Hospital EDs are using a voucher system to divert patients to private clinics

Brian from Mount Roskill

What's happening:
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Waitākere Hospital’s stretched 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 EDs have long wait times and cover consultations which can cost as much as $200 at private centres. The voucher system has been in place at emergency departments for at least 10 years, but their use has risen dramatically at some hospitals. In the last three years, the number of vouchers issued at Waitākere Hospital has increased nearly 60%. The total spent on vouchers in Waitematā (North Shore and Waitākere EDs) was $1.8m in 2024, up from $1m in 2022.
The response:
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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... because it spreads the load and it redirects those patients to the care they need in urgent care." But Northland ED 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. "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." Payinda estimated that the $1.8m spent on vouchers last year in Waitematā would pay for up to 14 nurse practitioners, who could see up to 100 patients a day.
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