Barrister Mark Preece, representing John Charles Doepel, 63, of New Lambton, told the court that NSW Ambulance received "several complaints" from victim Annette Henry and should have acted.

"It is somewhat lamentable the ambulance service did nothing whatsoever to intervene in the matter," Mr Preece said. "It is somewhat lamentable his conduct was not nipped in the bud by his employer."

Doepel, the former Merriwa Ambulance Station manager, failed to have his conviction for intimidation of Ms Henry overturned on mental health grounds.

It is the second time his legal team has unsuccessfully argued Doepel's mental health conditions, PTSD associated with his duties as a paramedic and adjustment mood disorder, rendered him unable to control his behaviour.

Judge Tim Gartelmann, SC, dismissed an all-grounds appeal by Doepel on Wednesday, finding there was no evidence that his mental illness was linked to his offending.

He said Doepel knew his conduct, over 18 months from early 2014, was likely to make Ms Henry "fear mental harm".

"The offence reflects a pattern of conduct over a period of about 18 months toward the victim comprising repeated unwanted sexual advances, innuendo and references," Judge Gartelmann said.

"The conduct concerned might effectively be summarised as sustained sexual harassment over an extended period."

The court heard the veteran paramedic with more than 30 years' experience, was working as Ms Henry's boss at the time.

Doepel pleaded guilty in August, on what was supposed to be the first day of a two-day trial to be heard in open court.

The witness list included a who's who of past and present NSW Ambulance Hunter management.

According to an agreed statement of facts, the harassment was that bad that not long after Ms Henry started working at Merriwa, she would hide out in the female toilets "for lengthy periods of time" to escape Doepel.

He would follow her "around the station constantly for no reason" and regularly asked her or guessed what colour underwear she was wearing.

Doepel once brought a sign to work which read: "Liquor in the front, poker in the back". After showing it to Ms Henry, he asked if she "liked it like that".

The former intensive care paramedic and educator often made "sexually suggestive comments" about women he encountered during shifts, including that "she would go off" and "she would be good".

"The victim recalls the accused would often look at naked women who had body paint on using the Ambulance station computers and on his mobile phone," the facts read.

"The accused would regularly ask the victim to look at the pictures and ask if she liked them."

In mid-2015, Ms Henry was talking with colleagues about how she had completed the Kokoda trek and lost weight.

Doepel then said to another colleague as Ms Henry walked away, "as long as she never loses that arse".

Ms Henry previously told the Newcastle Herald it was "common knowledge" in the Hunter if paramedics made complaints they ended up with "a target on their back".

"If you complain, they don't want you anymore," she said.

"They just want you signed off and paid off. Out of the way. But I refused to go, because I was worried about the next woman stationed to Merriwa. I told them I was staying as long as they refused to fix it."

The matter has been adjourned to December for sentence.

The case comes after numerous Hunter ambulance bosses have been stood down over the past year following wide-ranging investigations not linked to this case.

The Newcastle Herald revealed last year that two of the region's most senior NSW Ambulance managers, husband and wife team Kerry and Robert Akester, resigned after being stood down, and inspectors Mick O'Connor and Brian Knowles were removed from duty four months later.

It's understood there were several investigations underway into the operations of the bitterly divided service in the Hunter.

As reported in May last year, two Sydney barristers, based at an inner-city Newcastle hotel, interviewed more than a dozen past and present paramedics over several weeks.

NSW Ambulance's Deputy Director of Clinical Operations, Inspector Jordan Emery, who is the most senior officer in the region, outlined plans last year to review the Hunter ambulance service and address "workplace grievances".

"It's no secret there have been significant cultural challenges in Hunter New England - that's been reflected in staff surveys and that's been reflected in people's experience," Inspector Emery said.

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