Half of NZ Heart Attack Victims Not Treated Within Accepted Timeframes: Study

New Zealand has only a third of the cardiologists it needs, and a charity head says people are dying as a result of inadequate care.

Code blue team resuscitating a patient. spakadet2/Depositphotos

A shortage of cardiologists means that half of all New Zealand heart attack patients aren’t being treated within internationally accepted timeframes, a new study by Otago University has found.

The country has just a third of the number of cardiologists it needs, leading to significant backlogs in patient waiting lists.

Of the eight largest types of heart disease categories reported in the study, heart attacks caused the most years of life lost and deaths, regardless of whether it was someone’s first or subsequent attack.

The study was commissioned by cardiac advocacy charity Kia Manawanui Trust, whose chief executive, Letitia Harding, said exposed a system that was failing at every level.

“Heart care in New Zealand isn’t just stretched—it’s on the verge of collapse,” she said. “We are failing in all aspects, and it’s costing New Zealanders their lives.”

It found it was costing the country an estimated $13.8 billion (US$8.17 billion) a year from 74,708 life years lost, marking the first time the total cost of heart disease to the New Zealand economy has been calculated.

It also found that cardiac care is a “postcode lottery,” with those regions with the lowest numbers of heart specialists, unsurprisingly, having the highest death rates.

Half the European Average

New Zealand has just 173.2 full-time equivalent cardiologists nationwide (32.8 per million people), which is significantly below the international best practice of 95 per million and three times lower than the average of all countries measured by the European Society of Cardiology.

With 96.3 full-time cardiologists per million, Auckland was the only city with a comparable number of specialists to European countries. Waikato (47.5 FTE per million) was half the European average, while others were much less, ranging from 21.4 to 27.

The number of cardiology sonographers had dropped from 70.4 in 2013 to just 43.5 in 2024, despite the population having increased by 17 percent. That meant the ratio of sonographers had nearly halved, from 16 per million to 8.2.

Some hospitals also lack sufficient dedicated cardiac beds, causing further delays.

The standard set for a patient who has suffered a heart attack to undergo an investigative angiography is three days (72 hours from the event).

In the luckiest area, Nelson-Marlborough, 91.4 percent of patients received this care within that timeframe. But in Whanganui, this fell to 27.2 percent, with nine other regions recording scores that were considered below acceptable.

“This contrasting data shows that the Ministry of Health is not tracking cardiac staffing levels accurately. It is therefore unclear how the Ministry of Health proposes to address cardiac staffing inadequacies when it is unaware of their extent,” the report says.

Māori and Pacific people are hospitalised or die from heart disease more than a decade earlier, on average, than other New Zealanders; their heart failure hospitalisation rate is four times higher than for other racial groups.

Patients ‘Slipping Through the Cracks’

Trust medical director Dr. Sarah Fairley, who is a cardiologist based in Wellington, said the findings by Otago researcher Lucy Telfar-Barnard matched the experience of front-line clinicians.

“From inside the system, I can tell you that this report reflects what we see every day—a workforce stretched beyond safe limits, patients slipping through the cracks and no end in sight,” she said, adding that it should be “a wake-up call for the government.”

The trust wants to see the government make an immediate investment in public hospital cardiac care beds and equipment, and a national strategy to recruit and retain cardiology staff. The report also urged Health New Zealand to maintain a national record of cardiac staff and expand bed capacity in tertiary hospitals to reduce treatment delays.

Health Minister Simeon Brown said in a statement that the report highlighted several key areas Health New Zealand must act on, including addressing regional variations in service quality and patient outcomes.

“I have been advised that Health New Zealand has established a National Clinical Cardiac Network, which is developing national standards and models of care, while also establishing dedicated work streams to ensure consistent, quality care,” the minister said.

“This includes funding for new training positions for cardiac sonographers—a key workforce needed to bring down the echocardiogram waitlist.”

A spokesperson for Health NZ admitted that expanding the senior and specialist doctor workforce could be a challenge in some areas and specialities.

“Health New Zealand remains committed to retaining and growing our permanent medical workforce,” they said.

From 2000 to 2020, there were about 150,000 deaths from heart disease in New Zealand, meaning it accounted for 20 percent of all mortality, as well as 5 percent of hospital admissions.