Hato Hone St John ambulance officers have begun the first of two strikes this week amid concerns over their pay and funding for the service overall. 1News explains how this emergency lifeline is financed and supported.
It might surprise some New Zealanders to learn the country’s ambulance services are not fully funded by the Government.
Despite often being the difference between life and death for patients, New Zealand’s ambulances still rely on donations, fundraising and patient co-payments to help keep the lights on.
It’s an issue that has been raised many times before but has come to a head once again with more than 2500 ambulance officers voting to withdraw their labour for four hours today and again on Saturday (August 24).
So, how did we get here?
Funding shortfalls
While the police are fully funded by the Government, and Fire and Emergency is funded almost entirely through levies on insurance policies, the Government only funds around 83% of Hato Hone St John’s costs through Health NZ and ACC.
The service relies on donations, fundraising and patient part charges to make up the funding shortfall.
Hato Hone St John says the cost of a typical emergency call-out is approximately $934. People who are treated by a St John ambulance officer or transported in an ambulance for a medical emergency may have to pay $98 towards that call-out. The cost is usually covered by ACC if it’s an accident-related injury.
St John staff are taking industrial action as ongoing negotiations for better pay hit another stalemate. (Source: 1News)
Hato Hone St John covers ambulance services everywhere in New Zealand except Wellington, Hutt Valley and Wairarapa, which are covered by Wellington Free Ambulance.
Wellington Free Ambulance also receives most of its funding from the Government but relies on around $8 million in fundraising each year to keep its own services free.
A coalition promise
There have been calls for New Zealand to switch to a fully funded ambulance service for some time.
Although it didn’t go as far as promising a fully funded model, New Zealand First did pledge to fund 95% of St John’s costs in its pre-election manifesto last year.
The party managed to get a vaguer funding figure in its coalition agreement with National, with a promise to “renegotiate the Crown funding agreement with St John with a view to meeting a greater portion of their annualised budget”.
In announcing this week’s strike action, FIRST Union and the New Zealand Ambulance Association (NZAA) said the coalition funding promise had failed to eventuate.
“The strike vote comes in the absence of any pay rise offer above 0% per hour from Hato Hone St John or confirmation from the Government that funding to the partially charity-funded service will finally be increased after failed coalition promises and a ‘shameful’ silence from Shane Reti, the responsible Minister,” they said.
1News asked Health Minister Reti for comment on the issue yesterday. His office immediately passed the issue on to Associate Health Minister Casey Costello.
Costello said the Government’s key role was around the funding of ambulance services and that they had received “significant extra investment recently”.
“The strike action relates to bargaining between the union and St John as the employer, however Health NZ and ACC are working with Hato Hone St John in order to minimise disruption to ambulance services and ensure that essential services remain available,” she said.
“The joint contract that Health NZ and ACC have with St John and Wellington Free Ambulance currently provides $384 million a year in total and over the past two years they’ve received $148 million extra - nearly a third more.
“The Government contract with the emergency road ambulance providers runs from 2022 to 2026 and adjusts for inflation each year.
“Hato Hone St John has been informed of its funding uplift for 2024/25 and I’ll announce this increase as soon as it is finalised.”
Budget documents earlier this year showed the estimated additional support funding for emergency road ambulance services was static through to 2027/28.
A truth 'somewhere in the middle'
Speaking to Breakfast, emergency medical technician Tom Bannan said in his 36 years of working at St John, he has not seen it “in more dire straits” than what it is in now. (Source: 1News)
Back in May, Prime Minister Christopher Luxon said that Hato Hone St John did not want 100% funding, which was a surprise to union members.
At the time, FIRST Union national coordinator for ambulance services Faye McCann said Luxon’s comments were “shocking”.
"It was really shocking to hear the Prime Minister claim that St John don’t actually want any more money from Government when we’ve been sitting at the bargaining table with them since December last year and have been repeatedly told that a wage freeze is in place because Government funding isn’t sufficient for ambulance officers to receive any pay increase," she said.
Emergency medical technician Tom Bannan told Breakfast in May paramedics didn’t know what to believe.
"We feel undervalued, we always seem to be fighting for more, even just to get the basics. Don’t get me wrong, St John has some really good ideas but to push those forward, we need the Government to step up and come up with some funding,” he said.
"We get told St John has asked for 100% [funding]. The Government says, ‘no, they haven’t’. Somewhere in the middle of the murky water is the truth but we don’t know exactly what that is.”
Hato Hone St John said yesterday it had been working with Health NZ and ACC to secure additional funding to resolve outstanding bargaining claims.
It said it supported the ambulance workforce’s calls for a pay rise “within reasonable market movement, but the unions’ ask is greater than the available funding”.
Two frontline ambulance officers also claim the organisation is in a hiring freeze. (Source: 1News)
Strike action this week
St John FIRST and NZAA union members began staggered four-hour withdrawals of labour at 4am today. This industrial action is due to finish at 4am tomorrow.
A second round of staggered strikes is set to take place from 4am Saturday until 4am Sunday.
The unions said it had worked with St John to provide “life preserving services” to cover those four-hour strikes at the beginning of each shift.
Dan Ohs, Hato Hone St John Deputy Chief Executive - Ambulance Operations, said patient safety was their focus.
“Be assured we have plans in place to provide emergency care during this time,” he said.
“Remember if you have an emergency, you should still dial 111. If your call is not immediately life threatening, there may be a delay, or you may be asked to self-transport to a medical facility if it is considered safe for you to do so.
“For all non-emergencies we are asking people to contact Healthline, their GP, or their local pharmacy in the first instance.”
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