When 3-year-old Corban Martin suffered a severe allergic reaction to cashew nuts, his mother was dismayed to be told there were no ambulances available to take him to hospital.
"I would think twice about calling 111 next time," Vicki Martin says.
What she now realises is that the dispatcher for St John Ambulance had assessed Corban's symptoms correctly.
Corban's allergic shock was not life-threatening and, with only seven ambulances available in Auckland for such cases, his mum was better to just drive him to the medical centre herself.
With limited numbers of ambulances available at any one time, St John Auckland City has revealed that if you do take ill the best time to do it is midday on a weekday.
District operations manager John Takerei said that was generally the time the most ambulances were on duty. "Our decisions about what resources are needed on the road, and at what times, are based on our robust data collection and analysis of our workload," he said.
"We constantly monitor our workload throughout the day and night, which informs our decision-making about where we place our resources to meet patients' needs."
St John has a minimum of 35 ambulance crews on the roads at lunchtime on weekdays, covering all incidents between Wellsford and Waiuku. Most are prioritised for emergencies; only seven are available that day to cases that are less serious.
"Like the entire health sector, we have the challenge of meeting increased demand for services. St John is meeting this challenge by ensuring urgent and immediately life-threatening incidents are our top priority."
Vicki Martin, of New Windsor, called the ambulance for Corban on Thursday last week, at midday.
"He has allergies to dairy and eggs, and he has been tested lots of times but he never had any allergies to nuts before," she said.
"He wanted a cashew nut so I gave him one. But after 5 to 7 minutes he started getting hives all over his chin.
"I gave him the medication I give him for other allergies. It usually stops the reaction as soon as I give it to him but this time it did nothing.
"I phoned 111. When I phoned them they were nice and everything and told me to get a bag ready and to wait by the door."
After waiting for an ambulance for 20 minutes, not knowing whether his reaction was life-threatening, she called 111 again.
"Corban was getting distressed and I was very worried. His face was puffy, his eyes were closing and he had red hives all over.
"I called the ambulance back and I asked if an ambulance was coming and if not should I drive him to the medical centre. They went through a checklist and said I should bring him to the medical centre," she said.
"I was home alone with a 3-year-old and a 1-year old. Every medical practitioner I have spoken to about his allergies told me never to put him in the car because that's when you have an accident and you're not going to be able to help your child sitting in the back.
"I realise now he wasn't going to die but I was never told that."
At the medical centre, the staff were able to calm Corban's allergic reaction and reassure Martin that her son would be fine.
"While I was there, the nurse said to me there were only three ambulances for the whole of Waitakere and even when the medical centre called for an ambulance they had to wait up to two hours for non-urgent cases," she said.
"I just worry for people who don't have a car, or for elderly people who play down how sick they are - I would think twice about calling 111 next time."
Takerei explained that St John used a five-colour coded response system.
Martin's call had been coded grey, which was non-urgent.
Takerei said the system focused on allocating the closest crew to highly acute, immediately life-threatening and time-critical calls.
"On that day, between 11am and 1pm, there were 28 on-going incidents. The seven resources local to the grey call you refer to were either responding to or dealing with other incidents," he said.
St John chief executive Peter Bradley has told the Herald on Sunday St John is going to have to change to keep up with demand, particularly in Auckland.
In the next five years, the number of 111 calls is forecast to rise to 500,000 a year.
"That's 20,000 extra, so we are going to have to think about how we are going to respond to this," he said last week.
"We will always be underfunded, but we have to look after our staff and volunteers."
Contracts with the Ministry of Health, ACC and district health boards fund just under 80 per cent of the ambulance service's direct operating costs.
The rest is made up of funding from community donations and fundraising.
St John ambulance services run at an annual operating loss of $16 million a year.