NZ retail demand surges, hospital EDs divert patients with costly vouchers, UK halts Israel trade talks, Christchurch debates dumped trolleys.
Auckland emergency departments are diverting patients to urgent care clinics with vouchers to cover the cost.
The number of vouchers given at Waitākere ED rose 60 per cent since 2022, but fell at other hospitals.
Some emergency doctors support the system, while others question the value for money.
Waitākere Hospital’s emergency department is sending about 25 patients a day to an urgent care clinic with a voucher to cover the cost.
The vouchers are offered to patients when emergency departments have long wait times and cover consultations that can cost as much as $200 at private centres.
Emergency department doctors and patients say the vouchers help relieve pressure on bottlenecked hospitals. Others say they are a quick fix that channels money away from public services.
The voucher system has been in place at emergency departments for at least 10 years. But their use has risen dramatically in the past few years at some hospitals.
Figures released under the Official Information Act show that in the past three years, the number of vouchers issued at Waitākere Hospital had risen nearly 60% - from 5586 a year to 8879.
Experts said that was likely due to growing pressure on the Waitākere ED and the availability of healthcare options nearby.
The total spent on vouchers in Waitematā (North Shore and Waitākere EDs) was $1.8m in 2024, up from $1m in 2022. About 100,000 patients go through the two EDs each year.
The trend is uneven: the number of vouchers being given out was unchanged over the same period at North Shore Hospital and falling at Middlemore Hospital.
Auckland City Hospital trialled a voucher system but did not implement it, partly as no urgent care service was nearby.
Amanda Murphy, who lives in West Auckland, said she went to Waitākere Hospital’s emergency department last month because her throat was swollen and she had trouble breathing.
When she arrived about 3am, a screen on the wall said patients should expect to wait three hours to be seen by a doctor.
Murphy said she was offered a voucher for the White Cross on Lincoln Rd, about 1km away. Once there, she was seen by a doctor within five minutes.
“It was very pleasant and easy,” she said. “I didn‘t pay for parking, didn‘t pay for treatment, didn‘t pay for my prescription.”
The Henderson White Cross usually charges up to $185 for an overnight consultation.
Some Auckland patients say they have used the voucher system as a backdoor to free health check-ups.
One patient said on social media that patients who could not afford a GP should go to an emergency department and ask for a voucher so they could get free treatment at an urgent care clinic.
Dr Kate Allan, the NZ chair of the Australasian College for Emergency Medicine, said the voucher system relieved pressures on the EDs where they were offered.
“Where it is in effect it makes a difference for those patients and those waiting because it spreads the load and it redirects those patients to the care they need in urgent care.
“It is not saying they don‘t need to be there, it’s saying that they can be managed appropriately somewhere else.”
She said all patients were tracked to make sure no one was diverted inappropriately. Patients could also decline the vouchers if they wanted to be seen in the emergency department.
Dr Kate Allan, NZ chair for the Australasian College of Emergency Medicine, said patients who received vouchers were tracked to ensure they received appropriate care.
Photo / Corey Fleming
Northland emergency department doctor Dr Gary Payinda said he believed the voucher system was one of a growing number of areas in which public services were being privatised.
“For the individual patient facing a five-hour delay or the emergency doctor facing an overwhelming crush of patients, it seems like a good idea at that second.
“But in order to have a good, stable system in the future, you cannot keep giving public taxpayer money to private corporations because it weakens the system from within.”
GPs had complained they were losing doctors to urgent clinics, where the pay was often higher and workloads lighter, Payinda said.
Because the data supplied by Health NZ did not show how many patients actually used the vouchers, it was not possible to calculate the cost of the scheme per patient.
Emergency department doctor Dr Gary Payinda said the voucher system was a short-term fix that undermined public services. Photo / Michael Cunningham
Payinda estimated that the $1.7m spent on vouchers last year in Waitematā would pay for up to 14 nurse practitioners, who could see up to 100 patients a day.
Emergency department wait times are one of the Government’s five national health targets. In the last reporting period, 67.4% of patients at Waitematā EDs were being admitted, discharged or transferred within six hours. The 2030 target is 90%.
Health NZ acting northern region director for planning, funding and outcomes Kate Dowson said the rise in voucher use at Waitākere had not been reviewed and could be the result of a number of factors.
A 2018 review found the voucher system had a positive impact on the North Shore and Waitākere EDs by shifting low acuity patients to appropriate primary care, she said. And an economic analysis within the Waitematā DHB found the system to be cost-effective.
Dowson said Health NZ planned to review the emergency voucher system during the next financial year to reassess value for money and identify opportunities for improvement.
Isaac Davison is an Auckland-based reporter who covers Auckland Issues. He joined the Herald in 2008 and has previously covered the environment, politics, social issues and healthcare.
Sign up to The Daily H, a free newsletter curated by our editors and delivered straight to your inbox every weekday.
