Western Sydney doctors have labelled NSW public hospitals "basically Third World" at a parliamentary inquiry into bottlenecks at emergency departments.

Emergency medicine experts were quizzed on Wednesday at the upper house probe about "war zone" conditions at public hospitals that remain under pandemic stress.

Emergency doctors Pramod Chandru and James Tadros told of their frustrations working in the "disheartening" setting of public hospitals in the city's west.

"It was not our goal when we started out our training in medical school to find ourselves in circumstances that see us failing the needs of our patients on a daily basis," Dr Tadros said, reading in a statement authored with Dr Chandru.

"But this is the truth of our current working environment ... it's not equitable, equal or fair," Dr Tadros said.

Medical staff were saving lives "in spite of the system rather than because of it", he said, before reading a text exchange between the pair that described the system as "basically Third World".

The pair were discussing an 88-year-old woman with terminal cancer who was left for 12 hours in an ED before getting a bed.

"The worst part is her and her daughter have been so nice the whole time despite our rubbish care," Dr Tadros said in the exchange.

Healthcare in Sydney's west was "lagging behind" other health districts in terms of access to resources and medical care, Dr Tadros said.

"Why are people getting different access to medial care depending on where they live across our state?" he asked the committee.

Dr Chandru said ED doctors often started shifts above 100 per cent on patient capacity, meaning 10 to 15 patients were were left in "inappropriate treatment spaces" such as a chair or the waiting room.

Earlier, Australasian College for Emergency Medicine president Clare Skinner said blocked access and overcrowding had left EDs under "incredible pressure", with some patients waiting up to 36 hours to be admitted.

Dr Skinner said there was a crisis in the system that was "under incredible pressure", describing COVID-19 as "the straw that broke the camel's back".

A patient's chance of death lifted 10 per cent if they waited more than eight hours in an ED, Dr Skinner told the inquiry.

Asked about government claims that so-called ambulance ramping - where ambulances get stuck at hospitals unable to offload their patients - was rare, Dr Skinner said: "it's not rare, it's common."

ED access block was not only harming patient outcomes, but was also affecting healthcare workers, especially senior nurses, she said.

"Access block is the biggest cause of stress, poor morale and burnout in their work," she said, noting that healthcare staff had "had enough".

Vice-president of the Australian Paramedics Association Scott Beaton said ambulance ramping was worse than a previous low point in the early 2000s.

"I think that it's probably at its worst at the moment," he said.

"It's certainly back with a vengeance across the whole of NSW."

Lawmakers were "completely out of touch" with the situation on the ground, he said.

Ramping was happening at Gosford, Dubbo, Wagga Wagga and Westmead hospitals "on a daily basis".

"The problem is out there everywhere," he said.

Australian Paramedics Association president Chris Kastelan said the problem had spread from metro to regional parts of the state, with paramedics having to keep patients on stretchers at EDs for "many hours".

He called it a "dire diagnosis" for hospitals and said stories of paramedics doing CPR in hallways and patients short of breath waiting 30 minutes for care then going into cardiac arrest and dying were "significant concerns".

The inquiry comes after the latest Bureau of Health Information quarterly report revealed patients waited longer in EDs and faced record waiting times for ambulances from January to March.