Waitakere Hospital has hit back at an urban Maori authority which urged sick people to avoid expensive after-hours clinics by going straight to the free emergency department.
Waitemata District Health Board says residents should only go to the emergency department if they have a medical emergency or are seriously ill.
It comes after Whanau Waipareira announced an advertising campaign to drive its clients away from White Cross Healthcare, the medical centre which provides after-hours care to sick and injured adults in West Auckland for a $92 fee.
Whanau Waipareira chief executive John Tamihere said $92 was "outrageous" and "an impediment for whanau".
"Many within our community can't afford that ridiculous overhead."
Mr Tamihere said the amount was unacceptable and many of the authority's 38,000 members often waited until the next day to see their GP instead of paying the after-hours fee.
"We can't allow this to continue because what we don't want is a whanau member to die or be hospitalised because they didn't have the money for proper treatment."
He said many of the "working poor" did not qualify for community services cards, and those that did also could not afford the lesser $33 fee.
Waitemata DHB funding director Debbie Holdsworth said Waitakere Hospital emergency department must be used responsibly and patients should seek the most appropriate care for their need.
"Unnecessary presentations to ED will have a significant impact on the care we can provide to people who are seriously ill or injured."
She pointed out that urgent care clinics were free for children under 13 and heavily subsidised by the DHB for community members with high needs and those over 65.
White Cross Healthcare chief executive Alistair Sullivan said the majority of adult patients at the centre qualified for the lower $33 fee because they were identified as high need. He said for those that did not qualify, payment options were available, including part payment and payment over time.
"The true cost of seeing a doctor at night and on weekends is well over $100. We are in constant dialogue with the DHBs, and would welcome any new initiative that would enable new funding to lower the cost for a patient who currently has to pay to see the doctor after hours."
Ministry of Health group manager of community health Andrew Inder reiterated the DHB's stance.
"Emergency departments are designed for those who are seriously ill or injured. Patients seeking treatment there rather than through their GP or after-hours clinic may impact on the care of others who need urgent attention."