A woman is appalled it took three emergency calls to get help for an Auckland student writhing in pain at her inner-city campus - less than a kilometre away from the ambulance station.
During the second call, the caller was told by a Christchurch-based operator to phone a non-urgent 0800 number, which St John Ambulance service admits should not have happened.
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A student and staff members at Auckland's Whitireia Community Polytechnic campus are considering laying complaints over the case.
The drama unfolded when IT student Laurie Williams, 22, found a young Chinese woman writhing on a campus toilet floor in Queen St last week. She is believed to have been suffering ovarian pain.
The woman's friend had already dialled 111, but because both had limited English they passed the phone to her.
"They [the ambulance operator] basically asked things like what was her name and where she was born and eventually after 10 minutes they agreed they would come and get her ... they said go and wait outside," Miss Williams said.
But she said an operator called back saying they were "really busy" and asked if she could further consult with the ill woman over the phone. "The problem was she was in and out of consciousness and wasn't really capable."
Miss Williams said she was told by the operator that a nurse would call for a further assessment. She says no one called back.
A handful of staff members soon arrived in the bathroom, including student counsellor Diana Fergusson.
She also called 111 but said an operator demanded the student's vital details before she was able to send a vehicle, leaving the woman in continuing agony as they went through school records to find her information.
"I had a bad reception from the woman and she wasn't going to call the ambulance either, she was very rude," she said.
"I said 'What the heck? Seriously? You're not going to send an ambulance? This girl is going in and out of consciousness'. But in the end she said to me 'I can't help you I'm in Christchurch' and I said 'You've got to be joking'."
After calling the 0800 number, which is listed as a "non-urgent" phone number on the St John website, an ambulance arrived within 10 minutes and took the woman to Auckland Hospital.
St John spokesman Robbie Walker said the first call at 3.31pm was "correctly triaged as suitable for a further telephone assessment".
He said St John set targets for phone assessments of patients within 30 minutes and this was met.
"When we triaged a higher priority response the attendance time is eight minutes and this was met."
The second 111 call was answered at its Christchurch Clinical Control Centre with the operator giving the 0800 number. An ambulance arrived at 3.54pm.
Mr Walker admitted referring callers to the toll-free number was not "regular process", but he said the initial operator wasn't told the victim was unconscious.
"What should have happened is we should have linked the jobs and updated the caller on the process instead of giving another number."
Ms Fergusson said the response was "atrocious" and staff were not equipped to deal with the situation and needed a paramedic sooner.
In late 2012, St John announced sweeping changes, which meant ambulances were no longer sent to minor 111 calls, to help stem its $15 million-a-year loss. Instead, such calls were redirected to a GP or other health care, or a St John officer would be sent in a car - rather than an ambulance with two crew members.
Another change to reduce the workload for ambulance officers was in the way 111 calls were handled.
Earlier this year an internal report aimed at improving ambulance service found St John was failing to get to emergency callouts in Auckland and some rural areas inside the time limits set for it.
First emergency call for a severely-ill woman at Whitireia Community Polytechnic by her friend, and the phone given to passerby Laurie Williams.
Second emergency call - a polytech staff member is told to call an 0800 number for help.
The staff member calls 0800 number for ambulance.
Read David Fisher's interview with St John chief executive Peter Bradley at tinyurl.com/stjohnboss