In the two years before she died, Joseph Kowaluk's mother Chelle was hospitalised frequently from excruciating pain and "severe" hip dislocations, a result of surgeries she'd been having since her family found out she had terminal cancer.
Mr Kowaluk said he "struggled to keep count" of how often she was admitted.
He thinks it was around 23 times, 15 of which required an ambulance. Many of these experiences, he describes as "terrifying and traumatic" for his family — with him on one occasion finding his father outside, crying inconsolably.
In a Tasmanian parliamentary inquiry into ambulance ramping on Monday, the secretary of the Department of Health, Kathrine Morgan-Wicks, acknowledged the "terrible impact" of patient transfer delays and apologised for the impact on individuals and their loved ones.
While Mr Kowaluk said his family mostly experienced "moderate ramping" when caring for Chelle, once they waited nearly 12 hours for an ambulance to arrive.
During this time, his father administered the maximum legal dosage of morphine to his mother to ease her pain.
Mr Kowaluk said it allowed her to sleep that night, but his father was left sleepless.
"When my father had to administer that third dose of morphine… he knew his options were limited after that. And what if that didn't work, where was he left?" Mr Kowaluk said.
Mr Kowaluk says the state of the Tasmanian health system is so dire paramedics had to ask him to provide blankets and pillows to transport his mother safely and comfortably.
He said this was not the fault of health staff, whom he called "the most incredible workers".
Paramedics use pillows for both comfort and to support injuries or elevate limbs.
A spokesperson for the Department of Health said it "is not aware of issues with the availability of linen or bedding in our hospitals or ambulance services".
Ambulance boss defends letter
In an inquiry into ambulance ramping on Monday chaired by Greens leader Rosalie Woodruff, Ambulance Tasmania chief executive Jordan Emery was questioned about a letter he wrote to the committee in January.
In the letter, he named Ryan Posselt and responded to claims the paramedic made earlier to the inquiry.
The inquiry heard Mr Emery's letter misquoted and refuted Mr Posselt's claims about the frequency of emergency calls that are not responded to.
Mr Emery acknowledged he did not have data to back up his rejection of Mr Posselt's statement, and said the letter was not intended to dissuade staff from speaking out, and any perception of it doing so was "deeply regrettable".
"I would never seek to intimidate an employee away from making submissions on matters that are in the public interest," Mr Emery said.
Ambulances often unavailable
After the hearing, the Health and Community Services Union's Lucas Digney questioned why Mr Emery "sent a letter to a parliamentary inquiry that wasn't based on any factual data".
Mr Emery said ambulance wait times were a "cause of distress" for all staff, including himself, and acknowledged the extent of the crisis, including that 25 per cent of cases don't receive an ambulance within the desired time frame.
"There are certainly cases where we do not have an ambulance available to respond to a priority 1 or priority 2 case," Mr Emery said.
"There are occasions, and sometimes there are several occasions, where we have priority 1 and priority 0 cases where we can't allocate an ambulance in the target time frame," he said.
Mr Digney called on the government to immediately employ 126 paramedics and supporting staff, which the need for was highlighted in a government report in 2023.
"Without that, the status of ambulance services in Tasmania is simply going to worsen," Mr Digney said.
On the weekend, Health Minister Guy Barnett announced Tasmanian paramedics can drop off patients with minor ailments directly into emergency department waiting rooms, rather than wait to be formally accepted, to reduce ramping times and free up ambulances.
Mr Digney said any attempt to alleviate ramping was welcome, but that the new measure "won't go a great way to doing anything about that".
Acknowledgement of 'terrible impact' on families, carers, staff
During the inquiry, Ms Morgan-Wicks thanked witnesses and apologised to those who had suffered long ambulance wait times and inadequate care.
"I acknowledge the terrible impact that this has on families, on carers and on our staff," Ms Morgan-Wicks said.
"I wish to extend my apology to those who have not received the care themselves or for their loved ones in any way if that care fell short of what they should have expected to receive from us.
"I acknowledge these failures and reinforce my department's commitment to continue to face these challenges head-on and to keep pushing to improve."
A spokesperson for the Department of Health said the department is "implementing a range of measures to address patient access and flow challenges across our health services, including a number of new protocols aimed at freeing up paramedics from hospitals to respond to other emergencies in the community".
The department said it was "committed to the House of Assembly Select Committee on Transfer of Care Delays process, and we are listening and acting on the evidence being presented".
Mr Kowaluk said his mother spoke up "numerous times against the health system" when she was alive, and now he wants an "opportunity to tell his family's story".
But apart from one email acknowledgement of his message, he said he hasn't heard from the state government since he first contacted them in June last year.
"We hear the statistics around ramping, we hear the statistics around the lack of beds. But we don't hear the personal stories, not only of the patients but the carers," Mr Kowaluk said.
On Tuesday, Minister for Health Guy Barnett said in a statement to the ABC, "My heart goes out to Mr Kowaluk and his family".
"The Health Department will of course investigate his concerns."
Labor leader Rebecca White said Mr Kowaluk's family's experience was a symptom of a health system under severe strain.
"These aren't just stories of statistics, these are stories of people's lives. These are people who every day deserve access to priority health care are being denied that because ambulances are ramped, and workers are completely exhausted," Ms White said.
View the Tasmanian health system dashboard for data about wait times, admissions and other information