A western NSW paramedic has told an inquiry into rural health and hospital services that he and his colleagues have never been so exhausted.
Scott Beaton, a working paramedic who is vice president of the Australian Paramedics Association, also voiced concerns over a lack of resources and the use of ambulances in the NSW upper house inquiry hearing on Friday.
"I have never seen my colleagues, and I myself, have never been so exhausted," said Mr Beaton, who works as an intensive care paramedic (ICP) based in Gilgandra.
He works an eight days on and six days off roster, but not a recent week had gone by where Mr Beaton had not been called in to work on his days off.
While the paramedic welcomed a recent boost in ICP numbers, he said rural communities continue to be "let down" by NSW Health due to a lack of resources and funding.
Mr Beaton said while COVID-19 funding had given ICPs new training, they couldn't use those "life-saving skills" because of a lack of equipment.
He also criticised NSW Health for using ambulances like taxis.
"We spend a lot of our time acting as a taxi service for New South Wales Health," Mr Beaton told the inquiry.
"This is not to say that patients do not need to be transported, they absolutely need to be in the right healthcare facility for their injury or illness, but much of the time we are transporting patients who do not require our level of clinical care.
Mr Beaton told the inquiry he and his colleague once had a three-day transfer from his small rural town of Gilgandra transporting a patient to Adelaide.
"When I'm on these transfers, there is no one on duty, or on call in my community. If someone has a heart attack, they have to hope that there's an off-duty paramedic who is viable, and fit for work."
He told the inquiry five paramedics are based in that town.
Mr Beaton said non-emergency patient transport services need to be more available statewide.
The paramedic said lives are put at risk by diverting ambulances hundreds of kilometres out of the area.
" It does scare me because if someone is in desperate need of an ambulance in my town or in any other town ... where there's no ambulance available, I don't know how they're going to be attended."
Tuncurry-based paramedic Liu Bianchi, also from the Australian Paramedics Association, echoed the comments that paramedics were being overworked.
The paramedic of 25 years told the inquiry "the amount of increase in workload has been exponential ... our workload is crazy".
Ms Bianchi said more needed to be done to match the skills of the paramedics with the communities they served, and called on NSW Health to listen to their concerns.
The inquiry also heard from the Society of Hospital Pharmacists of Australia chief executive Kristin Michaels, who represents 5200 hospital pharmacists around Australia.
Ms Michaels said "virtually all NSW hospitals" are not staffed properly due to "chronic underfunding" of hospital pharmacy departments.
Ms Michaels gave evidence that patients are often handed a "bag of medicine" by a nurse as they leave a rural hospital.
"Our New South Wales members report that a large portion of their patients don't get any pharmacist counselling when being discharged on the medicines."
Ms Michaels said more medication-related incidents will occur without more resourcing in rural hospitals.