Dozens of unwell or injured people desperate to see a doctor are queuing for hours outside a South Auckland clinic every morning.
Local Doctors Otara is part of the Very Low Cost Access scheme, which subsidised GP appointments in communities with the greatest healthcare issues, and the greatest need.
It charged a co-payment of $19.50 - which is significantly cheaper than many general practices or urgent care centres in Auckland, where appointments typically cost more than $60 per visit.
Staff at the clinic had reported people queuing for hours before it opened, even through the winter.
Local Doctors Otara is owned by Tāmaki Health, which has more than 40 GP surgeries and clinics throughout New Zealand. Its chief executive Lloyd McCann told Checkpoint the daily queues to see a doctor were "a sign of desperate times".
People queueing for hours outside Otara doctor's clinic
"We've unfortunately been having queues develop outside our clinic where people come in the early hours of the morning to get a place as far to the front of the queue as possible to ensure they are seen by our doctors and nurses so they can get the healthcare they need."
The lines were starting as early as 6.30am, and staff were opening up soon after they arrived, he said.
"Our teams will generally get in quite early as well - our doors formally open at 8am but the teams will generally get in by 7am, 7.15 to get prepared, to ensure that we can get patients in by a quarter to eight.
"But the fact remains people are queuing up - obviously these are the winter months as well - from as early as 6.30 in the morning in some instances."
Patient Tiu Tuiatara said he had heart problems and needed to see his doctor regularly.
"I have to wait [outside] for like an hour and a half. It's a long queue before you get in here, and then you wait for another three or four hours."
On Monday, Tuiatara waited at the clinic for about three hours to be seen for a different issue with his ankle.
He said he lost count of the number of people waiting outside the clinic.
"There's too many of us - I don't count because I just want to get in here. But it is long, it is a long wait."
He was worried about what would happen if he could not a see a doctor regularly.
"My blood pressure is very high. And with this pain it doesn't help. I've got a heart problem - I don't think [my doctor] wants me to get a heart attack. I don't want myself to get a heart attack too."
His doctor, Silva Ponnampalam, said she seeing the queue outside her clinic every morning made her very sad.
"I've seen even people with children wait there... sickness will get worse, there are people with COPD, asthma, so many things. Exposed to the cold that will get worse."
McCann said the clinic was seeing patients with a range of ailments, with respiratory tract infections much more common in the winter months, as well as workplace injuries, he said.
The numbers were growing month by month, and it was not uncommon to have 20 to 30 people turning up early on a Monday morning, he said.
"It is safe to say that healthcare need is increasing. While we've always had people struggle to get access to primary care, what we're seeing is that our patients are presenting with more complex needs.
"Patients have multiple co-morbidities as well - so that often takes longer to work through the number of health challenges they do have. So the situation is getting worse.
"Our teams don't want this to be occurring but it is a sign of how desperate people are to get healthcare."
As a VLCA (Very Low Cost Access) practice, it received additional funding given the high-needs population it served, which in turn meant lower up-front charges for patients.
"I think it again speaks to the inadequacy of funding generally for primary care and for general practice. But certainly the organisation has always been focused on low-cost, high-access [care] and that is something we continue to focus on because a number of the communities we serve have the highest health need given their co-morbidity status and a number of other social determinants of health."
The underfunding of GP services was a political issue that had been "decades in the making", he said.
"There is no doubt that primary care is a component of the sector that has been hugely underinvested in for a number of years.
"This is not a current government, or a previous government problem - it's a problem that's been decades in the making, where funding hasn't kept up with increasing demand, increasing complexity, and increasing health inflation.
"If we are to invest more... what we will see over a period of time ... is a better functioning health system for everyone.
"Because if we are able to detect illness and disease earlier, if we are able to invest more in the preventative component of health, it will mean we will save downstream on the more costly interventions that generally take place in hospitals."