A prominent surgeon has written a letter claiming there's a two-tier health system in the Cook Islands.
The letter to the Cook Islands News was provoked by recent debate about the absence of doctors on the outer islands.
New Zealand-based surgeon George Ngaei says most of the islands lack the population to support a doctor and nurse practitioners can meet most health needs.
But he told Jo O'Brien a lack of funding to support health services on the islands is of more concern.
The Cook Islands-born doctor says a health budget of 3.4 percent of GDP is an outrage.