Revelations this week that almost 30,000 New Zealanders are caught in delays for hospital treatment presents another daunting crisis looming for the health sector.
The estimates are drawn from Covid-19 pandemic recovery plans district health boards submitted to the Ministry of Health last summer.
According to the ministry's latest figures, more than 15,700 people are waiting longer than four months - the maximum time someone should wait under official guidelines - for a first appointment with a specialist. Another 13,500 have been accepted for treatment, but are waiting longer than the four-month target.
It might seem, on the face of it, to be incongruent for our health system to deteriorate while the citizens of the country were locked down to protect it. However, our hospitals and clinics weren't unaffected while the pandemic raged at the gates.
Precious resources were pooled to install Covid-capable facilities within hospitals. Staff needed training in prevention as well as preparedness for an outbreak.
District health boards did much of the heavy lifting in the testing regimes, being readied to mobilise in communities at the onset of clusters. Management and staff were seconded to the vaccination effort, which has risen in capacity over the past few months.
Health boards have been working to clear the delays after lockdowns were lifted, attending nearly 14,000 patients (for appointments and treatment) from when we emerged from level 2 last year. However, the ministry's associate deputy director-general this week told Herald journalist Nicholas Jones progress had been slower than expected.
Sarah Dalton, executive director of the Association of Salaried Medical Specialists, told the Herald the findings reflected a lack of action on long-standing problems, including staffing shortages, and the "parlous" state of hospital infrastructure.
"People are paying for this with their health and wellbeing. It is shameful in a country like New Zealand that people might go blind for lack of timely care."
Those trapped, uninsured or exempted from insurance cover, are essentially left with the difficult choice of suffer and wait; or find the means to go private.
New Zealand's two-tiered health system of public and private at least offers that choice and those who can afford private specialists and treatment may be further comforted in the belief they are easing pressure and opening access to public care for others.
Sadly, this isn't always the reality.
Gynaecologist Dr Alison Barrett has expressed the view a private healthcare system actually harms the public sector through doctors "moonlighting", administration duplication, and patients with means able to queue-jump.
There is also evidence of a small but significant number of private healthcare patients becoming a burden on the public system for follow-up acute care. A University of Otago study published this year found the public system spends about $11.5 million annually providing follow-up care to private patients.
It's yet another challenge facing Health Minister Andrew Little's "first truly national health system" being phased in over the next three years. However, improving our public health system can fit hand-in-glove by allowing private providers to specialise more in the nice-to-have, but expensive, procedures.
That would, indeed, be nice to have.