Workers First Union

Today, we’re very excited to launch our new report – “Emergency: Saving New Zealand’s Ambulance Services”.

We make the case for why our ambulance services need full government funding now – not more one-off top-ups during an election year – and why public ownership must be the future.

The findings are revealing. New Zealand is one of the only comparable countries in the world that still funds its ambulance services partly through charity - coins in a bucket, community drives, and donations from an ageing donor base that is shrinking every year. That model was never designed for the modern world. And right now, five compounding pressures are pushing it toward breaking point.

1 - An ageing population is driving demand through the roof. The over-65 population will double by 2065, pushing ambulance callouts up 61%. The total annual cost of running our ambulance services is projected to grow from $508 million today to nearly $2 billion by 2065. The service will cross the $1 billion mark for the first time by 2045, and charitable giving will cover an ever-smaller fraction of that.

2 - Our ambulance officers are being paid to leave. Any NZ ambulance officer would be 17-33% better off the moment they cross the Tasman. Training a registered paramedic costs the public nearly $150,000, and when they go to Australia, that investment goes with them. Every 1% increase in attrition costs the system roughly $5 million a year. We are effectively paying to train the Australian health system's workforce.

3 - The charitable model is collapsing just when we need it most. Donations to St John fell 25% in 2022 and have barely recovered, while costs rose $154 million over the same period. The average NZ donor is now 71 years old. There is no pipeline of younger donors to replace them in a cost-of-living crisis. So instead of fixing the funding model, the system is quietly shifting costs onto patients - St John raised its call-out charge by 28% last year, to $125, the first increase in eight years.

4 - The fuel crisis has made a long-term problem urgent. Our entire ambulance fleet runs on diesel. After the 2026 fuel crisis, diesel prices nearly doubled. Electrifying the fleet would save money in the long run - but the $259-300 million upfront cost is simply impossible for a charity to raise. Only the Crown can do it.

These are not problems that band-aid solutions and one-off funding top-ups will fix. The Government is already the effective employer - it sets the funding, and that dictates everything else. It's time to make that relationship formal, fund the service properly, and move toward public ownership.