Pennington, Reporter
Health NZ (HNZ) is
sending more eye operations to
the private sector under longer-term contracts without
first working out how much that is likely to save compared
to short-term outsourcing.
It is moving to set up a
“panel” of private providers of ophthalmology it can draw
on, though it does not appear to be using all options to
boost public care.
One option was for more weekend and
evening surgeries in public hospitals.
“Health NZ has
not added more evening and weekend operating theatre
sessions for ophthalmology,” it told RNZ this
Also, it had aimed to add more types of surgery
at hospitals in Auckland and Christchurch; however, asked by
RNZ if it had added ophthalmology, it did not say.
tender for the panel has just closed.
said the country’s four health regions could not meet demand
for eye care so it would outsource some of the work for five
years to start with, with a further five-year right of
Other related “commitment” contracts would be
three years long.
HNZ said the panel would not set a
volume for outsourced surgery and more complex procedures
would usually still be done in public hospitals.
coalition of health sector organisations, Kaitiaki Hauora,
accused it of going further than ever towards
privatisation.
“If the public system is struggling,
the answer should be to rebuild it, not hand more of it
over,” the group said.
HNZ’s director of hospitals
funding Rachel Haggerty pushed back.
“There has been
no decrease in public hospital provision for elective
treatments in ophthalmology, rather outsourcing has enabled
Health NZ to treat the unmet needs of our patients requiring
elective treatment intervention. This in part is reflective
of our aging population growth,” she said in a
Health NZ already had a mini ophthalmology
panel in Auckland and Northland of eight private clinics on
three-year contract terms, a table released to RNZ by HNZ
It also had panels set up for outsourcing
“surgical”, radiology, endoscopy and cardio procedures,
among the 16 clinical specialities.
The five-year
duration of the new ophthalmology panel would deliver
“better value for money through stronger commercial
leverage”, Haggerty said.
Yet when asked if the agency
had analysed how much the long-term deals might save
compared to the short-term ones, she said no.
NZ has not completed a standalone analysis quantifying
savings from longer-term versus previous short-term
outsourcing contracts, including for ophthalmology,”
Haggerty said.
“This work is currently in the planning
The agency’s savings programme was among the
areas ranked weakest in a recent report to a committee
working to decentralise Health NZ.
Outsourcing hits
The share of outsourced elective
procedures versus those done in public hospitals had climbed
steadily, from 8.6 percent of public-funded treatments in
2011-12, to 12.5 percent halfway through the Labour-led
government’s term in 2020, to 16.7 percent in
The government’s introduction of its
‘Elective Boost’ policy last year would likely push that
share higher.
The boost was an attempt to hit a target
of 95 percent of patients getting their elective surgery
within four months.
told Health Minister Simeon Brown last year hitting that
would take two things: more outsourcing and more
insourcing.
For the latter, to increase operations in
public hospitals required “better use” of the country’s
newest surgical hospital Tลtara Haumaru, which had a delayed
start in 2024 due to staff shortages, and also of
Burwood “by expanding the elective treatments they are
funded to provide”.
Asked if it had done this,
Haggerty said, “Service additions at individual facilities
(including Tลtara Haumaru, Manukau Health Park, and
Burwood) are set regionally based on workforce, theatre
capacity, and demand.
“Any ophthalmology expansion is
coordinated with national clinical and capacity
She did not make clear what if any
speciality procedures had been added where.
Waitematฤ, she said, ophthalmology procedures increased
from about 19 a month before April 2025 to about 125 a month
now in public facilities.
As for the second must-have
– more outsourcing – Brown was told this demanded setting up
longer-term agreements such as of two-to-three
HNZ told RNZ the longer terms provided more
certainty for patients and clinics and a more stable market
to build a workforce and infrastructure plus better
commercial leverage.
It told Brown last year the main
risks to upping volumes both in- and out- sourced were
around how to increase the availability of senior
specialists and still safely manage public hospital clinical
workloads; and that the private workforce might be
“insufficient” to take on the extra work.
commentator Ian Powell, who used to head the senior doctors’
union, said in a column
the new panel plan would hit the reality of ophthalmology’s
small number of clinics that faced huge technology costs to
There were only 175 ophthalmogists
countrywide, 85 of those primarily in private clinics,
Powell said. “Already stretched, it is unlikely that there
is the workforce capacity.”
Ophthalmology elective
treatments had risen from 23,000 five years ago to 31,600
last year, said Health NZ. Five years ago, about 7700 were
outsourced, versus 11,600 now with several months yet to run
in the financial year.
Kaitiaki Hauora contended the
panel tender signalled a clear shift to
privatisation.
Its chair – and ex-chair of HNZ – Rob
Campbell – said the move was qualitatively and
quantitatively “significant” for community
eye-health.
He called the panel a case of “contract
fishing … cast it out and see what we catch. It is very
dangerous as the bidder can start to control the
Haggerty said outsourcing was a
long-standing part of planned care.
“Volumes are
managed so outsourcing complements public services, improves
access, and supports elective
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Original source: nz