IF Brian Bishop does not get to Westmead hospital for dialysis by 7.30am three times a week he loses his spot in the queue and might not be treated for hours.
But the slot opens before his local community transport provider does. Mr Bishop, from Quakers Hill, is reliant on lifts from the health department that can regularly fail to turn up.
''The driver, if he takes a rostered day off or something, the bus doesn't come,'' Mr Bishop, who has heart disease, failed kidneys, and diabetes, said.
''It has happened about three or four times now in about six months.''
The demand for providing non-emergency transport to health services in NSW has doubled in the past 10 years.
But according to a report by the Council of Social Service of NSW, released on Thursday, funding for services that help take people to regular procedures and check-ups at hospital or medical centres has remained flat during that period.
The problem was to have been addressed in 2006, when the former state government launched its Transport for Health policy. The policy laid out a framework for co-ordinating transport networks in local health districts, and also monitoring how well these worked.
But according to the Council of Social Service report, endorsed by the Cancer Council of NSW, the NSW Carers' Association, the Combined Pensioners & Superannuants Association, and the Physical Disability Council of NSW among others, the 2006 policy barely got going.
As a result, broader and deeper gaps have opened up in the provision of health services across the state.
According to the report, which was informed by workshops in Sydney and Lismore attended by transport and health providers, the difficulty of providing transport has been exacerbated by the consolidation of health services in the regions. And in major cities, there has been insufficient growth in funding for community transport providers, organisations that help people like Mr Bishop to and from hospital appointments.
''They're terrific,'' Mr Bishop, 76, said of Blacktown Community Transport, which drops him home from Westmead.
''They've just got to have more funding to start earlier.''
The Transport Minister, Gladys Berejiklian, has boosted funding to community transport, which runs local pick-up services for the elderly and ill, by $500,000.
But the sector says funding remains inadequate.
"If the NSW Government is serious about ensuring equity of access to health care, it should address the unacceptable policy and funding gaps around health transport as a matter of urgency", the director of the Council of Social Service, Alison Peters, said.
The chief executive of the Community Transport Organisation, Greg Bondar, said: ''As community transport resources are consumed by demand for health transport, older people, people with disability, and their carers, will become increasingly isolated.''