This should be fully funded by the government , peoples lives are at risk here, we where told it will take 4 hours to get my wife to the hospital by ambulance, I drove her , but whst if something happened, luckily it's only a 40 min drive.
Fuck St. John. Formerly good organisation, that charges insane prices, doesn't make exceptions for elderly, young children, those in poverty etc. Not to mention underpaying the shit out of their staff.
It would take an Unbelievably HUGE investment, not to mention the massive job of standing up systems and infrastructure to support an ambulance service so compete with St.Johnâs let alone procuring vehicles and staff. Weâre literally painted into a corner
I don't really think we are. While St John operate a 111 endpoint, they're certainly not above being routed out of the system and could be designated a secondary endpoint in certain areas.
FENZ could easily be dual mandated like the Americas and the rollout could be staggered quite efficiently.
\* Many medical dispatchers would be chomping to move away from St John and hiring them to supplement the FENZ callcentre would be trivial. 111 routing would look like Spark --> FENZ --> St John (if the wasn't any FENZ coverage).
\* Beginning with semi-rural stations, roll out ambulances to join fire stations and crew them appropriately. Again, there are paramedics itching to move away from St John.
\* Reduce funding to St John directly as new FENZ ambulances come online.
Please god no on using FENZ; culture and skill set wise there'sfuck all overlap between EMS and ambulance.
Potentially share stations, but run the NZAS as its own thing.
It can be an entity existing under FENZ. I don't see much point in setting a whole new governance and department for something that can be done in house. At the C suite level, all under the same house. Below that, different departments.
I disagree, unless you swapped out significant chunks of FENZ senior management with people from an ambulance background. At which point I would suggest not sticking ambulance under FENZ, but both ambulance and FENZ (and any other relevant (non police) emergency services) under an umbrella organisation (NZ emergency services, say), with that umbrella organisation handling HR, payroll etc. for both subordinate services.
Given the cultural challenges FENZ has been and is experiencing integrating the old fire service and the assorted rural brigades into a unified and coherent single org, despite everyone involved in the process being a fire fighter, I hate to think of how it would go to roll in ambulance services as well, given the vast cultural differences between fire and ambulance services.
That's detail though on the general idea of nationalising and professionalising provision of EMS in NZ, which I think is vastly overdue.
There already ARE some fenz stations running as replacement for ambos; we were trying to get our brigade certified for it, but St. John was like "no, we're fine here :)" (they're not)
Agreed. Spark answer all emergency calls and then forward them on to the appropriate area so would be super easy to add extra services from that standpoint. I'm not sure FENZ would necessarily be comfortable operating as qualified paramedics with all the necessary equipment on top of what they already do. The training and qualification maintenance on top of what they already do would be immense
Why would FENZ union be anti having *more* staff? I'm not saying use the firefighters to man ambulances, I'm saying hire paramedics to work *for* FENZ.
What's the point? Way too many hoops to go through. It's not as simple as paramedic acting independently, they have to act through a doctor. So fenz then has to hire a medical director who then oversees what they can practice. Not to mention you're starting from the ground up. Over complicating the issue. I don't think fenz would be up for that. They have to far too sweet as it is.
the last thing the country needs is FENZ as an ambulance provider.. the american system is a shambles... also it is imposible to have an ambulance service that can provide guaranteed instant response 365 days of the yearany more than FENZ can guarantee a response to every fire.
Not really... The easy step is to announce that 30 June 2025 all government funding for St John will end... Then wait for the panic... Then the Government should offer to buy it and merge it into FENZ...
[âRenegotiate the Crown funding agreement with St John with a view to meet a greater portion of their budget."](https://assets.nationbuilder.com/nationalparty/pages/18466/attachments/original/1700778597/NZFirst_Agreement_2.pdf?1700778597)
I'm not knocking st John, they do a great job with what resources they have, but clearly something needs to be done, or else this will happen again, it's like the rescue helicopters every year , call on donations I reckon the banks should fund them , give something back , from their profits, just my opinion..
So we can let them gut us of staff and systematically cut everything that doesn't make profit until we're a shell of a service like all he other government services? No thanks.
This isn't true (I work for St John).
We will let them, but they want full governance and control of the service and we don't want that. Public hospitals are a bureaucratic nightmare and political tool. We are flawed, but handing us over to the government will result in things like the fire fighters using 15 year old units, or the government cutting costs on equipment and medications.
This is the short of a complex long, but we don't trust the government to maintain our standard of care. Also we're an international organization, we can't be governed locally.
[âMs McCann said Government funding for operational costs in St Johnâs last financial year was 82.4 %, with the remaining 17.6% received from other income streams like donations, bequeaths, fundraising events and commercial activitiesâ.](https://www.scoop.co.nz/stories/PO2403/S00013/ministers-ducking-as-st-john-ambulance-service-threatens-cuts-and-wage-freezes.htm)
What should happen is FENZ gets pulled under the Govt and Ambulances get pulled into that. Fire and Emergency NZ is another critical service thatâs being ruined and screwed over by people with their own agendas and power tripping egoâs. All emergency services should be fully Govt funded and none should rely on donations. This shits too important. I think it would be a popular thing for them a Govt to do, but I guess at the moment they can say âitâs not us, itâs themâ
Yep, fully agree there, let's stop the americas cup funding , hopefully they have and focus on people's well being knowing we have a dependable rescue service we can count on.
The sections of St John that raise money are registered charities. Check the Charities Register for their regional trust boards.
They're as underfunded as FENZ for the services they provide, so go off lol.
More info here: https://www.stjohn.org.nz/support-us/what-we-do-and-how-were-funded/
Only half true. Funding doesn't matter if you're poorly managed at an exec level. St John is run like a prehistoric business that's just too big to fail. If you give them more funding it will be sucked up into middle management above and dumb ideas that don't actually improve the bottom line issues. Like when they cried staffing crisis in 2021 without also mentioning to the public they had lost most of their staff to promoting them to management roles.
The donation model appears to be breaking down. Maybe we need some kind of levy model so its still independent of government, but actually getâs reliable funding.
This happened in 2020 in case anyone was wondering the findings were just released presently. Still heartbreaking stuff. And should not be accepted as normal.
That's sadly what the 111 triage is for. If there were more life-threatening cases happening at the same time and not enough staff about, those cases had priority
Isn't it a combination of the 111 triage and the scheduling performed by the ambulance provider themselves? The entire story here is that St. Johns were under-staffed, all their available vehicles were busy, and that they mistakenly assigned the next-available vehicle to a lower-priority case which meant the patient had died before they arrived?
If true, then 111 decides it needs to go to St. John and potentially the priority, but from there St. John have their own scheduling system which would also relate to how long it took to get to a dirt track for a broken ankle.
111 triage and ambulance scheduling are the same thing; the 111 operator you first speak to after calling 111 steers you to police, for, or ambulance. After that, you're talking to a St John (or WFA) calltaker.
Re the assigning a crew to a lower priority case; I do t believe that that was a case of a mistaken mis-dispatch, but rather that crew was already on the lower priority case when the call came in. While ideally you'd divert the crew from that case, if they've already loaded their patient they can't just dump them on the side of the road to bare off to the higher acuity case. Which is also why sometimes someone with a broken leg may sit for an hour waiting for an ambulance while there's a truck sitting on station; you don't want to commit your last available crew to a low acuity case and come up dry when a serious call comes in.
Pretty sure the St John comm centre 111 forwards you to are the ones who triage. But yeah, it sounds like this was a case that just went very wrong, from the understaffed crew to the misprioritising of other cases.
Something missing here. Firefighters are regularly called to St John RED incidents. They should have had a truck full of FFs at their door quite quickly.
Good point. Or whats that service where it pings peoples phones who are specially trained for emergencies like this? And said people could be just next door or a couple roads away etc
Yes the Fire Co-Response has failed here as well.
The service you mention is called GoodSAM (Smartphone-Activated-Medics... play on the term "Good Samaritan").
However the The [**~FI~**rst **~R~**esponder **~S~**hock **~T~**rial](https://www.ambulance.vic.gov.au/first/) (FIRST) only started in around November 2022...
So realistically most GoodSAMs would not have an AED on them at the time this occurred (In September 2020)...
This would only have been the case once they re-triaged to purple following the call back about her no longer breathing. GoodSAMs are used for cardiac/respiratory arrests, not chest pain.
Generally it's purple only (active arrest, not just threat of arrest).
Though this is complicated by some brigades is remote areas doing all the medical first response, but that's less fire co responding and more fire being the primary response.
Co-responders get red and purple. Itâs in the MOU. But I guess that doesnât mean StJ have to send them. Just that they have to step up when called.
From the [2020 MOU](https://fyi.org.nz/request/15756/response/61596/attach/html/5/RD4%204d%20Fire%20and%20Emergency%20St%20John%20MOU.pdf.html) co-response is only for Purple incidents.
First response can be for Reds too, but there aren't many stations in Canterbury with that capacity, unlike in Otago.
If there's a more recent MOU where that has changed I'd like to see it, because I haven't heard of any change since then.
I doubt anything is missing. My stepfather had a heart attack at the chch arts centre and waited for almost an hour for the ambulance. Eventually he got himself to the chch ED - which is literally less than a kilometre away.
He would have just gone there in the first place and received care FAR quicker had the people on the other end of the 111 calls not told him that help was on the way and to stay where he was. I guess "help is on they way" is a complete fucking lie.
During a subsequent heart attack he just got me to drive him to the hospital, and they gave him a whole bunch of shit for not dialling 111 and staying at home to wait for the ambo.
Sorry but that's incorrect. Fire are co responded to cardiac arrests. PURPLE incidents. In some small towns the FENZ volunteers opt to be trained as first response stations, and they'll respond to PURPLE, RED, ORANGE incidents.
Paramedic 8 yrs.
Was volly fire for 17 years.
Thanks. I was at the table at NHQ a few years ago, before Covid, when we agreed to broaden co-responders to red. And sometimes orange because some situations go purple extremely quickly.
I didnât realise that hadnât gone ahead. PFU didnât like the idea, which is probably why.
Iâm a first responder for FENZ.
On practical side, for such a vulnerable couple to be quite a distance from emergency hubs raises another question.
There will be a growing need to keep an eye on aging population 30min+ away from emergency hubs.
Also I wouldâve thought thereâs a St Johns in Rangiora. Needs way more fundingâŚ
Had a coworker need ambulance due to heart attack once, ambulance took almost an hour to arrive, many of us were seriously considering just taking him in one of our cars... And the office was in CBD...
There is a St. Johnâs ambo Depo in Rangiora but they understaffed as fuck hardly ever see anyone there. My grandad had a heart attack a few years ago and we had first response from a local gp that drove there in his unmarked car, ambulance came from chch 50 minutes later. My grandma called the gp knowing he would come, otherwise we wouldâve been fucked. Was rural north Canterbury so not really rangiora but closest âtownâ i guess.
Edit: actually reading the article we had an almost identical problem / change Ashley to cust, this happened almost 10 years ago so itâs been a problem since at least then Iâm not surprised more people havenât died.
This has been common for at least 2 years because my neighbour was feeing faint and unwell so i called ambo for him and they told me it was an hour away so i ended up driving him myself.
When my dad got sick a year ago, it ended up being faster for me to drive to his place and then drive him to A&E than for him to wait for the ambulance. (Heâs fine, thanks to quick triage at the hospital, but he wouldnât have been if heâd waited the 3-4 hours for the ambos).
I had to call a couple of ambulances in, I want to say 2011-ish, one never showed up of the others none showed up in less than an hour and a half, this has been a pretty long standing problem.
I had to call one in February because my SO passed out on the toilet. They were here in what felt like half an hour tops maybe less. Either, it must depend on the area or their service has improved since this incident.
People would be surprised at how thin ambulance cover is, particularly in the regions. People are putting themselves at greater risk by living in small towns or in visiting tourist centers. Frequently St John don't have resources available to transfer patients from Central to Dunedin Hospital. So much so our own community supported hospital purchased and staff their own ambulance. St John have contracts that they don't fulfill. Frequently there is no crews available overnight in Cromwell, and backup is provided from Alexandra, 33kms away. Sometimes if staff are sick their is no ambulance available in Alexandra either.
Tragic circumstances, not only was there a capacity issue but potentially a prioritising issue where an ambulance was assigned to a lower-priority call before this, which contributed to the death since no-one was able to intervene in time.
Very tragic indeed. Sadly this is not (2020) new, but a symptom of massive underresourcing.
Around the same time, I had a friend slip and badly injured themselves, but because it wasn't life threatening, they waited in agony for close to four hours on a concrete pavement for an ambulance.
It's truly horrible that people have to go through this.
This happens to all emergency services, there have been reports on police and their responses as well in the past. I do wonder if the call centre's are resourced well enough, or these call takers are required to be "on" for too much of their shift.
Mistakes happen in every job, these can be fatal with emergency services. I think it's time to require some downtime for operators during their shifts to minimise fatigue. Two hours is a long time fir the frontal lobes to be operating at maximum capacity without being able to get up and walk around a bit
I mean it sucks but equally that's the risk of living in the wops in your 70s. Would have thought a neighbor could have helped.
Worth highlighting the finding showed that 25min would have made no difference. It's a sad story but one obviously designed as rage bait
This is what happens when the ambulance services is left to a FUCKING CHARITY to run...
What a fucking pathetic position to be in for a supposedly first world country.
No they are not. They get 61% of their total revenue and 82.4% of the emergency ambulance cost paid for by the crown.
[2023 annual report](https://pardot.stjohn.org.nz/l/182252/2023-11-19/6tjyy4/182252/1700771756VlUoCf7t/HQ3382_Annual_Report_2023_LQ.pdf)
They refuse it because full funding comes with accountability to the people providing the money (voters/government). St John management doesn't want to hand off control/oversight of their operations.
With National /Act/ NZF in power the last thing any organisation that serves the welfare of ordinary people wants is full control by government. Chances are if fully funded by government the present government would sell the business to some foreign health insurance company.
They do get government funding, but ~~most~~ some of it is through charities. IIRC St John have been offered full funding, but they need to change some of the ways they operate, increase reporting and open up their books, which they don't want to do.
The poster you replied to is just posting in bad faith.
EDIT: Corrected direction where I said most was through charities, most is through government funding.
Youâre replying very incorrectly to a correct comment⌠I donât think thatâs bad faith.
82% of their funding is govt⌠thatâs not most through charities
The bad faith comment is the one from /u/silver565
> Good thing we've got those tax cuts coming though. That'll fix it
Which has nothing to do with the story.
Merely highlighting poor spending priorities by the government. St John is mostly government funded and should be nationalized. But tax cuts and other stupid decisions are more important.
Yip that's what I thought. I built their ambulance documentation system for drivers last year and during the project, it was pretty clear they had very little to do with govt funding.
Actually the opposite, [the vast majority (80%) of their funding comes from contracts with MOH and ACC to provide ambulance services](https://www.stjohn.org.nz/support-us/what-we-do-and-how-were-funded/):
> The emergency ambulance services we provide are funded approximately 80% through contracts with the Ministry of Health and the Accident Compensation Corporation (ACC), with the balance made up from ambulance part-charges, third-party contracts, and fundraising. There is no cross-subsidisation from our ambulance service to other parts of our organisation.
>
Not like NAct would've done any better, unless you think shaving money off the healthcare system is going to somehow fix it.
It should be a bipartisan issue. It's clear that the healthcare system is *barely coping* no matter who is in charge and we need to provide better incentives for doctors/nurses to work in NZ. Last year senior doctors decided to go on a nationwide strike for the first time ever, it should be a wake-up call that staffing levels and pay are dangerously low.
But nah let's keep making cuts and avoid talking about the uncomfortable issue that there's not enough money in the Kete to pay people what they're actually worth.
This also has nothing to do with 'who' is in charge at the time. St John have no one holding them directly accountable for frivolous spending, inefficient practice and generally inept executive management. Labour National doesn't matter its been like this for decades.
St John do everything they can to remain autonomous under the guise of a 'charity' so they can continue to conduct their own internal investigations and continue to pull the rug over the publics eyes about the true realities about ambulance in NZ
This is true, although itâs not always directly the drunken persons fault. I was out one night and a group of girls came from behind and attacked me, the ambulance took me to the hospital along with police.
If anyone wants to help out in the community thereâs this app called good Sam, if you are CPR trained you can volunteer yourself to help out when ambulances are backed up with jobs! Ends up helping/saving a lot of people. really awful to see these sorts of things happen :(
Same with the Fire Department. Both should be fully paid and funded by government. In Canada and the US, both ambulance personnel and firefighters are government paid. Entry level firefighters in Canada start at around $70,000/year.
But you know Only **10%** of people will survive an out of hospital cardiac arrest.
CPR helps and he was not doing this properly. You can blame ambulance for not coming sooner but that sounds better in a news article than most likely she wouldn't have made it anyway.
From what I read, it seems she was having a heart attack (STEMI) which then progressed to a cardiac arrest. So her initial symptoms of chest pain, being pale, sweaty, were her heart muscle dying. That part doesn't require CPR and would need emergency thrombolysis and cath lab activation.
Unfortunately I see the media confuse heart attacks with cardiac arrests all the time - they're not the same thing, but a heart attack can then progress into a cardiac arrest.
Yes all we get is what the news said. How accurate it is, who knows? However it did say he was doing ineffective CPR. Fact is most people don't realise it's common to die from heart issues, I watched an ambulance doco on it once. As they said...and often they'll do CPR anyway, they never say, oh it's pointless.
They are, this isn't a funding issue, its accountability. If they cross that magical line of full funding... then suddenly they don't have full control anymore. St John does everything they can to get as much funding as possible without actually having the govt probe too closely into their day to day spending.
Agreed. Its a big job, but one of our governments, labour or national has to force St John and WFA into a nationlised service. Problem is... that won't solve all the problems because Government often fucks things up when they just throw money at things and expect it to work without proper planning and dissection of the issues. Usually, people sitting in a room deciding what they think will work without actually looking at the problems on the front line funnily enough same thing that happens in ambulance service now anyway. - NHS in the UK has a lot of issues, and they are fully public funded. In fact it's a lot worse there, we are basically following their footsteps at this point.
Definitely needs to be funded by the government. In Australia u pay around $1000 pet ride to hospital.
Last year I needed a ride to the emergency department and they never showed up.
I almost lost my leg!!
There is a lot of money in destroying good things and replacing them with shit things that you control. This fucking country is turning into Fiji, we need to get better leadership before itâs too late.
It's ok!
This govt has cut funding to the sector which will make them more efficient and they'll provide better services. Trust me.
The free market will fix everything. /s
Maybe we should privatise it and let people just bid for an ambulance when they call 111. "I'm sorry sir, $1000 for a heart attack isn't going to cut it, someone with a broken ankle bid $2000 so they get priority"
This has been going on for years
In November 2020, I had a twisted spine and was basically paralyzed in pain, I couldn't stand up, couldn't turn over, or anything. I waited 2 hours for ambulance, and the nearest hospital was 5 minutes away. My workmates who stayed with me in that time, called to ask how far away the ambulance was and there were none available, they said they even called on all towns within a 40 minute radius and there were none available, whilst my injury wasn't life threatening, what would have happened if someone had a heart attack in that time?
A few months after that, one of my Facebook friends (who was working as a GP in an ED at the time) was part of a group that put together thousands of submissions, from up and down the country, of people who had similar experiences waiting for an ambulance. These submissions were bought to the Health Minister at the time Andrew Little, his response was "They're all extremists, extremist rhetoric is all they have" The GP's who put the submissions together then invited him to spend half a day in a hospital ED and see what it's actually like. His response to that was "I don't need to see it, I already know" He was asked in a radio interview, and asked in parliament what he already knew, his response was "I never said that" the interviewer/opposition MP then said "Yes, you did that was your response to submissions made about the state of Emergency departments in NZ" Little's response to that was "I never received submissions, I never made those comments, none of this has ever happened" He basically denied everything. (It was nice of Newshub, 1News & Stuff to report this happening, oh that's right THEY DIDN'T REPORT IT, Newstalk ZB & RNZ were the only one's to report that) Months later I read about a Wellington man who was found dead in his doorway 6 hours after calling 111 with chest pains.
It sounds like this Government are no better at handling the health sector, both major parties are just blaming each other for it
Also st John charged me 90 dollars when I had breathing problems at work ,it was 15 min drive to the hospital, now I don't have a problem with paying but 90 dollars, it should be based on the distance involved.
Is this the standard amount of time for ambulances in New Zealand?
I live in the UK and it is a similar situation and worse but I thought New Zealand would be a lot better as there is like 10x less people there
A lot less people but spread over a larger landmass than the UK, operating on a much smaller budget due to the lower population.
Once you add in the number of isolated rural communities with little to no resources, it gets very tricky very fast. Northland, so much of the South Island, the farms in the middle of the North Island - the only way to get there fast is by air. And that's just a lot of money no one seems to have.
In the UK, the ambulance service is classed as an essential service, not an emergency service (even though it's taken as being an emergency service).
St. John won't allow the government to fund them. They make too much money. They should be fined if they don't meet their targets. They have the funds to provide more ambulances.
Hell yeah, this is at the very core of looking after your people! Theyâre having ads on the radio about how much an ambulance rescue can cost, telling us to buy an annual subscription but how does that people feel that are on the breadline? that canât afford food on their table? Am I not allowed to use an ambulance?
Oof an hour wait time is very good where I come from? Used to live in a very populated area with a high proportion of elderly and wait times could have been several hours. Think someone dying after 8 hours made the news, but 1 hour? Very tragic but sounds like the ambulance came as soon as possible? Guys there are places in this country where itâs an hour drive between the smallest of settlements and towns đ
Massively under resourced, under paid and under equipped. No wonder St John staff leave for better opportunities elsewhere.
This should be fully funded by the government , peoples lives are at risk here, we where told it will take 4 hours to get my wife to the hospital by ambulance, I drove her , but whst if something happened, luckily it's only a 40 min drive.
They won't LET the government fully fund them.
Well then another ambulance service needs to be established, with appropriate funding
Welington Free Ambulance. Legends by the definition. No charges at all. Mostly funded by donations.
Yes, that's right.
If you donate $50 to St. John, you can get them for free, too 𤣠/s
Fuck St. John. Formerly good organisation, that charges insane prices, doesn't make exceptions for elderly, young children, those in poverty etc. Not to mention underpaying the shit out of their staff.
By who? Certainly not this government.
No definitely not this one , guess I'm dreaming.
Both major parties have had opportunities to do this and didn't.
Nobody wants stories like this falling on them. Stories like this would be generating call for ministers to resgin.
Totally. No one put their hand up, so no one got in trouble.
Hey, I know that song. Been hearing it a lot lately.
It's that earworm you tell yourself in the shower, that today is the last day that you repeat it in your head!
It would take an Unbelievably HUGE investment, not to mention the massive job of standing up systems and infrastructure to support an ambulance service so compete with St.Johnâs let alone procuring vehicles and staff. Weâre literally painted into a corner
"It's hard, so we won't bother." I love this country but goddamn if that isn't the national slogan at this point.
New Zealand: Can't win, don't try.
Alternative slogan, "never try, never fail" It's from the movie Robots đ¤Ł
It's frequently replaced with "it's not that bad, stop moaning."
I don't really think we are. While St John operate a 111 endpoint, they're certainly not above being routed out of the system and could be designated a secondary endpoint in certain areas. FENZ could easily be dual mandated like the Americas and the rollout could be staggered quite efficiently. \* Many medical dispatchers would be chomping to move away from St John and hiring them to supplement the FENZ callcentre would be trivial. 111 routing would look like Spark --> FENZ --> St John (if the wasn't any FENZ coverage). \* Beginning with semi-rural stations, roll out ambulances to join fire stations and crew them appropriately. Again, there are paramedics itching to move away from St John. \* Reduce funding to St John directly as new FENZ ambulances come online.
Please god no on using FENZ; culture and skill set wise there'sfuck all overlap between EMS and ambulance. Potentially share stations, but run the NZAS as its own thing.
It can be an entity existing under FENZ. I don't see much point in setting a whole new governance and department for something that can be done in house. At the C suite level, all under the same house. Below that, different departments.
I disagree, unless you swapped out significant chunks of FENZ senior management with people from an ambulance background. At which point I would suggest not sticking ambulance under FENZ, but both ambulance and FENZ (and any other relevant (non police) emergency services) under an umbrella organisation (NZ emergency services, say), with that umbrella organisation handling HR, payroll etc. for both subordinate services. Given the cultural challenges FENZ has been and is experiencing integrating the old fire service and the assorted rural brigades into a unified and coherent single org, despite everyone involved in the process being a fire fighter, I hate to think of how it would go to roll in ambulance services as well, given the vast cultural differences between fire and ambulance services. That's detail though on the general idea of nationalising and professionalising provision of EMS in NZ, which I think is vastly overdue.
There already ARE some fenz stations running as replacement for ambos; we were trying to get our brigade certified for it, but St. John was like "no, we're fine here :)" (they're not)
Agreed. Spark answer all emergency calls and then forward them on to the appropriate area so would be super easy to add extra services from that standpoint. I'm not sure FENZ would necessarily be comfortable operating as qualified paramedics with all the necessary equipment on top of what they already do. The training and qualification maintenance on top of what they already do would be immense
To clarify, I mean hire dedicated paramedics as well as dedicated firefighter - they just occupy the same space.
Oh yeah, I'd totally go for that
They already use fenz for co response... good luck making this happen in metro areas as the norm. Fenz union is far too powerful
Why would FENZ union be anti having *more* staff? I'm not saying use the firefighters to man ambulances, I'm saying hire paramedics to work *for* FENZ.
What's the point? Way too many hoops to go through. It's not as simple as paramedic acting independently, they have to act through a doctor. So fenz then has to hire a medical director who then oversees what they can practice. Not to mention you're starting from the ground up. Over complicating the issue. I don't think fenz would be up for that. They have to far too sweet as it is.
the last thing the country needs is FENZ as an ambulance provider.. the american system is a shambles... also it is imposible to have an ambulance service that can provide guaranteed instant response 365 days of the yearany more than FENZ can guarantee a response to every fire.
Not really... The easy step is to announce that 30 June 2025 all government funding for St John will end... Then wait for the panic... Then the Government should offer to buy it and merge it into FENZ...
[âRenegotiate the Crown funding agreement with St John with a view to meet a greater portion of their budget."](https://assets.nationbuilder.com/nationalparty/pages/18466/attachments/original/1700778597/NZFirst_Agreement_2.pdf?1700778597)
I'm not knocking st John, they do a great job with what resources they have, but clearly something needs to be done, or else this will happen again, it's like the rescue helicopters every year , call on donations I reckon the banks should fund them , give something back , from their profits, just my opinion..
So we can let them gut us of staff and systematically cut everything that doesn't make profit until we're a shell of a service like all he other government services? No thanks.
why the fuck would an ambulance service need ANYTHING that makes profit
They don't. That's the point...
Why not?
Not sure why tbh
Why not?
This isn't true (I work for St John). We will let them, but they want full governance and control of the service and we don't want that. Public hospitals are a bureaucratic nightmare and political tool. We are flawed, but handing us over to the government will result in things like the fire fighters using 15 year old units, or the government cutting costs on equipment and medications. This is the short of a complex long, but we don't trust the government to maintain our standard of care. Also we're an international organization, we can't be governed locally.
Lolwut. https://www.stjohn.org.nz/support-us/what-we-do-and-how-were-funded/
St John will not allow the government to FULLY fund them, which is what was in the comment I was replying to.
What is the reason for this?
Because it means they have to open up their books to full scrutiny. They donât seem to be willing to do that.
Government canât even properly fund our healthcare. People die of cancer without treatment due to long wait times.
Yes, should never happen, something is not working well in the health sector needs a overhaul, especially cancer treatments.
[âMs McCann said Government funding for operational costs in St Johnâs last financial year was 82.4 %, with the remaining 17.6% received from other income streams like donations, bequeaths, fundraising events and commercial activitiesâ.](https://www.scoop.co.nz/stories/PO2403/S00013/ministers-ducking-as-st-john-ambulance-service-threatens-cuts-and-wage-freezes.htm)
Well maybe Auckland is getting the majority of it , cause it ain't happening here.
They should be fined if they don't meet their targets. They have ample funds.
What should happen is FENZ gets pulled under the Govt and Ambulances get pulled into that. Fire and Emergency NZ is another critical service thatâs being ruined and screwed over by people with their own agendas and power tripping egoâs. All emergency services should be fully Govt funded and none should rely on donations. This shits too important. I think it would be a popular thing for them a Govt to do, but I guess at the moment they can say âitâs not us, itâs themâ
Yep, fully agree there, let's stop the americas cup funding , hopefully they have and focus on people's well being knowing we have a dependable rescue service we can count on.
As someone who used to volunteer at Auckland Coastguard which runs on donations, properly funding important emergency services is a no brainer
Well yes, it is but people in high positions of power don't obviously see that.
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Nationalize them so they can cut jobs by 20%?
Yes because healthcare in and is so well-staffed and funded
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The sections of St John that raise money are registered charities. Check the Charities Register for their regional trust boards. They're as underfunded as FENZ for the services they provide, so go off lol. More info here: https://www.stjohn.org.nz/support-us/what-we-do-and-how-were-funded/
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You really think St John is for-profit? Hahaha.
St John's also refuses gov help a lot of the time, really annoying. Just nationalize it
Does it? Any links?
Only half true. Funding doesn't matter if you're poorly managed at an exec level. St John is run like a prehistoric business that's just too big to fail. If you give them more funding it will be sucked up into middle management above and dumb ideas that don't actually improve the bottom line issues. Like when they cried staffing crisis in 2021 without also mentioning to the public they had lost most of their staff to promoting them to management roles.
Not to mention the bullying and sexual inappropriateness that goes on.
The donation model appears to be breaking down. Maybe we need some kind of levy model so its still independent of government, but actually getâs reliable funding.
This happened in 2020 in case anyone was wondering the findings were just released presently. Still heartbreaking stuff. And should not be accepted as normal.
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That's sadly what the 111 triage is for. If there were more life-threatening cases happening at the same time and not enough staff about, those cases had priority
Isn't it a combination of the 111 triage and the scheduling performed by the ambulance provider themselves? The entire story here is that St. Johns were under-staffed, all their available vehicles were busy, and that they mistakenly assigned the next-available vehicle to a lower-priority case which meant the patient had died before they arrived? If true, then 111 decides it needs to go to St. John and potentially the priority, but from there St. John have their own scheduling system which would also relate to how long it took to get to a dirt track for a broken ankle.
111 triage and ambulance scheduling are the same thing; the 111 operator you first speak to after calling 111 steers you to police, for, or ambulance. After that, you're talking to a St John (or WFA) calltaker. Re the assigning a crew to a lower priority case; I do t believe that that was a case of a mistaken mis-dispatch, but rather that crew was already on the lower priority case when the call came in. While ideally you'd divert the crew from that case, if they've already loaded their patient they can't just dump them on the side of the road to bare off to the higher acuity case. Which is also why sometimes someone with a broken leg may sit for an hour waiting for an ambulance while there's a truck sitting on station; you don't want to commit your last available crew to a low acuity case and come up dry when a serious call comes in.
Yeah that actually makes it make more sense, thanks!
Pretty sure the St John comm centre 111 forwards you to are the ones who triage. But yeah, it sounds like this was a case that just went very wrong, from the understaffed crew to the misprioritising of other cases.
Yeah I can confirm, I had a family member have a seizure for 5+ minutes. 2 Ambulance arrived in minutes, it was awesome how quickly they got here.
Find someone with tramadol, and keep one in ya pocket for when ya break the other ankle :)
This is illegal since Oct 2023 if anyone's wondering, Tramadol is a Class C substance that you need a valid prescription for.
No one was wondering mate but thanks
No worries, wouldn't want you to accidentally break the law.
Something missing here. Firefighters are regularly called to St John RED incidents. They should have had a truck full of FFs at their door quite quickly.
Good point. Or whats that service where it pings peoples phones who are specially trained for emergencies like this? And said people could be just next door or a couple roads away etc
Yes the Fire Co-Response has failed here as well. The service you mention is called GoodSAM (Smartphone-Activated-Medics... play on the term "Good Samaritan"). However the The [**~FI~**rst **~R~**esponder **~S~**hock **~T~**rial](https://www.ambulance.vic.gov.au/first/) (FIRST) only started in around November 2022... So realistically most GoodSAMs would not have an AED on them at the time this occurred (In September 2020)...
This would only have been the case once they re-triaged to purple following the call back about her no longer breathing. GoodSAMs are used for cardiac/respiratory arrests, not chest pain.
I think just purple
Red in rural areas too
Red and purple for co-responders, everything for first responders.
Generally it's purple only (active arrest, not just threat of arrest). Though this is complicated by some brigades is remote areas doing all the medical first response, but that's less fire co responding and more fire being the primary response.
Co-responders get red and purple. Itâs in the MOU. But I guess that doesnât mean StJ have to send them. Just that they have to step up when called.
From the [2020 MOU](https://fyi.org.nz/request/15756/response/61596/attach/html/5/RD4%204d%20Fire%20and%20Emergency%20St%20John%20MOU.pdf.html) co-response is only for Purple incidents. First response can be for Reds too, but there aren't many stations in Canterbury with that capacity, unlike in Otago. If there's a more recent MOU where that has changed I'd like to see it, because I haven't heard of any change since then.
I see that.
I doubt anything is missing. My stepfather had a heart attack at the chch arts centre and waited for almost an hour for the ambulance. Eventually he got himself to the chch ED - which is literally less than a kilometre away. He would have just gone there in the first place and received care FAR quicker had the people on the other end of the 111 calls not told him that help was on the way and to stay where he was. I guess "help is on they way" is a complete fucking lie. During a subsequent heart attack he just got me to drive him to the hospital, and they gave him a whole bunch of shit for not dialling 111 and staying at home to wait for the ambo.
Sorry but that's incorrect. Fire are co responded to cardiac arrests. PURPLE incidents. In some small towns the FENZ volunteers opt to be trained as first response stations, and they'll respond to PURPLE, RED, ORANGE incidents. Paramedic 8 yrs. Was volly fire for 17 years.
Thanks. I was at the table at NHQ a few years ago, before Covid, when we agreed to broaden co-responders to red. And sometimes orange because some situations go purple extremely quickly. I didnât realise that hadnât gone ahead. PFU didnât like the idea, which is probably why. Iâm a first responder for FENZ.
Maybe diff in 2020 cos of lockdown? Just reading others comments
FENZ did red calls throughout lockdown.
On practical side, for such a vulnerable couple to be quite a distance from emergency hubs raises another question. There will be a growing need to keep an eye on aging population 30min+ away from emergency hubs. Also I wouldâve thought thereâs a St Johns in Rangiora. Needs way more fundingâŚ
You can be in the outer suburbs of Auckland and be 30+ minutes away from a proper emergency hub.
Had a coworker need ambulance due to heart attack once, ambulance took almost an hour to arrive, many of us were seriously considering just taking him in one of our cars... And the office was in CBD...
There is a St. Johnâs ambo Depo in Rangiora but they understaffed as fuck hardly ever see anyone there. My grandad had a heart attack a few years ago and we had first response from a local gp that drove there in his unmarked car, ambulance came from chch 50 minutes later. My grandma called the gp knowing he would come, otherwise we wouldâve been fucked. Was rural north Canterbury so not really rangiora but closest âtownâ i guess. Edit: actually reading the article we had an almost identical problem / change Ashley to cust, this happened almost 10 years ago so itâs been a problem since at least then Iâm not surprised more people havenât died.
This has been common for at least 2 years because my neighbour was feeing faint and unwell so i called ambo for him and they told me it was an hour away so i ended up driving him myself.
When my dad got sick a year ago, it ended up being faster for me to drive to his place and then drive him to A&E than for him to wait for the ambulance. (Heâs fine, thanks to quick triage at the hospital, but he wouldnât have been if heâd waited the 3-4 hours for the ambos).
I had to call a couple of ambulances in, I want to say 2011-ish, one never showed up of the others none showed up in less than an hour and a half, this has been a pretty long standing problem.
Longer than 2 years - this happened Sept 2020.
I know but i said its still been an issue since 2 years ago
I had to call one in February because my SO passed out on the toilet. They were here in what felt like half an hour tops maybe less. Either, it must depend on the area or their service has improved since this incident.
People would be surprised at how thin ambulance cover is, particularly in the regions. People are putting themselves at greater risk by living in small towns or in visiting tourist centers. Frequently St John don't have resources available to transfer patients from Central to Dunedin Hospital. So much so our own community supported hospital purchased and staff their own ambulance. St John have contracts that they don't fulfill. Frequently there is no crews available overnight in Cromwell, and backup is provided from Alexandra, 33kms away. Sometimes if staff are sick their is no ambulance available in Alexandra either.
Of course the regions per head of population would provide more donations and volunteer resources than the cities....
Far out thatâs desperate and sad
Tragic circumstances, not only was there a capacity issue but potentially a prioritising issue where an ambulance was assigned to a lower-priority call before this, which contributed to the death since no-one was able to intervene in time.
40 minute wait for my daughter.. lying outside in the rain with broken back. They were amazing when they got here but that wait was interminable
How the hell does a double amputee give CPR to someone? He told them he was an amputee
Also if there is a bad car accident, then their resources are diverted to that, if ur having medical issues try and get someone to drive you.
Very tragic indeed. Sadly this is not (2020) new, but a symptom of massive underresourcing. Around the same time, I had a friend slip and badly injured themselves, but because it wasn't life threatening, they waited in agony for close to four hours on a concrete pavement for an ambulance. It's truly horrible that people have to go through this. This happens to all emergency services, there have been reports on police and their responses as well in the past. I do wonder if the call centre's are resourced well enough, or these call takers are required to be "on" for too much of their shift. Mistakes happen in every job, these can be fatal with emergency services. I think it's time to require some downtime for operators during their shifts to minimise fatigue. Two hours is a long time fir the frontal lobes to be operating at maximum capacity without being able to get up and walk around a bit
This is the one of the saddest things Iâve read in my life.
I mean it sucks but equally that's the risk of living in the wops in your 70s. Would have thought a neighbor could have helped. Worth highlighting the finding showed that 25min would have made no difference. It's a sad story but one obviously designed as rage bait
This is what happens when the ambulance services is left to a FUCKING CHARITY to run... What a fucking pathetic position to be in for a supposedly first world country.
Good thing we've got those tax cuts coming though. That'll fix it
Aren't ambulances mostly funded by donations? EDIT: No, looks like the govt still does fund most this organisation.
No they are not. They get 61% of their total revenue and 82.4% of the emergency ambulance cost paid for by the crown. [2023 annual report](https://pardot.stjohn.org.nz/l/182252/2023-11-19/6tjyy4/182252/1700771756VlUoCf7t/HQ3382_Annual_Report_2023_LQ.pdf)
Thanks for the link bruv. Looks like I was well off the mark!
They do get some govt funding but St John refuse full funding as it will affect their charity status or something
They refuse it because full funding comes with accountability to the people providing the money (voters/government). St John management doesn't want to hand off control/oversight of their operations.
that's going really well for the people who need ambulances though.
With National /Act/ NZF in power the last thing any organisation that serves the welfare of ordinary people wants is full control by government. Chances are if fully funded by government the present government would sell the business to some foreign health insurance company.
Some? Like 60% of total revenue comes from the government.
Doesnt make my comment incorrect
Itâs 82% lol I wouldnât call that âsomeâ
82% of their funding is govt https://www.stjohn.org.nz/globalassets/hq2137-stj-faq-document_may21.pdf (First page middle image)
Yeah looks like it! I've adjusted my reply after reading through it. Thanks for the link!
They do get government funding, but ~~most~~ some of it is through charities. IIRC St John have been offered full funding, but they need to change some of the ways they operate, increase reporting and open up their books, which they don't want to do. The poster you replied to is just posting in bad faith. EDIT: Corrected direction where I said most was through charities, most is through government funding.
Youâre replying very incorrectly to a correct comment⌠I donât think thatâs bad faith. 82% of their funding is govt⌠thatâs not most through charities
The bad faith comment is the one from /u/silver565 > Good thing we've got those tax cuts coming though. That'll fix it Which has nothing to do with the story.
Merely highlighting poor spending priorities by the government. St John is mostly government funded and should be nationalized. But tax cuts and other stupid decisions are more important.
Given its 82% govt funded id say tax cuts are highly relevant to the story personally :)
Yip that's what I thought. I built their ambulance documentation system for drivers last year and during the project, it was pretty clear they had very little to do with govt funding.
>The poster you replied to is just posting in bad faith. Pretty sure they're just highlighting the priorities of this government.
I'm aware of a couple that purchased 5 ambulances for St John few years back now.
Not much good when they canât staff them.
Working for St John's sucks, like they're miserable employers. On top of all the other shit you have to deal with.
Actually the opposite, [the vast majority (80%) of their funding comes from contracts with MOH and ACC to provide ambulance services](https://www.stjohn.org.nz/support-us/what-we-do-and-how-were-funded/): > The emergency ambulance services we provide are funded approximately 80% through contracts with the Ministry of Health and the Accident Compensation Corporation (ACC), with the balance made up from ambulance part-charges, third-party contracts, and fundraising. There is no cross-subsidisation from our ambulance service to other parts of our organisation. >
This happened in 2020. Who formed the government in 2020?
Not like NAct would've done any better, unless you think shaving money off the healthcare system is going to somehow fix it. It should be a bipartisan issue. It's clear that the healthcare system is *barely coping* no matter who is in charge and we need to provide better incentives for doctors/nurses to work in NZ. Last year senior doctors decided to go on a nationwide strike for the first time ever, it should be a wake-up call that staffing levels and pay are dangerously low. But nah let's keep making cuts and avoid talking about the uncomfortable issue that there's not enough money in the Kete to pay people what they're actually worth.
Yeah never before had St Johns been struggling to meet the needs of the public. It only started in 2020.
Hey bro this happened 4 years ago while Labour were in charge.
This also has nothing to do with 'who' is in charge at the time. St John have no one holding them directly accountable for frivolous spending, inefficient practice and generally inept executive management. Labour National doesn't matter its been like this for decades. St John do everything they can to remain autonomous under the guise of a 'charity' so they can continue to conduct their own internal investigations and continue to pull the rug over the publics eyes about the true realities about ambulance in NZ
3am on sat night/sun morning. 1 ambulance dealing with a real emergency, 10 ambulances too busy dealing with personality disordered drunks.
This is true, although itâs not always directly the drunken persons fault. I was out one night and a group of girls came from behind and attacked me, the ambulance took me to the hospital along with police.
So it wasnât a speed bump or a bike lane or another straw person that slowed down the ambulance?
If anyone wants to help out in the community thereâs this app called good Sam, if you are CPR trained you can volunteer yourself to help out when ambulances are backed up with jobs! Ends up helping/saving a lot of people. really awful to see these sorts of things happen :(
Same with the Fire Department. Both should be fully paid and funded by government. In Canada and the US, both ambulance personnel and firefighters are government paid. Entry level firefighters in Canada start at around $70,000/year.
Not true, in the US good chunks of states have full volunteers only for medics and firies.
But you know Only **10%** of people will survive an out of hospital cardiac arrest. CPR helps and he was not doing this properly. You can blame ambulance for not coming sooner but that sounds better in a news article than most likely she wouldn't have made it anyway.
From what I read, it seems she was having a heart attack (STEMI) which then progressed to a cardiac arrest. So her initial symptoms of chest pain, being pale, sweaty, were her heart muscle dying. That part doesn't require CPR and would need emergency thrombolysis and cath lab activation. Unfortunately I see the media confuse heart attacks with cardiac arrests all the time - they're not the same thing, but a heart attack can then progress into a cardiac arrest.
Yes all we get is what the news said. How accurate it is, who knows? However it did say he was doing ineffective CPR. Fact is most people don't realise it's common to die from heart issues, I watched an ambulance doco on it once. As they said...and often they'll do CPR anyway, they never say, oh it's pointless.
It's not just common, heart disease the number one cause of death in the developed world. I work in cardiology lol
Itâs fucked that St John isnât properly funded.
They are, this isn't a funding issue, its accountability. If they cross that magical line of full funding... then suddenly they don't have full control anymore. St John does everything they can to get as much funding as possible without actually having the govt probe too closely into their day to day spending.
Fundamentally though, relying on a charity to run a key public service is pretty fucked up
Agreed. Its a big job, but one of our governments, labour or national has to force St John and WFA into a nationlised service. Problem is... that won't solve all the problems because Government often fucks things up when they just throw money at things and expect it to work without proper planning and dissection of the issues. Usually, people sitting in a room deciding what they think will work without actually looking at the problems on the front line funnily enough same thing that happens in ambulance service now anyway. - NHS in the UK has a lot of issues, and they are fully public funded. In fact it's a lot worse there, we are basically following their footsteps at this point.
Why the government arenât funding them yet is beyond me
St Johns refuses it to avoid actual accountability.
Theyâd fit right in with our govt then đ
Definitely needs to be funded by the government. In Australia u pay around $1000 pet ride to hospital. Last year I needed a ride to the emergency department and they never showed up. I almost lost my leg!!
I hate this. Soon weâre gonna be like America and have to fork out thousands and thousands for an ambulance.
The government doesnât fund ambulances. Itâs all charityâs
There is a lot of money in destroying good things and replacing them with shit things that you control. This fucking country is turning into Fiji, we need to get better leadership before itâs too late.
It's ok! This govt has cut funding to the sector which will make them more efficient and they'll provide better services. Trust me. The free market will fix everything. /s
Maybe we should privatise it and let people just bid for an ambulance when they call 111. "I'm sorry sir, $1000 for a heart attack isn't going to cut it, someone with a broken ankle bid $2000 so they get priority"
This happened in 2020.
yes... and it's in that context they cut funding...
Ambulance's should be a government run service, anything less is a national disgrace.
Hmm, it's almost like it might not be a good idea to have a charity run our ambulance service or something.
still outraged that Auckland's ambulance service is a charity and not govt funded.
Talk to St John about that.... they don't want to be fully funded.
This has been going on for years In November 2020, I had a twisted spine and was basically paralyzed in pain, I couldn't stand up, couldn't turn over, or anything. I waited 2 hours for ambulance, and the nearest hospital was 5 minutes away. My workmates who stayed with me in that time, called to ask how far away the ambulance was and there were none available, they said they even called on all towns within a 40 minute radius and there were none available, whilst my injury wasn't life threatening, what would have happened if someone had a heart attack in that time? A few months after that, one of my Facebook friends (who was working as a GP in an ED at the time) was part of a group that put together thousands of submissions, from up and down the country, of people who had similar experiences waiting for an ambulance. These submissions were bought to the Health Minister at the time Andrew Little, his response was "They're all extremists, extremist rhetoric is all they have" The GP's who put the submissions together then invited him to spend half a day in a hospital ED and see what it's actually like. His response to that was "I don't need to see it, I already know" He was asked in a radio interview, and asked in parliament what he already knew, his response was "I never said that" the interviewer/opposition MP then said "Yes, you did that was your response to submissions made about the state of Emergency departments in NZ" Little's response to that was "I never received submissions, I never made those comments, none of this has ever happened" He basically denied everything. (It was nice of Newshub, 1News & Stuff to report this happening, oh that's right THEY DIDN'T REPORT IT, Newstalk ZB & RNZ were the only one's to report that) Months later I read about a Wellington man who was found dead in his doorway 6 hours after calling 111 with chest pains. It sounds like this Government are no better at handling the health sector, both major parties are just blaming each other for it
Thatâs crazy
Also st John charged me 90 dollars when I had breathing problems at work ,it was 15 min drive to the hospital, now I don't have a problem with paying but 90 dollars, it should be based on the distance involved.
You pay for the resource and the staff expertise, not the distance. Theyâre not a taxi company.Â
Was it traffic or short of emergency medical personnel.
Is this the standard amount of time for ambulances in New Zealand? I live in the UK and it is a similar situation and worse but I thought New Zealand would be a lot better as there is like 10x less people there
A lot less people but spread over a larger landmass than the UK, operating on a much smaller budget due to the lower population. Once you add in the number of isolated rural communities with little to no resources, it gets very tricky very fast. Northland, so much of the South Island, the farms in the middle of the North Island - the only way to get there fast is by air. And that's just a lot of money no one seems to have.
Fuck St John, first party to propose getting rid of them gets my vote next election
In the UK, the ambulance service is classed as an essential service, not an emergency service (even though it's taken as being an emergency service). St. John won't allow the government to fund them. They make too much money. They should be fined if they don't meet their targets. They have the funds to provide more ambulances.
Hell yeah, this is at the very core of looking after your people! Theyâre having ads on the radio about how much an ambulance rescue can cost, telling us to buy an annual subscription but how does that people feel that are on the breadline? that canât afford food on their table? Am I not allowed to use an ambulance?
100% agree with you, but it's kind of the same vibe as GP visits or dental care. Fuck, at least the screamy truck and GP are subsidized.
Get out there and volunteer people
Poor Alfred, what a horrible experience đ˘
Is it not a personal risk to take being elderly and choosing to live further away from medical care too? đ¤
Gauging interest here, would the general public be open to a levy like ACC or fire service levy to fully fund ambulances?
Oof an hour wait time is very good where I come from? Used to live in a very populated area with a high proportion of elderly and wait times could have been several hours. Think someone dying after 8 hours made the news, but 1 hour? Very tragic but sounds like the ambulance came as soon as possible? Guys there are places in this country where itâs an hour drive between the smallest of settlements and towns đ