NSW paramedics will take industrial action for 24 hours next week, vowing only to attend the most urgent, life threatening cases.
"NSW paramedics are at breaking point," Health Services Union NSW Secretary Gerard Hayes said on Wednesday.
"They're not trying to get rich.
"They just want a fair pay rise that recognises the cost of living and the intensity of their work."
Union members would take "a historic, statewide stand" against Treasurer Dominic Perrottet's attempt to cut their pay by only attending the most urgent, life threatening emergencies on June 10, he said.
Last year paramedics were awarded "a paltry 0.3 per cent" and this year's proposed 1.5 per cent pay offer was again less than inflation, which NSW Treasury forecasts at 2.2 per cent for the coming year.
Mr Hayes said in the past year paramedics had been exposed to COVID when required to transport positive patients, without adequate protective equipment.
"They were exposed to a wild and deadly disease, yet they continued to serve the people of NSW and protect their health," he said.
"To offer them a pay cut is humiliating and insulting."
NSW paramedics were the worst paid in the country and a pay cut would put them further behind their colleagues in other states, Mr Hayes said.
"We are flagging this action well in advance and have designed it to avoid impacting life threatening emergencies," he said.
"There will, however, be significant disruption on the day."
NSW Health Minister Brad Hazzard said he was having discussions with the union over the planned action, but said any industrial action must follow the processes outlined by the Industrial Relations Commission.
"The government obviously values our paramedics, as we all do," he told reporters.
"We'll continue those discussions and (see) if we can find reasonable resolution... we'll just see how that plays out."