Abusive patients to pay for ambulance care under Labor election policy

Labor has pledged a crackdown on people who are aggressive towards Victorian paramedics if re-elected, including forcing patients to pay for ambulance care if they abuse or assault staff.

The move has been welcomed by Victoria's ambulance union which says more than half of its members were threatened with violence over the past year.

Advocacy groups, however, warn vulnerable people could be left without vital services.

The Labor Party says it will force abusive patients to pay for their ambulance rides if re-elected in Victoria next month.

Premier Ben Carroll announced an election commitment to crack down on patients assaulting or intimidating paramedics, stripping them of their Ambulance Victoria membership and charging them for the ride.

"If you assault a paramedic, if you threaten or intimidate a paramedic, it does not give you the right to have free public transport by that paramedic," Mr Carroll said.

Under the proposed system, abusive patients would have their membership revoked for 12 months, forcing them to pay costs of more than $2,000 for ambulance care.

The plan would come with a new patient charter devised by the government and Ambulance Victoria.

"When you pay your $56 for an Ambulance Victoria membership, you are signing up to a code of conduct," Mr Carroll said.

"If you are someone who has been a repeat offender or if you have actually acted out a violent episode with a paramedic, that would look at immediate suspension."

Ambulance Victoria would have the final say on whether a patient has been abusive and should have their membership revoked.

Mr Carroll said it should be left to medical professionals "who know their patients" to determine what constitutes abuse or intimidation.

The announcement comes amid a reported rise in attacks on first responders and paramedics.

The government said in the past year, 59 per cent of union members at Ambulance Victoria were threatened with violence and 28 per cent were assaulted.

Acting Victorian Ambulance Union secretary Olga Bartasek said the move was a welcome step to stemming a rising tide of violence.

"These things are just escalating and we need something to de-escalate," she told 774 ABC Melbourne.

"This year we've had a paramedic that was stabbed, that was one of the first ones here in Victoria.

"We had a member last week who had stitches in their head because they had been hit over the head with a bottle."

The Victorian Alcohol and Drug Association is the peak advocacy body for treatment and support services.

Spokesperson David Taylor commended Labor's focus on protecting ambulance workers but said reducing access to healthcare for those with serious needs was problematic.

"For some folk who may well be unwell, whether with mental health issues or alcohol and drug or other things, they may not necessarily be able to grasp or be in a situation where they can consider the consequences of their actions," Mr Taylor said.

"So they wouldn't consider this policy when engaging in potentially inappropriate behaviour."

Mr Taylor also questioned how the policy would be enforced.

"Let's say they're involved in a serious accident or something like that, are they actually really going to get turned away?

"If you're experiencing a significant level of disadvantage, to have that disadvantage exacerbated through reduced access to health services or financial penalties ... may be the inadvertent outcome from such a policy," he said.