Ronald McDonald House Charities may be forced to charge families of sick children who stay in their accommodation, due to a triple threat of rising costs, surging demand and a significant decline in donations.
Nearly 4500 families saved more than $10 million dollars from the accommodation, food, parking and internet access the charity provided while their loved ones received treatment last year.
Chief executive Wayne Howett says the number of families relying on the group's houses had grown by more than 25 percent on the previous year.
He said centralisation of services at Starship National Children's Hospital were seeing more families having to travel to Auckland to access treatment.
But the tough economic times was also having an impact, with some families living close to where treatments were being done still struggling to meet even basic costs.
"The people that it's going to effect most are the people that can least afford it. We've got a case of a family who live in a suburb in Auckland - their child is needs treatment at National Children's Hospital - and they can't even get a bus or transportation to get to the hospital. So we put them up.
"They're they're outside the current guidelines with regards to government funding. If you had to charge them for accommodation they probably wouldn't turn up, which would probably mean that child wouldn't get the medical care that they need," Howett said.
Howett said the charity was reliant on public donations for nearly half of the $12 million it cost to run the service every year.
"For New Zealanders right across the country, their disposable income is shrinking. So we still have the same number of people supporting us on an annual basis. But the gift that they give has almost halved. That's completely understandable but you don't have to be much of an accountant to see if you keep increasing demand, keep increasing costs and your revenue starts shrinking, you're gonna be heavily in the red real quick," Howett said.
Howett said every dollar invested in the charity returned more than five times that value in social benefit.
"We can talk about that social return but what does that mean for those families? It's all about taking away all the day-to-day issues that they face.
"When you're in the hospital and you've got a really sick child even the smallest thing that takes away from you concentrating on that child can blow out to be massive. So our team are really good at making sure that they take away all those day-to-day burdens so the family can focus on the one thing they need to focus on and that's their child in the hospital," Howett said.
He said the organisation was working to access new avenues of funding and appealing to existing supporters to step up, but if a solution could not be found, the charity could have to start charging family's for accommodation by the end of next year.
"Certainly facilities around the globe charge families to use the accommodation experience. We haven't done that in New Zealand in our 37 years that we've been around and certainly the last thing we want to do is add that burden onto those families.
"We're doing everything we can to continue to increase that revenue and make sure that we're very diligent about our costs. But some of these costs are beyond us. Electricity for a start, even just basic supplies into the house for families when they're there [and] the cost of labour continues to increase.
"We're looking at every every possible option. We don't want to be in a place where a country like ours has to turn people away in their greatest need," Howett said.