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[2026] NSWIRComm 1067
General information, not legal advice.
Industrial Relations Commission (NSW)
2026-07-27
Commissioner Howell
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Medium Neutral Citation: Health Secretary o/b Ambulance Service of NSW v Health Services Union, NSW Branch Re dispute regarding Intensive Care Paramedics [2026] NSWIRComm 1067
Hearing dates: 22 July 2026 (and as to form of Orders, 23 July 2026)
Date of orders: 23 July 2026
Decision date: 27 July 2026
Jurisdiction: Industrial Relations Commission
Before: Commissioner Howell
Decision: Dispute Orders were made on 23 July 2026 as set out in paragraph [82] of this Decision. The matter is stood over for Report Back and Directions at 10:00am, 4 August 2026.
Catchwords: EMPLOYMENT AND INDUSTRIAL LAW — Industrial disputes — Dispute orders — Public interest — Other factors
Legislation Cited: Industrial Relations Act 1996 (NSW) ss 130, 136, 137, 138, 163
Cases Cited: Bluescope Steel (AIS) Pty Ltd v Australian Workers’ Union (NSW) (2005) 138 IR 324
Industrial Relations Secretary on behalf of the Department of Primary Industries and Regional Development v Public Service Association and Professional Officers' Association Amalgamated Union of New South Wales (Work Bans by Fisheries Officers) [2024] NSWIRComm 1065
Public Service Association and Professional Offıcers’ Association Amalgamated Union (NSW) v Industrial Relations Secretary (2018) 96 NSWLR 762; 277 IR 263
Secretary of the Ministry of Health v New South Wales Nurses and Midwives’ Association (2022) 320 IR 249
Sydney Water Corporation v Australian Services Union (NSW and ACT Branch) (2005) 146 IR 388
Texts Cited: Nil
Category: Principal judgment
Parties: Notifier: Health Secretary o/b NSW Ambulance Service
Respondent: Health Services Union, NSW Branch
Representation: Notifier:
Mr M Sullivan, Lander & Rogers, Solicitors
Respondent
Ms C Lemos, HSU
File Number(s): 2026/300405
Publication restriction: Nil
Industrial dispute notified by Health Secretary o/b NSW Ambulance alleging industrial action (in the form of work bans) organised by HSU gave rise to a “risk to patient care and service delivery” and had “potential to adversely affect emergency response capability”, seeking urgent assistance from the Commission. No active contest on whether the work bans amounted to “industrial action”. The Commission found the actions were plainly industrial action as defined in the Industrial Relations Act 1996. However, the evidence did not establish the work bans gave rise to any meaningful risk to patient care and service delivery, or any likely adverse effect on emergency response capability. Nonetheless, for the reasons outlined in the decision, the Commission was satisfied that public interest considerations weighed in favour of the dispute orders sought by the Notifier. Those factors included the HSU again failing to properly follow the dispute resolution clause in the Paramedics Award or otherwise invoke the jurisdiction of the Commission in a timely way, rather than resorting to industrial force to resolve an industrial dispute.
On 21 July 2026, the Health Secretary, the nominal employer of employees of the NSW Health Service, including the Ambulance Service of NSW (NSW Ambulance) [1] , notified the Commission of an industrial dispute with the Health Services Union, NSW Branch (the HSU) that had led to members of the HSU taking industrial action in the form of work bans. The industrial action was said to be “associated with the ‘splitting of ICPs’ in metropolitan regions”. It urgently sought the Commission’s assistance, including making an application for dispute orders under ss 136(1)(c) and 137(1)(a) of the Industrial Relations Act 1996 (NSW)(the IR Act).
An ICP is an Intensive Care Paramedic. Further explanation is required, but for introductory purposes it is sufficient to note the issue of “splitting of ICPs in metropolitan regions” relates to how NSW Ambulance manages its workforce to deliver the intensive care services required of a Category A ambulance station in the metropolitan region when a shortage of ICPs arises. Establishment staffing levels for a Category A station are built around an intensive care ambulance being available 24 hours a day, staffed by two fully qualified ICPs. “Splitting” ICPs refers to separating a pair of ICPs (a dual ICP crew) to enable an intensive care ambulance to be staffed with a fully qualified ICP and a regular paramedic (known as a P1) when there are shortages of ICPs. That ‘splitting’ or reallocating of an ICP pair is the first option in a process of staff movements available to mangers be taken to ensure an ICP service continues to be available. The process culminates in drawing on “premium labour”, meaning casuals or overtime, where necessary.
The HSU contends that practice gives rise to a number of issues, including substandard clinical care to patients in need of an ICP service and foreseeable risks to the health, safety and welfare of the ICP workforce. For that reason, it has imposed work bans. As described below, the nature of those work bans has recently escalated. The Dispute Notice, having traced the evolution of the work bans, concludes by saying (at [21], emphasis added):
“As a consequence, NSW Ambulance is unable to adequately assess, mitigate or manage the risks to patient care and service delivery arising from the industrial action. The escalated action took effect on 21 July 2026, has no specified end date, and has the potential to adversely affect emergency response capability across metropolitan operations. NSW Ambulance therefore seeks the urgent intervention of the Commission to prevent further operational disruption and assist the parties to resolve the dispute
The Notifier’s evidence does not establish the work bans give rise to any meaningful “risk to patient care and service delivery”, or any material “potential to adversely affect emergency response capability”. Nonetheless, for the reasons I outline below, I was satisfied that the work bans are industrial action as defined in the IR Act, and that public interest considerations weigh in favour of the dispute orders sought by the Notifier.
For that reason, on the morning of Thursday, 23 July 2026, having heard from the parties on the form of the Orders, I made the dispute Orders sought by NSW Ambulance. These are my reasons for making those Orders.
NSW Ambulance provides a broad range of clinical services to the community. An ICP ambulance service is one of those clinical services.
ICPs are “specialist clinicians and senior clinical members of paramedic teams …[that]... provide clinical leadership by monitoring clinical practice, assessing and mitigating risk to patients, improving efficiency and coordination at the point of care and advocating for patients with high acuity presentations” [2] . ICPs have a different scope of practice to a regular Paramedic and are typically deployed in a vehicle marked as an Intensive Care ambulance containing equipment, medications and a layout somewhat different to a general duty ambulance (again, better reflecting that different scope of practice). They are identified in the relevant Award, the NSW Ambulance Paramedics (State) Award 2023 (the Paramedics Award), as a type of Paramedic Specialist [3] , attracting higher rates of pay than a P1.
NSW Ambulance organises its clinical services via its Statewide Specialist Capability Framework (the SSCF). The SSCF is the product of an analysis of “location demand projections, the skills profile required to meet demand, models of care, speciality resources, frequency/complexity of clinical exposures, and infrastructure availability” (described as “a service planning methodology”) to provide an “evidence-based rationale” to determine “the placement of clinical resources required to maintain safe patient care for the people of NSW” [4] . It does that by assigning a Category to each station, from Category A to Category I.
The scope and service requirements for each Category of station are outlined in a document entitled NSW Ambulance Role Delineation of Services. The Categories are hierarchical. By way of illustration (emphasis added):
Category D (otherwise referred to as Service Level 2):
“Paramedics. Supports development of Vocational Entry Trainee (VET) interns post-completion of first inservice. Caseload and casemix sufficient for provision of paramedic service. May deliver patient care in collaboration with Clinical Volunteers or other health providers.
Caseload and casemix supports development of graduate Paramedic Interns, VET interns and VET trainees.
24-hour on-duty Paramedic module. Caseload and casemix sufficient for provision of Intensive Care Paramedic (ICP) paramedic specialist service. May include up to 6 ICPs with greater than 24 months in-field clinical practice at a Service Level 5 (SSCF Category A) location.
24-hour on-duty ICP module with a minimum of 12 established ICP positions. Supports development of novice ICP practitioner or ICP trainee.
As I understand the evidence, a Category B station has been assessed using the “service planning methodology” that informs the SSCF, to have a “Caseload and casemix” to warrant an ICP paramedic specialist service, but not a sufficient ICP caseload and casemix to be used in the development of trainee ICPs. The “6 ICPs” referred to means 6 ICP positions. That is sufficient to ensure an intensive care ambulance staffed by a P1 and an appropriately experienced ICP (someone who has spent at least two years working as an ICP in a Category A station) is available each day shift and night shift across a 9 week roster.
The “minimum of 12 established ICP positions” for a Category A station reflects an assessment, using that service planning methodology, that the station has a sufficient caselaw and casemix to be used in the development of trainee ICPs. That minimum staffing establishment ensures that there will be a sufficient number of ICPs attached to a station to enable it to have an intensive care ambulance staffed with two ICPs, a dual ICP crew, on each day shift and each night shift.
To become an ICP, one must first be a qualified Paramedic for at least 3 years, then apply for and be accepted (on a merit-based assessment) into a ICP training program. The training program involves three phases: a theory/classwork component, a period of placement within a hospital, and a period of on-road supervised practice as a trainee ICP. The training process takes something in the order of 6 months, of which approximately 14 weeks is the on-road supervised practice as a trainee ICP. To remain accredited as an ICP, one must (amongst other things) maintain a sufficient recency of practice as an ICP (meaning they have to work as an ICP with sufficient regularity to maintain their skills and experience, and thereby justify continued recognition as an ICP).
I understand the evidence of Mr Marty Nichols, the Associate Director Paramedicine & Clinical Practice, to be a Category A station “Supports development of novice ICP practitioner or ICP trainee” because it has a sufficiently high exposure to calls that require an ICP response to both facilitate appropriate supervision of trainee ICPs and ensure that two qualified ICPs working a dual ICP crew will be exposed to a sufficient body of work that they will maintain their recency of practice as an ICP.
ICP resources are widely spread across the metropolitan region. Under the SSCF:
Metro North Sector has two zones (North Sydney zone with 5 Category A stations and no B stations, and the Central Coast zone which has four Category A and two B stations);
Metro West Sector has two zones (Western Sydney Zone which has three Category A and 1 Category B station, and the Nepean Blue Mountains zone which has two Category A and two Category B stations)
Metro South West Sector has two zones (South West 1 with 1 Category A and 1 Category B station, and South West 2 which has two Category A stations); and
“The South West Sydney Dom group voted to endorse a resolution that demands NSWA fund and maintain the fourth ICP car on an interim basis, as the organisation has agreed it is required, without splitting or moving existing ICP resources below those funded (that is, CAT A ambulances cannot be split from being a double IC crew to form additional ‘IC’ cars), and complete an urgent and thorough assessment so that the current and near future needs of the Sydney South West staff and community are matched by ICP rostering.
As todays meeting was not able to resolve these concerns, I informed you that action had been voted on and would commence first day shift on Saturday with the commencement of the new roster.
South West Sydney DOMs will not split any existing ICP crews in the South West or seek additional ICPs from other Sectors to either staff a fourth ICP vehicle OR to open additional Category A stations in the South West.
To clarify, If there is a double crew at Bankstown, they will not be split to open a 4th ICP car, nor will they be split to open Liverpool. Other sectors will also not be contacted to deplete their resources to open these stations in the South West.
This action is not designed to put crews or community at risk. If NSWA can demonstrate that all reasonable attempts have been made to fill vacancies (including advertising availability of vacancies and utilisation of premium labour) and the vacancies are still unable to be filled, this will be communicated to staff who may be requested to split for an existing cat A station in South West Sydney.
As also discussed, this action will be communicated to the broader membership including, but not limited to, Metro ADHSU DOM members, South West Sydney ADHSU members including the IC cohort.”
“Immediate steps
1. Short-term EOI for ICPs
- The Sector will proceed to advertise a short-term expression of interest (EOI) for ICPs across Metro Operations to support SWS for an initial period of two roster cycles (with a possible extension).
- While there will be some lead time before placements commence, we expect an early indication of interest within the first few days, with the EOI remaining open for two weeks.
- We acknowledge this is not a long-term solution and is being implemented as a temporary measure while more sustainable options are progressed.
- Workforce planning for staffing stability
- The Sector will continue working with Workforce Planning and People and Culture to address longer-term shortfalls in current ICP rosters in SWS, with a view to strengthening and stabilising ICP capability within the Sector.
Medium to long-term options
In parallel, work has been progressing on potential structural solutions to enhance ICP resources in SWS. This includes consideration of locations that previously held ICP capability, such as Fairfield Ambulance Station, as well as future locations such as the new permanent station in Oran Park.
These options require further detailed assessment and consultation, including with relevant internal and external stakeholders, and will take time to properly evaluate.
These steps are being progressed in good faith and we remain committed to ongoing engagement throughout this process and are willing to provide regular (e.g. weekly) updates on progress.
In light of the above, we ask that the proposed industrial action due to commencing this Saturday be reconsidered and that the status quo be maintained while these steps are actively progressed through the Issue Resolution process.
Our focus remains on progressing both immediate mitigation measures and longer-term solutions. We propose scheduling a further meeting next week to provide an update on progress and to continue working through these matters, including the issues raised in your email regarding safe timeframes and risks to staff. Please let me know your availability.
We remain open to further discussions and to working collaboratively towards a resolution.
“I note that in your email you have raised the Status Quo. In this situation, it is currently unclear as to what the status quo is considered to be.”
References to “status quo” during “Issue Resolution”, is a reference to a feature of the dispute resolution mechanism in cl 47 of the Paramedics Award (entitled Issue Resolution), described below.
The HSU emails include an invitation for further discussion:
“We look forward to continued discussions and consultation for both the short and long term solutions to improve the availability of IC resources in South West Sydney to meet the demand of our staff and community.”
NSW Ambulance did not immediately notify an industrial dispute to the Commission. Ms Lorenzen gave evidence this was because, following a risk assessment, mitigation measures were able to be adopted to appropriately manage the situation. In short, rather than having DOMs apply the usual business rules for dealing with ICP staff shortages that involved the splitting of dual ICP crews, a more senior level of management did it. The splitting of dual ICP crews would, in that way, continue as part of the normal work practice when required. ‘business as usual’ .
Notwithstanding the HSU action continuing, NSW Ambulance continued to actively implement the measures committed to during the dispute resolution process. I understand within days of the NSW Ambulance email of 28 May 2026 describing short term measures, an expression of interest for ICPs from other sectors to temporarily work in the SWS Sector was issued, resulting a small number (3 or 4) of ICPs volunteering to assist in the then current roster period.
On 3 June 2026, the General Secretary of the HSU sent a newsletter entitled South West Sydney DOMs stand up for Staff Wellbeing. It said:
“ADHSU DOMs in South West Sydney (SWS) have commenced action in support of their staff’s safety.
Recently, NSW Ambulance introduced a requirement for a fourth ICP transport vehicle to be staffed, yet no additional FTE was provided to support the new resource.
With only three Category A stations in the SWS already operates with limited specialist resources. The ADHSU DOM group have consistently raised concerns that current staffing levels are not meeting demand, and the ongoing practice of splitting ICP crews is having a serious impact on staff wellbeing and operational effectiveness.
The South West Sydney ADHSU DOM group has called on NSW Ambulance to:
- Fully maintain all funded ICP rosters in SWS with double-crewed ICP units.
- Temporarily fund and staff the fourth ICP transport vehicle.
- Undertake a comprehensive review of Intensive Care resources in South West Sydney to determine what is required both now and into the future.
These are not unreasonable requests. Unfortunately, NSW Ambulance has been unable to commit to these measures. As a result, SWS ADHSU DOMs have commenced action.
- Double crewed ICP units will not be split to open other Category A stations, or the fourth ICP transport vehicle.
- SWS DOMS will not request other sectors to deplete their own ICP resources.
- An exception to this action may be made where NSWA can demonstrate that all reasonable attempts to fill vacancies have been exhausted.
While this issue directly affects ICPs, it highlights the broader issue across NSWAs: funded positions not being maintained, increasing workloads, and staff continually being asked to do more with less.
The South West Sydney DOM group has taken a stand because crews have reached breaking point. Their action sends a clear message - staff wellbeing, clinical safety and properly funded resources must come before short-term budget measures.
All ADHSU Metro DOMs are invited to stand in unity with the ADHSU South West Sydney DOM group and join the campaign.
Intensive Care Paramedics should also keep an eye out for upcoming member meetings and a Zoom forum to discuss how they can become involved in the campaign.”
Following that Newsletter, NSW Ambulance and the HSU had a further dispute resolution meeting on 5 June 2026. The HSU again declined to pause or halt their industrial action.
On 9 June 2026, the HSU informed NSW Ambulance of the inclusion of other sectors in the action, and a further dispute resolution meeting occurred on 12 June 2026.
Following that meeting, by way of email sent 10.42am 12 June 2026 from Mr S Hatter, Ambulance Division Secretary of the HSU, NSW Ambulance was advised of an escalation of the HSU action:
ADHSU DOMs and ICPs are taking the following action across Metro Sectors:
- DOMs will not split or move ICP crews to staff another ICP transport car unless NSWA has exhausted all other avenues, including overtime, to staff the ICP car.
2. DOMs will not ask another Sector to provide an ICP resource to staff ICP a transport car unless NSWA has exhausted all other avenues, including overtime, to staff the ICP car.
3. If there is any need to split or move an ICP resource for reasons not covered by the above, the DOMs will have a conversation with the ICPs to assess the risk of splitting or moving them, and will support ICPs decision to say not to moving or splitting.
- ICPs will not split or be moved to open a cat A station unless overtime has been advertised and exhausted, or in consultation with their DOM.
“DOMs who are credentialed as ICPs will only build themselves onto the MDT as P1 DOMs. (it should be noted ICP DOMs still make themselves available if requested by crews); and
If an ADHSU crew requests an ICP response and there are none available with an appropriate timeframe (as determined by the crew in the circumstances), they will request to go offline at the completion of the job for no less than 30 minutes to facilitate the completion of a safety report”.
“A metro wide vote was held recently on a number of options for escalation in the ongoing dispute to maintain dual crewed IC cars 24/7 in all Cat A stations.
Two actions were endorsed and will commence first day shift tomorrow, 21 July in Sydney Metro.
- DOMs who are credentialed as ICPs will only build themselves onto the MDT as P1 DOMs. (It should be noted ICP DOMs still make themselves available if requested by crews) AND
- If an ADHSU crew requests an ICP response and there are none available with an appropriate timeframe (as determined by the crew in the circumstances), they will request to go offline at the completion of the job for no less than 30 minutes to facilitate the completion of a safety report.
The above action continues indefinitely until further notice. All other bans and other actions in relation to this dispute continue.”
An urgent meeting took place between NSW Ambulance and the HSU on 20 July 2026. The HSU was asked and again refused to withdraw its industrial action whilst discussions regarding the underlying staffing shortages continued. It would appear in the course of that meeting the HSU denied the actions it was organising was industrial action, but characterised the action as “safety actions”.
NSW Ambulance replied to the HSU at 9.16pm on 20 July 2026, rejecting that characterisation of the actions and saying:
“As discussed, NSW Ambulance acknowledges the concerns raised by the HSU regarding ICP availability, clinical support, staff wellbeing and the potential impact on patient care. We remain committed to working with the HSU to address those concerns.
NSW Ambulance notes the HSU's position that the notified actions constitute "safety actions" rather than industrial action. NSW Ambulance does not agree with that characterisation. The notified actions involve employees not performing work in the manner ordinarily required and are capable of impacting operational service delivery.
We are particularly concerned about the uncertainty created by the proposed actions. The second action indicates that decisions regarding whether an ICP is available within an "appropriate timeframe" will be determined by individual crews based on the circumstances. This creates a subjective threshold that may be applied differently between crews, irrespective of actual staffing levels, operational demand, geographical considerations or the availability of alternative clinical resources. Similarly, crews requesting to go offline for a minimum of 30 minutes is likely to impact ambulance availability and service delivery. These factors make it challenging NSW Ambulance to effectively assess and mitigate operational and patient safety impacts.
During today's meeting, Clare outlined the significant work already undertaken since these concerns were first raised in late May. Additional ICPs have already commenced in South West Sydney days after the first dispute meeting and recruitment activity has continued since. A further eight ICPs are expected to commence across Bankstown and Campbelltown stations from 1 August 2026, with additional ICPs expected later in the year. As discussed, these appointments will increase ICP staffing in South West Sydney above current establishment levels and represent a significant investment by NSW Ambulance in addressing the issues raised.
Clare also provided an update on the work underway to review future ICP service delivery arrangements in South West Sydney, including consideration of a future ICP capability at Oran Park.
NSW Ambulance has committed to facilitating further discussions with Service Planning so that the HSU's concerns can be considered directly as part of that review.
While we acknowledge the concerns that have given rise to these actions, NSW Ambulance remains of the view that the issues raised are best addressed through the dispute resolution mechanisms rather than through the continuation and escalation of action.
Given the substantial progress already made, the imminent uplift in ICP resources and the ongoing service planning work, NSW Ambulance again requests that the actions cease and that the parties utilise the Issues Resolution Procedure in the Award to progress and resolve the matters in dispute.”
I understand the parties conferred on 21 July 2026, and that the HSU again refused to withdraw the industrial action.
The matter notified to the Commission on 21 July 2026 and was treated as requiring urgent attention. That was because the Dispute Notice described the application as “urgent” in light of the 20 July 2026 escalation of the industrial action. In that connection, the dispute notice said (emphasis added):
“… the escalation notified on 20 July 2026 significantly alters the operational and clinical environment in which emergency services are delivered. The additional restrictions are variable and dependent on individual employee assessments and decisions, making their practical effect difficult to predict, assess and manage.
The escalated action introduces additional complexity into established dispatch and resource allocation processes. It may require Control Centre staff to undertake manual verification of appropriately qualified ICP resources, reducing operational efficiency and increasing the potential for delays, dispatch variability and human error where timely access to specialist clinical resources may be critical.
The action also creates uncertainty regarding resource availability. NSW Ambulance is concerned that operational crews may become temporarily unavailable for response duties while undertaking activities associated with the industrial action. The scale, timing and cumulative impact of such activity cannot be reliably anticipated, reducing NSW Ambulance's ability to efficiently deploy resources in accordance with established operational practices.
As a consequence, NSW Ambulance is unable to adequately assess, mitigate or manage the risks to patient care and service delivery arising from the industrial action. The escalated action took effect on 21 July 2026, has no specified end date, and has the potential to adversely affect emergency response capability across metropolitan operations. NSW Ambulance therefore seeks the urgent intervention of the Commission to prevent further operational disruption and assist the parties to resolve the dispute.”
The evidence does not ultimately establish any meaningful “risk to patient care and service delivery arising from the industrial action”. Nonetheless, because the dispute notice raised risks to patient care, it was treated as urgent.
The dispute was listed for Conciliation before Commissioner Webster that day. A Certificate of Attempted Conciliation was issued in the early evening. The matter was reallocated to me for arbitration. I listed the matter for Directions at approximately 5.30pm, 21 July 2026. At the Directions hearing the Notifier sought the matter be listed for an urgent hearing on 22 July 2026, with a view to the Commission making Dispute Orders under s 137 of the IR Act. The HSU, acknowledging a Certificate had been issued, nonetheless sought further conciliation before the arbitration was heard.
Discussion ensued both on record and off record with a view to facilitating the resolution of the dispute. In the course of the on-record discussion both Parties:
agreed there may be utility in further Conciliation;
were content for me to conduct that further Conciliation. To facilitate that further conciliation, each of party confirmed on record that they waived any right to invoke s 173 of the IR Act if I were to conduct that further Conciliation (noting the matter had been allocated to me for arbitration); and
the Notifier’s preparedness to further conciliate was nonetheless prefaced on its application for dispute orders being heard on 22 July 2026, if conciliation proved unsuccessful.
Directions were made to facilitate the further progress of the matter involving Conciliation at 9am, 22 July 2026, in person at Parramatta, with a hearing of the Notifier’s application for dispute orders to commence at not before 10am. Directions were also made fixing the amount of time for each side to present evidence and submissions. No direction was made for the filing and service of any written evidence, or any proof of evidence, or any written submissions. The parties were advised if they relied upon written statements of evidence they were to ensure the deponent was available for cross-examination, but otherwise the evidence would be adduced orally. As it transpired, the evidence was substantially received viva-voce.
The matter proceeded to Conciliation at 9am, 22 July 2026. It appeared to me the parties were close to a resolution and so the Conciliation continued beyond 10am. Ultimately, it did not resolve the matter.
It is in those circumstances the Commission came to hear the Notifier’s application for dispute orders on an urgent basis, commencing at approximately midday 22 July 2026. At the commencement of the hearing, in light of the additional time consumed in further Conciliation, I revised the time the parties would be allowed for evidence and submissions, with a view to concluding the hearing by approximately 6pm. Neither side objected to the procedure outlined. The matter proceeded accordingly.
(a) must clearly identify the persons against whom the order is made and who are bound by the order, and
(b) must state a time within which the order is to be complied with or state a period during which it remains in force, and
(c) may be varied or revoked by the Commission at any time.
“industrial action means a strike by employees or a lock-out by an employer, and includes—
(a) a practice relating to the performance of work, adopted in connection with an industrial dispute, that restricts, limits or delays the performance of work, or
(b) a ban, limitation or restriction affecting the performance of work, or the offering or acceptance of work, that is adopted in connection with an industrial dispute, or
(c) any failure or refusal in connection with an industrial dispute to attend for work or to perform work,
but does not include any action taken by employees with the agreement of their employer or any action taken by employers with the agreement of their employees.”
An “industrial dispute”, a critical element in the identification of industrial action, is defined in the Dictionary (relevantly) to mean “a dispute (including a question or difficulty) about an industrial matter*…”.* An “industrial matter” is broadly defined in s 6 of the IR Act to mean “matters or things affecting or relating to work done or to be done in any industry, or the privileges, rights, duties or obligations of employers or employees in any industry”. The definition expressly includes “the conditions of employment in any industry (including hours of employment, qualifications of employees, manner of work and quantity of work to be done)**” in the “Examples” of industrial matters listed in s 6(2).
There was a minor dispute about whether the flowchart in Ex N5 to guide managers dealing with ICP staff shortages (described above), was agreed or endorsed by the HSU. That arose because the document Ex N5 was attached to an HSU bulletin broadcast by Mr Hayes, the Secretary of the HSU, on 19 December 2025 providing an update on consultations between the HSU and (amongst others) the Notifier, in what was described as a “peak consultative meeting” (Ex N6). Mr Hatter’s evidence described the genesis of that peak consultative process, and its conclusion. I need not traverse that evidence, suffice it to say he was at pains to emphasise that whatever the view of the particular HSU members who were participating in some of those consultation processes, the HSU never endorsed the process articulated in the flowchart for dealing with ICP shortages. His evidence had a flavour of the union’s right hand not knowing what its left hand was doing, but I need not take that any further. Suffice it to say, whether the HSU endorsed the flowchart or not, it was plainly aware of it. There is nothing in the evidence to contradict the Notifier’s submission that the flowchart reflected the work practice in operation at the time of the industrial action. I accept the flowchart in Ex N5 does in fact record the extant current work practice/business rules for managers dealing with ICP shortages.
As for that element of the action that involves DOMs refusing to nominate themselves as an ICP resource available for deployment in the MDTs, I accept (in light of Ex N3 and the evidence of Mr Kingston), that that is a material change from an existing work practice.
In its dealings with the Notifier, the HSU asserted the actions it organised were safety actions and not industrial action. Before me, the HSU did not want to be heard on whether its actions were industrial action as defined in the IR Act. That was a sensible approach. Plainly, the actions organised by the HSU are industrial action: the actions announced on 29 May 2026, 13 June 2026 and then on 20 July 2026 (with one exception, to which I will return), are a “practice … that restricts, limits or delays the performance of work” or a “ban, limitation or restriction affecting the performance of work” taken and/or imposed in connection with an industrial dispute.
“(1) the Industrial Relations Act does not make industrial action of itself unlawful, absent dispute orders;
(2) there is no presumption that upon industrial action occurring dispute orders will be made; and
(3) whether to issue dispute orders is a discretionary decision that will involve consideration of matters including in particular:
(a) whether to do so would assist with the resolution of the industrial dispute, including to assist the conciliation of such a dispute; and
(b) the wider public interest, including the impact the industrial action will have on the parties and the wider public.”
“Dispute orders are rarely made by members of the Commission. Long experience has demonstrated that most matters can be resolved by conciliation and/or arbitration without resorting to the prospect of sanctions. The making of a dispute order is a serious step given the consequences for contravention. Persons against whom a dispute order is made are bound to take it seriously, especially members, officials and employees of organisations who may be putting in jeopardy the very existence of their organisation.”
“It is vital that the Commission recognise the broad discretion granted by [the IR Act] to fashion appropriate relief by reference to the merits of the industrial dispute itself and the steps necessary to resolve it. This will involve a variety of considerations, …, but more usually will include the public interest in managing the industrial dispute in a fair and just manner with minimum disruption and disputation”.
NSW Ambulance accepts that the standard establishment for a Category A station involves deployment of an intensive care ambulance staffed by a dual ICP crew. It characterises that as the “gold standard” in the dispute notice and the “ideal” or “optimal” service in its evidence, but it is nonetheless the establishment staffing NSW Ambulance has set for itself in the routine staffing of a Category A station, based on its “evidence-based” workforce planning model. The practical impact of the industrial action is, albeit at potentially higher cost associated with using premium labour, to drive NSW Ambulance to achieve its own establishment staffing level in those areas where the dual ICP crews are available in accordance with the normal roster. That, on the HSUs case, has the additional benefit of reducing the stress on the ICPs, reducing risks of psychological injury, and places the burden of staff shortages where it should be (that is to say, on the shoulders of NSW Ambulance and not the ICP workers who have to split their dual ICP crew). On the HSU case, which I accept has some force, that is a matter that weighs in the public interest against making dispute orders.
NSW Ambulance does, however, rightly highlight deploying an intensive care ambulance staffed by an ICP and a P1 is business as usual in a Category B station, and has always been one of the means of dealing with ICP staff shortages. That is not in dispute: both Mr Kingston and Mr McDonald accepted that splitting dual ICP crews had happened for at least some years (although Mr Kingston said many years ago it was very rare). Indeed, Mr McDonald described it happening with higher frequency approximately 19 months ago (the timeframe being meaningful for him because he has been off with an injury for an extended period) than in more recent times. Using premium labour, including ICPs on overtime, is and continues to be one of the means available to manage ICP shortages.
The practical effect of the bans is to deny to NSW Ambulance some of the steps contemplated by the current work practice/business rules triggered when a manger is presented with an ICP shortage in a zone. NSW Ambulance submits denying management those measures restricts the options available to the Health Secretary to “adopt and implement all necessary measures (including systems of planning, management and quality control) as will best ensure the efficient and economic operation and use of resources in the provision of ambulance services” [14] . To do so is contrary to the public interest and weighs in favour of making the dispute orders. There is real force in that submission and I accept it.
I also accept the Notifier’s submission to the effect that whilst there may be more work to do on the broader ICP staffing issue, the influx of ICP resources on 1 August 2026 will have a meaningful impact on the ICP resourcing issues that lay at the heart of the HSU concerns. Those steps and the Notifier’s preparedness to continue to engage with the HSU to address the underlying industrial dispute in the medium to longer term, weigh in favour of granting the dispute Orders sought whilst the Issues Resolution process outlined in cl 47 of the Paramedics Award continue. Again, there is force in those submissions.
“In particular, I emphasise that the Act clearly makes the Commission the principal organ to assist with the resolution of industrial disputes. It is clear that Parliament intended for industrial disputes to be resolved by negotiation between the parties themselves, or conciliation with the assistance of the Commission and, if necessary, arbitration; and not by taking industrial action contrary to the public interest.”
“[14] Firstly, the ability of the HSU and the APA to use the Commission’s powers, and whether conciliation and arbitration have been used, is a significant factor in this matter. The HSU and APA confirmed that the underlying dispute in the matter being conciliated by the Commission consist of the same issues which have precipitated the foreshadowed industrial action. Despite this, and other than participating in conciliation proceedings in a dispute notified by the Secretary, the HSU has not initiated any proceedings or made any application in the proceedings before the Commission to pursue any relevant relief for their members’ grievances. The APA has had no involvement in Commission proceedings on the underlying dispute whatsoever, until its email concerning industrial action this morning. The dispute proceedings involving the HSU had been adjourned on 21 November 2024 for the very purpose of giving the parties an opportunity to advance the matter to arbitration. The fact that the Commission’s extensive arbitration powers are yet to be utilised by the parties is a significant factor in favour of issuing the dispute orders in this case.
[15] I note again that the recent removal of the so-called “wages cap” from the Act has effectively restored the arbitral powers of the Commission. The fact that the HSU and the Health Secretary have a dispute currently before the Commission which has not yet proceeded to arbitration of the very issues that are motivating the unions’ planned industrial action is a powerful factor in exercising the discretion to ensure that the parties utilise, in the first instance, the principal means by which their differences should be resolved in our system in this State, namely, by conciliation and arbitration in this Commission.
…
[18] Thirdly, cl 47(f) and (g) of the NSW Ambulance Paramedics (State) Award 2023 provides that the status quo with respect to work procedures must continue while the dispute procedures are in place, including the referral of the matter to the Commission. The Commission’s procedures should be utilised in accordance with this award provision. The provisions contained in awards about dispute resolution processes, such as cl 47, are relevant and I consider that it would be inconsistent with the objects of the Act to disregard their terms or obligations under this award.
[19] In the course of closing submissions, Ms Barker for the HSU conceded that arbitration of the dispute by the Commission might be “a good process”, but expressed her members’ concerns about the process potentially taking up to 12 months and, frankly, expressing confidence in achieving the union’s aims by the use of industrial force.
[20] For the reasons given earlier, the system of regulation of industrial disputation under the Act does not tolerate this approach. I do not propose to do so.”
The decision extracted earlier in these reasons summarising the principles informing the discretion to make dispute orders (Health Services Union v Health Secretary (NSW Ambulance) [2025] NSWIRComm 1014), refused the HSU’s application for leave to appeal from his Honour’s decision (and a subsequent decision). The Full Bench expressly accepted that the first and third of the considerations identified by his Honour were, when his Honour’s observations were properly understood, relevant considerations ([2025] NSWIRComm 1014 at [8] – [9]). The balancing of the factors identified by his Honour, which included the impact of the industrial action in that case and how it bore upon the public interest in the delivery of the ambulance service (the second consideration not extracted above), reflected an orthodox exercise of discretion ([2025] NSWIRComm 1014 at [13] – [16]).
The factual circumstances are somewhat different in this matter as against the matter before the Hon. Justice Chin, but those same public interest considerations weigh in favour of making the dispute orders in this matter.
As to the matters against making the dispute Orders, from the perspective of the HSU, the industrial action was said to be driven via a group of mid-level managers, the SWS Sector DOM group, because of concerns they held regarding the impact on ICPs of the increasingly frequent need to split dual ICP crews in the Category A stations in their Sector, and the risks they perceived to the health and welfare of their staff. Whilst I am satisfied that the evidence supports a finding that there is currently a shortage of qualified ICPs in the SWS Sector and that this is having a material impact on the ICP workforce in that area, the evidence does not justify a finding that there is an imminent material risk to the health and safety to the ICP workforce in that sector such as to warrant either the imposition initially, or the continuation of the bans. The subject of the dispute could (and frankly should), have been raised as a dispute under the Issue Resolution clause and/or by way of dispute notified to this Commission.
Noting the bans extend beyond the SWS Sector, the HSU evidence certainly does not demonstrate any risk to the health, safety and welfare of ICPs in the Metropolitan region outside of the SWS Sector at all.
In my view, the matter was finely balanced. The claimed adverse effect of the industrial action on the ability of the Notifier to “adequately assess, mitigate or manage the risks to patient care and service delivery” said to arise from the industrial action was not made out on the evidence. There were, however, a number of other considerations that weighed in favour of granting the dispute Orders sought. On balance, I formed the view it was appropriate to make the Orders and did so on 23 July 2026.
“Pursuant to s 136(1) and s 137(1)(a) of the Industrial Relations Act 1996 (NSW), the Commission makes the following orders and direction:
- ORDER that the Health Services Union NSW (HSU), its officers, employees and its members employed with NSW Ambulance (NSWA) immediately take steps to cease organising and refrain from taking industrial action in the following forms:
a. DOMs will not split or move ICP crews to staff another ICP transport car unless NSWA has exhausted all other avenues, including overtime, to staff the ICP car;
b. DOMs will not ask another Sector to provide an ICP resource to staff ICP a transport car unless NSWA has exhausted all other avenues, including overtime, to staff the ICP car;
c. if there is any need to split or move an ICP resource for reasons not covered by the above, the DOMs will have a conversation with the ICPs to assess the risk of splitting or moving them, and will support ICPs decision to say not to moving or splitting;
d. ICPs will not split or be moved to open a category A station unless overtime has been advertised and exhausted, or in consultation with their DOM;
e. DOMs who are credentialed as ICPs will only build themselves onto the MDT as P1 DOMs. (it should be noted ICP DOMs still make themselves available if requested by crews).
1A. For the avoidance of doubt, subparagraphs 1(a) to (c) of Order 1 do not apply in circumstances where the DOM obtains authorisation for their action from more senior management.
- ORDER that the HSU, its officers, employees, agents and members must not induce, advise, authorise, support, encourage, direct, aid or abet members of the HSU to organise or take industrial action contrary to Order 1.
- DIRECT that the HSU must as soon as practicable:
a. publish these orders in a prominent position on its social media accounts, and by electronic newsletter disseminated by email to members;
b. provide a copy of these orders to the HSU’s officers; and
c. advise the Notifier in writing of the steps taken to comply with the directions above, including the form of communications, and if written, a copy of the communications.
- ORDER that Orders 1, 1A and 2 shall commence on and from 4.00pm on Thursday, 23 July 2026 and remain in force until 5.00pm on Wednesday, 21 October 2026 or until further order of the Commission.”
**********
Health Services Act 1997, s 116H
Ex N4 pg 4
Paramedics Award 2023, cl 5(c)(ii)(1)(A)
Ex N1 pg 2
Ex R1 pg 1
Section 137(1)(a) of the IR Act
Section 138(2) of the IR Act
Ex 4, Attachment 2 pg 2
Secretary of the Ministry of Health v New South Wales Nurses and Midwives’ Association (2022) 320 IR 249 at [36], referring to Bluescope Steel (AIS) Pty Ltd v Australian Workers’ Union (NSW) [2005] NSWIRComm 260 at [29]
Secretary of the Ministry of Health v New South Wales Nurses and Midwives’ Association (2022) 320 IR 249 at [38], and the cases there referred to.
Bluescope Steel (AIS) Pty Ltd v Australian Workers’ Union (NSW) (2005) 138 IR 324 at [106]
Industrial Relations Secretary on behalf of the Department of Primary Industries and Regional Development v Public Service Association and Professional Officers' Association Amalgamated Union of New South Wales (Work Bans by Fisheries Officers) [2024] NSWIRComm 1065 at [16], per Commissioner McDonald; Secretary of the Ministry of Health v New South Wales Nurses and Midwives’ Association (2022) 320 IR 249 at [37]]
Referred to with approval in Secretary of the Ministry of Health v New South Wales Nurses and Midwives’ Association (2022) 320 IR 249 at [39] and the cases there referred to, including Public Service Association and Professional Officers’ Association Amalgamated Union (NSW) v Industrial Relations Secretary (2018) 96 NSWLR 762; 277 IR 263 at [128]
Health Services Act 1997, s 67B(1)(d)
Incorrect time "09:30am" changed to "10:00am" in paragraph [83] and cover page.
Health Secretary o/b Ambulance Service of NSW
Health Services Union, NSW Branch Re dispute regarding Intensive Care Paramedics
(2005) 138 IR 324
(2018) 96 NSWLR 762
(2022) 320 IR 249
(2005) 146 IR 388
Metro South East Sector which has two zones (Sydney with 2 Category A stations, and South East Sydney with three Category A stations).
On the evidence, the genesis of the current dispute is a significant shortage of qualified ICPs in the South Western Sydney Sector (the SWS Sector). There is no dispute that there is currently (and it would appear has been for at least some time) a significant shortage of ICPs in that sector. The evidence does not enable any understanding of how workforce planning within NSW Ambulance has allowed that problem to arise, but it appears clear (particularly noting the time it takes to train up a newly qualified ICP), it is a problem that has arisen over time. As noted, the SWS Sector, which covers a reasonably large geographic area, has three Category A stations split across two Zones (Liverpool in Zone 1, and Bankstown and Campbelltown in Zone 2), and one Category B station (Bowral in Zone 1).
Mr David Kingston, a Duty Operations Manager (a DOM) and qualified ICP based at Campbelltown, described having undertaken a review of the available ICP resources in the South Western Sydney Sector over the first 25 days of May 2026. As a DOM, Mr Kingston “supervises Station Officers and Paramedics (either at a large station or a number of stations) on a day to day basis to ensure the delivery of high quality, cost effective, emergency health transport, clinical and operational practice, rescue and patient transport services” [5] . His evidence, which went unchallenged, presented a somewhat alarming lack of ICP resources in the SWS Sector at that time.
Under the current work practice/business rules, reflected in a flow chart in a document marked Ex N5, the “Backfilling of ICPs on rosters” follows a series of steps. The relevant manager (which would often, but not necessarily be a DOM), is to assess:
“Are there 2 ICP transport vehicles operational in the zone”. If yes, no backfilling occurs.
If not, then the manager is to assess whether either a paramedic car (not identified as an ICP resource at the time) has an ICP qualified paramedic on it, or whether there is a “dual ICP crew in the Zone”. If either question is answered yes, the instruction is to “Split crew and deploy ICP to work on a second ICP transport vehicle”.
If that cannot be done, then the manager is to assess whether there are greater than 2 ICP transport vehicles in a neighbouring zone within 60 minutes travel time. If yes, they are to “Deploy crew to depleted zone”.
If not, they are to assess whether “there is a dual ICP crew in a neighbouring zone that can be split”. If yes, they are to “Split crew and deploy an ICP to work on ICP transport vehicle in depleted zone”.
If none of those steps cures the problem, the manager is to escalate to an appropriately authorised officer who is then approved to backfill ICP vacancies to provide “1 x ICP per ICP transport vehicle to a max of 2 ICP transport vehicles per zone”. A notation provides “Non-premium labour options to be exhausted in the first instance”. Ms Lorenzen described the labour options to include engaging a casual, using a part-time worker (although how that could be done without triggering an overtime entitlement is not immediately clear), or bringing on a full-time worker on overtime.
In the result, the application of these business rules in the significantly short staffed (from an ICP perspective) SWS Sector in the lead up to the dispute, meant ICPs would frequently be “split” from their rostered car crew and deployed as an ICP resource, working with a P1, at another station. Mr Paul McDonald, an ICP with some 25 years experience (between time in the United Kingdom and Australia) within the SWS Sector described a period of 2 ½ months (albeit some time ago) in which the roster would have had him working with 8 other qualified ICPs, in fact resulted in him working with 45 other people, the vast majority of which were P1s.
P1 paramedics are highly qualified and capable paramedics. Indeed, the evidence demonstrates in recent years P1 paramedics have received additional training to ensure they are readily able to provide high quality care, including in advanced life support. There is, nonetheless, a difference in knowledge and skill of an ICP and a P1, reflected in their different scope of practice. For example, there are only certain types of medication that can be dispensed and administered by an ICP. There are certain interventions that can only be performed by an ICP (an example in the evidence was intubation).
Both Mr Kingston and Mr McDonald described the impact on an ICP of being rostered with a P1, rather than another qualified ICP. Broadly described, there evidence was the ICP will necessarily take the lead on jobs within an ICP scope of practice, and often on jobs that did not require that scope of practice because they are the more senior/qualified paramedic. For that reason, whilst they work as part of a paramedic team, they nonetheless take on the majority of the decision-making burden, and to the extent necessary, the supervision of the P1 working with them. Consistently baring that responsibility, rather than being able to share the decision-making burden with a fellow qualified ICP, increases the stress on the ICP working with the P1. Similarly, working with another qualified ICP gives a degree of confidence that the skill, experience and judgment of the second ICP can be relied upon. Again, consistently baring that responsibility increases the stress on the ICP.
Neither Mr Kingston nor Mr McDonald raised concern about being split to work with a P1 in a Category A station from time to time. That is unsurprising. After all, that is the standard establishment model of ICP deployment in a Category B station, and ‘splitting’ a dual ICP crew has been part of the management of short time ICP shortages for years. However, they both describe a problem arising when, in the context of a Category A station (which is designated that Category in the SSCF at least in part because the caseload and casemix of the area) that splitting of dual ICP teams happens more or less consistently.
Mr Kingston described his observations of his staff when he has conversations with them about having to split their rostered dual ICP crew. They appeared to him demoralised. I understand him to say that to him, as their immediate supervisor, he observed presentations consistent with increased stress and anxiety. He attributed the consistent splitting of dual ICP crews to an increased frequency of requests for reduced hour flexible working hour agreements, and for increased levels of sick leave. Mr Richardson gave similar evidence from his personal perspective as a long standing ICP, describing consistently being split from dual ICP crews as having an adverse impact on his mental health, such that he would have to take “mental health days” from time to time.
Those concerns resulted in the HSU raising concern about health and safety risks for ICPs in the SWS Sector.
In May 2026, a group of HSU members, referred to in the evidence as the South West Sydney DOM group, passed a resolution to request a meeting to address these concerns. Agreement could not be reached, resulting in the South West Sydney DOM group voting to endorse “action”, described in an email from the HSU on 26 May 2026 as follows:
In the result, I reserved my decision at approximately 6pm. I made these observations at the time I reserved my decision, but I again express my gratitude for the efficient and courteous way in which each of the representatives conducted themselves in the hearing.
The Notifier called evidence from Mr Marty Nichols, the Associate Director Paramedicine & Clinical Practice, and Ms Clare Lorenzen, Director Metropolitan Operations. It also tendered a number of documents including the SSCF (Ex N1), the Role Delineation of Services (Ex N2), the Dispute Notice including the collection of annexed correspondence tracing the above background (Ex N4), and documents relied upon to establish the existing work practice for dealing with shortages of ICP staff including the flowchart I referred to above (Ex N5), and the Clinical Operations Work Instruction for the “Utilisation of Duty Operations Managers for Responding to Incidents” (Ex N3). A document was tendered to demonstrate that the HSU was at least aware of that work practice (via a bulletin broadcast by Mr Hayes dated 19 November 2025, marked Ex N6), since at least December 2025.
The Respondent called evidence from Ms Stuart Hatter, Ambulance Division Secretary for the HSU, Mr Kingston DOM and ICP for the Campbelltown station, and Mr Allen McDonald, an ICP based at Campbelltown with in excess of 25 years experience as an ICP. They also tendered the Role Descriptor for a DOM (Ex R1).
There was no real factual dispute that required determination. It is unnecessary to traverse their evidence in any detail in this decision, beyond what is mentioned in the above summary or below in my Consideration.
The one exception is that part of the action advised to NSW Ambulance as part of the escalation of action on 20 July 2026, involving an ICP making a “request t**o go offline at the completion of the job for no less than 30 minutes to facilitate the completion of a safety report”. Mr Nichols gave evidence that the Notifier requires a safety report to be prepared after an appropriate event, and that it must be prepared as soon as practicable and not beyond the conclusion of the relevant paramedic’s shift. He accepted, and the evidence otherwise makes clear (including that of Mr Kingston, who has been a DOM for many years), that an ICP (or any paramedic) may make a request to “go offline” for a time for any number of reasons, including personal reasons. In that event, the relevant manager, such as a DOM, is expected to make an assessment about whether that “request” can be accommodated and make decisions accordingly. The action notified by the HSU on 20 July 2026 in that connection is, in substance, nothing more than business as usual. It is not industrial action.
In light of how the evidence landed, the Notifier, quite appropriately, did not invite a finding that that aspect of the action notified on 20 July 2026 amounted to industrial action, nor did they seek a dispute order directed to that action.
There was some minor disagreement as to whether the industrial dispute to which the industrial action is connected was properly characterised as a dispute over the work practice/business rules around the reallocation of ICP resources in the event of an ICP staff shortage (as the Notifier approximately described it), or about a shortage of ICP staff and the consequences of that shortage on the work environment of the ICP membership, including the health safety and welfare of ICPs in consequence of that shortage (as the HSU would have it). For present purposes, that disagreement matters little as either characterisation would, on any view, be a dispute about an industrial matter. It does, however, influence what should happen in the dispute beyond the question of dispute orders and so warrants some attention.
The Notifier is undoubtedly correct in identifying a dispute about the relevant work practice/business rule (that is, after all what the bans are immediately directed to), but that appears to me to be better described as a symptom of the broader underlying industrial dispute. The underlying ICP staff shortage in the SWS Sector is the substantive industrial matter demonstrated on the evidence (and reflected in the HSU correspondence). In real terms, the practical impact of the existing work practice/business rules is but one of the consequences for the ICP cadre of workers arising from the failure of NSW Ambulance to ensure there were adequate ICP resources available in the SWS Sector to meet the staffing establishment for Category A stations in that Sector. As noted elsewhere, the evidence demonstrates splitting a dual ICP crew to manage an ICP staff shortage in a Zone has been a work practice for years without giving rise to a dispute.
NSW Ambulance has certainly conducted itself as though the staff shortage in the SWS Sector is the main industrial issue in its efforts to address the HSU DOM group’s concerns. As noted in the correspondence between the parties referred to earlier in these reasons and in the evidence of Ms Lorenzen, NSW Ambulance response to the HSU “concerns” has been all about ensuring additional ICP resources were available in the sector in the short, medium and longer term:
A small-number of additional ICPs came to work in the SWS Sector days after the expression of interest went out in late May 2026 (one of the “Short-term” measures noted in the email from Mr Davies dated 28 May 2026 referred to above) [8] ;
From 1 August 2026, in light of the progress of a current ICP course, a further eight ICPs would commence across the SWS Sector (in particular, Bankstown and Campbelltown); and
Following further ICP course evolution, additional ICPs would be deployed later in the year. In that connection, there is a class of ICPs that will commence their 14-week supervised on-road placement on or around 8 August 2026, some of which will likely go to the SWS Sector. There are currently 24 in that course. Even allowing for some attrition, that class will likely make a further meaningful contribution to the ICP workforce (not only in SWS Sector), further alleviating pressure on current ICP resources.
Additionally, in the longer term, the evidence indicates there is currently active contemplation to making an additional Category A station within the SWS Sector at Oran Park. In that connection, “NSW Ambulance has committed to facilitating further discussions with Service Planning so that the HSU’s concerns can be considered directly as part of that review”.
That those steps were taken by NSW Ambulance, and with real expedition, is to the Notifier’s credit. The HSU essentially acknowledges as much. Mr Kingston, in substance, in cross-examination accepted that the influx of additional staff into the SWS Sector on 1 August 2026 would likely have a meaningful impact on the need for splitting dual ICP crews at the relevant Category A stations (I recognise he also raised a potential concern about the impact of that influx on other stations in another Zone, but there is no real evidence of those impacts). I consider the industrial dispute with which the industrial action is connected is properly characterised as a shortage of ICP staff in the SWS Sector, and the consequences of that shortage on the work and working environment of ICPs in that sector.
Turning then to the application for dispute orders, there was no dispute as to relevant principle. In Health Services Union v Health Secretary (NSW Ambulance) [2025] NSWIRComm 1014, the Full Bench summarised the following uncontroversial propositions (at [13]):
It was submitted that the industrial action, by limiting the usual options to manage shortages of ICPs, may lead to a delay in the ability of the Notifier to deploy an ICP service, and would likely (I would think almost certainly) lead to an increase in the cost of providing that ICP service on that occasion. I accept that submission, so far as it goes. There is no evidence as to the likely impact or magnitude of the delay (either to date or prospectively), nor of the increased cost associated with engaging additional ICPs (either on a casual or overtime basis). The weight these factors can be given is diminished by the absence of evidence showing a material impact, particularly as to the impact of delay in the delivery of services, but also as to cost. Indeed, on one view, reducing the options for the relevant manager may mean a final decision on deploying additional resources may be made more quickly, or could result in a closer off-duty ICP being recalled to duty on overtime rather and a dual ICP crew being split and redeployed from a distant station (either in the same Zone or an adjacent Zone), and thereby increase the speed with which an ICP service could be put into operation.
As to cost, Mr Kingston, a DOM with many years experience, gave unchallenged evidence that in some circumstances, deploying someone on overtime may resulted in less cost than applying the usual business rules.
The evidence does not justify a finding, reflecting the claims made in the dispute notice itself, that the industrial action organised by HSU gave rise to any material “risk to patient care and service delivery” or the “potential to adversely affect emergency response capability”. Nonetheless, I accept that from the perspective of the public interest, both factors identified by NSW Ambulance arise on the evidence and at least to some extent weigh in favour of granting the dispute Orders sought.
Finally, whilst I am well satisfied there is currently (and was at the time of the initial bans in May 2026) a shortage of ICP resources in the SWS Sector (which I accept will be meaningfully improved by the influx of resources on 1 August 2026), the Notifier is right in its submission that there is no evidence from which I could conclude there is currently a shortage of ICPs more generally across the metropolitan region. In fact, there is no evidence of any issue with respect to the splitting of dual ICP crews in Category A stations outside of the SWS Sector at all. The industrial action originated in the SWS Sector, but now extends well beyond it. That weighs strongly in favour of granting the dispute orders sought.
There were two other matters said by NSW Ambulance to weigh in favour of making the dispute orders sought in the public interest:
The HSUs resort to industrial action and ignoring the Paramedics Award Issues Resolution clause, including the ‘status quo’ commitment, particularly in circumstances where the evidence demonstrates the Notifier was actively working to try and find both short and long term solutions to the HSU concerns; and
The HSU’s failure to bring the industrial dispute to this Commission, rather than taking industrial action and trying to achieve its objects by industrial force.
I accept there is force in both of those submissions. In that connection, the Notifier referred to Health Secretary (NSW Ambulance) v Health Services Union NSW & Anor [2024] NSWIRComm 12, in which Vice-President Chin, in the context of a dispute somewhat reminiscent of that before me, after noting authority on the proper approach to the discretion to issue dispute orders, said (at [11]):