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When there is an unexpected medical crisis, major or minor, we expect a St John ambulance will not be far away.
So it was this week as the tragedy unfurled on Whaakari/White Island and paramedics had to assess the injured and ensure they were safely transported to hospitals.
We rely on St John personnel to be on hand at public events where there may be a risk of injury, to attend road crashes, and to come to our homes if we need urgent medical help.
Their work, while it may often be rewarding, is also difficult and dangerous, and all too frequently nowadays we hear of instances when officers have encountered abuse when they are trying to do their job.
Most of the time, unless we are responding to a fundraising appeal, we may not think too much about how the organisation is funded or how adequate that funding might be. Maybe it is time we paid greater attention. Years of rumbling about the funding for the service are gaining greater urgency.
Following the Christchurch mosques massacre in March, in which St John staff played a vital role in horrific circumstances, the organisation’s management got into hot water with an advertisement calling for donations to help the crews who responded to the Christchurch tragedy. Protests from its angry paramedics resulted in the advertisement being withdrawn.
At the time, one of the mosque first-responder paramedics wrote to the Prime Minister asking for an overhaul of the funding model for ambulance services and expressing concern at the penny-pinching which he considered had been used as an excuse to keep ambulance staff’s pay low.
He was incensed that the ambulance service was run as a
charity with 72% government funding (through ACC and the Ministry of Health) and the shortfall made up by donations and part charges, while other core emergency services, such as the police and Fire Emergency New Zealand, were fully government-funded and regulated.
The service got a one-off boost in funding in this year’s Budget and soothing noises were made by Deputy Prime Minister Winston Peters about how this would relieve immediate pressure and uncertainty while St John and Wellington Free ambulance worked with the Ministry of Health, ACC and District Health Boards on the long-term sustainability of their services.
Wearing his party leader’s hat, Mr Peters has since promised to make it an election issue, NZ First opting for a boost in government support to 90% of costs.
St John chief executive Peter Bradley considers that level of funding will be enough to give a long-term sustainable future for the service.
He says the service cannot continue providing what it does now on the basis of its existing funding. The Budget boost will cover this financial year, but the following one will be difficult.
Cuts would mean slower responses to non-urgent calls, reducing staff numbers by not replacing those who leave, less training provision and fewer people answering calls from the public. Put bluntly, he says it could mean telling people: ‘‘We’ll come to you if you’re dying, or we’ll get there but you’’ll wait longer.’’
Response time statistics show that, in most of the country, people are already waiting longer. In Otago-Southland in 2017-18, 64.6% of incidents were responded to in six minutes, but this fell by almost 7% the following year. Mr Bradley says, at the moment, ambulance services cost about $50 per head of population, compared with double that in Australia. Increasing the government funding as he suggests would translate into $70 a head.
This is an issue which is not going to go away and perhaps election year will provide the impetus for a less piecemeal and more realistic long-term approach than we have seen to date by any government.