Half of heart attack patients not treated within accepted timeframes, study finds

By Ruth Hill of RNZ

Half of all heart attack patients are not being treated within accepted timeframes in New Zealand, which has just a third of the cardiologists it needs, according to a new Otago University report commissioned by cardiac advocacy charity Kia Manawanui Trust.

For the first time, the total cost of heart disease to the New Zealand economy has been calculated at an estimated $13.8 billion a year.

Trust chief executive Letitia Harding said the findings exposed a system that was failing at every level.

“Heart care in New Zealand isn’t just stretched – it’s on the verge of collapse,” she said. “We are failing in all aspects and it’s costing New Zealanders their lives.”

Key findings from the “Heart disease in Aotearoa: morbidity, mortality and service delivery” report include:

• Life-threatening delays: Half of all heart-attack patients are not seen within internationally accepted timeframe.
• Workforce shortage: New Zealand has only a third of the cardiologists it should have.
• Māori and Pacific people hospitalised or die from heart disease more than a decade earlier, on average, than other New Zealanders
• Heart disease costs the country’s health system and economy $13.8b per year
• Postcode lottery for care: Regions with the highest death rates – Tairāwhiti, Lakes, Whanganui and Taranaki – have the fewest cardiac specialists
• Wellington-based cardiologist and trust medical director Dr Sarah Fairley said the findings by Otago researcher Dr Lucy Telfar-Barnard matched the experience of front-line clinicians.

“From inside the system, I can tell you that this report reflects what we see every day - a workforce stretched beyond safe limits, patients slipping through the cracks and no end in sight.”

Harding said the report should be “a wake-up call for the Government”.

The trust is calling for immediate investment in public hospital cardiac care infrastructure – beds and equipment – and a national strategy to recruit and retain cardiology staff.

The total cost of heart disease deaths in 2020 was $13.09b, from 74,708 life years lost.

In 2024, New Zealand had 173.2 fulltime cardiologists or 32.8 FTE per million people. That is three times lower than the average (95 specialists per million) of all countries measured by the European Society of Cardiology.

Ministry data showed no cardiac staff at all in Wairarapa or Whanganui, no cardiologists or sonographers/cardiac physiologists in Lakes, West Coast or Southern Canterbury, and no cardiologists in Tairāwhiti.

With 96.3 fulltime cardiologists per million, Auckland was the only city with a comparable number of specialists to European countries. Waikato (47.5 FTE per million) was half the European average, while others were much less, ranging from 21.4 to 27.

The number of cardiology sonographers had dropped from 70.4 in 2013 to just 43.5 in 2024, despite the 17% population increase. The ratio of sonographers had nearly halved from 16 per million to 8.2.

Heart disease was responsible for one in five deaths and 5% of hospital admissions.

The cost of heart disease:

• Hospitalisations cost an estimated $538,790,541 a year
• Work days lost $17,996,766
• GP visits $65,166,640
• Prescriptions $61,906,660
• Mortality $13,094,819,487
• Total: $13,778,680,094

These were minimum costs, as they did not include the cost of emergency department visits, nor indirect costs of workdays lost to emergency department and outpatient visits, nor years lost to disability.

In a statement, Health Minister Simeon Brown said the Government expected Health New Zealand to have a continued focus on strengthening cardiac services nationwide.

He said the report highlighted several key areas Health New Zealand must act on, including addressing regional variations in service quality and patient outcomes.

“I have been advised that Health New Zealand has established a National Clinical Cardiac Network which is developing national standards and models of care, while also establishing dedicated work streams to ensure consistent, quality care.

“This includes funding for new training positions for cardiac sonographers – a key workforce needed to bring down the echocardiogram waitlist.”

-RNZ