The Niuean Health department is calling for more vouchers to be made available to medical patients being referred to New Zealand for treatment.
Niue's Chief Medical Officer, Dr Eddie Akau'ola, said some patients may be missing out on treatment as they cannot access vouchers to enter the quarantine facilities in New Zealand.
Online bookings showed the facilities were full until 28 December, but some patients had already secured their medical appointments.
The Ministry of Business, Innovation and Enterprise told Radio NZ there is a very restrictive emergency allocation criteria, and, given it is a last resort option, the threshold is extremely high.
"At this stage, Niueans who are New Zealand citizens or resident-class visa holders without a voucher who have an imminent threat to life or serious risk to health, which requires urgent travel to New Zealand can apply for an emergency allocation."
"We will endeavour to process applications which meet the criteria within 1 working day (NZDT). If we need further information to consider the application, we will contact the applicant as quickly as possible to request this."
Akau'ola said missing that treatment would complicate their medical conditions which could become fatal.
There is only one flight a fortnight between New Zealand and Niue and there is an average referral of around 10 patients a month.
The Chief Medical Officer said there should be a conversation around a dedicated quarantine facility for travellers from Covid-free countries.
Akau'ola pointed out these patients are coming from a Covid-Free island, so quarantining in the same facilities as those with higher exposure to Covid-19 could be a risk.
He said if Niuean patients could quarantine elsewhere given they were Covid-free, this would leave more space in the facilities for others.
The New Zealand government requires all travellers entering the country to enter managed isolation for at least 14 days, regardless of the Covid-19 status of where they travelled from.
MBIE responded saying there were currently no plans to set up a dedicated managed isolation facility for travellers from Covid-19 free countries.
"A key constraint on adding new facilities is the essential workforce who care for returnees. We need nurses, defence personnel and police to run these facilities, and this a limited workforce."
"In addition to workforce supply issues, a minority of hotels meet our requirements. There are a limited number of suitable facilities that are in locations where there is also a suitable hospital facility."