Ryall rules out big changes

Health Minister Tony Ryall promises to act to improve ambulances - but has ruled out a radical change to a state-run service or a single provider.

The National Ambulance Sector Office was established by the Government last September in response to a critical Parliament select committee inquiry into ambulances.

In a consultation document, the office said there had never been a cohesive national approach to emergency services. It blamed a lack of leadership from the Government.

As a result, service has been variable - a trend confirmed by today's Weekend Herald front-page story on slow response times - relying on volunteer goodwill and the sector's best endeavours to meet quality requirements.

Unlike most other Commonwealth countries, there is no legislation in New Zealand to regulate ambulance services to a national standard.

Mr Ryall has received a draft report from the office and expects to make those recommendations public in the next two months.

An office discussion document says some "far-reaching" recommendations such as the establishment of a Government-run ambulance organisation, a sole provider, or amalgamation with the Fire Service have merit.

Mr Ryall has ruled out all three options but wants better co-ordination between the four different organisations.

St John covers nearly 90 per cent of New Zealand ambulance services; the rest are provided by Wellington Free Ambulance and the Wairarapa and Taranaki DHBs.

"Clearly there needs to be greater leadership. One of the frustrations I pick up is: 'What is the future?'

"Our focus is on what improvements can we specifically fund and deliver to improve ambulance services."

He listed rural access, double crewing, training of volunteers and the need for highly trained paramedics on ambulances.

The previous Labour Government had set aside an extra $10 million in ambulance funding for each of the next five years.

Mr Ryall confirmed to the Weekend Herald the National-led Government would maintain that level of funding - but there were no promises about more money. Despite his ruling out a single-provider, documents obtained under the Official Information Act show that St John wants to be the lead agency in controlling ambulance services.

"St John does not believe that nationalising the ambulance service or integrating with the Fire Service is in the best interest of New Zealanders," said its submission released under the Official Information Act.

"We do recommend the single provider approach to providing sector leadership, and given its current position, capability and performance, St John is best placed to fulfil this role."

St John chief executive Jaimes Wood welcomed the Government's commitment to the extra $10 million each year.

But he said St John - a charitable organisation that relied on donations - faced a shortfall of $10 million each year. Successive Governments had conducted numerous reviews of the ambulance sector for many years.

"They've been kicking for touch. It is time someone made a decision."

Craig Page, a former paramedic who represents ambulance staff in the National Distribution Union, said the main priority should be double-crewing of every ambulance.

"Clearly we cannot deliver effective and safe pre-hospital emergency care when there is only one person in an ambulance."

Mr Page likened Mr Ryall's call for co-operation across the four fragmented ambulance operators to "putting a sticking plaster on an arterial haemorrhage".