Frontline St John ambulance staff say the organisation is broken and on life support Photo: Davina Zimmer
Some St John ambulance staff have voted to strike again this month after rejecting their latest pay offer. They say they're at breaking point
"111, what is your emergency?"
The emergency is St John.
Frontline staff have told The Detail it's broken and on life-support - underfunded, understaffed, and overstressed.
And now First Union members have voted to strike again, on 27 September, after rejecting the latest offer from Hato Hone St John.
Staff say it's a last resort but they are facing dangerous situations and fear a colleague will be killed on the job.
"That's my worst fear," said emergency medical technician Tom Bannan, who has worked for Hato Hone St John for 35 years. "I've seen it happen in Australia... and it's only a matter of time before it happens here. I have never wanted to say that but now... I think so."
He says they desperately need more funding and support.
While St John can be the difference between life and death for patients, the Government only funds it to about 83 percent. The rest is made up of donations, fundraising and patient co-payments.
"It's sad, I see my colleagues, they are really frustrated by the funding, we heard about the promises the coalition government promised us... but nothing. We need 100 percent funding, and we need it now. We may have to strike again."
Burnout, he says, is rife.
"In 2022, there were 300 to 400 peer support recommendations for staff to talk to someone; today, there are more than 1000. That's huge.
"Young staff are heading to Australia, where they can earn 23 percent more. In the past six months we have had six people leave our station alone. We need to retain staff. We need more staff.
"We are broken."
Earlier this month, Auckland councillor and Northland farmer Chris Darby came to the rescue of a lost ambulance, which was looking for a stroke patient on a remote beach. It was a code red incident.
The two-wheel drive ambulance had been given the wrong directions, so Darby guided them over 2km of unmaintained council road to within 600m of the patient.
He said it could have been avoided if rural first responders had been contacted.
"It took them about an hour and a quarter to get to where I was," Darby told The Detail. "The real problem here is we have rural fire services - and within these are very well trained first responders and the protocol is they are notified when it is code red, and orange, and they can respond.
"But for months now they haven't been getting calls from St John dispatch, there seems to be a problem.
"Patients are waiting 90 minutes for care instead of 10 minutes. That's the difference between life and death.
"Talking to first responders up in Northland, they are really concerned they will not get a callout, and somebody will die. They are very, very concerned."
He says the problem doesn't lie with frontline staff but with top-tier management.
"I think there is a culture problem at St John. Maybe a minister needs to say, 'I am going to call for a review of this service, I am going to look independently, I am going to take an external look at this organisation, see what's wrong with it'."
In response, St John sent us a statement which included the following -
Funding and assurance
Hato Hone St John takes the management of Crown funding very seriously and is held accountable through a number of stringent reporting measures. Our primary accountability lies in the quarterly performance meetings between Hato Hone St John and our purchasers, during which we provide detailed reporting on 26 lead measures and 49 supplementary measures related to our operations - and include how quickly we respond to patients.
Importantly, the funding we receive for the ambulance service is ring-fenced, meaning it is strictly allocated for purposes outlined in our contractual agreement with the Crown. We are held fully accountable for every cent spent, and the Crown may request that ring-fenced funding is repaid if we do not spend it on its intended purpose.
Rural response
Delivering emergency and unplanned healthcare in rural and remote environments poses a number of challenges for our people that are not present in an urban setting. These challenges include the physical distance our team need to travel to respond to patients, the variable coverage of mobile and radio networks, access to backup from other ambulance personnel and allied emergency services when necessary and accessing tertiary medical facilities (especially when helicopter support is unavailable). We are grateful for the amazing mahi our people do in these challenging environments.
Hato Hone St John focuses its rural resources in areas of higher population, and where historic workload data indicates communities have the most need. Over the past two years, we have been pleased to introduce additional paid staff and ambulances into several rural communities. We have also introduced several roaming resources which start in provincial hubs and move into rural areas to provide additional cover (including the Northland, Lakes District and South Canterbury).
One of the challenges with ambulance resourcing is that people do not call 111 in a predictable pattern - by time of day, location, or day of week. This means that a rural community may have an assigned paid paramedic ambulance which is on station and available to respond the majority of the time, however when it does respond to an incident, it may need to leave the area for several hours while it responds to the incident and transports the patient to hospital. If we receive a second call for help while the ambulance is out of town, we are then reliant on local first responders or Fire and Emergency New Zealand to provide an initial response, while a helicopter or road ambulance is sent from further afield. We acknowledge this can create response delays and sometimes frustrations in the community and are in active discussion with Health New Zealand around how we can improve the rural response framework over the coming years.
Ambulance staffing
We currently have a national vacancy of 6.2 percent, with 1815 frontline ambulance personnel in place. This is 100 more frontline personnel than the same time last year, and 270 more than two years ago.
Recent Northland incident
We are aware of the recent incident in Northland where a member of the public was asked by an ambulance crew to help locate the patient. The patient was at a remote beach and our team found it challenging to locate them, a challenge made worse by unnamed and unpaved roads. We are grateful for the public's help in locating the scene.
The local Fire and Emergency first response unit was not requested to respond, and it should have been. We apologise for this and are working through an internal process to determine why this did not occur. Had this happened we agree the local knowledge from our FENZ partners would have helped us locate the scene quicker.
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