A fatal crash on the Kapiti Coast last night is the latest in a string of horrific head-on collisions a local emergency doctor has attended, and he says lives would be saved if a median barrier was put along the deadly State Highway 1 stretch.

The head-on crash near Paekakariki, between Beach Rd and the Whareroa Rd on-ramp last night killed a 28-year-old Lower Hutt woman and left two men in serious condition in Wellington Hospital.

It was the fourth death on the stretch in the past four months.

An 18-year-old woman and her stepfather died last December and a 17-year-old woman last September in head-on crashes on SH1 just north of Otaihanga.

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Emergency Medical Services doctor Chris Lane has attended every crash in the Kapiti Coast area for about 32 years - including last night's.

He believes preventing roads deaths in the area is simple; put a median barrier down the middle of the road.

"There's always going to be human error but the road has to be made as safe as possible for the innocent victims of human error, and the only way of doing that is to separate the traffic with a median barrier.''

Dr Lane has been a long-time vocal supporter for installing wire rope median barriers at known black spots along SH1, north of Paekakariki and Otaihanga.

A median barrier was installed along a 10km stretch south of Paekakariki in 2005. In the 20 years before it was installed, Dr Lane attended crashes which claimed 40 lives and left about 120 people with serious injuries.

As of six months ago - the latest figures Dr Lane had - that barrier had been hit 86 times.

"So that's potentially 86 head-on collision that have been avoided.''

The same type of median barrier needed to be installed north of Paekakariki to prevent even more deaths, he said.

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New Zealand Transport Association (NZTA) Wellington State Highway manager Rod James said the installation of a wire rope barrier in the area required buying land as roads needed to be widened to build them.

The section of State Highway 1 had been the focus of several safety improvements in recent years, including reducing the speed limit to 80kmh, he said.

"Work is already under way investigating how planned safety improvements can be expedited, and this could involve bringing forward the construction of a portion of the barrier north of Paekakariki where property has already been secured.''

NZTA was also considering extending a 70km/h speed limit through Paekakariki to the north section of road.

But Dr Lane said he did not accept NZTA's "excuses for stalling'' and said they should have planned for an increase in traffic volumes long ago.

"My stand is really that there's a tremendous volume of traffic that passes through the Kapiti region, I think it's between 22,000 and 25,000 vehicle movements per day along State Highway 1, and the road just can't cope with that volume of traffic.''

Wellington Road Policing manager Inspector Peter Baird said not having a separated highway was a problem all around New Zealand, but he could definitely see the benefit of installing a barrier along the stretch of road north of Paekakariki.

The Wellington roading network was running above capacity, Mr Baird said.

"Because it's heavily congested the odds of you hitting another vehicle coming the other way is certainly of a higher percentage than if you were in one of the more remote locations around New Zealand.''

Police would always support the installation of a median barrier, he said.

Detective Sergeant James McKay said police wanted to hear from anyone who saw last night's crash, or who saw a green Toyota Camry stationwagon around the Paekakariki area just before it.