Purpose In a nationalised health system, it would be expected that surgical approach to cancer would be centralised, and that there would be minimal variation within a single city. Anecdotally however, there seemed to be areas of our large city where fewer people were being treated by minimally invasive surgery for prostate cancer. We sought to objectify whether there were variations between electorates that were represented in the frequency of prostate cancer being treated by robotic vs open surgery. Methodology All radical prostatectomies in the city of Melbourne, Australia were identified for a 3-year period, coinciding with the electoral cycle for representatives from this state. The percentage of patients from each electorate who had treatment by robotic vs open radical prostatectomy was calculated. Electorates were then compared by the political party which was the incumbent in the seat. Results Marked variations in the frequency of robotic radical prostatectomy in a given electorate were apparent, with a range from 24% to 79%. Open radical prostatectomy was the inverse. These variations were however, consistently in favour of robot assisted surgery in the seats held by the more conservative parties, and in favour of open surgery in those seats more aligned to the parties that aligned with the left of the political spectrum. Conclusion Even in a nationalised healthcare system patients from electorates that have voted in a conservative representative are more likely to be treated with minimally invasive surgery than open surgery. Measures should be taken to correct this inequity and to provide the same standard of care to all members of the community regardless of where they live in a metropolitan area.