The head of the Canterbury Charity Hospital Trust says it's time for a debate about why the public health system fails to provide all the healthcare that's needed.
In an article in the New Zealand Medical Journal, Christchurch surgeon Philip Bagshaw says there's a substantial unmet need for elective healthcare in Canterbury.
He says it's been partly addressed by the establishment of the charity hospital, focussing on things like hernias, cataracts and tubal ligations, but other similar hospitals are likely to be needed elsewhere.
Mr Bagshaw and others say it's now unusual for patients with haemorrhoids, hernias and similar problems to be seen in the public system unless their case is acute.
But they say many people can't afford to pay to be seen privately.
Health Minister Tony Ryall says 13,000 extra procedures have been provided in the past year and this will continue.