One in three people are not eligible even to be considered for elective surgery in at least two district health boards, a study published today in the New Zealand Medical Journal has found.
The research says the Ministry of Health has trumpeted the reduction in waiting times for such surgery which will be cut to four months next year.
The research into patients needing hip and knee replacements in Northland and Hawke's Bay found that nearly 40 percent miss out because of DHB budget restrictions.
Brett Krause, president of the Orthopaedic Association and a surgeon in Wellington said this situation is all too common.
Dr Krause said a scoring system using a questionaire determines who gets elective surgery and an aging population adds to the pressure.
"It is difficult because basically, we're put in a position where we have to select the patients who we think and they think are most deserving. And it's not an easy choice sometimes."
The executive director of the Health Funds Association, which represents private health insurers, said there is capacity in the private sector to do more operations.
Roger Style said that, given the right framework and incentives, it would invest in more operating theatres.
"Private sector would build more because they know that there's that level of insured population and they know that there's that level of demand coming through."
Mr Styles said tax concessions for people aged over 65 could also help speed up the process.