More people are rescued by helicopter from Waiheke Island than anywhere else in the Auckland region and locals are calling for a boost to medical services.
Data provided by the Auckland Rescue Helicopter Trust (ARHT) showed about a third of all rescues in the region were from the island, which has a permanent population of about 9400.
The helicopter services the 1.6 million people in the wider Auckland region and the 29,600 residents of the Coromandel Peninsula.
Waiheke residents have raised concerns over the past few years about a lack of emergency services on the island, and the island's medical centres are working with the Auckland District Health Board on a business case for increasing after-hours care.
However, the ARHT chief paramedic Karl Taylor said the nature of the emergencies they were dealing with meant they required more than after-hours care.
"I guess one day they might put a hospital on the island, but until then it is important if their injuries or situation dictate they need to go to hospital, they can.
"An after-hours service would not be able to deal with what we are dealing with."
A typical trip might take 30 to 40 minutes, and cost about $4000 to $5000.
"It is expensive, but we have always accepted through our history Waiheke will make up a large proportion. It is the island with the largest population, so it will always generate work for us.
"Waiheke doctors do a good job, and try keep to keep patients on there if appropriate. Those who are being flown off the island are in desperate need of urgent care."
The overall number of rescues had increased from 628 in 2010, to 1000 in 2018. Waiheke rescues increased from 217 to 307 and averaged about 30 per cent each year.
Rescues to the island were more likely to be for medical emergencies rather than accidents, and the patients were generally several years older than the average rescue patient age - 54 compared to 50.
The typical mix for missions in 2018 was 60 per cent medical, 35 per cent accident and 5 per cent other (like search and rescue and inter-hospital transfers). For Waiheke Island, it was 83 per cent medical (including women in labour), and 17 per cent accident.
An 2016 Auckland District Health Board report said many locals were concerned about a lack of emergency and after-hours services on the island.
Waiheke Local Board chair Cath Handley said they had been supporting a call for an increase in medical services on the island for several years because of the growing, and slightly older, population.
Over summer, the population swells to more than 40,000, when all the holiday homes are at capacity. There are an estimated 1.3 million visitors to the island each year.
The island holds a fundraiser each year for the ARHT, which raises about $100,000 to $200,000.
But as the population continued to grow and more tourists visited, the board supported calls to increase medical services.
"I think the bigger cause is that people living here are more frail and with medical issues, meaning they have got to get to hospital fast," Handley said.
"Increasing options at this end would obviously be good for health and wellbeing of residents, and getting immediate treatment may reduce the need to send them across to the mainland."
Waiheke Health Trust general manager Julie Cairns said they were currently working with the DHB and the other health care providers on the island to develop a business case for urgent and after-hours funding to address the growing needs of the island.
The ARHT was majority funded through donations and sponsors, with a small proportion provided through central and local government grants.