Paramedics speak out after damning report into St John Ambulance NT's governance and culture

Paramedics at the Northern Territory's troubled private ambulance service fear they are "failing their patients" due to poor governance and delayed response times in dangerous situations.

It comes after the leaking of a report that found "serious concerns" within St John Ambulance NT's clinical governance and cast doubt over the organisation's contract with the NT government.

The report recommended St John NT urgently appoint more senior staff, suspend some life-saving procedures and address a "disconnect" between senior management and frontline staff.

Several employees have now told the ABC the report — which found some processes may have led to patient deaths and "significant risk" to staff — was an accurate reflection of what was happening on the ground.

A St John NT paramedic, who was not authorised to speak to the media and spoke to the ABC on the condition of anonymity, said there was "a feeling of lack of trust between operational staff and executive management".

They said the distrust stemmed from the removal of St John NT's chief medical officer late last year and the resulting "lack of governance structure".

The paramedic said that had led to "an acceptable level of harm" within the service, something staff were struggling with.

"There's certainly a feeling that there might be less risk accepted in other states."

The United Workers Union NT, which represents paramedics and ambulance officers, has long called for the service to be de-privatised and brought under government control.

The paramedic echoed those calls, saying the organisation needed "cultural change".

"People are less likely to report bullying and harassment in their workplace … less likely to report acts of violence in the community against them, because they are not confident anything will be done about it," they said.

Richard Brady is a restocking and sales officer who has worked for St John NT for 13 years.

He told the ABC there had been a "remarkable" turnover of staff in the organisation in recent years, which he attributed to a loss of trust and confidence in senior management.

"There's this general feeling with most of the staff that I've worked with where they're treated with not only with indifference, but with contempt," Mr Brady said.

"There's been lots of really valuable employees of long service who have left very unhappy and have been damaged."

Mr Brady said he believed the ambulance service would be better run by the NT government.

"There's never enough funding, and I'm certain that there isn't enough now, but I also am very deeply certain that there's been a tremendous wastage of funds," he said.

Union renews calls to de-privatise service

United Workers Union NT secretary Erina Early said the report highlighted concerns the union had held for two decades.

She said it was further evidence the ambulance service was "in crisis" and had to come under government control.

"We deal with a lot of paramedics who are fatigued, who are desperate, they're broken," Ms Early told ABC Radio Alice Springs.

"They feel there's no value for them, that no-one's listening to them … there's high assaults on them as well.

Ms Early accused both sides of government of "not listening" to a string of damning reports into the ambulance service in recent years.

"Would you allow them to privatise our NT Police Force, privatise our NT fireys, privatise our hospitals?" she said.

"We need accountability, we need to keep our paramedics here in the Northern Territory, we need to ensure they're properly trained."

Contract under review

St John NT director of ambulance services Andrew Thomas said the organisation had "openly engaged" with the review and supported staff to raise their concerns during the process.

It came after the report said some staff had been reluctant to raise concerns due to fears of litigation and St John NT's "involvement of lawyers" during the review.

Mr Thomas said St John NT acknowledged the report had raised "concerns for the community and patients".

"We have made significant improvements in terms of our patient safety and quality areas of the organisation, and that had been going on well before the review commenced," he said.

Mr Thomas said those improvements included regular reviews of intensive care paramedic cases and improved reporting between NT Health and St John NT.

Health Minister Steve Edgington said the health department was continuing to review the ambulance service's contract.

Rising attacks on paramedics

With concerns about St John NT's clinical governance emerging, the service has said its paramedics face violence and threats "every other day".

St John NT territory response manager Craig Garraway said there had been 117 reported incidents since the start of this year.

He also said there had been six incidents across the territory on Wednesday night alone, including one in which a paramedic was threatened with a knife while treating a patient in Palmerston.

In Alice Springs, paramedics had to call for police back-up to two separate incidents of abusive behaviour, which Mr Garraway said delayed their response to a patient suffering a heart attack.

Mr Garraway said St John NT's leadership was currently reviewing how it could "reduce the risk immediately".

"What we're trying to do is actually stop our paramedics attending some of these cases that are really dangerous and holding back until we can get police to help us," he said.

"It may be that we've got to send more [St John NT] staff in together.

In an email sent to all staff on Friday, obtained by the ABC, St John NT announced a range of measures to support staff safety.

The service said it would immediately stop dispatching solo responders and would request that the NT government send transit security officers to all emergency call-outs at bus stops.

St John NT paramedic Bridie Morley said she had faced several dangerous situations in her eight years working in the territory, including "many near-misses" that had left her considering leaving the profession.

"When you've got somebody with a weapon that is threatening to kill you, you drop everything and run," she said.

Mr Edgington said the government hoped new mandatory sentences for assaults on frontline workers would act as a deterrent to attacks on paramedics.

"We need to call out this behaviour now," he said.

"We need to do everything in our power to stop this behaviour."