A doctor struggling to cope with staffing levels at Nelson Hospital says he and his colleagues fear no one is listening to them.

Dr Patrick Meffan has been a urologist in Nelson for more than three decades. He is now the sole doctor in the region doing complicated surgery for a number of cancers.

He said the current problems with healthcare were decades in the making.

"It really was magnified when two colleagues left a year ago and neither of those have been replaced. I have tried by every method I can to try and get this problem resolved and I don't think I'm being heard," he told Checkpoint.

"I've been worried that our system may entirely collapse and leave everyone stranded."

The current staffing levels meant some people would miss out on being seen, he said.

Operations involving the prostate, bladder and kidneys were difficult, he said, and he was having to do far more to keep up.

"In most of my career, I have done one of those a fortnight, roughly.

"In the last little while I've been doing two a week - so that's approximately four times as much.

"I'm not getting any younger, and the physical demands of that are pretty hard. I think even outside of that, that's a lot of work to do," he said.

"They are an operation that takes, generally, three or four hours. But sometimes up to six hours," he told Checkpoint.

Staffing levels meant smaller cases were taking a back seat too.

"The smaller cases are the ones that are waiting a long period of time, maybe even up to a year sometimes."

Invercargill was a good example of what happened with healthcare when you "get to the point of implosion", he said, and Nelson was not far behind.

"I find it enormously frustrating and I've had a lot of sleepless nights trying to work this all out.

"Everyone struggles with this fact that we have a system that the clinicians all think is failing, and then all of the bureaucratic side is saying 'oh, no, we've got this'.

"That's fundamentally where I can't see a way forward from this, unless there is an understanding that the health management system is, in my view, broken.

"Everyone talks about a broken health service. I think we've got a broken management service."

Te Whatu Ora said it shared doctors' concerns over staffing at the Nelson-Marlborough urology service, which had been impacted by a global shortage of specialists.

It anticipated having two more urologists on board halfway through 2027.

Nelson Hospital's interim chief medical officer Dr Derek Sherwood said wait lists for initial specialist urology appointments had almost halved since last year.

He said he was taking the situation seriously, and those requiring urgent care could still expect to be assessed and treated in a timely manner.