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A major overhaul of Victoria's triple zero call service is "long overdue", the state's ambulance union says, adding it is open to re-negotiating staff enterprise agreements to help ease future surge demand.
The Emergency Services Telecommunications Authority report, led by ex-Victoria Police chief commissioner Graham Ashton, found "continued and systematic underperformance" within the service.
At least 12 Victorians have died while waiting for an ambulance since October, but the review found problems with surge demand at ESTA pre-date the COVID-19 pandemic.
"I understand the pain, of course, that those who have lost loved ones endure ... particularly when there may have been more that could have been done," Emergency Services Minister Jaclyn Symes told reporters on Thursday.
Mr Ashton made 20 recommendations, including moving ESTA into the Department of Justice and Community Safety, renaming it Triple Zero Victoria and disbanding the current board. All have been accepted by the government in principle.
Victorian Ambulance Union secretary Danny Hill said the Ashton report highlighted systemic reforms it has been calling for.
"It's long overdue. It's probably the first real reform for ESTA in its existence," he told AAP.
Interim ESTA chief executive Stephen Leane said the relationship between the call-taking body and Ambulance Victoria has been "strained".
Mr Hill agreed a "disconnect" had formed, with frustrated paramedics often sent to non-urgent cases.
"AV have wanted to use a bit of clinical evidence to alter ESTA's approach, and that's often been met quite stubbornly by ESTA," he said.
In the 80-page review, Mr Ashton suggests ESTA's current EBAs should be amended to move to a blended roster model for call-taking and dispatch staff, rather than most working a standard 12-hour shift.
The VAU represents some ESTA call-takers and Mr Hill said he was open to talks.
"We're happy to have discussions with them ... but I don't really accept that's been the issue that's led to the situation that we're in," he said.
Mr Leane said ESTA is due to strike new EBAs next year, after the government committed to recruit 400 new staff as part of a $333 million budget pledge.
Opposition health spokeswoman Georgie Crozier criticised the Andrews government for releasing the ESTA report two days before the federal election and said issues should have been fixed years ago.
Health Minister Martin Foley again dodged questions on Friday about when he first received the report.
The health department had a number of opportunities to contribute to the review of the service, Mr Foley told a budget estimates inquiry, but he would not say when the report first landed on his desk.
The minister is expected to face more questions about ESTA on Friday afternoon.