Ambulance ramping: What happens when you can’t afford to even get on the ramp?

MEDIA RELEASE: As ambulance ramping takes centre stage in the SA state election campaign, key community service groups are highlighting the problem of the cost of ambulance call-outs, with many people not calling an ambulance when they need one because of fear of the costs. 
 
The cost of an emergency call-out and trip to hospital in South Australia is currently $1,064, plus $6.10 per kilometre travelled. There is a 50% discounts for age pensioners, but not for other Centrelink recipients or other people on low incomes. This base rate for emergency ambulance transport is equivalent to 1.3 week’s pay for someone on the minimum wage, and more than two-and-half weeks of JobSeeker payment. 
 
Ambulances in South Australia are paid for by a combination of direct government funding, payments from the Ambulance Cover insurance scheme, and by user-pays fees as above. South Australia’s emergency ambulance transport fee is the second highest in the country (after Victoria). Emergency ambulances are free in Queensland and Tasmania, and the cost in NSW is less than half of the SA fee. 
 
Michelle Kemp, CEO of St Vincent de Paul Society in SA said: 
“Many of our volunteers report receiving requests for assistance from people who had received invoices for over $1000 for an ambulance callout, which they are unable to pay. That creates immediate financial hardship, and often leads to a reluctance to call for an ambulance in an emergency. That is a bad outcome for the patient – but also for the health system as health problems can spiral over time and require much more complex treatments later on.” 
 
James Hill from the Louisa DaCosta Trust said:
“The Louisa DaCosta Trust provides financial assistance for both unplanned illnesses and also for lifelong illnesses where government support is not available, and we see that ambulance costs are a significant cost to people who have been hit by a sudden medical emergency. It is hardly surprising that many patients receiving a $1,000 ambulance transport bill have trouble paying for it. Many can’t pay, and while they may be put on long-term repayment plans, the SA Ambulance Service writes off approximately $20m each year in bad debts. It is difficult to even begin to imagine the number of South Australians represented in this figure, or the full extent of the distress caused by ambulance transport bills.” 
 
Ross Womersley, CEO of SACOSS said:
“Ambulances are a vital public service which should not be run on a cost recovery basis. We would not expect a public hospital or public school to fund themselves by recovering core costs from patients or children, and we should not expect it for ambulance services.” 
 
“We need a commitment from all parties at this election to address the issue of ambulance affordability and ensure that everyone who needs an ambulance can call one without worrying about cost. Expanding the concessions available on ambulance cover would be a small first step, but ultimately we need a fundamental rethink of ambulance funding and costs. We need ambulances to be free, at least for those on low incomes, if not for all South Australians.” 

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MICHELE WACHLA

Michele is an accomplished social services professional with a dual background in Social Work and Business, bringing over 18 years of experience to her work. She has developed a deep understanding of the unique challenges and opportunities within Regional, Rural, and Remote (RRR) environments, particularly in South Australia. Michele is a recognised leader, known for her expertise in designing and implementing place-based initiatives that address the complexities of RRR communities. Her work is underpinned by strategic planning, effective resourcing, and a strong focus on policy review and advocacy to ensure that services remain relevant, equitable, and sustainable. Michele’s commitment to community-centred approaches drives meaningful outcomes, nurturing resilience, and growth across regional South Australia.

KHATIJA THOMAS

DAVE ADAMSON

Dave moved to Australia following a 30-year academic career in the UK. He has since worked in the Community Housing sector and authored the 2016 Towards a National Housing Strategy, and helped to establish the Everybody’s Home campaign. He also researches the interface between poverty and climate change and actively supports the United Nations Sustainable Development Goals. He has worked with government at all levels and has experience of policy development and evaluation. He is co-author of Sustainable Places: Addressing Social Inequality and Environmental Crisis (2022, Routledge). In his spare time he plays and builds guitars.

ROHAN FEEGRADE

Rohan is an experienced and forward-thinking CEO, senior executive and board director with demonstrated expertise across the not-for-profit, private and government sectors. Currently CEO of Lutheran Care, he has proven record for creating substantial organisational, stakeholder and client value, and has extensive experience in strategically positioning organisations for transformational change and growth within the health, disability, education and community service sectors. Rohan is a socially responsible professional, genuinely passionate about creating opportunities for people who live with disadvantage and disability, always acting ethically to serve those he works with and for.

JANE MUSSARED

Jane has worked in for purpose and government health and human service settings throughout her career. In June 2024 she returned to SA and joined the Maggie Beer Foundation as CEO following 20 months based in Canberra as an Advisor to the Federal Minister for Health and Aged Care. Previously she was Chief Executive of COTA SA and before that an executive of ACH Group. Jane served on a range of boards and committees prior to moving to Canberra, including the SACOSS Policy Council until 2022, as chair of the South Australian Circus Centre and as a non-Executive Director with the Maggie Beer Foundation.

NANCY PENNA

Nancy has than 30 years of experience in South Australian community services, and a a unique understanding of the political and social landscape and the issues and opportunities facing South Australia. Currently responsible for the strategic and operational oversight of AnglicareSA’s community services portfolio, she has previously held executive roles in government within child protection and disability, with her executive experience underpinned by her earlier career as a social worker in child protection and youth justice. She is also Chair of the Child and Family Focus South Australia (CAFFSA) Board and most recently on the Housing Security for Older Women Taskforce.

NICOLE CHAPLIN

Nicole is a dedicated and experienced youth support professional, specialising in solutions for disadvantaged young people in South Australia. As CEO of St John’s Youth Services, she oversees innovative programs like youth110 and Foyer Port Adelaide. With over thirty years in the community sector, Nicole has built extensive networks and her expertise spans governance, service delivery, policy development, and partnerships. Recognised with the 2018 AHI Inspirational Leader Award, Nicole is an active participant in housing and homelessness networks. She holds leadership roles in various organisations, including Anglicare Australia’s National Reconciliation Network.

EMMA CROSBY

Emma is a chartered Accountant with more than 15 years experience as a board member, finance and business professional, strategic advisor and company secretary. She has strong values and a passion for enabling and leading organisations to meet its operational and strategic direction through long-term financial sustainability, operational efficiency, innovation, leadership, transformation and partnerships. As Treasurer and Board member at SACOSS, she is committed to successfully leading and making a purposeful impact to the organisation and its stakeholders.

David PANTER

David has worked in health and social care for almost 45 years, over half of which has been as a Chief Executive. In the UK he initially worked in the NHS and more latterly in local government, where he was Chief Executive of Brighton & Hove City Council. In 2004 David was recruited to the South Australian public health system for over 10 years leading reforms including the development of the new Royal Adelaide Hospital. From 2015-2022 David was the Chief Executive of not-for-profit aged care provider ECH. At the end of January 2022 David became the Chief Executive at Minda, SA’s largest provider of services to people living with an intellectual disability.

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