We have a very good ambulance service, provided largely by volunteers and partly financed by charges to those who are taken to hospital in emergencies. It is a classic "public-private partnership" on both counts, but it is coming under stress.

The Weekend Herald yesterday disclosed that the St John service has told the Government it will not continue sending single-crewed ambulances to emergencies, which it is having to do in some parts of the country. The harrowing account of the death of a diabetic woman in an ambulance called to her home in Kaitangata, South Otago, illustrates a risk that should not exist anywhere in a well-off country.

If the ambulance driver had been accompanied by a second medic, the woman might have survived. She could at least have been carried to the ambulance without the mishaps that occurred as the driver and her daughter struggled to get her there. She needed breathing assistance and collapsed unconscious on her way to the ambulance. The driver might have kept her alive in the vehicle and waited for help from the fire service but decided to try to get her to Balclutha hospital 13kms away without delay. On a cold, winters night in the country, nobody should have to make these decisions alone.

Today we report a proposal from St John to the Government for an increase in patient charges and public funding that should put an end to single-crewing. To do that on patient charges alone would increase the present charge of $88 for non-ACC call outs to $150, but St John is proposing an increase to only $98 and wants the Government to increase its 70 per cent contribution to St John's costs. That is surely what will happen.


Many would say a charge to patients of nearly $100 is too much, though it pales by comparison to the $700-$800 that uninsured Australians can be charged for an emergency dash to hospital. Ambulance services are not quite primary care, which carries a charge in New Zealand, and not quite the free hospital care we expect. But they seem more akin to the hospital than the general practice clinic. They are normally racing to an A and E unit.

St John's chief executive, Peter Bradley, has told the Ministry of Health and the ACC that it will cease dispatching ambulances without at least two crew after the current financial year. An ambulance with a single crew is unsafe, he says, and an unsafe ambulance is not an ambulance.

His logic is irrefutable. Single crew responses have been declining for many years but they should no longer be happening at all. The Government needs to respond this time. It is an emergency.

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