A major report says patients in Dublin are being put at risk due to a lack of proper ambulance cover.
The HIQA review says the current situation can't continue and a clear plan for the future is needed.
Dublin Fire Brigade is in charge of ambulance services in the city and the National Ambulance Service looks after the rest of the country.
Now a damning report shows that if a patient wih a life threatening emergency in Dublin needs an ambulance, getting one can be delayed due to the way the service is run.
A key problem is the lack of integration between the Dublin and the National Service and the way calls are transferred from one to the other
It means a Fire Brigade ambulance could be dispatched even though one from National Service may be closer.
The report also highlighted a lack of resources at the National service - relying on overtime to maintain its operations.
Independent Councillor Ruairi McGinley believes Dublin Fire Brigade's Emergency Medical Service should be merged with the National Ambulance Service:
"There are tensions between DFB and the NAS but really that needs to be got over from the point of view of the patients. I think the HSE are willing to spend money in terms of increasing the level of ambulance cover which is also needed."