Ambulance Employees Australia Victoria (AEAV) wants the state's ombudsman to initiate a wide-ranging review into the sector's performance after another code red was enacted at the weekend, the seventh this year.
Under the emergency procedure, Ambulance Victoria calls in off-duty staff, rapidly offloads patients at hospitals and sends non-emergency vehicles to respond to cases.
The ambulance system is failing the Victorian community and authorities cannot keep blaming COVID-19 for its woes, AEAV Secretary Brett Adie said.
"There is no doubt that COVID has been the catalyst, but the root cause of the current issues is far more insidious," he said on Thursday.
"If we don't understand the underlying issues that led to the current crisis then how can the public or paramedics have any confidence that things will improve."
Ambulance Victoria has driven its staff into the ground to meet key performance indicators and used them to hide their failures, Mr Adie said.
"The government and Ambulance Victoria cannot be trusted to be honest about the cause of the crisis. Critical eyes need to look through the COVID smokescreen to find the real cause," he said.
Ambulance Victoria recorded its busiest quarter for time-critical 'Code 1' cases amid the first Omicron wave from January to March, with 93,234 across the three-month period.
The COVID-19 pandemic continues to have an "unprecedented impact" on domestic and international health systems, an official said.
"Prior to the pandemic, Ambulance Victoria's response performance was the best in our history and we have since responded to increasing demand, including our two busiest ever quarters," they said.
A Victorian government official echoed that sentiment, declaring the state continues to face significant pressures from two years of deferred care, increased COVID-19 hospitalisations and staff furloughs.
"Ambulance Victoria and their dedicated paramedics have one priority - patient safety - which remains their key focus amid the unprecedented and ongoing pressure from the COVID-19 pandemic," they said.
"We're investing billions to address the demand our entire health system continues to face."
Former Victoria Police chief commissioner Graham Ashton recently completed a similar review into the state's triple-zero call-taking body, the Emergency Services Telecommunications Authority (ESTA).
In response to "continued and systematic underperformance", ESTA is being rebranded and brought under government control with its board disbanded in a major overhaul.
A budget estimates hearing in May heard the call-taking service was responsible for 18 deaths of people waiting for an ambulance over the past six months, with a further three attributed to paramedics not getting to patients on time.
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