A leaked briefing document drawn up by the capital's Fire Brigade Committee, raises the possibility of fire crews being trained to use specialist equipment, such as defibrillators to deal with patients suffering heart failure. Such victims are normally treated by ambulance crews and paramedics.
The paper also examines the idea of joint fire, police and ambulance control centres which deal with all emergency calls - along a pattern tried out in other countries like Canada and Sweden, where everything from coastguard emergencies to snow clearance and emergency midwifery is co-ordinated from one control centre.
The current British system is described as a "wasteful duplication of resources at a time where funds need to be deployed intelligently and to maximum effect".
If ever implemented it would a massive increase in the duties and responsibilities of fire crews similar to their role in areas of North America, Western Europe, South Africa and Australia where firefighters are already responsible, as the report states "for the delivery of emergency medical services".
Although the briefing document - entitled "The Provision of Emergency Medical Services [EMS] in London : A Role for the Fire Service" - insists the proposals would not amount to a takeover of the heavily criticised London Ambulance Service, the idea would be strongly opposed by the Fire Brigades Union.
A spokesman said: "We do not see a role for fire officers papering over the cracks left by an underfunded ambulance service."
He added that if someone needed the help of a properly qualified and trained member of the ambulance service, it was not the role of a firefighter to provide that help.
With hospitals increasingly specialising their accident and emergency procedures and treatment, the document appears to want to extend this into EMS.
It states that pre-hospital emergency patient care has become recognised as crucial to patients and wants the "next stage in the evolution" to mean "joint approach" fire and ambulance services.
Accepting that the use of firefighters to undertake work "traditionally fundamental to another service" will cause problems, the committee's report nevertheless states "the fire service is well managed" while the ambulance service is not.
It justifies this assertion by quoting figures which reveal that only 17.3 per cent of London ambulances reach the scene of emergencies within eight minutes of being called, while firefighters in Tower Hamlets - the area proposed for a forthcoming pilot study - are on the spot within five minutes in 97.3 per cent of cases.