Lack of access to general practitioners is driving record-high emergency department attendances and ambulance call-outs in NSW, according to the state's health minister.
But Ryan Park says he has no control over the number of GPs and has to deal with commonwealth funding arrangements.
People are facing increasingly long waits, or giving up and leaving the state's strained public hospitals, fresh data released on Wednesday has revealed.
NSW emergency departments were flooded with 810,201 attendances from the start of January to the end of March, an increase of more than five per cent compared with the same period in 2023.
The Australian Medical Association (AMA) described the situation as a "catastrophe waiting to happen" that could only be fixed with sizeable investment.
Emergency-department attendances reached the highest of any quarter since the state's Bureau of Health Information began reporting in 2010.
Just over two-thirds of those who attended emergency departments started treatment on time, but only 55.9 per cent of patients left within the targeted four-hour period - a record low.
The figures come amid a falling number of GPs providing care to patients in the state.
One in 10 people spent nearly 11 hours in emergency departments, while more than 74,000 patients left without treatment or with incomplete care - an increase of almost 17 per cent.
Mr Park said emergency departments were under unbelievable pressure.
"We're also seeing sicker and more complex cases present by patients to our busy emergency departments," he said.
In response, the government was hiring more nurses, expanding urgent-care services to prevent people ending up in hospitals and allowing pharmacies to do some work that traditionally fell to GPs, Mr Park said.
Fewer doctors and a lack of bulk-billing options meant more people treating the emergency department as a first port of call, he said.
Bureau of Health Information chief executive Diane Watson called for an expansion of the "hospital in the home" clinical model, which provides care for common conditions including infections outside hospitals.
Public hospital admissions across the state increased to 481,335 patients in the quarter.
Ambulance activity increased more than 10 per cent to a record 383,341 responses.
More than 17,000 of those call-outs were the highest-priority cases, an increase of more than 57 per cent.
AMA NSW president Kathryn Austin said record demand must be matched with record investment.
"It is becoming increasingly impossible for the doctors and health workers of NSW to deliver the care that the citizens of this state deserve,” she said.
NSW Nurses and Midwives’ Association general secretary Shaye Candish said emergency departments were pushed to their limits.
"This reflects the sheer volume of patients presenting to public hospitals, coupled with the issue of bed block, and the challenging conditions our members work in, often while chronically understaffed," she said.
Opposition health spokesman Matt Kean called for more money for health in the June budget, adding that the crisis would only deepen without extra funding.
The record-high emergency department attendance and ambulance activity come after the number of GPs in NSW fell by more than 500, leading a national fall.