The Royal New Zealand College of General Practitioners

Waitakere's emergency department had 57 per cent more patients in December 2010 than in December 2009.

To an extent this was expected because of the progressive extensions last year, but it has also been linked to difficulties in obtaining affordable, subsidised primary care".

"What is particular about Waitakere," said Dr Brant, "is that we have seen - as a different trend from North Shore Hospital - a large number of patients who would otherwise [go] to a GP. There would be conditions such as coughs and colds - and scripts and changing dressings and so forth.

"The reasons are probably related to understanding our department is for emergencies rather than GP care, and, secondly, probably the availability of GPs after hours and there may also be a cost issue.