Women are waiting up to half a year for procedures to help rule out cancer - and a GP fears lives are at risk.
Counties Manukau DHB has been about seven gynaecology beds short for the past 12 months, a shortfall it says carries "very concerning" risk.
Dr Mark Arbuckle, a GP at Otara Family and Christian Health Centre, has patients caught up in the delays.
"Gynaecology is under huge pressure," he told the Herald. "We are having to try manage patients who should have had surgery. And the gynaecologist is saying, 'just keep a close eye on them, because we can't do it at the moment.'
"The real risk is that cancers are missed if these procedures are being delayed.
"The gynaecologists will try to pick those who are at higher risk and get them in, but it is possible that early cancers are missed on initial screening procedures or that cancers will develop if delays are substantial."
Arbuckle said he had patients who needed a hysteroscopy, a procedure that allows a doctor to look inside the uterus to diagnose causes of abnormal bleeding, which can include cancer.
The wait-time is normally up to three months. However, patients are being left for longer.
"Recently one of my patients was told it couldn't be done until March next year - that was six months away. They say, 'keep a close eye on them and refer them back if there's any significant change,'" Arbuckle said.
There are delays for other procedures. An outpatient clinic letter sent by the DHB to Arbuckle recently regarding a patient needing a total hysterectomy for possible cancer noted an apology had been given for "delays with planned surgery due to waiting time issues".
A recent Counties Manukau board meeting discussed "ongoing pressure" on the women's health service.
"We have been 7-8 gynaecology beds short for the last year fairly consistently as well as being short of maternity beds," the board was told in September.
"The risk associated with working under this pressure and not meeting a number of measures around best practice is very concerning."
Dr Chris Jackson, medical director of the Cancer Society of New Zealand, said timely access to diagnosis and treatment is critical for those with cancer.
"Every day that people who think they might have cancer are waiting is agonising for that person, their family, friends and loved ones. People deserve to have timely access to care, and more needs to be done to ensure this happens.
"The scale of the waiting times problem is hidden from sight because the faster cancer treatment targets were removed earlier this year, and have not been replaced...New Zealanders have worse cancer outcomes than in Australia, and long waiting times can only worsen outcomes."
Counties Manukau DHB did not respond to a request for comment.
Prime Minister Jacinda Ardern joined Health Minister David Clark yesterday to announce an $80m investment, which she said would fix long-standing problems with buildings and infrastructure at Middlemore Hospital and the Manukau SuperClinic.
The funding will cover four projects including re-cladding the Kidz First Building, relocating the radiology department and establishing a hub at the SuperClinic. New infrastructure to support expanded services at the SuperClinic will also be funded, included IT and medical gases.
"These projects will significantly improve the standard of key facilities," Clark said. "They will also help Counties Manukau DHB better handle a growing population with some of the most challenging health needs in New Zealand."
The Herald is investigating New Zealand's public health sytsem in a Fair Care? series. Reporting has detailed other problems facing Counties Manukau DHB, including a young girl who lost sight while languishing on a waiting list.
Her case was buried in a huge backlog of overdue appointments. Counties has warned pressure on eye services remains "very real and concerning".
Other services including dermatology are under strain. Half of South Auckland children sent for specialist care for serious skin conditions are declined an appointment, with hundreds of referrals for both adults and children declined each year because of a lack of capacity.
Counties Manukau DHB will dip in and out of a $75m overdraft over the remainder of the financial year. Land has been sold to fund works including a dialysis laboratory.