When you were a child, did you dream of being something brave? Like a policeman? An astronaut?
Rosa* did.
For her, becoming a paramedic wasn’t just a dream – it was a calling.
“I loved the idea of helping people, my mum’s a social worker and I was raised around a lot of people that spent their time and energy helping others,” Rosa says.
“It’s innately in me”.
When she moved to Margaret River at 20, Rosa applied to volunteer with the fire service – but they were full.
So, she turned to ambulances.
At the time, the crew was almost entirely made up of volunteers, with just one registered paramedic. Rosa was thrown into the deep end, learning on the job.
Now, Rosa is more than half-way through her paramedicine degree at Edith Cowan University.
She has spent the past two years studying, training and on placement, preparing for the moment she steps into an ambulance, envisioning herself wearing a St John uniform.
Except… she will be entering the frontlines during one of the most unstable times in Western Australia’s ambulance history, alongside nearly 200 yearly graduates.
‘Ramping’ towards burnout
In late April, paramedics could be seen wearing their black workers’ union shirts instead of their traditional green uniform.
Handwritten messages on the outside of their ambulances appeared around Perth.
Things like “response times…flatlined” and “learn CPR… we’re ramped!” reflected the rising frustration of paramedics, with ramping stretching their already long and demanding shifts even further.
‘Ramping’ is when paramedics are forced to wait with patients outside a hospital’s emergency department due to no available beds or staff to admit a patient. Instead of a quick handover, they become ‘ramped’ outside, sometimes for hours.
Ramping not only puts the paramedics at risk of burnout, it drastically delays emergency response times.
“Given what is going on with St John and paramedics having their say and putting these on the ambulances, it has brought a lot of attention towards what it is going to be like and the difficulties that current paramedics are facing,” says Rosa.
“I think it’s good that it has been brought to the public’s attention”.
Ongoing dispute in enterprise bargaining
This protesting comes not long after St John’s latest pay deal was rejected by their workers, resulting in protected action over the system’s decline.
On March 14, St John put forward their ‘best offer’ in the form of a draft enterprise agreement, as the 2021 agreement had expired in June 2024, with negotiations ongoing since December 2023.
The March offer addressed wages, working conditions and ramping response times.
The draft agreement was ultimately rejected by 987 out of 1,110 participants.
Senior organiser for ambulances with the United Workers Union (UWU), Rebecca Thompson, says there are “a number of reasons” for the overwhelming result.
“Part of it was that paramedics throughout the Covid period had quite low pay rises and they took big financial hits,” she says.
“There is no doubt the health system is under a lot of pressure. [Ramping] is a global phenomenon at the moment, we’re an under-resourced sector.”
On March 24 2025, St John applied to the Fair Work Commission to resolve the industrial dispute.
“Through rejecting that offer they’ve actually increased the most recent pay offer by another 3 per cent, which is a huge win for those members who went out and took action.”
The UWU has had frequent conferences with The Fair Work Commission in an attempt to resolve the issue.
“It’s clear that St John isn’t going to be able to provide much more of a pay rise than the 17 per cent over three years”.
“If this agreement is voted down, it will lock us into a process where a fair work commissioner will make a decision on the agreement. It’s called an intractable bargaining declaration“.
St John will be putting forward another offer to the workforce, with the access period starting on Wednesday the 28 of May.
Escalating workloads
In 2017, ambulances were ramped for an average of 819 hours per month. By 2025, that figure has surged to over 5100 hours each month.
In 2015, former Health Minister Roger Cook labelled it a ‘crisis’ when ramping was just one-fifth of what it is today.
As for Rosa, and many other paramedicine students in Western Australia, she was born and bred in Perth, and has no intention of leaving the state, but St John is the only choice for employer in the industry.
“We only work under St John unlike other states and territories where there are other services in play, we’re just one private company, it’s the only way you can get a full-time job in WA and get paid a decent amount”.
Paramedics have been thrusted into not only a highly demanding job, but also complex system – where policy, politics and patient care are colliding.
* Name changed to protect the student’s privacy.
