A child's access to life-saving specialist respiratory care in New Zealand may depend on where they live.
There are just nine public respiratory paediatricians serving the entire country, with 14 regions reporting no dedicated service, or no service available at all.
Those figures come from a new national audit done by Asthma NZ and the University of Auckland, which highlights significant gaps in respiratory care.
Asthma was the number one condition causing potentially avoidable hospital admissions for children under five in 2025.
Data from 2023 showed respiratory diseases were the country's third-leading cause of death.
University of Auckland respiratory health expert Amy Chan, who carried out the audit, said the data provided a map of where respiratory services were and what they looked like
"What's most concerning is really a postcode lottery. Where you live depends on how easy you can access care. And for some New Zealanders, that's no care at all, unfortunately," Chan said.
"I found nine paediatric children respiratory doctors service all of New Zealand. That's just such a small number, servicing over 600,000 children."
The audit found the nine doctors were just in two regions, in Auckland and in Christchurch.
"Without these doctors flying out from Starship to get to different parts of New Zealand, then there would be no paediatric respiratory service or specialist service, even though we have very rare sick children. So I think the concern is there is if someone resigns or retires, that's just on the brink of collapse. There is just not enough specialists to service the need," she said.
Four districts - Tairāwhiti, Whanganui, Wairarapa and the West Coast - did not have a respiratory physician at all, Chan said.
"That's really concerning where there's nothing. And there's an international benchmark. So based on what is safe in terms of our respiratory need ... we are actually 35 adult specialists short across all of New Zealand," she said.
Chan said a national co-ordinated strategy was needed to address the issue.
"We've actually done some work pulling a multidisciplinary group together to drive a national strategy. We're just waiting for the new government to be confirmed so we can work in partnership with the government once we know who's in Parliament," she said.
Health New Zealand clinical executive national director Dr Richard Sullivan said the agency recognised the significant impact respiratory disease had on individuals, whānau and communities across New Zealand.
"Health NZ met with Asthma NZ and has only recently received copies of the BREATHE Strategy and audit report. We are taking the time to review the material and consider any implications for Health NZ," he said.
"Until that work is complete, Health NZ is not in a position to comment on the specific findings of the audit or the recommendations contained within the Strategy."
There were more than 97,000 hospitalisations last year due to respiratory disease.
