Pre-empting the Government's own research, expected later this year, the report by the GMB union describes a 'climate of fear' among staff, serious defects in its call-out systems and a catalogue of failures in organisation. In the report, a majority of staff say that in 'their professional opinion', the LAS is near to collapsing.
Coming only five months after the death of an 11-year- old girl, Nasima Begum, whose family waited 53 minutes for an ambulance - and only two years after the collapse of an untried computer system with estimates of 20 deaths - the crisis survey, according to a senior health official, depicts 'a time bomb waiting to go off'.
Virginia Bottomley, the Secretary of State for Health, is now likely to face pressure to speed up her department's own survey and attend to problems that it finds.
The LAS's 3,000 staff cover 600 square miles and a resident population of 6.8 million boosted daily by a substantial influx of commuters. In the past five years there have been three changes of management. Poor industrial relations and a 'macho management' have, according to the report, resulted in staff fearing that any criticism will end their careers.
For the first time, current restrictions on overtime for accident and emergency staff are cited by the majority of staff as creating delays. A majority also said 'they felt like leaving'. The inquiry also found that most staff did not regard it as financially worthwhile to work nights or weekends. Many privately admitted that it was common practice for crews to 'go sick' on their nights and to take annual leave when they were rostered for night shifts.
On the Sunday night of Nasima Begum's death, the Shoreditch station closest to her home had six ambulances off the road. Four were due to annual leave; two due to absenteeism.
As pressure on the service increases, and the Government's plans to close certain London hospitals advance, ambulance staff were almost unanimous in believing that closing accident and emergency departments, such as Bart's, may result in deaths.
Following the chaos of 1992, when the LAS's computer system crashed, the central ambulance control (CAC) returned to a 'paper-operated control'.
Questioned on the information currently received by crews, it is revealed that almost half of the 999 and urgent calls details on patients' conditions given out by CAC are incorrect and that just over a quarter of all addresses given out are wrong.
In detailed recommendations, the GMB calls on the Government to halt the predicted break-up of the LAS. It says that over 500 new recruits are needed, overtime restrictions must be ended and new funds found to reintroduce computerisation.