Photo: Unsplash / RNZ
The chair of the College of Surgeons says legislation that pegs healthcare funding to population size means people in need are missing out.
A new auditor-general report, Providing equitable access to planned care, showed elective services in the public system were often "not equitable or timely", with people with the same level of clinical need qualifying for treatment in some districts, but not others.
Ros Pochin told Morning Report the report outlined that the so-called 'postcode lottery' hit Māori, Pasifika and disabled patients the hardest.
She said rural patients also suffered from inequitable care because smaller areas did not have the same access to specialities and staffing as metropolitan hospitals.
"What we know is that a relatively higher percentage of vulnerable and underserved populations live in the rural regions but have a smaller portion of the pie to feed them with.
"So, the capacities and the threshold by which you can treat people has to be made higher because you simply don't have the resources to treat all that you want to.
"That means that you've got different thresholds around the country, which is clearly inequitable."
Pochin said treatment should be based on clinical need, not resources, and argued greater investment was needed to resolve the imbalance in care.
"We definitely support efforts to introduce nationally consistent thresholds - but thresholds alone won't solve the problem without funding and infrastructure to match that demand."
She was also sceptical about the recent directive to outsource elective surgeries to private hospitals, claiming it would exacerbate current inequities.
Pochin said private hospitals, which were generally based in cities, tended to take on low-complication work that skewed towards more "middle class and better off patients".
"We know our rural communities have a greater number of people who are under-served.
"[So], you're just increasing the number of people who are waiting, who are in those groups that are already not getting equitable care."
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