Potential immigrants should be screened for obesity and smoking habits because they place such a heavy burden on health services, respiratory specialists have suggested.
Doctors Jeff Garrett and Andy Veale from Middlemore Hospital in South Auckland say obesity is a huge and increasing problem in Counties Manukau but chronic health disorders are not funded adequately.
Obesity leads to a range of problems, from diabetes and cancers to respiratory disease and sleep disorders, and severely stretches an already cash-strapped budget, they say.
Their comments follow the death of Samoan mother Folole Muliaga, who was obese. She died after her power was cut off and she could not use her breathing machine.
Mrs Muliaga arrived in New Zealand in 2000 and was first treated at Middlemore in 2002. Dr Garrett says South Auckland has more obese patients than most areas.
"We've got something like 40 patients who are very similar to her in terms of their needs."
The area has a high immigrant population and Dr Garrett says doctors are seeing people migrating to New Zealand who are "very high users of the health system, and that's a particular problem for South Auckland".
Health systems in some Pacific islands are not good and this is reflected in the health of the people.
"So we're inheriting that ... and they're not being screened appropriately at the border."
Dr Veale said: "I personally think that healthcare delivery to the Pacific Islands should be part of our foreign aid and should be accepted as such."
While immigrants were screened for tuberculosis, their body mass index (BMI), which can indicate obesity, was not checked. And if NZ let people in who were obese, this must be acknowledged in health funding, he said.
A World Health Organisation report this year shows that of the top 10 countries for overweight people, seven are in the Pacific.
Dr Garrett suggested New Zealand could screen for smoking, which can lead to expensive health treatment.
Muliaga family spokesman Brenden Sheehan said he was not impressed with the idea of screening for obesity, or smoking.
"The issues of obesity are a problem facing both New Zealand and the Pacific community.
"I mean, if you're going to discriminate against people who are overweight, what's next? Do you then discriminate against people who are blind or who are deaf or are we back to the dark old ages of discriminating against people with disabilities?"
He said more education work needed to be carried out about obesity both in New Zealand and the Pacific.
Health Minister Pete Hodgson refused to comment but Immigration Minister David Cunliffe said processes were tightened in 2005 to provide more comprehensive health screening.
This was done by medical professionals - and obesity and smoking were both canvassed.
Having just one risk factor might not exclude the person from consideration, Mr Cunliffe said.
"Our approach to immigration is to weigh up a variety of factors and to balance a person's health status against the potential benefits they may bring to New Zealand."