St John WA blames funding, mould and measles for ambulance failures, despite revenue increase

St John WA has blamed a funding shortfall and record number of priority one cases for failing ambulance response targets, while using a measles outbreak and mould to excuse the repeated breach of a key contract requirement. Metropolitan response rates in every category have gone backwards, according to the ambulance provider’s latest impact report. And The West Australian has uncovered documents which reveal repeated warnings that a staff shortage was crippling ambulance services in Bunbury — leaving St John WA in breach of a contracted KPI. The State’s privately-run ambulance provider has revealed a $27.7 million deficit in 2024-25, despite a 7.8 per cent increase in operating revenue to $528 million. It warned it may need taxpayer-funded relief — or “onerous contract provisions” — to maintain services. Outgoing St John WA chair Sally Carbon said the deficit was “strategic” and defended a round of redundancies, first revealed by The West in July. She called it a “workforce reset” of 43 roles to “align to digital advances and economic realities”. Documents obtained under Freedom of Information — heavily redacted — revealed the litany of excuses used when the Health Department issued abatement notices to St John WA for failing a key performance indicator, by repeatedly closing its Bunbury sub-centre, at least nine times in nine months. “Mould contamination” resulted in a waiver being granted from April to June 2024, while a measles outbreak was blamed for staffing shortages that suspended Bunbury transport crews in March 2025. But a waiver request for seven closures between June and December 2023, for a combined duration of almost 24 hours was rejected — meaning an abatement would be enforced and taxpayer-funded payments to St John WA reduced. The West understands the abatement value totalled less than $1 million, and that the Bunbury sub-centre was closed for a further 31 hours across January and February of 2024. Analysis of St John WA ramping figures shows that Bunbury Hospital recorded a record 239 hours of ramping in September this year out of 263 hours of ramping across all country hospitals. St John WA argued it deployed an additional crew to support Bunbury “on an ad hoc basis” to meet periods of high demand. “Emergency ambulance coverage in the Greater Bunbury region has been continuous,” a St John WA spokeswoman said. “When Bunbury crews have been unable to dispatch from their home base, they have operated from — or been supported by — surrounding stations including East Bunbury to maintain service to the community. “Emergency response performance in Bunbury continues to exceed metropolitan averages.” But in a letter dated August 2024, the WA Country Health Service accused St John WA of failing to take up an offer to trial a Perth-based country retrieval service. “On 8 May 2024, WACHS provided authorisation to SJWA to commence a trial,” WACHS Chief Operating Officer John Quinn said. “It is not clear when SJWA will be in a position to commence this trial. “Whilst the State remains open to discussing ambulance service requirements, including in relation to Bunbury, it is the State’s expectation that SJWA ensure it is meeting existing contractual requirements prior to any further development.” St John WA blamed “resource constraints” and noted that East Bunbury and Bunbury had recorded the highest level of shift extensions, calling that a “strong indicator that additional number of crews are required”. Under current contract provisions, St John WA is funded to provide one paramedic crew 24 hours a day, seven days a week for the Bunbury sub-centre. A St John WA letter to WA Health’s Purchasing and System Performance unit called for funding to be doubled. “The current paramedic resourcing model for Bunbury does not enable SJWA to replicate the metropolitan model relative to maintaining paramedics on standby every shift,” it said. “The activity profile in Country year to date is currently double FY23/24 funding”. In November 2024, WA Health Director-General Shirley Bowen warned that “further discussion on performance is still required”. Months earlier, in July 2024, she signed a ministerial briefing note that declared her “support” for St John WA’s “keen interest in reviewing some contract parameters”. The note warned that ambulance response times were declining. Response times have since gotten even worse, according to St John WA’s latest Impact Report, with only 83.3 per cent of priority one calls were attended within 15 minutes in the 2025 financial year — below the 90 per cent target. The response rate for “urgent” priority two calls was down 4.5 per cent to 74.4 per cent. St John WA said emergency ambulance activity increased 7.7 per cent at the same time, stretching resources. In its annual report, St John WA warned about funding adequacy and suggested an “onerous” contract provision may be needed, to ensure it remains viable. “A failure of funding to adequately match demand with cost-of-service delivery could lead to material financial strain,” the report said. “Sensitivity to these estimates is monitored by management, with ongoing discussions with the State.” But an “evaluation” that was promised in late 2025 as part of the Government’s response to a parliamentary inquiry into the “critical condition” of WA’s ambulance services is yet to start, despite repeated requests from St John WA. A five-year contract, believed to be worth $1.5 billion, is due to expire on 1 January 2028. Health Minister Meredith Hammat said St John WA’s contract performance was being “closely” monitored. “The contract, agreed to by both parties, sets out clear expectations for service delivery and performance standards, and has contingencies in place to deal with performance issues when they arise,” she said. “The Department of Health continues to monitor SJWA’s contractual obligations closely. “Our Government is also growing ambulance services in the regions. “Since 2023 we have funded an additional 43 paid paramedics for regional communities and our $16.3 million election commitment includes doubling the number of paid paramedics in Australind and construction of a new station.”