Dialysis rationed for Kiwis as ineligible immigrants get treatment

This is a disturbing report from RNZ:  Dialysis for NZ patients ‘rationed’ as ineligible immigrants treated

New Zealand dialysis patients are having their treatment rationed because of ineligible immigrants turning up for emergency care, according to government documents.

Immigration New Zealand’s chief medical officer said at times staff said they have had to reduce dialysis sessions to twice a week and patients “get sick and die quicker” at that level.

Documents obtained by RNZ from Immigration New Zealand include slides from a presentation by its chief medical officer on the costs and demands on the health system, made in a meeting with the Immigration and Protection Tribunal last year.

“When we get ineligible overseas patients turning up we are obliged to treat them urgently but we are often full in which case we will reduce the dialysis our existing patients are having in order to fit everyone in,” said one.

“We have had to stop training patients for home dialysis which has meant more hospital beds full up and at times we have had to limit patient dialysis sessions to two per week per patient.

“The minimum acceptable standard is three sessions per week, below that, patients get sick and die quicker.

“But we have had to ration dialysis due to lack of resources to deal with demand.

“So the care our patients receive is impacted when we are working above our capacity.”

In 2016, there were 2750 dialysis patients in New Zealand, but there is no data on how many were overseas’ patients.

About 400 people died while on dialysis in New Zealand that year.

It is not clear how many DHBs are affected, and by how much overall, although the three Auckland DHBs receive partial compensation from the Ministry of Health for the cost of treating ineligible patients for all health conditions where the immigrant or tourist has not repaid that debt. Last year that was $5.5 million.

Patients ineligible for publicly funded healthcare include tourists – except for those from the UK and Australia which have reciprocal health agreements with New Zealand.

However, detailed immigration medical assessments before visas are issued are not compulsory for many temporary immigrants.

And ineligible patients do not have to pay for healthcare costs upfront.

When there is finite resources to provide dialysis, immigrant patients are reducing the care available for New Zealanders.

With our health system already under pressure this is a concern.

And it’s not just dialysis.

Slides from the meeting, obtained under the Official Information Act, refer to the world-wide numbers of diagnosed diabetes cases, many of which come from New Zealand’s immigrant source countries in Asia and the Pacific. There are also a number of undiagnosed cases.

The slides also looked at the cost of mental illness among immigrants on the health system.



  1. NOEL

     /  August 13, 2018

    And that’s only one of the costs.

    “Pqatients who do not meet the criteria for eligibility (‘ineligible people’) impose significant costs upon the New Zealand health system in several different ways.
    1. Identification – DHB administration and clinical staff spend a great deal of time trying to determine the eligibility status of some patients, including multiple phone calls to Immigration New Zealand (INZ). Delay has the potential to add avoidable cost to a patients treatment regime;
    2. Fraud and mistakes – Patients may declare their immigration status as a New Zealander, when in fact their nationality disqualifies them from free treatment. They may also be incorrectly assessed as eligible;
    3. Cost of recovery – DHB staff spend a great deal of time trying to obtain payments from ineligible patients. This involves working back through treatment related files to determine costs incurred, invoicing, following up unpaid invoices, commissioning and briefing credit collection agencies and chasing up offshore insurance companies;
    4. Unrecovered debt – Ineligible patients may leave the country without paying for the treatment or may simply not be able to pay. “

    • NOEL

       /  August 13, 2018

      Should have added in 2011 was estimated at 10 million. Lot of Kiwi hip replacements.

      • Kitty Catkin

         /  August 13, 2018

        I was going to say that this has been going on for a long, long time. It’s one of those stories that appears as a hardy perennial.

        I have never needed to use my travel insurance, but would never go abroad without it.

  2. Blazer

     /  August 13, 2018

    turn up or be delivered to many foreign hospitals near death or any other excuse,and if your CCd does’nt work…and its…curtains..

    • Kitty Catkin

       /  August 13, 2018

      A Kiwi boy whom I knew was on a scholarship to the US and discovered too late that the health insurance thereof was so limited as to be all but useless. He broke his neck in a diving accident, and while the surgeons generously waived their fees when they heard this, the hospital didn’t. His mother had to sell her Wellington house to pay for it.

  3. Kitty Catkin

     /  August 13, 2018

    I would like to see a breakdown of this.

    Where are these people from ?

    • Gezza

       /  August 13, 2018

      That’s a good question, actually. This data should be available somewhere. If not it should be a priority to gather it.