Íæż½ã½ãRaises Alarm Over Crisis in Access to Gynaecological Care in Aotearoa New Zealand
RANZCOG
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
1 April 2025, Wellington – The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG, the College) is deeply concerned about the increasing barriers to gynaecological care in Aotearoa New Zealand. Many of the College’s members have reached a point of distress over their inability to provide timely care, with some clinical leaders speaking out publicly to highlight the extent of the crisis.
Íæż½ã½ãcontinues to hear from O&G specialists working in Aotearoa New Zealand’s healthcare system about their concerns for the wellbeing of women in their communities. The College has communicated these concerns to the Minister of Health, the Honourable Simeon Brown, and senior leadership within Te Whatu Ora, emphasising the urgent need for intervention.
College Systemic Failures Leading to Delays and Denied Care
Gynaecology waiting lists to see a specialist and receive treatment are among the longest in the Aotearoa New Zealand health system. Women across the country face significant barriers to accessing care, with the extent of access greatly dependent on geographic location. Some hospital gynaecology units, such as the one at Nelson Hospital, have thousands of women on their waitlist, with many units no longer accepting GP referrals unless there is a high suspicion of cancer, or the case causes severe functional impairment.
Even when referrals are accepted, patients frequently wait more than 120 days for a first specialist appointment, and many then face further delays exceeding 120 days for necessary surgery.
“Women with conditions such as endometriosis, incontinence, and prolapse— serious conditions that significantly impact quality of life and the ability to work—are being left to languish on waiting lists whilst their conditions worsen,†says Dr Gillian Gibson, Íæż½ã½ãPresident.
The lack of access to specialist care is further exacerbated by constrained access to primary care – particularly affecting those experiencing economic hardship who may not be able to see a GP – and then later present to hospitals after their condition has deteriorated and emergency care is required.
The current focus on hospital waiting times from referral to treatment provides an incomplete picture of access to care, as many referrals are simply not accepted. This results in a significant number of patients not being counted in official performance measures, meaning the true extent of unmet need remains hidden.
A Health System Under Strain
A range of factors is contributing to the crisis, including insufficient O&G staffing levels, limited availability of operating theatres, shortages of anaesthetists and nurses, and a growing need to prioritise acute care, including maternity. Specialists are also witnessing an alarming increase in the acuity and complexity of pregnancies, with more women presenting late in pregnancy after receiving little or no antenatal care. This places additional strain on the system, diverting resources away from gynaecological services.
Short-Term and Long-Term Solutions Needed
While outsourcing cases to private hospitals is a pragmatic short-term solution that may help some women receive the care they need; it is not a sustainable fix. Private hospitals typically only accept less complex cases and rely on the same overstretched workforce that resources the public system. Furthermore, most specialist training for future O&Gs occurs in public hospitals, meaning a shift toward private outsourcing could negatively impact the training pipeline. Ensuring that specialist trainees gain experience across both public and private sectors is essential for the future workforce.
In the long term, a comprehensive plan is needed to build capacity within the public healthcare system. This includes investment in hospital facilities, staffing, and the expansion of services that could be provided by skilled GPs and physiotherapists with appropriate training and resources.
“It is critical that Te Whatu Ora takes a national, as well as local, approach to improving access to gynaecological care, ensuring that solutions transcend district boundaries so that all women in Aotearoa New Zealand receive the care they need, says Dr Gillian Gibson, Íæż½ã½ãPresident.
Íæż½ã½ãcontinues to call for strong clinical leadership and a national health strategy that prioritises women’s health across their lifespan.
For media enquiries
Bec McPhee
Head of Advocacy & Communications
bmcphee@ranzcog.edu.au
+61 413 258 166