The Ambulance Service is being compared to the "Gaza Strip" which has been "neglected" by management and the HSE.
That is according to the head of a private ambulance service who says target response times across the service are not being met because of poor regulation.
SIPTU says HIQA is due to review the Ambulance Service shortly and it wants the impact of cutbacks to be a key focus.
However, Chief Executive of Lifeline Ambulance Services, David Hall, says the service has suffered years of underfunding and neglect.
Mr Hall said: "The HSE Ambulance Service is like the Gaza Strip.
"It is its own entity which has been neglected and left aside for many years, and someone has been put in to run it on an ad hoc basis.
"It deserves more, the staff deserve more, and more importantly the patients deserve more."