Ōmārama in South Canterbury is one of a number of small towns in New Zealand whose residents are growing concerned they aren't receiving timely medical help when they need it.
The town relies on the fire brigade's First Response Unit for faster medical care in an emergency, but St John is failing to deploy them in some situations.
Rebekah Cochrane experienced this two months ago when she had a fall at home.
"I just literally slipped in the snow and as I slipped my knee took the brunt and I heard this instant pop and it was one of those feelings, I knew I had done something wrong," said Cochrane.
She ended up fracturing her knee and rupturing tendons.
"it was the worst pain I had ever had."
Cochrane called 111 and asked for the First Response Unit.
"We always got told when we were younger if we needed that help they'd be the first ones on the scene."
But instead, she was put through to St John.
"They said 'oh sorry the First Response doesn't cover that type of injury, it's not something they look into, it's not that serious.'"
"I was gutted, just to have that taken away, I was really disappointed," she said.
Cochrane ended up waiting for four hours for an ambulance, despite a First Response Unit being just down the road.
There's no local ambulance in Ōmārama, they rely on teams 30km away in Tekapo, 50km away in Kurow or even further afield in Oamaru, a 120km drive.
There's an understanding between St John and Fire and Emergency NZ that St John can deploy FENZ specially-trained units for the most serious calls.
But unit members feel they're being sidelined.
"Basically, we've got highly trained individuals that are here to be used and they're not being used" said Ōmārama First Response trustee Craig Dawson.
"They're feeling frustrated, they've gone and done all their courses, and to an advanced level, and they're sitting here not knowing what's going on and it's crazy," he said
"The locals are passionate about it, they're worried, we have a lot of elderly people living in these areas and they do need help more than anything."
A longstanding agreement between the two agencies states any medical response to an emergency is decided by St John.
Fire and Emergency's Otago district manager Phil Marsh says they will always give assistance where needed, under the guidance of ambulance staff.
"We've got the resources available if it's required but it'll come under that clinical governance of St John," Marsh said.
But the First Response Trust says many patients are going without immediate medical help under the current system, particularly for low-level calls.
"We have a lot of vehicle accidents here, 50% of our call outs go out to motor vehicle accidents so that emergency response is absolutely vital," said Dawson.
"That's why we need to be used and we've got the stuff here, St John supply us with oxygen, bandages all of those things, let's help."
St John says it recognises the problem.
"St John is aware that there are some concerns within the Ōmārama community regarding the first response unit potentially not being dispatched to some incidents," said Otago operations manager David Milne.
But it's not just Ōmārama that's facing this issue, 1News has been told almost 15 southern regions with first response units have the same problem.
"Which to me is a waste of a resource," said Dawson.
A public meeting has now been called so all parties involved can find a resolution.
Milne says it's an opportunity to discuss the finer points of the dispatch criteria and provide some clarity for the community.
"We're aware that there may be some jobs that we are missing," he said.
"We're going to look at essentially reviewing the lower acuity jobs that we go to in Ōmārama and ensuring that where it's applicable, the Ōmārama First Response Unit is dispatched."
The meeting is scheduled to be held next week.