Key Points:

St John Ambulance is asking for its Government grant to be doubled - at an extra cost of $75 million over the next eight years.

Chief executive Jaimie Wood told Parliament's health committee yesterday that an extra 400 paid frontline officers were needed.

He said the service had long been under-funded. Single-crewed ambulances were putting patients and staff at risk, and more money was the only solution.

In September, the committee launched an inquiry into how well ambulance services were performing in response to a request from the NZ Ambulance Association and questions in Parliament over single-crewing of ambulances.

Association spokesman John Stretton said yesterday that the service was in chaos.

The management and governance of ambulance services by St John was "woefully inadequate" and there were concerns the service had lost its focus.

The success of the personal alarm business had resulted in a "blurring" of the service's core responsibility - responding to emergencies.

Under questioning at the committee meeting, Mr Stretton said a reorganisation of the structure of St John, splitting its emergency and non-emergency responsibilities, would be an improvement. Emergency services could be placed under the Fire Service, which had superior communications.

The association represents about 4 per cent of St John's paid staff.

Mr Stretton said the fact that single crewing was increasing was a "national disgrace".

It had an appalling effect on the standard of care for the very ill, and the association believed there was no place for it.

Mr Wood said St John's position was clear - "We believe all emergency ambulance responses should be fully crewed."

Single-crewed ambulances attended 46,000 callouts last year, about 18 per cent of the total.

Committee chairwoman and Green MP Sue Kedgley asked if Mr Wood would be happy to see the voluntary ambulance standard given regulatory force, and a legal standard requiring all emergencies to be attended by double crews.

Mr Wood said he would be happy to see an ambulance standard in force that St John was funded to deliver - one that was affordable, sensible and practical.

Ms Kedgley replied: "I would have thought that it was sensible and practical, given a life-and-death situation, to send two trained ambulance officers to any emergency in New Zealand."

Mr Wood said that in high-density urban areas it was cost effective to initially send single-crewed ambulances, as backup was quickly available if needed.

"What we do believe is one is better than none. And anybody who is in those circumstances would prefer to get a single-crewed ambulance than no ambulance at all.

"So we don't withhold services because we don't have a full crew, which is what emergency services do elsewhere."

Mr Wood said the request for extra funding was based on four key issues: growth in demand was constant, growing at 6 to 8 per cent a year; the service was underfunded compared with other ambulance jurisdictions; single-crewed emergency responses were unsafe; and there had long been a lack of a strategic approach to Government funding of the sector.

If approved, the request would see the service's Government funding increase from $75 million a year to $150 million by 2015.

The number of paid fulltime staff would increase from 800 to 1200.

There are 2200 volunteer ambulance officers - a number Mr Wood said had remained stable for several years.

St John provides 86 per cent of ambulance services in New Zealand and the Wellington Free Ambulance and two district health board services provide the rest.