Emergency medical services in New Zealand (more commonly known as Ambulance) are provided by the Order of St John, except in the Greater Wellington region where Wellington Free Ambulance provides these services. Both have a history of long service to their communities, St John since 1885 and Free beginning in 1927, traditionally having a volunteer base, however the vast majority of response work is undertaken by paid career Paramedics. Strategic leadership of the sector is provided by NASO (the National Ambulance Sector Office) which is a unit within the Ministry of Health responsible for coordinating the purchasing and funding of services on behalf of the Ministry and the Accident Compensation Corporation. Funding occurs by means of billing part-charges for medical callouts (except Wellington Free) and charitable funding such as donations, bequests and corporate sponsorship to supplement Government funding. In recent years, the government has begun to examine more sustainable funding for ambulance services. however there is still significant exertion within the sector that the level of funding provided falls far below what is required to cover the actual cost of service delivery Organisation Since the age of the motor vehicle many Hospital Boards ran their own services. From 1957 to 1990 the Hospital Act stipulated that Hospital Boards had to provide an ambulance service. Many contracted that out to St John or had ad hoc arrangements with them, often for after hours staffing. When the Hospital Act was replaced by Health Boards, many of these Boards saw this as a chance to avoid being responsible and subsequently St John took over from many Boards (e.g. Thames, Bay of Plenty, Wanganui, Palmerston North, Waipawa, Dannevirke, Nelson, West Coast, Ashburton, Southland). Marlborough stayed a Hospital-based service until 2007 and Taranaki until 2011. Wairarapa was the last region with a hospital-based service, ceasing in March 2012 and being taken over by Wellington Free Ambulance. While both land ambulance service providers do have paid staff, they also rely very heavily on volunteer members. In most cases, paid staff tend to be concentrated in urban areas and in the management of rural areas, with rural response staff being largely volunteer-based. St. John Ambulance reports a total of 2,211 paid staff in New Zealand, supplemented by 7,647 volunteers. By contrast, Wellington Free Ambulance currently staffs 108 paid paramedics and 35 volunteers, not including the 21 paid staff and 21 auxiliary (volunteer) staff previously from the Wairarapa