Wait until the pain is so bad that you cannot sleep - then you might get on the public health waiting list.
That is the advice from GPs to patients who contacted RNZ to tell stories of living in agonising pain - sometimes for years.
Health Minister Andrew Little has announced a special taskforce that will tackle hospital waiting lists, managing them nationally to clear a backlog caused by the pandemic.
But those RNZ spoke to said the problem began long before that.
Lucy described the agony she was in as arthritis caused bone deformities in her hip in 2019.
"Painkillers weren't working very well and the spasms were getting worse and I was having to walk with a stick. I mean I'd get out of the car, I'd stand up and have to wait for the spasms to go before I could walk across the road," she said.
"It was just awful, it was horrendous."
RNZ has agreed not to use her real name.
By this point, her GP had already said it was not worth applying for a hip replacement referral.
But when it worsened, she tried again.
"And I went back to the doctor again and they said 'no point, no point in referring you - they won't see you because there are just so many people on the waiting list, there are so many people being referred back - there's no point in referring you'."
"So they didn't refer me," she said.
For three years, Lucy put up with the spasms, despite sometimes being unable to walk or stand.
Alex Hallatt is in a similar boat - she has been told by her GP, podiatrist and an orthopaedic surgeon she needs surgery on her feet.
"I talked to my GP about whether it was possible to get on a waiting list and she said: 'no, you'll just need to wait until the pain is so bad, it's stopping you sleeping - and then come back'," she explained.
"I was told that you know, I'd basically have to be crippled before I could get onto a waiting list."
Nearly four years on, the pain is becoming unbearable and Hallatt is now awaiting an appointment to find out how much money she would need to go private.
"I feel bad about it because if I have enough money, I will be able to have the surgery done by the same surgeon but operating privately, not publicly. And I think that's wrong."
Lucy did go private - and got her hip replacement within four months - but it came at a great cost.
"Best $20,000 I ever spent and it's absolutely great!
"The trouble is, he said at the time, he says 'you're going to need another hip replacement'. That was about 18 months ago and that's now getting worse," she said.
"I'm thinking to myself 'oh well, we're going to have to raid the retirement fund again' and as my husband says, 'we're just going to have to die a bit earlier'."
Jonathan had emergency surgery within days of learning he had a clotted artery and wondered how much time it added for others.
"Usually, there is a reasonable waiting list through in the private system... but it's definitely not as long as people would be waiting for in the public system," he said.
"I suppose people like me come along with their urgent surgery and you bump those elected surgicals off the list."
Nationalising waiting lists supported
All those RNZ spoke to believe nationalising waiting lists would cut the time those in pain have to wait for the help they need although Lucy said assessment criteria - which currently differ between district health boards - need to be standardised across the country.
"The points system is ridiculous because where I live, you needed 80 points to get orthopaedic surgery," she said.
"If you went to the Hutt or Palmerston North, you needed between 40 and 50 points."
The government gave few details on how lists might be cut - but it could involve moving people to different parts of the country for operations or appointments.
Hallatt said travel will not concern those who desperately need surgery.
"I mean, people are already going to Australia to have operations that they can't have here.
"So yes, I'm sure it would make a difference and it would be more equitable," she said.
Lucy also thought it was a good idea but only if people did not have to pay for the transport while Jonathan pondered what impact a specific, Australian-style medicare tax could have on the public health service.
The task force will carry out a national review of all waiting lists and a reassessment of everyone on them by September.
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