Health New Zealand tracks declined specialist appointments only for hospitals in the South Island, meaning the true national scale of the issue remains unknown, a 1News investigation has revealed. Reported by Jessica Roden, 1News.
An Official Information Act request shows that while declined referrals are monitored in southern hospitals, there is no nationwide system in place to record how many patients are turned away across the country or the reasons behind those decisions.
Health NZ said the gap was due to limitations in how its IT systems are connected and confirmed work is underway to improve national data capture.
In the South Island alone, 37,662 patients were declined specialist appointments in the 2024–2025 financial year. This followed 39,498 declined referrals in 2023–2024 and 36,814 in 2022–2023.
Orthopaedics recorded the highest number of declined referrals, followed by gynaecology, ear, nose and throat services, general medicine, and paediatrics.
The most common reason for patients being declined was failure to meet the clinical threshold required for specialist care. Other reasons included insufficient referral information or cases where a specialist appointment was deemed unnecessary or inappropriate.
In recent years, Health NZ and general practitioners say that when referrals are declined, hospital specialists often provide guidance to GPs on how patients can be managed in primary care.
However, the figures do not account for the thousands of patients in the North Island whose specialist referrals are declined each year.
Health NZ chief clinical officer Dr Richard Sullivan said efforts were underway to improve data visibility.
"We do have visibility of the patients we decline in a department in a hospital, but we don't have it that we can easily capture that at a national level."
Medical professionals say declines on the rise
While the official numbers remain unclear, medical professionals say as the number of people waiting to be seen has grown, so has the number of people being declined.
More than 200,000 Kiwis were waiting for a first specialist appointment at the start of 2025, and while that number has gone down slightly since, tens of thousands are still waiting longer than the recommended four months.
Dr Luke Bradford of the Royal NZ College of GPs told 1News workload impacted who could be seen.
"What we see is that as services become more and more busy, their threshold for what they're able to see and accept rises, and therefore we get increased declines. What happens in reactions to that is that GPs learn where the threshold is and often won't make referrals."
He said suspected cancer and more serious issues would almost always get through but chronic conditions were often the ones that don't get accepted.
Dr Ros Pochin of the Royal Australasian College of Surgeons said the threshold was it's "fairly random" and could change depending on the hospital..
"What I can do in the South Island seems to be very different what some of my colleagues in the North Island and the big metropolitan centres can do."
Dr Sullivan agreed that at the moment there was not a level playing field.
"We're looking to come up with consistent criteria based on clinical need, based on urgency, that we can then have across the whole country, so we create that fairness," he said.
For much of 2025, Auckland woman Tracey Rollinson had little to celebrate when a cascade of problems followed a running injury in May.
"My bodyaches, my nerve pain, my feet not working so I couldn't walk, and then my hands didn't work at one point," she told 1News.
"With the amount of pain that I was in I just, I thought that was going to be me forever."
She was hospitalised multiple times but was declined an appointment with a neurologist.
Because she lives in the North Island, she is one of the patients whose declined appointment isn't being collated by Health New Zealand.
Rollinson went to a private neurologist who found she had colon cancer.
"Basically, what happens is when you have a tumour in your body, sometimes you can get a thing so it's similar to neuropathy, where it affects your nerves," she said, adding her story could have been very different if she didn't have health insurance.
"I believe I still wouldn't know that I have cancer and so by the time I would have found out it probably would have been far too late."
In a statement, Health NZ said Rollinson was declined because she was already set for a follow up with a private neurologist.
ISSUE
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