Ambulance services in Birmingham and Solihull are still failing to meet Government targets for responding to 999 calls - six years after the deadline set by Ministers, opposition politicians have claimed.
But services in Staffordshire, which are now run by the same ambulance trust, are among the best in the country.
Tory shadow health minister Stephen O'Brien accused the Government of presiding over a "growing disparity" in health care.
The Government's NHS Plan, published in July 2000, said the ambulance service should respond to 75 per cent of "category A" calls - the most serious emergencies - within eight minutes.
It said: "This progress on ambulance response times will save up to 1,800 lives a year."
The deadline for meeting the target was 2001.
But the ambulance service achieves a response time of eight minutes for only 67 per cent of category A calls in Solihull.
In the area covered by South Birmingham Primary Care Trust, which includes Selly Oak, Northfield, Edgbaston and Hall Green, ambulances arrive within eight minutes to 72 per cent of calls.
The figure was the same for the area covered by North and East Birmingham Primary Care Trust, which includes Yardley, Erdington, Perry Barr and Sutton Coldfield.
By contrast, the target is being met in Worcestershire, Warwickshire, Sandwell and Dudley.
The target was also met in the area covered by Heart of Birmingham Primary Care Trust, which includes Aston, Small Heath, Sparkbrook and Ladywood.
And in Stoke, Staffordshire, ambulances arrive within eight minutes to 90 per cent of calls.
A spokesman for West Midlands Ambulance service said that across Birmingham and the Black Country, 80 per cent of category A calls were now responded to in eight minutes.
West Midlands Ambulance Service merged with Shropshire, Warwickshire and Hereford and Worcestershire services in 2006.
The process was completed last year when Staffordshire Ambulance Service merged with West Midlands Ambulance Service, to create a single trust serving five million people.
The figures were obtained by the Conservatives after they submitted a Freedom of Information request to the Department of Health. They cover the 12 months up to April 2007.
Mr O'Brien said: "It is a damning indictment of Labour's treatment of our NHS that ambulance provision varies so widely across the country. Alan Johnson has clearly not got a grip on the NHS."