Regional Victorian ambulance officers and paramedics contributed just under half the responses to a VEOHRC report which uncovered distressing levels of bullying, discrimination, victimisation and harassment within Ambulance Victoria.

In the first of a two-volume report, the VEOHRC found more than half of 2163 respondents to a survey had been bullied and 47 per cent were discriminated against.

"The experiences shared with the commission show that Ambulance Victoria's efforts to prevent unlawful and harmful conduct have so far been ineffective," the report says.

"They speak to a workforce, many members of which do not feel safe, many of whom have lost trust and many whom, unlike their patients, do not feel valued or cared for."

General secretary of the Victorian Ambulance Union Danny Hill said the impact of the culture at Ambulance Victoria had a increased effect on regional ambulance officers and paramedics, who struggle to cope with something as basic as rostering for childcare.

"We've got members who, for example, might work in a small regional town; there are pretty much zero options for childcare," Mr Hill told The Courier.

"So they need some sort of roster that suits their their children's school's start and finish times. And they have to battle every six months to go through a flexible work arrangement negotiation to try to get some sort of reasonable roster that allows them to look after their children or deal with their childcare responsibilities. I mean, you have to battle tooth and nail every six months to do that."

Mr Hill says it's appalling that in a job where the staff facing the public have enormous amounts of stress already, a managerial culture ignores their needs.

"The focus of Ambulance Victoria is on meeting its operational requirements, and its operational requirements at all costs, basically," he says.

"So anything related to health and safety, allowing people to finish their shift on time, access to flexible rostering, that will become secondary to them trying to get ambulances to patients. What we've always said is that if you're going to do those things effectively, you have to actually blend them together, there has to be a reasonable balance. And the balance is just purely in favour of the employer meeting its KPIs at the moment."

Ambulance Employees Australia - Victoria (AEAV) secretary Brett Adie told The Courier he began his career as a paramedic in the Bendigo region and understands the increased pressure on regional staff.

"Part of the issue for regional areas is they have their own separate regional management teams, who want to show Melbourne and Doncaster they're doing a great job," Mr Adie says.

"So the preferred option is to make it look like we're doing a great job out here, and to cover up the problems. We've seen that: we've been involved in those cases where regional management teams have been tasked with sorting out problems, and brushed them under the carpet. There's been a lack of oversight of those regional management teams.

"As recently as yesterday morning I was in a meeting - so this is 12 months after the VEOHRC review was announced - where a regional management team has made up its own rules. So regionally it is a really significant concern, possibly more so than in the metro, because there's more oversight in Melbourne. Once you get out of Melbourne, the CBD and the suburbs, they're a law unto their own to a degree.

"I think the main issue has been the focus on performance indicators. That's been at the expense of those who were working on road providing the front-facing roles, but also those behind closed doors, who were doing all the admin work to keep those trucks on the road. It has become so much about performance. As was quoted in the report, you're just seen as a bum on a seat. Your experience is not valued, because it's all about how quickly we can get an ambulance to the job."

He says it's unfathomable that early reports indicate managerial heads are coming together over the problem, rather than rolling.

"We can see a pattern already here: in a week we'll forgotten about, we'll have the same people in charge," Mr Adie says.

"The fact that a whole department is being taken off one person and shifted to another area... if that is not an indicator... if there was if a paramedic ended up on the front page of your paper, because they cause significant harm to somebody one person, they'd lose their job, because Ambulance Victoria protects the brand.

"Yet we have senior executives here who have overseen this. They can't say that they didn't know; they knew. The email trails go all the way to the board, and they did nothing about it."

Ambulance Victoria is a statutory authority which employs 7550 people and provides emergency health care to over 6.5 million people across the state of Victoria. The organisation covers an area of more than 227,000 square kilometres and has around 260 different locations across metropolitan, regional and rural areas, the report says.

Forty-two per cent of the report's respondents were from regional Victoria. The VEOHRC conducted 223 interviews with current and former employees, conducted observational shifts and onsite visits, undertook focus groups and received submissions during their investigations.

The commission was called in to do a review of the service in October 2020.

"Certain behaviours, particularly everyday forms of disrespect, have seeped into the fabric of the organisation," the commission found.

Women are at a heightened risk of experiencing sexual harassment and discrimination, as were those belonging to different demographic groups, cohorts and regions.

"It's very much - you've got to be aggressive and alpha and mean and rude. This is how this whole thing started, I believe... then once it happens to someone, they think, 'Well, I went through it, so you can go through it'. (A) rite of passage," said one interview participant.

"Who would've guessed the most traumatic thing I've experienced and witnessed as a (P)aramedic was workplace behaviour?" wrote another.

Ambulance Victoria has accepted all 24 of the commission's recommendations to improve how the organisation seeks to prevent and respond to discrimination, sexual harassment, bullying and victimisation.

"The stories many of our people shared with the commission - experiences of discrimination, sexual harassment, bullying and victimisation, are deeply confronting," Ambulance Victoria chief executive Tony Walker said.

"To those of our people who shared your experience, either with the commission or directly with me, I thank you for your enormous bravery.

"To those of you who have been subjected to behaviours and actions that are disrespectful, hurtful or unlawful, I unreservedly apologise."

Among the measure it will now undertake, Ambulance Victoria will create a new, dedicated division to drive workplace equality and reform, redesign its reporting and complaints system and create multiple anonymous reporting pathways.

The final report by the VEOHRC is due in March 2022.

The article in part relies on Australian Associated Press copy.