Victoria's beleaguered ambulance system was again forced to call a code red overnight, because of extreme demand for services and a dispatch system breakdown.
The code red was called shortly before 1am and lasted for just over an hour.
Patients in metropolitan Melbourne were told not to call for an ambulance unless it was an emergency.
Ambulance Victoria's executive director of operational communications Lindsay Mackay said a confluence of factors led to the code red being called.
"We had some technical difficulties at times around the computer-aided dispatch system," Ms Mackay said.
"We also had increasing numbers attending hospital, we had workload and demand pressures, and just everything came at the same time which just pushes the system that little bit further."
Ms Mackay said while the code red did mean an escalation, it did not signify a critical emergency.
"We're not saying that everything is at crisis or that everything is falling over," she said.
"It's just that the system is a little bit more overloaded and at that point we really just want to pull additional levers to see how we can try ease the system."
Victorian Ambulance Union secretary Danny Hill said there were about 70 pending call-outs at the time the system collapsed.
"They literally need to go back to a manual card system. So, it's very difficult to be able to detect which crew might be nearest to a case, who can actually get to go to a case quickest," he said.
"They rely on the crews actually having to manually call in and say "this is our location, this is where we are".
"So, it's very inefficient and it does lead to delays."
Mr Hill said unnecessary calls to Ambulance Victoria contributed to the system being overwhelmed.
"Some of the cases that have come through overnight are people being sent to cases where the patient wasn't even home."
"It's just such an inefficient and inappropriate use of ambulance resources."
The overnight code red followed a report last month that showed about one third of urgent code 1 ambulance patients waited more than the target time during the March quarter.
The number of call-outs surged during the same period, at a time when record numbers of paramedics were furloughed after being exposed to COVID-19.
Ambulance Victoria responded to 93,234 code 1 incidents between January and March, a 14.2 per cent increase on a year earlier.
Code 1 cases represent urgent "lights and sirens" emergencies.
Ambulance Victoria acting chief executive Libby Murphy said the surge made the three-month period the "busiest in Ambulance Victoria's history".
Paramedics responded to 66.8 per cent of those calls within the 15-minute target set by the state.
Elderly man waited two hours for help
Joseph Gatt, 96, was one of many Victorians left waiting for help after he had a fall while trying to get out of bed on Thursday just before midnight.
His daughter Carmen Uren called an ambulance over fears her father had badly hurt himself at his Port Melbourne home.
Mr Gatt then started to experience symptoms of a heart attack, sweating and shaking on the floor.
When help arrived two hours later, two ambulances arrived at their home when they only needed one.
Mr Gatt's son-in-law Chris Uren said the entire experience had left his wife traumatised and in tears.
"They were already stressed out as it was, and the longer the ambulance took, the worse it was getting for them," he said.
Mr Uren said it didn't help that his father in law experienced regular periods of confusion in his old age.
"The fact that he has to wait on the floor for two hours for treatment is certainly distressing for him and the family," he said.
"They're not professionals. They were relying on professionals to help them and it didn't happen."
The Black Rock man said it was "sad" and "just wrong" that the system wasn't prepared to meet high demand.
"These sorts of things should not be happening," he said
"They should be well and truly tested under pressure conditions to ensure that the glitches in the system are ironed out before they are critically needed."
Issues not a quick fix, minister says
Victorian Tourism and Sport Minister Martin Pakula defended his government this morning, and said it was doing "everything in its power" to support the state's strained health system.
He said ongoing staff shortages, topped by a "pretty significant" flu season were major factors that contributed to Thursday night's delays.
Mr Pakula said the government hoped to fix the problem with its investment of more than $330 million dollars to recruit 400 new staff for the emergency service.
But Minister Pakula said issues with the ambulance system were not a quick fix.
"When the government sees a system under pressure and hires the additional staff and makes the additional investment, hundreds of millions of dollars, that is not something that has an immediate impact," he said.
Ambulance Victoria recorded one of its busiest quarters on record at the beginning of this year.
Mr Pakula urged Victorians to save their triple-0 calls for emergencies to reduce pressure on the system.
"It is a crucial service, it's a crucial service for people who are suffering from acute medical emergencies," he said.