Doctors and paramedics say the health system, already struggling with the regular winter spike in activity, has been swamped by a record flu season and a lack of capacity to deal with the rise in very sick people. The result, known as "trolley block" or "bed block" means hospitals get chocked with patients they are unable to admit, and ambulance get stuck with patients they are unable to unload. By late lunchtime Fairfax Media has been told parts of the inner city that include Royal Prince Alfred, St Vincent's and Prince of Wales hospitals had so many ambulances stuck waiting to deliver patients to overburdened emergency departments that there were none left to transport patients when further calls were made. At the same time the area had three outstanding triple zero calls and two time-critical medical transports, five ambulances were parked with patients at Royal Prince Alfred, one of which had been waiting more than an hour. Another three each were at St Vincent's Hospital and Prince of Wales. Health Services Union councillor and paramedic Greg Bruce said when senior managers were being called in to work as paramedics the system was "beyond breaking point". "They only rely on them when there's no other available ambulance crews to do the job, so that shows you how bad it is," he said. "That quite often means there is nobody to respond, or they could be on the other side of Sydney".

HSU secretary Gerard Hayes said the ambulance service was taking 30,000 more calls each year in Sydney than it was in 2010, but there had been no increase in staff to deal with it. "This will keep occurring until Health Minister Jillian Skinner steps in and provides the funding for... more paramedics and more ambulances," he said. "I am beginning to wonder what it will take to make this minister listen." Fairfax Media understands that in the South West of Sydney delays were even more severe, with six ambulances stuck at Liverpool Hospital while a further six emergency calls were waiting for a response and seven people were waiting for time-critical medical transport. In the area surrounding St George Hospital there were also no cars available, despite four triple zero calls waiting.

The Ambulance Service was then forced to issue the call for station superintendents and zone managers to shift to treating patients rather than undertaking their normal managerial duties. Labor health spokesman Walt Secord​ said in the past six months there had been reports of bed block at a number of major hospitals. "In an emergency situation, every minute counts... this puts lives at risk," he said. "NSW has the longest ambulance response times in Australia and it has increased in the last five years." Australian Medical Association NSW president Saxon Smith said the state was suffering from its worst flu season in a long time, against the back of increasing demand for hospital services that was not matched by increasing resources. But it was suffering equally from a lack of political will to fix the problem of hospital under-resourcing.

"The solutions are in proper planning and we need to continue in the agenda of health reform, but I'm not sure that's the conversation our federal and state leaders are having right now when they are talking about tax reform," he said. "Taxation reform is not health reform". A NSW Ambulance spokeswoman acknowledged it was "experiencing heavy demand for its resources across the greater metropolitan area" on Monday. "NSW Ambulance remains focused on providing a timely and appropriate response to patient requests for paramedic assistance and activating strategies to maximise the availability of our emergency resources," she said. The service had also recently launched a campaign called "Is Your Urgency An Emergency" to discourage people from calling ambulances unnecessarily. acorderoy@smh.com.au