However, Wanaka's two paid St John ambulance staff have found a "short-term fix" to maintain 24-hour local cover.
Wanaka operation team manager Don McMillan and paramedic Rod Walker, who between them cover the day-shift hours from 6am to 6pm seven days a week, will take a pager home and be on call for those nights where there is a shortage of volunteers.
Normally, the night-shift is covered solely by volunteers.
Mr McMillan told the Otago Daily Times yesterday he and Mr Walker might have to cover up to two or three night-shifts per week for a year.
And it could mean they sometimes end up either working or being on call for periods of 24 hours including nights with "at least one or two" calls.
"It solves a short-term problem but the long-term problem is that the ambulance service is grossly underfunded."
Mr McMillan said the choices were for himself and Mr Walker to cover the night shift, or have no service and "wait for Cromwell to come up".
But Cromwell was also a largely volunteer service "so the acid goes on them".
"I don't mind doing it [being on call] and Rod doesn't mind.
"We are looking after our own community and rather than see the community go without anything, we are prepared to do it."
He considered Wanaka was at a tipping point where population growth warranted four, rather than two, full-time staff.
The number of emergency callouts was growing 5% to 10% each year, and in a "quiet month" there could be 60.
Mr McMillan said figures for the newly configured Southland region showed Wanaka had more emergency callouts than Queenstown - where there are eight paid staff - and was behind only Invercargill and Gore.
While Wanaka had close to a full complement of volunteers, Mr McMillan said it was the volunteers' availability that was the problem.
"We put a text around and say 'anyone available for tonight and tomorrow night?' and if nobody puts their hand up, what do you do?"
Mr McMillan said it was "the reality" of operating a volunteer service where a lot of employers did not like their employees doing an ambulance night shift before coming to work.
"That's very understandable considering you can be up all night, although it's not common here.
"There are probably three or four or five nights a month where the guys will get less than two hours [sleep] a night."
Mr McMillan questioned whether the volunteer system was still appropriate for New Zealand.
He said Wanaka volunteers gave more than 300 hours of their time every week and every volunteer station in the country probably did that much or more.
He believed the solution was more government-funded permanent staff.
Asked if having a Cromwell ambulance cover Wanaka was a satisfactory arrangement, St John Southland Lakes District operations manager Pauline Buchanan said there were times when "we request on-call ambulance officers to work and there are times when ambulance officers from other towns such as Cromwell will assist to ensure we have the optimum cover for the Wanaka area".
"Staffing levels in all areas, including Wanaka, are constantly reviewed to ensure we are providing the best possible service."
Ms Buchanan said St John would welcome any inquiries from members of the public interested in volunteering.
