The cashed-up NSW government has become over-reliant on stamp duty and its latest budget highlights skewed priorities, the state opposition claims.
Treasurer Dominic Perrottet's debut budget confirmed a massive $4.5 billion budget surplus this financial year, with enormous funding allocated to health, education and infrastructure.
But Labor leader Luke Foley says the budget highlights the muddled priorities of the Liberal and National parties.
"This is a government that seemingly just isn't in touch with the cost of living pressures on families across NSW," he said in Sydney on Tuesday.
"People are battling."
Mr Foley said the government had failed to provide relief from soaring power prices, unaffordable road tolls and flat wage growth.
The government will spend big on upgraded hospital facilities, including $720 million for the Prince of Wales Hospital in Randwick, however much of the health spending had been revealed prior to Tuesday.
Mr Foley said the government's announcements were exposed as "a cruel hoax", with most of the hospital projects not due for completion until the mid-2020s.
The NSW Council of Social Service described the budget as "lukewarm", and said with billions of dollars in surplus the government should have allocated more money for marginalised communities.
"While we're spending record amounts on some parts of the social sector, we're missing the opportunity to make significant investments early on for children and young people at risk of disadvantage," chief executive Tracy Howe said.
The Australian Paramedics Association accused the government of "dicing with death" by boosting relief officer numbers by just 50, in an attempt to address a chronic shortage across NSW.
"NSW Ambulance is at least 500 paramedics short of what is required to cover existing shifts," state president Steve Pearce said.
The Greens welcomed health and education infrastructure funding, but described it as a "catch up on a backlog".
Greens treasury spokesman Justin Field said the "short-sighted" budget failed to prepare for the impacts of climate change.