A cross-party report by the Commons Health Committee said that "lives may well have been lost" and it accused London Ambulance's management, the regional health authority, the NHS Executive and ministers of "a complete failure of nerve" after the 1992 computer crash that itself came after almost a decade of a serious under-performance.
Ineffective management, under investment, awful industrial relations - for which the unions receive their share of the blame - and a complete inability to target resources to match demand, produced "negativity" at all levels, the MPs said.
Tom Sackville, the junior health minister, condemned the report as "unhelpful". He said it would "shake the confidence of staff and the public" alike by "dwelling on past problems".
But MPs on the committee accused the minister of "extraordinary complacency". Marion Roe, its Tory chairwoman, took the unprecedented step of issuing a detailed rebuttal of Mr Sackville's criticisms. There had been "a failure of political will at all levels," she said, "including ministers". The service's performance had consistently been not only worse than that of any other ambulance service but "spectacularly worse".
Labour members called on Virginia Bottomley, the Secretary of State for Health, to consider her position given her failed assurances after the computer crash that the situation would improve. A year's wait before pounds 14m was put in for new ambulances and technology had compounded the problems.
It took the death last June of 11-year-old Nasima Begum after an "inexcusable" delay of 53 minutes in getting an ambulance to her, and the committee's own inquiry, to produce real action, the MPs maintain.
LAS's management is castigated, but "culpability" for what happened goes far higher. "We do not think ministers can be absolved of blame for the sorry record of the LAS. Had the political will existed at ministerial level, the problems of the LAS might have been effectively addressed years ago."
The former South West Thames region bears "a heavy responsibility" for "squandering" the opportunity for decisive action after the computer crash. The Page inquiry, which was set up then, had too restrictive terms of reference producing "a period of deeply regrettable inactivity. It may well be lives have been lost in consequence".
Chris Spry, chief executive of South West Thames and its successor region, said the Page report had not been a "whitewash". Big improvements had been made by the region.
Martin Gorham, the LAS chief executive, said "to have repeated the mistake of trying to do too much too fast" after the CAD crash "would have been reckless and undoubtedly would have destroyed the LAS".
8 London Ambulance Service; Second report Health Committee; Session 1994- 5; pounds 17.Reuse content