Waikato volunteer fire brigades believe it is only a matter of time before someone will die on their watch as they are sent to a growing number of medical callouts.
"And I don't want that kind of outcome hanging over the head of my guys," said Te Aroha fire chief Lindsay Spooner.
The region's fire chiefs are eagerly awaiting the findings of an independent fire service review ordered by Internal Affairs Minister Chris Tremain, with a formal report into the $325 million-a-year operation due this month.
Alongside the operational functions of the Fire Service, the report is expected to cover the issue of medical response volumes.
In the Waikato, fire crews are being sent to an increasing number of medical callouts including cardiac arrests, abdominal pain and migraines.
Morrinsville firefighters were recently called to a baby born seven weeks premature with breathing difficulties. When the parents had gone to the ambulance station for help, the only ambulance available was out.
"Don't get me wrong, our beef is not with the ambulance staff in our town who do a marvellous job, but the callouts are going to the wrong places and it really needs to be looked at."
The Morrinsville crew have so far been sent to seven cardiac arrests, but were unable to save any of those involved.
The Fire Service and St John have had a Memorandum of Understanding (MOU) in regard to medical callouts since 2005.
St John operations director Michael Brooke said the service had changed its system and now dispatched the nearest available resource to all life-threatening and time-critical emergencies.
"This means Fire Service brigades and stations are more likely to be co-responded to cardiac or respiratory arrests in the future and less likely to be dispatched to other less serious emergencies," he said.
Fire Service assistant national commander Ron Devlin said the new protocols were working well, though he was aware some regions were experiencing "teething problems" which were being worked through.
A review of the current MOU is looking at several areas, including sharing high-level property plans to co-locate where appropriate and a trial of a combined Fire Service/St John vehicle.
Ngaruawahia senior station officer Karl Lapwood welcomed the volume of medical calls and said his brigade was looking to fundraise for a defibrillator.
"We are already going to cardiac arrests, but it would be good to have more gear on board to maximise what support we can provide to our community," he said.
But others, such as the Matamata Fire Brigade, want their focus to be fire and rescue responses only.
Matamata fire chief Kevin Curtis said his team were unhappy about being called out at 11pm because someone in the community had forgotten to take their medication.
"There are safety concerns on both sides, the last thing we want is to go to a medical callout where someone dies and they point the finger at us - there is no way I want someone's death on my hands," he said.
Which is a possibility, according to United Fire Brigades chief executive George Verry, who said the issue of medical callouts was a topic of hot debate at last month's annual conference.
"Some brigades have trained paramedics with medical knowledge geared to go to these calls but there are others that don't," he said. "The work is definitely being extended to different levels - beyond rescue work."
Te Awamutu fire chief Ian Campbell said the growing expectation for the fire service to attend medical-based calls was having "a ripple effect throughout the community".
"We have already done 22 more medical callouts than last year and it feels like the floodgates will open and it just won't stop," he said.
While he stopped short of calling it exploitation, Mr Campbell said the extra calls were placing pressure on an already fragile volunteer base - and their employers.
However, Mr Devlin said while medical callouts were an increasing part of fire service operations there was no indication volunteers were being lost because of it.
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