Several private hospitals have decided they will only treat vaccinated people and others may follow suit.
Mercy Hospital in Dunedin and Grace Hospital in Tauranga have updated their policies stating that patients and visitors must be double vaccinated from the end of this month or early next month.
The country's largest private independent healthcare network, Southern Cross, requires all visitors and carers who enter its hospitals to show evidence of at least one vaccine. The vaccination status does not apply to patients.
The moves by Mercy and Grace hospitals have not gone down at all well with the Ministry of Health, which says private providers must have good justification before refusing services.
A ministry spokeswoman said private providers have responsibilities to deliver health services as set out in a ministry Covid-19 position statement on dealing with unvaccinated patients in community and secondary care settings. It says "denying access to health care on the basis of vaccination status is unacceptable" and "access to health care is a fundamental right".
It says in most cases, with vaccinated staff and other precautions, the risks are unlikely to be high enough to provide sufficient justification to not follow the code.
A ministry spokeswoman said in respect of visitors, hospitals set and control their policies, which will have regard to risks to patients, staff and visitors as well as restrictions on movement under alert level orders and other instruments.
The country is getting ready to move into its Covid Protection Framework, also known as the traffic light system, from next Friday, which restricts unvaccinated people from easily accessing venues such as restaurants and bars, but not to essential services such as health care.
Hospital bosses at Mercy and Grace are warning it's not as straightforward as the policy suggests and there may be some exemptions or exceptions.
From December 15, Mercy Hospital requires all patients and their visitors to be fully vaccinated against Covid-19 before admission for surgery and before visiting the hospital other than in exceptional circumstances.
Mercy Hospital chief executive Richard Whitney said it was a balancing act, but the safety and wellbeing of patients and staff was their priority so the hospital preferred that patients were vaccinated.
"Unvaccinated patients have elevated risks for themselves and for those around them. Elective services allow time for patients to be vaccinated should circumstances see that they currently can't."
Unvaccinated patients could have their operations cancelled if they developed cold or flu-like symptoms before their admission and they may have to stand down for between eight and 10 weeks, he said. The complication rate also rose significantly if they were unvaccinated and developed Covid symptoms after surgery.
Mercy Hospital would look at unvaccinated situations on a case-by-case basis and would go ahead if the benefit of treating the patient outweighed the risk of treating the patient.
"Our view is that while vaccination isn't the silver bullet for Covid, what it does do is certainly reduce the risk to the patient themselves and to others around them and we believe that is the right messaging to be sending to people."
Whitney was well aware of criticism of the decision on social media, but so far they had not received any negative feedback from patients.
He said surgery was hazardous and people were close with patients and doing procedures that created aerosol blood and body fluid contacts. They also provided chemotherapy services so it would be "unsafe and inappropriate" to allow patients that create a higher risk of infection to be in close contact.
Whitney, who also chairs the New Zealand Private Surgical Hospitals Association, said all member hospitals were looking at whether they would require all patients and visitors be fully vaccinated, but it was ultimately up to them to decide whether they would or not.
"It's not a straightforward decision, but individual member hospitals will need to assess what their risk profile is, the nature of the patients they serve and make the call as they see fit. But it has to be based on risk and mitigating that risk, it's not a matter of being biased against someone's vaccination status."
Grace Hospital general manager Janet Keys said its expectations that patients had to be double vaccinated was not "black and white".
The policy aimed at protecting patients, staff and consultants in its Tauranga hospital and stated that from November 29 patients coming to Grace for a procedure should be double vaccinated. Evidence of their vaccinations were also required.
Unvaccinated patients would be individually assessed for urgency of surgery and it may still go ahead with additional measures in place.
Since November 15, all visitors and carers have had to provide proof of at least one vaccine when entering Southern Cross hospitals. This can be either an electronic or paper record.
Southern Cross Healthcare interim chief executive Chris White said vaccination status does not apply to patients.
"Our planned approach is to continue to risk-assess all patients prior to admission to mitigate the risk of them being Covid-19 positive on admission. We are currently developing a testing strategy against the new Covid-19 Protection Framework."
White said employees, medical specialists and contractors all have to be fully vaccinated.
"We have worked extremely hard throughout the Covid-19 pandemic to ensure the safety of our patients, employees, medical specialists and contractors. We have implemented rigorous testing regimens to minimise the risk of transmission of the virus in alert levels 3 and 4. This has included regular testing and in particular testing of patients within 48 hours of admission to our facilities."
In the 2020 financial year, Southern Cross provided elective surgery, high-end diagnostics and cancer treatment to more than 86,000 patients at its own or joint venture hospitals and medical facilities.
Meredith Connell partner Anna Adams, who specialises in health law, said it was not clear whether the law now going through Parliament would allow private hospitals not to treat unvaccinated people.
If the Government drew a line around essential services such as health services then private hospitals may not have the option, she said.
The current definition of health services under the Health and Disability Service Safety Act was very broad and would include hospitals, GPs and physiotherapists in the public and private sector.
Other more conventional approaches hospitals could take - and some already were - would be requiring the patient to return a negative Covid test before having an operation, Adams said.
ACC, which has contracts with private hospitals to provide elective surgery, clinical and treatment services, is also working with the Ministry of Health and the wider health sector to understand the implications.
ACC chief clinical officer and head of health partnerships, Dr John Robson, said ACC's role is to assess a client's needs and then fund support to meet those needs.
"Where a client is not able to access health care due to their vaccine status, we will work with them to find a suitable alternative."
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