Newshub can reveal St John is drawing up a new agreement with Health New Zealand after it let a National MP tag along in night-time emergencies for three months.
The ambulance service has had a telling-off for allowing Dr Shane Reti into hospitals without its permission.
Ambulances are our emergency frontline and for 19 nights a politician was riding along.
"I wanted to get a sense of what the frontline was like after dark, where were the gaps, where were the holes, where might changes be needed," Dr Reti said.
He is a practising GP and was officially an observer, mostly with St John.
Dr Reti's ridealongs covered emergencies from Whangārei to Invercargill.
"Actually seeing it with my own eyes, goodness that was something," he said.
He saw it all, going into people's homes, seeing a woman in labour and people in a "range of conditions".
Dr Reti also witnessed mental health assessments and the aftermath of a suicide attempt.
There are concerns he saw too much.
"Some people wouldn't be able to consent, for example if they were intoxicated, mentally ill or unconscious," said Health Minister Dr Ayesha Verrall.
Nicole Moreham is a privacy expert and also has concerns.
"If you call a doctor, you do so because you think they are there to assist you, you don't expect them to bring somebody who is there for some ulterior purpose," said Moreham.
Asked if he knew whether every patient gave informed consent, Dr Reti said: "What I would say is that I fully understand and respect patient confidentiality."
Dr Reti also went into emergency departments with St John, but without the hospitals' permission.
Health NZ has given St John a scolding, telling Newshub: Some providers of ambulance services have, "with good intentions, hosted MPs to visit some of our facilities, without informing us first. We have reset expectations with providers."
Dr Reti said: "My purpose here was to try improve what we have, surely that's a good thing."
Hato Hone St John refused to be interviewed about this but said in a statement that it's reviewing its policy and procedures for observation shifts which it says it does regularly.
St John and Health NZ are also now drawing up an agreement on how to manage ambulance observers.
