The head of a private hospital project planned for Rarotonga has admitted that only a third of working Cook Islanders have medical insurance and will be able to afford the facility.
However Dr Robert Woonton, the former Prime Minister of the country, who will head the hospital, says that doctors won't turn away locals urgently needing care.
Dr Woonton says construction of the first phase of the 5 million US dollar facility - an accident and emergency department - is due to start around March next year.
New Zealand developer Tim Tepaki is behind the project, which is being developed to complement five-star Cook Islands hotels he plans to build.
Dr Woonton says foreigners on holiday will make up a large proportion of the clientele, and its hoped the facility will boost tourism.
"Once it's established I think it will be a great benefit not just to our local people but to our visitors as far as tourism is concerned. And it'll give some assurance to visitors that the facilities are what they expect in their own country."
It's hoped the hospital will eventually be able to do joint replacements, breast reconstructions and cosmetic surgery.