes, all right.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9936
VICE PRESIDENT LAWLER: Unless you are concerned, there is nothing wrong with that, Mr Phillips?---Pardon?
PN9937
There is absolutely nothing wrong with a legal representative or adviser suggesting to a witness that they ought to cover topics A, B, C and D?---Yes, yes.
PN9938
MS MACLEAN: The example you give in relation to the ACOs in paragraph 11 where at the first dot point, you attended a road traffic accident on the Colac Apollo Bay road; you suggest there do you that an off duty paramedic ought to have been called in to respond with you to that case?---Not to respond to me - not to respond with me because I was on the first vehicle that went out. I was actually on duty.
PN9939
All right. So just let's go through this step by step. One full time paramedic crew was despatched, that's two - - - ?---That was - - -
PN9940
Two officers?---Yes, that's correct.
PN9941
And that was you and another person?---Yes, that's correct.
PN9942
From Colac?---Yes.
PN9943
Yes, a second ambulance was then despatched with a recalled crew?---Yes, with a recall officer, yes.
PN9944
And that was one paramedic?---One paramedic, yes.
PN9945
And one ACO?---Yes.
PN9946
Yes, and you're suggesting there I take it, are you, that a person who was off duty ought to have been called upon to respond instead of the ACO?---Yes, that's correct.
PN9947
Isn't it part of your complaint, Mr Phillips, that the paramedics at RAV are fatigued, they're called in from days off, from periods of rest et cetera? With three paramedics already responding to that particular incident I don't understand, given the concerns that you and others have about disturbing people's family life and their rest periods, why it would be necessary to call in an off duty paramedic in that situation. What sort of point are you making there?---The point I'm making was that the jobs that go off in Colac that are what we call the big jobs, including two cars that hit at a hundred Ks - - -

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9948
Yes?---You see I come, again I'll refer to the London scenario. I worked in London and people no matter what, got the highest level of care and support that they could get.
PN9949
Yes?---I don't believe that despatching an ACO in front of an officer, a paramedic officer, was right for this job.
PN9950
There were three paramedics responding to this incident?---Yes, that's correct.
PN9951
Yes. Was MICA called?---I was working with a MICA officer, yes.
PN9952
So there was two paramedics, non-MICA paramedics and one paramedic?---Yes, that's correct.
PN9953
And you think that it was inappropriate, is this what you're suggesting, that an ACO was put as the fourth level of response if I can put it that way, on that particular incident?---Well, there's two problems with that statement. One it's in breach of the EBA 2001 not to call - to recall or to call an off duty paramedic and replace them with an ACO.
PN9954
I'm sorry, just run that by me again?---The EBA - - -
PN9955
In breach of the?---EBA 2001.
PN9956
Yes, which particular provision?---The community officer provision, section E I believe.
PN9957
Right, and you say that was in breach to utilise the ACO in the manner that you've described here?---Yes.
PN9958
Yes, all right and what do you - - - ?---And - - -
PN9959
Go on?---And that the clinical - I don't believe there was a clinical justification to - we had one patient trapped and the other patient was sick and ended up going to the Alfred Hospital anyway and I don't believe that the ACO was the right level of care to respond.
PN9960
Two paramedics, one MICA officer, what did the ACO - I'll put that another way. Let's go back to this breach; what was the breach?---The breach of the EBA?

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9961
Yes?---That an ACO was used where a full time paramedic was available to respond.
PN9962
Full time paramedic available?--- Yes.
PN9963
How do you know that there was a full time paramedic available?---Because I asked him at the completion of the job.
PN9964
You took it upon yourself to ring who?--- I didn't ring him. He was - I met him in town in that afternoon and I asked him if he was available to respond.
PN9965
This is the person who was off duty?---Yes.
PN9966
And he said he was available to respond?---Yes.
PN9967
Even though he was off duty?---Yes.
PN9968
Yes, I see. All right, and did you have any idea whether he'd been contacted by the communications people in RAV?---He informed me that he had not.
PN9969
He had not?---He hadn't.
PN9970
And it's part of the union's high level of concern in this case isn't it, Mr Phillips, that people are disturbed on their days off for periods of rest?---Yes, that's correct.
PN9971
There have been grievances about people being disturbed on those days off?
---The - - -
PN9972
Isn't that right?---The - again I'll rephrase it. It's not the fact that the ACO was called, it's the fact that a paramedic should have been - well the paramedic should have been requested first. If the paramedic then could not respond, then the ACO could have responded.
PN9973
I see, all right. Now, having identified this breach of the EBA as you describe it, what did you do about it?---I believe I - I can't remember. I believe I just spoke to my station officer about it.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9974
Perhaps if I could just go through a few figures with you. Just one more thing; what is your understanding of standby, Mr Phillips?---My understanding of standby is basically that when the Colac vehicle goes out of town, basically an off duty officer is phoned to be asked if they can be put on standby for a period of time what that vehicle's out of town.
PN9975
What is your understanding of rostered on call; that is the period of duty that you spend each evening, as we have just been discussing, between 6 o'clock and the commencement of the next day shift?---My understand - - -
PN9976
Rostered on call?---Rostered on call is a period when I'm rostered on call, basically.
PN9977
Non-rostered on call is utilised by RAV to have vacancies or absences due to illness in the on call roster covered, isn't it?---Yes, that's correct.
PN9978
Yes and you know, don't you, that it's part of an industrial tactic adopted by the union to place a ban on either rostered or perhaps non-rostered on call and demand payment for standby as an alternative?---That has been the case. That has been the case, yes.
PN9979
Can you explain to the Commission the difference in remuneration between standby and on call?---Standby is paid at - sorry, a non-rostered call is paid at double the on call rate which is about $6 something.
PN9980
Per hour ?---Per hour.
PN9981
Yes?---And standby is paid at normal rate which is $25 or something like that.
PN9982
Yes, so a substantial difference in remuneration?---Yes.
PN9983
Would you agree with that?---That's correct.
PN9984
You yourself, in fact, undertook a ban of that kind in September of last year, did you not?---Yes.
PN9985
Yes, and that was unprotected industrial action?---Yes, I believe so.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9986
Can I just show you this? Do you recognise that email, Mr Phillips?---Yes, that's correct.
PN9987
This is an email - if we start at the bottom, this is an email from you to Mr Roger Williams; who's that?---He was the area manager at Area 1.
PN9988
I'll tender that, if the Commission pleases. I tender that, your Honour.
PN9989
VICE PRESIDENT LAWLER: Mr Friend?
PN9990
MR FRIEND: Yes, I still have to get some instructions. This has all just been handed to me but the witness has identified it. I've no objection.

EXHIBIT #MM EMAIL FROM BARRY PHILLIPS TO ROGER WILLIAMS

PN9991
MS MACLEAN: Mr Phillips, I think you said Mr Williams was the area manager for your particular area, is that right?---That's correct.
PN9992
You sent him this email and you say:
PN9993

In line with resolutions passed at the general meeting of ambulance officers' union last week -

PN9994
You're referring there, aren't you, to the meeting at Trades Hall that was undertaken after the bargaining periods were terminated?---Yes.
PN9995

I am writing to inform you that staff at Colac are no longer willing to accept rostered call.

PN9996
Are you referring there to rostered call which is part of your normal rostered duty?---Yes, that's correct.
PN9997
And you're writing that you're no longer willing to accept rostered call for the time being "If however an alternative offer is made, this will be looked at". The response was that standby would be accepted by the employees. That was unprotected action wasn't it, Mr Phillips?---That's correct, yes.
PN9998
You understood that?---Yes.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN9999
There were then proceedings in the Commission I think a few days after that where a section 127 audit was made in relation to that and other unprotected action?---Yes.
PN10000
As a general proposition, Mr Phillips, would you say that you use your - or the ALS skills, cannulation and matters of that kind, infrequently?---More regularly.
PN10001
Daily?---Daily.
PN10002
You see, the figures that I've got suggest that in a month period of November to December - you were working November to December?---Last year?
PN10003
You weren't on leave or anything? Yes?---I was on leave for the first half of November.
PN10004
All right. Let's take December to January; were you working in the full period of that month?---I believe so.
PN10005
Yes, can I suggest to you that the ALS skills you've utilised in that month period were two IV - the administration of two drugs by an intravenous canula, one morphine and one Midazolam?---Yes, it's possible.
PN10006
The use of the laryngeal mask airway would be infrequent?---Infrequent, yes.
PN10007
We've discussed Ceftriaxone also infrequent?---Yes.
PN10008
Can I suggest to you finally, Mr Phillips, that your earnings for the financial year ending June 2003 were in the vicinity of 96,000 as a package?---I have no idea.
PN10009
You don't know? For the period ending 30 June 2004 about 97,000?---Again, I have no idea.
PN10010
You have no idea of what your earnings are?---I don't - not my yearly earnings, no. The only time I look at my yearly earnings is when I go and file a tax return but I don't keep a record of how much I earn a year.
PN10011
Does that sound to you about right?---I thought I was somewhere in the lower - I thought I was somewhere in the 80s rather than the 90s but if that's the figures that you've got, then yes.

**** BARRY RAYMOND PHILLIPS XXN MS MACLEAN

PN10012
All right. Just excuse me for a moment, Mr Phillips. Thank you.
PN10013
VICE PRESIDENT LAWLER: Mr Friend?

<RE-EXAMINATION BY MR FRIEND [11.59AM]

PN10014
MR FRIEND: You said just before, you use ALS skills daily and then you were asked about the month of December January. What did you mean when you said you use ALS skills daily?---When I say use ALS skills daily, it's - if you mean actually inserting them into patients or working on patients then no. But there's - like, there's all these drugs to be checked and the drug kits have to be checked et cetera, et cetera. So I don't use the skill of putting things in but the skills are daily as far as drugs and things that I have to use. It's part of my job now to do that sort of thing.
PN10015
You said earlier on that you had a scholarship from RAV to do the ALS course at Victoria University?---Yes, that's correct.
PN10016
How did that come about?---RAV identified - no, I'll rephrase that. The government identified a need for advanced life support in country areas. Colac was identified as one of those areas and therefore I applied for the scholarship and was successful.
PN10017
I see?---Mainly just - to lead on from that - mainly because of the long transport times of patients we have. If we have to bring someone in from the Ottways we can have them on board for an hour and a half or so.
PN10018
You were asked about the incident on the Great Ocean Road when and ACO was responded and you started to say something about there being clinical reasons?
---Yes, that's correct.
PN10019
In relation to the ACO but you were then taken back to another issue. I think my learned friend, Ms MacLean, started to ask you what the ACO did at the scene?
---Right.
PN10020
Can you tell the Commission?---I don't know what the ACO did because I was basically in a car with a trapped patient trying to put a line in et cetera, et cetera. So I don't know - all I know is the other patient was sick and had to go to the Alfred eventually anyway.

**** BARRY RAYMOND PHILLIPS RXN MR FRIEND

PN10021
Right, and what were the clinical reasons that you referred to?---Not the clinical reasons are those - that particular case but generally the clinical reasons I've had, not with Colac's ACOs but the ACOs within the area. Their training and their clinical support has been extremely poor.
PN10022
Thank you, Mr Phillips.
PN10023
VICE PRESIDENT LAWLER: Thank you, Mr Phillips, you are free to go.

<THE WITNESS WITHDREW [12.02PM]

PN10024
MR FRIEND: I call Olga Bartasek.

<LAURA OLGA BARTASEK, SWORN [12.03PM]
<EXAMINATION-IN-CHIEF BY MR FRIEND

PN10025
MR FRIEND: Is your full name Laura Olga Bartasek?---That's correct.
PN10026
Of (address supplied)?---That's correct.
PN10027
You're an ambulance paramedic?---That's correct.
PN10028
You've prepared two witness statements in relation to this matter?---Yes, I have. Can I just bring to the attention there's a typo error in one of them.
PN10029
Yes, all right. Well, is that in the first one?---In the second one.
PN10030
Okay we'll come to that in a minute?---Yes.
PN10031
In the first one, that has some 10 pages and 3 attachments?---That's correct.
PN10032
The contents of that are true and correct?---Yes.
PN10033
I tender that.
PN10034
VICE PRESIDENT LAWLER: I have 4 attachments, Mr Friend.
PN10035
MR FRIEND: Are there four? I missed one there, sorry.
PN10036
VICE PRESIDENT LAWLER: Yes.
PN10037
MR FRIEND: Yes, I'm sorry?---Yes, there's four.
PN10038
MR FRIEND: Four attachments. I tender that if the Commission pleases.

EXHIBIT # 52 FIRST WITNESS STATEMENT OF LAURA OLGA BARTASEK

PN10039
MR FRIEND: The second statement is 17 paragraphs and an additional 5 attachments?---That's correct.
PN10040
You say there's an error in the second statement that you wish to correct?---Yes, in paragraph 9.
PN10041
Yes?---Line number 5.

**** LAURA OLGA BARTASEK XN MR FRIEND

PN10042
Line number 5?---It says, paramedics are still called to hypovolaemic cases. It was meant to be hypoglycaemic.
PN10043
Glycaemic?---Yes.
PN10044
Subject to that correction, is that witness statement true and correct?---That's correct..
PN10045
I tender that, if the Commission pleases.

EXHIBIT # 53 SECOND WITNESS STATEMENT OF LAURA OLGA BARASEK

PN10046
MR FRIEND: Thank you, Ms Barasek.

<CROSS-EXAMINATION BY MR PARRY [12.06PM]

PN10047
MR PARRY: If the Commission pleases. Ms Barasek, you deal with advanced life support in paragraph - I think commencing in paragraph 8 of your first statement and you deal in paragraph 9 with training in certain areas and you list some 12 matters there. Your second statement in paragraph 1 refers to paragraph 98 of the witness statement of Mr Walker and you agree in part with what Mr Walker says. Mr Walker says in paragraph 98 that - now I think he deals - yes, in paragraph 98 he says - and I think I can deal with this in a sort of a summary way - 9.1 and 9.4 are the same thing aren't they?---That's right.
PN10048
9.2 is something that you were trained in well before ALS?---That's correct, but the reason I only agree in part is because we had to - each person had to still conduct those skills and make sure they were competent in those skills before they continued with ALS. So if you weren't competent in that skill you weren't allowed to then continue with ALS or you would have to make sure you were then at that level again to continue with the ALS programme.
PN10049
It was a revision exercise, wasn't it?---Well it was a subject of the ALS certificate.
PN10050
Yes, revising previously learnt skills and making sure that they were up to scratch as it were?---Yes, making sure that you were competent.
PN10051
That revision and making sure you were competent applied also to 9.5, 9.6 and 9.7?---That's correct but there would have been a lot of paramedics in the field that were taught those skills five, six, seven even 10 years earlier and never used them. So that's why you still had to do the work required for those subjects.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10052
Yes you say, I think in your second statement, that some of these skills were hardly ever used in practice. Can I take it that some paramedics may well have used them more often than not and others not often?---Some would have used them more often, yes, and some not at all.
PN10053
Right. Now you then go on with regard to pre-ALS training and you refer to additional courses of training and I think you deal with Narcan and GlucoGen in the first part. Narcan was a drug of which you were well aware before you were given training about its administration; wasn't it?---We weren't aware of the contraindications or any of the precautions or how to use Narcan at the time.
PN10054
Yes?---We were - - -
PN10055
But you heard my question; you were aware of the drug and its operation in respect of heroin overdose victims?---Yes, just the name of it and how it was used.
PN10056
Well, you didn't just know the name of it. You knew it was used on heroin overdoses?---For heroin overdoses, yes.
PN10057
To treat the effects of heroin overdose; didn't you?---That's right.
PN10058
You knew that before you were taught this in the intramuscular administration course?---All we knew was that Narcan treated heroin overdoses.
PN10059
Overdose?---Yes.
PN10060
GlucoGen, was that a drug known before you were taught about it in the course in the 1990's?---No.
PN10061
That's an oral drug given to people suffering hypoglemic I think you say, emergencies in 10.1?---No, it's an intramuscular drug used. It's not oral.
PN10062
I'm sorry I'm dealing - I looked at glucose pace there. I had that. Hypoglemic - hypoglycaemic, I'm sorry - emergencies, they are emergencies which you in your course were trained to recognise?---A hypoglycaemic event, yes. A patient in hypoglycaemic situation, we were taught to recognise.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10063
That's a fairly basic part of ambulance training?---If you want to call it basic.
PN10064
You also refer I think in the pre-ALS training to oral - 10.2 - to oral Anginine for central chest pain and pulmonary oedema. Again, in your training to be a paramedic you were taught about pulmonary oedemas, weren't you?---Yes, we were. Just to recognise the signs and symptoms.
PN10065
You were taught to recognise the signs and symptoms?---Yes.
PN10066
You also refer to the spine - in 10.3 - to the spine board application for advanced spinal management. This was a new piece of equipment?---Yes.
PN10067
It replaced existing equipment?---Yes, it replaced a Jordan frame.
PN10068
It was a better piece of equipment?---It was, yes. It was an improvement.
PN10069
You also refer in paragraph 11 to giving intramuscular adrenaline for anaphylaxis. Anaphylaxis was a condition that you were trained in your course to recognise?
---Again, the signs and symptoms, yes.
PN10070
In your course you were taught of the existence of adrenaline and its effects?
---We were only taught that if a patient had their own adrenaline that someone could administer it or they'd have a - sometimes people wear an emergency bracelet or necklace to say that they have severe allergic reactions so we were taught to look for these signs and to recognise anaphylaxis.
PN10071
Right, so if you recognised anaphylaxis and somebody was or had adrenaline as part of a medical practitioner's prescription, what would you then do pre this training in 1990?---If they had their adrenaline with them we would just basically give them basic life support and take them to a hospital if they were still in an anaphylactic reaction condition. If they didn't have any adrenaline which was in most cases, we'd call for MICA backup.
PN10072
The MICA would have adrenaline?---Yes.
PN10073
I'm sorry, in the first example when they did have adrenaline would you give them adrenaline?---We weren't allowed to administer it.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10074
The administration of adrenaline pre this training would take place by a MICA?
---Yes.
PN10075
So you knew pre-training about the effects of intramuscular adrenaline on the anaphylactic condition?---All we were taught was if they've got it and they've had the adrenaline and it works then sort of assess and reassess the situation. If it didn't work in the sense that they still were anaphylactic, then we'd call for MICA or have to transport them.
PN10076
Midazolam, you say in paragraph 11, you were trained in the administration of Midazolam for continuous and recurrent seizures. Presumably the recognition of the possible causes of seizures was part of your basic training?---Yes, again the signs and symptoms of seizure we were taught to recognise.
PN10077
Midazolam was a drug that pre this training was used by MICA officers?---Yes.
PN10078
You were aware pre the training that Midazolam was a drug that was used in respect of such seizures?---That's right.
PN10079
You refer in paragraph 12 to the administration of Narcan and GlucoGen reduced the number of patients transported to hospitals; how often have you used Narcan yourself?---When I was a paramedic in MAS I probably used it on a weekly basis, two or three times a week.
PN10080
Right, for the last 4 years you've been with RAV; how often with RAV?---I've used it once.
PN10081
With regard to GlucoGen, in paragraph 13 you refer to, "Patients receiving intramuscular GlucoGen as early as possible have a reduced risk of becoming unconscious". Presumably you would accept that such patients may already be unconscious?---Semi-conscious or unconscious, yes.
PN10082
You then go on in your first statement and deal with adrenaline and Midazolam. In paragraph 16 you refer to intravenous cannulation, fluid resuscitation for patients in hypovolaemic shock. You refer to the benefits of that and you say "this can be a life saving procedure and can risk hospital stay and further complications". Mr Walker in his statement at paragraph 107 says he's not aware of any evidence that fluid resuscitation reduces hospital stays. Do you have any evidence of that?---Yes, in my reply to Mr Walker's comment, my reply witness statement paragraph 5 I refer to that comment and the ROTES Report which - the ROTES Report was the whole initiative as to why ALS was introduced into ambulance and to ambulance paramedics and it was because they found that a lot of the road trauma deaths in Melbourne and rural areas, there were three major causes of preventable death and one of them was airway management, poor airway management; the second was hypovolaemic shock and the third one being patients that had attention pneumothorax that would die; and then ALS was actually introduced to cover those three preventable deaths; and that hypovolaemic shock is why we had Hartmanns introduced.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10083
Yes, I understand that Ms Bartasek, but my question was this: do you know of any evidence that fluid resuscitation reduces hospital stays?---In actually reducing hospital stays I have to say I'm not a hundred per cent sure but certainly in saving lives.
PN10084
The answer is you don't know of any evidence for that proposition, do you?---I haven't come across an actual study, no.
PN10085
VICE PRESIDENT LAWLER: Mr Parry, can I just raise programming issues with you and Mr Friend. Mr Friend on the list you gave us yesterday, unless
Mr Parry's decided to engage in further extensive cross-examination of Mr Morris, this is the last witness today?
PN10086
MR FRIEND: Yes, your Honour.
PN10087
VICE PRESIDENT LAWLER: Mr Parry, how much longer do you think you will be? One of the members of the bench has an engagement that can be delayed a little because it would be desirable to finish this witness rather than come back after lunch, if that can be achieved.
PN10088
MR PARRY: I would hope to be finished by 1 o'clock.
PN10089
VICE PRESIDENT LAWLER: Right, thank you, and Mr Morris?
PN10090
MR PARRY: I think we can forget Mr Morris.
PN10091
VICE PRESIDENT LAWLER: Thank you. I do not want to forget Mr Morris but you do not have any further cross-examination.
PN10092
MR PARRY: Paragraph 17 is about the - I think there is a few things rolled in there. The adrenaline, laryngeal face masks but the final thing is "The finalise where resuscitation fails in the pre-hospital setting, the patient is not taken to hospital and is dealt with externally, saving the resources of the hospital". That's an argument based on the death of the patient, I take it. That there's some benefit because these steps are not successful?---The fact is before we used to have to take most patients to the hospital and they would have to deal with trying to fully resuscitate and if that attempt wasn't viable, then that person would be dealt with in the hospital field. Whereas now we're actually doing the full resuscitation that you would have in an emergency department, out in the field. So if it's not successful then we're dealing with the death of that patient out in the field.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10093
Do you still take them to hospital when they're dead?---No.
PN10094
No, you take them to the - - - ?---We don't transport at all.
PN10095
Paragraph 19 deals with chest decompression, of attention pneumothorax. The recognition of that was a basic part of your training wasn't it?---Initially it was, the signs and symptoms again, yes.
PN10096
Over the page in, Developments and training since ALS, paragraph 21 deals with the 50 per cent Dextrose or diabetics. It's administered intravenously; as I understand, that's the only way it can be administered isn't it?---That's correct.
PN10097
You say a new ALS guideline has been developed for the use of this drug; can I suggest there are no ALS guidelines but there are RAV clinical practice guidelines?---Again, I actually referred to that in my reply and yes, I was merely referring to an ALS guideline being like a subclause of the RAV guidelines. In the sense that there are ALS guidelines incorporated in the rural ambulance guidelines.
PN10098
Well all your procedures, both ALS and outside ALS, almost invariably have a clinical practice guideline attached to them?---That's correct.
PN10099
Next you deal with Atrovent. You say it's a new drug; you're aware that it has been around for a number of years?---Only because patients take it, yes, with their - like an asthmatic usually has a preventative which is Atrovent and Ventolin in conjunction.
PN10100
Could I go on to the next page to deal with part-time work. You work at Romsey, you're a full time paramedic?---Yes.
PN10101
Romsey is an on call branch?---Yes.
PN10102
That's 8 day shifts on, 6 day shifts off in a fortnight?---That's right.
PN10103
How many people are at Romsey?---There's five of us.
PN10104
One is always on annual leave?---Yes.
PN10105
The other four, two of them are one and two of them are off?---Off, yes.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10106
You want an opportunity to go part-time if you so choose?---That's right.
PN10107
Let's assume you're at Romsey and you decided you wanted to go part-time and RAV was compelled to let you go part-time, how are RAV going to fill the other half of the line or the one that you don't want to work?---What you can do is have a - what we call a job share situation where you could have two people running a one-person line. So in effect you would have the 8 days on shared by those two people and the 6 days off. In effect it would be 4 days on for two paramedics and 10 days off for the two paramedics but they're in effect running the one line and having annual leave as one person. So when that job share line's turn to be on annual leave, it would in effect be two people on annual leave which is in effect one.
PN10108
Yes, but what if they can't find somebody that wants to job share?---You do it like any other position. You advertise it.
PN10109
Yes, let's assume we advertise it?---Yes.
PN10110
And we say we want somebody to job share the line at the Romsey branch and we don't get any responses?---We don't know that. It hasn't happened yet.
PN10111
Bear with me?---Yes.
PN10112
Let's assume we don't get any responses; what do we do then?---If you don't get a response then, I don't know, you look at the next option.
PN10113
Yes, what is that?---Which could be to - whether I decide to go to another branch with the same title or whether - because there are other branches that you can do part-time at. You can go to a 24-hour branch, whether it be Ballarat or you know, something like that or even a larger regional branch like Kilmore, who has about 9 paramedics and maybe job share with someone there.
PN10114
What if you don't want to go to another branch?---You deal with those issues as they arise. I mean, we haven't had that yet. I can't predict what could happen or what may not happen.
PN10115
But your union opposes the employer having the right to direct inter-branch transfers, doesn't it?---Yes.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10116
So let's assume you didn't want to leave Romsey, you wanted to work part-time and they couldn't fill the other half of the roster?---The only other - - -
PN10117
Where do we go there?---The only other option would be to fill it with overtime.
PN10118
Right?---Where there's gaps at branches as there are now.
PN10119
That's the only other option, isn't it, that they'd have to fill the position with overtime?---No, like I said, I could negotiate to go to another branch.
PN10120
So if it was acceptable to you, you could go to another branch but otherwise not? That's a yes is it?---Yes.
PN10121
Would you accept that if you wanted to go overtime it might not be unreasonable for RAV to have a right to send you to another branch?---No, because I'm - you know, I've bought and put my house or my life in a certain area. I mean, does RAV then have the option to send me anywhere and have travel time of up to 2, 3 hours to a branch?
PN10122
How many RAV branches are there within one hour's drive of your branch?
---They're basically call branches. The next closest 24-hour branch is Ballarat which is an hour and 15 minutes away.
PN10123
I asked you about branches, not just call branches?---Ballarat.
PN10124
No, all branches from Romsey?---How many there are?
PN10125
What's the closest branch to Romsey?---Is Gisborne.
PN10126
How far away is that?---It is 20 kilometres.
PN10127
Twenty kilometres?---Yes.
PN10128
Right, that's about what, 20 minutes drive, 10, 15 minutes drive. I assume it's country driving?---Yes.
PN10129
That's an on call branch?---Yes.
PN10130
So that might not be satisfactory. What is the next nearest branch?---Woodend.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10131
How far away is that?---Twenty two kilometres.
PN10132
Fifteen minutes?---And that's a call branch as well.
PN10133
I see, so really the only option would be to send you if they couldn't fill the other branches, to a rostered branch such as Ballarat?---That's right.
PN10134
You don't want to go there?---No.
PN10135
You deal with some of the other claims that the union make and you say in paragraph 32 about on call. You want to go - you propose a return to an old provision. You say RAV - do you understand that RAV propose to maintain the status quo on that position?---I didn't.
PN10136
You don't know?---No.
PN10137
But halfway through that you say:
PN10138

At Romsey branch I am usually called out on average once or twice per night.

PN10139
Do you see that?---Yes.
PN10140
Just to look through the call numbers at your branch, at the Romsey branch. The figures that I have indicate that the average on the day shift, the average over a whole year on the day shift is 1.1 cases on a day shift; and on the - or thereabouts and the other - I'm sorry. I withdraw that. I'm looking at the wrong sheet of paper and I apologise to the Commission. So the average number of cases is just over one a day?---It can be.
PN10141
On day shift, yes?---It can be.
PN10142
Yes, but the essence of an average is it can be higher or it can be lower?---Yes.
PN10143
So on some days you don't have any calls?---Some days, yes.
PN10144
On some days you might have a couple of calls?---Yes, up to four or five.
PN10145
But is it fair to say that on average it's just over one?---Average across the board, if that's what the statistics say.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10146
They can be Code 1, Code 2 or Code 3?---That's right.
PN10147
During the on call period, on the figures that I have, it's just over - I've got point 6 cases in the on call period. So that when you're on call perhaps over 2 nights you might get one callout on average?---That can happen, yes.
PN10148
That's an average, remember?---Yes, sometimes more, sometimes less, that's right.
PN10149
You see, I suggest that when you say you're called out on an average once or twice per night, that is a bit higher than what the real average is?---Yes, if that's what your statistics are saying.
PN10150
You also say each case lasts a minimum of 3 hours. Isn't the position - these are the figures that RAV have provided me and they might be right or they might be wrong and that's why I'm raising them with you?---Yes.
PN10151
They say the average time on emergency cases is about 84 minutes and the average time on non-emergency is about 112 minutes?---I wouldn't agree with that, not at Romsey.
PN10152
All right, you take issue with that?---Yes.
PN10153
Do you accept that when you say each case usually lasts a minimum of 3 hours, that's a bit of an exaggeration isn't it?---Not at all. Can I say why?
PN10154
Yes, go ahead?---Yes, we're basically 60 kilometres from the CBD and our area probably covers as far as 80 or 90 kilometres out of Melbourne so whenever we do attend a patient, they all come to Melbourne because the hospitals within our area - there's only really Kyneton Hospital which is a lower level hospital, level of care; and we actually have intensive care paramedics at Romsey so if an intensive care paramedic is on board, we take all our patients to Melbourne so the travel into Melbourne's an hour, the travel out's an hour due to - depending on traffic and then you're usually with the patient for half an hour or so.
PN10155
Yes, but what's the split between emergency and non-emergency, about 50-50?
---No, there'd be more emergency than non.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10156
Have you looked this up or is that just your assessment?---We've got stats and I'm the station officer at Romsey and I take the statistics and we basically hand them in, in the monthly report; and the other thing is Romsey is a brand new station. It's only been there for two and a half years, fully operational, and slowly our workload's increasing.
PN10157
Paragraph 34 deals with another claim which I'm not sure I follow:
PN10158

When an on call officer is on a rest break he or she should not be recalled for duty as this adds significantly to the cycle of fatigue.

PN10159
Do you understand that the union in this case are prohibiting an on call officer being recalled for duty?---That's right. At the moment if you're on what's called an 8-hour break you can be called back to duty. You need to state that you're on a fatigue break and bring the vehicle back to the branch before you are not disturbed at all.
PN10160
At present it's by agreement, isn't it?---That's right.
PN10161
You and your union want to go to prohibition?---Yes.
PN10162
The way you say that, I'm aware the union is making a claim in relation to this, if an on call paramedic is absent due to being on a rest break, he or she can be covered by recalling off duty staff by agreement. So that requires the agreement of the off duty staff, doesn't it?---That's right.
PN10163
If they don't agree, what happens then?---They call the people at another branch. It can be an off call - it can be an off duty officer anywhere in the area. It doesn't have to be a Romsey off duty paramedic.
PN10164
Yes, but if it's an emergency in the Romsey area it's rather desirable that the work that is performed is done by people as near as possible?---That's all well and good if the people aren't fatigued. It then becomes dangerous not only for the paramedic but for the patient.
PN10165
Yes, but two things. Firstly, this is fairly rare, isn't it?---True.
PN10166
Yes, firstly. Secondly, the paramedic, if the paramedic has the view that he or she is fatigued can refuse the work at present; correct?---They - yes, bring the vehicle back to the branch, yes.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10167
Right, so it really is the last - it's a fairly serious situation that's been reached at this stage when they recall people when they're on their rest break, isn't it?
---That's right.
PN10168
It would only presumably occur when there is a fairly serious issue confronting Rural Ambulance Victoria?---That's right. But talking - I can only speak about Romsey and like I said, it's a brand new station and the workload is gradually increasing so sooner or later that occurrence is going to be a lot more frequent. At the moment it's rare. I know branches that are a lot busier that occurrence is a lot more.
PN10169
This ban may well have an impact in some circumstances on the delivery of services by RAV, might it not?---It shouldn't. It should still be the same. If you can't get an off duty person as close as possible, you get the off duty person that you can get rather than sending a fatigued paramedic out onto a job.
PN10170
You next deal with another claim, the 10-hour rest break within the current provisions existing, time to wind down. Now can we accept that the number of times that you are called out is probably closer to once every two nights?---At the moment, yes.
PN10171
Well why is it at the moment? The moment is typical, isn't it?---At the moment, like I said, each month our statistics are getting higher and higher, the workload's getting more.
PN10172
That callout may well be after 6.00 pm?---Yes.
PN10173
Immediately after 6?---Yes.
PN10174
So in a callout that's at 6.00 pm and to give you your period of time, 3 hours and 3 hours, can we accept, would be the absolute maximum for the callout?---No, it can be 4 to 5 hours depending on what the job is.
PN10175
If you were called out at 8 o'clock, 3 hours, 10 o'clock back. You would then have ample time to have a break?---Well, we don't get an 8-hour break in that case because from midnight you're - I can come back at - - -
PN10176
No, you're back at 10?---Yes, even if I'm back at 11.30, I'm back at work at 8 o'clock the next day. So yes, it's ample time.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10177
So it's ample time?---That's right.
PN10178
A number of the callouts that you attend are not going to involve a break that is say less than 12 - 10 hours?---If you come back at 10, yes.
PN10179
So the circumstances in which this happens will certainly be less than one in two nights. It might be one in three or one in four?---Well, I've actually stated in my statement that most of those callouts aren't at 6.00 pm or 7.00 pm.
PN10180
Yes, I know what you stated in your statement?---Yes.
PN10181
But I don't know where you've got it from. You don't seem to have got it from
- - - ?---From my experience.
PN10182
Yes, will we get that from the records of your station?---You should, yes.
PN10183
You accept that you've seen the statement of Mr Gough, have you?---No, I haven't seen his statement.
PN10184
Mr Gough says in paragraph 169 of his statement, that the introduction of a 10 hour rest break would significantly impact on the current rosters worked in RAV locations including the 10/14 roster. That's the fact, isn't it? If a 10-hour rest break was introduced it would impact on 10/14 and on call rosters?---I can see that occurring, yes.
PN10185
The next one you claim or you seek to support is the union is seeking a meal break provision for paramedics in the on call period. So this is the time when you are at home or nearby home, you want a provision for a meal break when you're at home?---That's right.
PN10186
Do you accept that when you're at home on call you can eat whenever you like?
---That's right.
PN10187
And you probably do eat whenever you like?---Well, we eat when the jobs allow us to eat.
PN10188
Yes, but presumably - - - ?---Otherwise whenever you want, yes.
PN10189
I think you generally knock off at what time? About 6 o'clock?---Yes.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10190
And indeed you might be sleeping, presumably, as well?---That's right.
PN10191
The next claim you make or you seek to support is:
PN10192

A minimum of 4 hours at double time for each callout to duty during the period of on call. This is reasonable because an off duty employee receives 4 hours at double time when recalled to duty. There should be some equity for the two groups of employees.

PN10193
Do you accept that when a person is on call they are receiving an allowance and an off duty person is not receiving an allowance?---That's correct.
PN10194
They're different, aren't they?---Whereabouts are you referring to?
PN10195
I'm sorry, paragraph 37?---Okay. Yes.
PN10196
Your second statement, in the last financial year you earned about 120,000?
---That's correct.
PN10197
And the year before that about 103,000?---That's correct.
PN10198
You've given evidence in the first part of your statement about your ALS skills. In the last 3 months how often have you used morphine?---Gosh, I'm guessing about eight or 10 times.
PN10199
Are those the occasions you have cannulated a vein of a patient?---That's right.
PN10200
What about the laryngeal mask?---I haven't used that yet.
PN10201
Not used that one?---No.
PN10202
Ceftriaxone?---Once.
PN10203
Adrenaline?---Once.
PN10204
Then in the last 3 months, Midazolam?---No.
PN10205
Sorry?---No, I haven't. Sorry, the other night, yes, once.

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10206
What about in the last year? Let's go through those again, with regard to morphine in the last year?---Well, for the last 3 months it was eight or 10 times. I don't know, 50, 50, 60 times.
PN10207
That's just a guess is it?---Yes.
PN10208
Ceftriaxone?---Just the once.
PN10209
The use of an LMA mask?---I haven't used it during the last 12 months.
PN10210
Have you ever used it?---No, not to this stage.
PN10211
Adrenaline?---About four or five times.
PN10212
In the last year?---Yes, probably about four.
PN10213
Four times in the last year?---Yes, that's including arrests because you use anaphylaxis for an arrest as well as - sorry, you use adrenaline for anaphylaxis as well as arrest. Obviously anaphylaxis is a lot rarer.
PN10214
Fluids, administered fluids in the last 3 months?---Three times - sorry, 3 months?
PN10215
The last 3 months?---Three months, once.
PN10216
In the last year?---Probably about three or four times.
PN10217
And Maxolon?---Maxolon, probably half the time that I've given morphine. So if it was 50 times morphine, probably about 25, 30 times Maxolon.
PN10218
Right and I think we agreed earlier you haven't used Narcan in your time at RAV at all?---Once, I said.
PN10219
How many years ago was that?---It was probably my first year in RAV so 3 years ago.
PN10220
What about decompression of attention pneumothorax?---I haven't done that yet.
PN10221
You occasionally have done shift extension overtime?---Yes, as in continuous overtime?

**** LAURA OLGA BARTASEK XXN MR PARRY

PN10222
Yes?---Yes, whereby you get a job at 4 or 5.30 and you come back after the 6 o'clock that you're meant to start call.
PN10223
In the last few months - I'm sorry, the last 3 months that's occurred about on average, what, once a fortnight?---Probably twice a fortnight at least.
PN10224
With regard to shift - I'm sorry, total shift overtime; how often have you done that?---I haven't done much at all, at least the last - probably the last 12 months. I'd be - it'd be at a guess probably 10 or 12 full day shifts at another branch on overtime.
PN10225
You've been rung up and asked about that?---Yes.
PN10226
You've accepted that?---Yes. But there's been many that I've not accepted.
PN10227
Which branches have you been prepared to go to, to do that overtime?---Basically the local branches, Woodend, Gisborne or Kyneton and of course at Romsey.
PN10228
I have nothing further, if the Commission pleases.
PN10229
VICE PRESIDENT LAWLER: Thank you, Mr Parry. Yes, Mr Friend?

<RE-EXAMINATION BY MR FRIEND [12.49PM]

PN10230
MR FRIEND: You were asked about being able to eat while rostered on call and at home and you said "we eat when the jobs allow us to eat". What did you mean by that?---Well, if a job comes in at, you know, 6.30 or 7 o'clock and you're about to eat, well you just have to wait till you get back or maybe get something on the run.
PN10231
Prior to the introduction of ALS, you were asked about whether you knew about Narcan and what it was for; how did you treat heroin overdose?---We used to basically have to bag them as in give them oxygen or EAR until MICA came to us and/or we'd have to transport them to hospital that way.
PN10232
How did you treat hypoglycaemia?---The same way, give them basic life support. If MICA were around we'd sit at the scene and wait for them or start transporting and meet them on the way or go straight through to a hospital.
PN10233
Pulmonary oedema?---The same way.

**** LAURA OLGA BARTASEK RXN MR FRIEND

PN10234
I think you've already said what you did with anaphylaxis?---Yes.
PN10235
Seizure, which you would now use Midazolam for?---We'd have to just control their airway and give them oxygen and wait for a MICA or meet up with a MICA or take them to hospital.
PN10236
How would you control their airway?---Well, it's not easy but you try to get an airway in. If not, you'd try to bag without an airway and hopefully get some sort of oxygen. If you're not getting it through their mouth maybe even through their nose.
PN10237
What sort of airway would you use?---If you couldn't - a lot of people that are seizuring tend to clamp down their mouth so you can't always get an oral airway into their mouths so you just put the mask on and like I said, hopefully it'll at least go down their nose. We did since have the introduction of nasopharyngeal so you can put a tube sort of - a short tube into their nose and bag them with their mouth closed.
PN10238
When was that introduced?---Gosh, now I'm guessing. 2000 I think.
PN10239
The airway that you're talking about getting in through the clamped teeth, what sort is that?---It's a oropharyngeal airway. It's a hard plastic - - -
PN10240
What is it called, has it got a name?---Oropharyngeal airway, yes.
PN10241
How long is it?---They vary in size for different size patients.
PN10242
Nothing further.

<THE WITNESS WITHDREW [12.52PM]

PN10243
VICE PRESIDENT LAWLER: Thank you, Mr Friend. That concludes today's hearing and we will adjourn until 10 o'clock tomorrow.

<ADJOURNED UNTIL WEDNESDAY 2 MARCH 2005 [12.52PM]

LIST OF WITNESSES, EXHIBITS AND MFIs

VINCENT LUPPINO, SWORN PN9467
EXAMINATION-IN-CHIEF BY MR FRIEND PN9467
EXHIBIT #48 STATEMENT OF VINCENT LUPPINO PN9473
EXHIBIT #49 REPLY STATEMENT OF VINCENT LUPPINO PN9473
CROSS-EXAMINATION BY MR PARRY PN9475
RE-EXAMINATION BY MR FRIEND PN9672
THE WITNESS WITHDREW PN9681
BARRY RAYMOND PHILLIPS, AFFIRMED PN9682
EXAMINATION-IN-CHIEF BY MR FRIEND PN9682
EXHIBIT #50 FIRST WITNESS STATEMENT OF BARRY RAYMOND PHILLIPS PN9690
EXHIBIT #51 SECOND STATEMENT OF BARRY RAYMOND PHILLIPS PN9699
CROSS-EXAMINATION BY MS MACLEAN PN9704
EXHIBIT #MM EMAIL FROM BARRY PHILLIPS TO ROGER WILLIAMS PN9990
RE-EXAMINATION BY MR FRIEND PN10013
THE WITNESS WITHDREW PN10023
LAURA OLGA BARTASEK, SWORN PN10024
EXAMINATION-IN-CHIEF BY MR FRIEND PN10024
EXHIBIT # 52 FIRST WITNESS STATEMENT OF LAURA OLGA BARTASEK PN10038
EXHIBIT # 53 SECOND WITNESS STATEMENT OF LAURA OLGA BARASEK PN10045
CROSS-EXAMINATION BY MR PARRY PN10046
RE-EXAMINATION BY MR FRIEND PN10229
THE WITNESS WITHDREW PN10242