Half a million New Zealanders do not have access to a respiratory physician despite respiratory disease being the leading cause of hospital admissions and death in the country.
This finding came after a study was conducted by the country's leading respiratory physicians, on behalf of the Thoracic Society of Australia and New Zealand.
It was the first detailed evaluation of New Zealand respiratory services and involved all 21 district health boards responding to a survey.
The results were published in the New Zealand Medical Journal and showed New Zealand historically had the highest mortality rate for asthma and currently has one of the highest mortality rates for lung cancer in the developed world.
While all the boards responded to the survey, their answers showed only 10 of them complied with the minimum standards of care in respiratory evaluation and treatment.
The main issues were in relation to inadequate medical staffing rates, lack of quality assurance measures and insufficient laboratory testing.
Furthermore, none of the boards were accountable to anyone for the quality of service they provided as no quality measures existed.
However, compared to other regions, Otago stacked up quite well, head of the Respiratory Unit at the Dunedin School of Medicine and medical adviser to the Asthma and Respiratory Foundation of New Zealand, Professor Robin Taylor said.
"The availability of services in Otago is excellent. We are really up there with some of the winners."
This came down to the availability and quality of radiotherapy treatment, comprehensive lung cancer services, sleep services, and a pulmonary function lab.
To improve the situation nationally, Prof Taylor believed a "fresh look" at national health priorities by the Ministry of Health was required as they had not been reviewed since 2000.
"The key message is that respiratory disease is really common and there is a need for it to occupy more prominent, consistent attention across the DHBs."
Lead researcher Associate Prof Jeff Garrett said the survey uncovered large holes in the provision of services.
"This is deplorable in a first world country. 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."
Prof Garrett believed these issues could be addressed through a National Respiratory Council.
Such a council would follow a similar structure and function as other services in place for cancer and diabetes.
It would have an advisory role with respect to new technologies, new therapies, establishment of national targets to assess district health board performance, and would support the development of national guidelines on a variety of respiratory disorders.
