The health minister in the Cook Islands is being criticised for approving too many patients to be sent for medical treatment in New Zealand.
An audit of three years' worth of special government payments has revealed that heads of departments, and hospital staff more likely to themselves and family members repeatedly sent to New Zealand.
The audit office manager, Aolele Su'a Alose, can't disclose the names of patients.
Ms Su'a Alose says in at least one case they obtained more treatment in New Zealand than they were entitled to.
"There were evidence to show that some sort of favours were given to hospital staff in terms of number of referrals being made."
In one case, auditors asked one woman how she had got approval to accompany her sick husband to New Zealand.
The report recommends a private doctor joins the medical referral committee to make sure it's independent from patients.