The St John ambulance service is having to be smarter with its resources as demand for its services grows while Government funding is being constrained and pressure for the fundraising dollar mounts.
That picture was painted by St John chief executive Jaimes Wood at a media day in Auckland lastweek.
Mr Wood told the Chronicle that the organisation's revenue for the 2010-11 financial year totalled $223million with the Government contributing $127million.
He said the shortfall of $96million came from St John commercial activities such as first aid kits, first aid training, medical alarms and defibrillators, fundraising and income from emergency ambulance part charges.
But he said the funding from the Ministry of Health - to provide ambulance services across the country - was less than the norm in countries like Australia and the UK.
"There have been good lifts in funding in the last decade but we're still behind the eight ball."
It means the ambulance operations have to be heavily subsidised from its commercial and charitable activities. St John is a big fundraiser simply because it has to be, but Mr Wood said the organisation faced stiff competition.
As well a separate contract covered the communications centres St John manned in Auckland, Wellington and Christchurch.
"We're in the same tough space as anyone else in health now and we're getting big 'no more money' messages from Government," he said.
"At a time when we're facing volume increases of 4-5 per cent a year, our funding increase last year was just 2.1 per cent.
"We're having to work out how to manage that and it will come about through innovation, collaboration and change of service-delivery models," he said.
But those contracts do not cover the costs of ambulances, other service vehicles, ambulances stations, buildings and equipment or other services St John provides.
Mr Wood said he believed St John and the Government were "in a good space" in terms of understanding the needs of the organisation.
"But health covers a huge area and our services are but one part of it," he said.
