The Association of Salaried Medical Specialists’ report ‘‘Unmet and Unseen’’, a study into patient deferrals and the official waiting lists, was released yesterday.
Researcher Virginia Mills, who helped on the report, said the results were worrying: in the Southern health district, just over 18% of all requested patient referrals were declined by Health New Zealand Te Whatu Ora (HNZ).
Last year, nearly 12,000 patients had their referrals declined in the Southern district — about 65,000 individual patients’ referrals were lodged by GPs in the district during the same period.
The figures do not stipulate the types of referral, only that the GP has made the request on behalf of the patient.
‘‘There had been a big backlog in the waiting list even before Covid-19, but that has exacerbated since.
‘‘Health New Zealand and the government has been trying to address this through increasing outsourcing and setting health targets.
‘‘But there’s a significant amount of unmet need, and reports on the health targets only tell part of the picture.’’
Ms Mills said because of staffing issues across the health workforce, there would be patients with ‘‘genuine need’’ who would not be able to ‘‘get through the front door’’ to see a specialist.
‘‘We need to do something to address the entrenched shortage of senior doctors, whether it’s encouraging overseas doctors to come here, increasing the training of doctors at our medical schools and ensuring our existing senior doctors are well looked after.’’
HNZ was able to provide data for seven health districts — including the Southern district — but did not have an overarching national figure.
Of the seven districts, the worst for rejections was the Lakes district, which rejected 5559 patients’ referral applications last year, just over 25% of all patient referrals (21,808) received in the district.
Ms Mills said there were large gaps in the data, because the situation for 13 of the health districts was unknown.
‘‘As a result, we have no idea how much unmet need is out there.
‘‘In effect, the high number of cancelled referrals creates an invisible waiting list almost as big as the actual one.
The number of accepted first specialist assessment referrals last year was lower than in 2023 in the seven health districts studied, despite population growth.
‘‘This means an increasing number of New Zealanders are being declined the healthcare they need.’’
The study makes three recommendations for HNZ.
• Asking HNZ to improve its data collection.
• Ensuring workforce targets accompany health targets.
• Providing transparency on the cost effectiveness of outsourcing.
HNZ executive director for clinical health Dr Richard Sullivan said reducing wait lists remained a priority.
‘‘We acknowledge the Association of Salaried Medical Specialists focus on access to care — this is a shared priority, and we agree that we have had too many people waiting too long for care at various points in the healthcare journey.
‘‘This is why we have had such a dedicated focus in recent years.’’
The number of patients waiting for a first specialist assessment (FSA) had reduced from its peak last February, when there were 212,000 people waiting.
‘‘Latest results for April 2026 (based on operational data) show the total FSA list is now down to just over 198,000 people.’’
A re-referral could occur if the patient’s condition changed, did not improve or new information became available, Dr Sullivan said.
HNZ expected to have ‘‘validated data available for reporting on declined referrals’’ by the end of this year.
‘‘This data set will give us a national picture on declined referrals, allowing us to identify any trends and opportunities for improvements.’’
