A New South Wales paramedic and Health Services Union (HSU) delegate says it has become "the norm" for patients to be forced to wait for an ambulance for an hour or more.
Campbelltown paramedic Tess Oxley is one of a number of public health employees speaking out about the impact of what the HSU describes as mismanagement and poor funding allocation in the health system.
Her situation is highlighted by research by the organisation Impact Economics and Policy, into how $33 billion in health funding, a third of the state budget, is allocated in New South Wales.
The research, compiled over the past nine months for the HSU, includes evidence that 10 per cent of people urgently needing an ambulance waited for more than two hours between July and September last year.
Ms Oxley said people apologised to paramedics for calling an ambulance when they were unwell, because they could not get a GP appointment or were on waiting lists to see a specialist.
That was leading to crowded emergency waiting areas and delays in ambulance arrival times.
"It's no longer really considered a delay for us if it's one hour — that's just what's expected," she said.
"Where I live, in Wollongong, they're (ambulances) being delayed for four and five hours, having to park at a petrol station across the road because the ambulance bays are so full."
In October last year, a New South Wales parliamentary inquiry heard patients are "dying unnecessarily" while waiting in hospital emergency departments in what one doctor called "third world" conditions.
Other HSU delegates working in the New South Wales public health system raised concerns about staff leaving to work in the private sector due to difficult conditions, bullying, ageing equipment and low pay.
Union secretary Gerard Hayes said he was deeply concerned that people could not access health care when they needed it, while at the same time it was unclear where significant amounts of money were being spent.
For example locums and visiting medical officers in New South Wales could earn $5,000 a day, he said.
"(That's) $20,000 a week, a million dollars a year for one person — multiply that by the range of regional hospitals that can't get doctors to work there," Mr Hayes said.
"When we look at visiting medical officers, one billion dollars a year is being spent."
Mr Hayes said a judicial investigation such as a royal commission conducted at arms length from government would look for solutions.
"The reality is unless we have an independent judicial body to be able to ask the hard questions and not the people who actually run the system ... we're just wasting our time.
The research also found patient complaints had increased 40 per cent since the start of the pandemic, while patients overstaying in hospital beds was costing the state $500 million annually.
It also highlighted underinvestment on preventative health, which it said was costing NSW more than $1 billion a year.
NSW Health said recent reports from the Australian Institute of Health and Welfare (AIHW) and the Report on Government Services showed New South Wales emergency departments continue to outperform those in all other states and territories, with the most patients seen on time and the lowest wait times.
It would deliver 25 urgent care services to help ease pressures on emergency departments, in addition to 13 clinics being delivered by the Commonwealth government, NSW Health said in a statement.
"This would make it easier for patients, families and carers to access urgent care in the community by creating better links between the hospital and primary care systems," it said.
Last year, the New South Wales government was handed a scathing report finding the rural health system was "in crisis and is failing residents of rural, regional and remote areas".
The government said it would support, or support in principle, 41 of the 44 recommendations.
