The country's largest District Health Board can't say if its pricey A&E referral scheme is saving money or reducing wait times.
Figures released under the Official Information Act show Waitemata DHB spent a million dollars sending people to after hours medical clinics in the year to Feburary, up five percent on the previous year.
The increase is partly due to a spike in Respiratory Syncytial Virus cases last winter.
The DHB said the scheme frees up the emergency department for more urgent cases, meaning shorter waits, and better use of staff.
But hospital services manager, Mark Shepherd, said the DHB 'doesn't hold information' on the difference in wait times since the system started in 2008.
And he said the DHB 'can't easily isolate' the financial benefits of the scheme, including any reduced staffing costs.
Shepherd said there's pressure on EDs since the Covid-19 community outbreak, and because of the district’s growing population.
Otago University Professor Robin Gauld said the DHB's budget is well over a billion dollars so it's, 'a small sum of money to relieve pressure in emergency departments'.
He said, 'Our healthcare system, shouldn't be set up in the way it is, which creates the need for this work around'.
Gauld said primary healthcare should, be free, or just with a 'nominal charge'.
He said many people go to emergency departments outside office hours, because it's very expensive to see a GP after hours.
Health commentator Ian Powell agrees and said free consultations would be 'a good investment', and 'lead to better health'.
He thinks Covid-19 has pushed more people to seek help at hospital emergency departments.
Powell said there's more pressure on EDs because people have 'more complex conditions', especially during the pandemic.
He said that was 'accelerated under Delta and massively so, under Omicron'.
Powell said a million dollars it seems a lot, but is 'understandable' given the DHB's fast-growing population.
He said Waitemata DHB wouldn't be doing this without, 'running a publicity campaign to encourage people who are feeling a bit unwell to go to their GP first'.
Powell said, 'That's been going on in every DHB for quite some time and Waitemata would be no exception.'
National's health spokesman, Shane Reti, said the amount of money Waitemata DHB is spending sending people to after hours medical clinics, 'shows our primary healthcare system's broken'.
He said there are staff shortages in primary care and a funding review's needed.
However, he doesn't think GP visits should be free.
Reti said difficulty getting a booking, not just cost, could be sending people to emergency departments, instead of to their GP.
He said children are being taken to emergency departments, even though it's free for them to go to the doctor, perhaps because their parents can't get them an appointment.
Reti said, 'It's a tragedy when the ED becomes your medical home, because that's not what it's for.'