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At least 500,000 New Zealanders have no access to a respiratory doctor, despite such illnesses being among the main causes of hospital admissions and death, a medical investigation has found.
The Thoracic Society of Australia and New Zealand report - to be published in the NZ Medical Journal today - calls for the establishment of a national respiratory council to function in the same way as organisations already dealing with issues such as cancer, renal medicine, diabetes, mental health and cardiac services.
It further calls for the establishment of four regional respiratory networks to organise services and formulate management plans for dealing with respiratory illnesses at a regional level.
The networks would concentrate on management of illnesses including cystic fibrosis, tuberculosis and lung cancer.
The investigation - the first detailed evaluation of New Zealand respiratory services - questioned New Zealand's 21 district health boards, finding that just 10 of them were complying with minimum standards of care.
Widespread deficiencies included: inadequate staffing, lack of quality assurance measures, and insufficient laboratory testing.
The report's lead author, Jeff Garrett, said the inquiry uncovered "large holes" in the provision of respiratory care.
The fact that none of the DHBs were accountable for the quality of their services was "deplorable in a First World country", he said.
"We will continue to fail New Zealanders unless we urgently address serious issues in our respiratory care.
"No national targets exist for any respiratory disorder and there are no efforts to assess the quality of care administered by any of the DHBs. This means that the quality of care you receive is very much determined by where you live."
New Zealand historically had the highest mortality rate for asthma, while five-year survival rates for lung cancer sufferers, at 10 per cent, are barely half that of the United States on 19 per cent.
It is one of the highest mortality rates in the developed world. And just 4 per cent of patients with sleep-related breathing disorders have been tested, or are receiving treatment, the report found.
Asthma and Respiratory Foundation executive director Jane Patterson said the findings showed the desperate need for Health Ministry standards of care.
"These findings and the recommendations of the report about the inequitable provision of respiratory services around the country particularly, a lack of accountability and other drastic shortcomings must be taken seriously if we are to have anything like a First World health system."
