The ambulance union has welcomed a commitment from MP Kevin Anderson to start "the push" for a replacement to their century-old Tamworth City station.
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Australian Paramedic Association (APA) delegate Lucas Hawkins said the 94-year-old Marius Street ambulance headquarters was "showing its age" and wasn't really fit for purpose in the 21st century.
"It's an unsafe station - the building can be potentially broken into," he said.
"The driveway into the station is very narrow, you can only barely just get an ambulance through there.
"[There] 100 per cent needs to be an upgrade."
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He said the building was cramped, asbestos-ridden and infested with a range of pests including cockroaches, mice, rats and worse.
It was also built without female paramedics in mind.
"I don't believe there are any change rooms in the city station. So you obviously [want] male [and] female change rooms. They do have male-female toilets, but generally they just share the toilets in the city.
"It wasn't built for the 20 staff I think that are in there at the moment."
Tamworth MP Kevin Anderson firmly resisted pressure to make an election commitment for a new ambulance station before the 2019 state election.
But in an end-of-year interview with the Leader he said getting a new station would be a priority for 2021.
Mr Anderson compared what he said would be a "campaign" for a new ambulance station to the battle to win a completely new Tamworth fire station, a process which took five years.
APA state secretary Gary Wilson said paramedics were "happy to see plans in motion for a new station - as all too often NSW Ambulance insist on putting lipstick on a pig and shy away from badly-needed station overhauls."
"It's simply unacceptable for first responders to be operating out of stations with the kind of workplace risks and substandard facilities that Tamworth has been dealing with for years," he said.
The real question will be whether to amalgamate both the Tamworth City and Tamworth South ambulance stations into a single super-station.
Mr Hawkins said Tamworth staff were divided on the issue - he is personally in favour of amalgamation and said it would probably create more jobs, rather than cutting them. Others are more sceptical of the idea, he said.
State secretary Wilson said there would need to be "extensive consultation" with local paramedics before any decision to join the two together.
"No such decision should be made without properly assessing current job loads and response times, and weighing up how best to serve the evolving and expanding community of the Tamworth region," he said.
Mr Hawkins said whatever the shape of a new station, it was time for a new building.
"I just hope Kevin Anderson keeps to his promise and gets on board because it's well and truly needed," he said.
"All the other bigger regional cities like Albury, Wagga, all got new stations built. New England has been left behind quite some time ago with buildings and staff and the maintenance of buildings. So let's hope that this happens."