Almost half of all public health spending – 46.4% – was
funnelled to the private sector in 2025, a
new report into growing private ownership in the health
system has found.
Private sector providers captured
80% of the $3 billion increase in combined Health NZ and ACC
health spending since 2022/23, according to the report, Who
Owns the Health System? which was released today.
the combined $31.9 billion Health NZ and ACC public health
spend, $14.8 billion went to private sector providers in
“Despite strong public support for a public
health system, billions in public funding now flow to an
increasingly consolidated corporate health sector, dominated
by private equity investors, pension funds, and asset
managers,” report researcher Edward Miller
“These corporate providers are obliged to
maximise shareholder returns, which can come at the expense
of safe staffing levels, wages, training, equipment,
infrastructure and patient care,” Miller says.
the โhealthcare and social assistanceโ industry
generated $4.5 billion in surplus before income tax (a
measure of pre-tax profit), up from just $2.2 billion in
The report documents increasing corporate
consolidation in five key health sectors (primary care,
radiology, pathology, private hospitals and outsourced
elective surgeries, aged care and community support
services). It also maps ownership and identifies ways public
money flows into the private health system.
said the prevalence of debt-financed leveraged buyouts used
by many corporate providers raises questions about the costs
of outsourcing.
“Tight fiscal constraints have capped
investment in public sector capacity, creating pressures
used to justify outsourcing. But private providers face much
higher borrowing costs than the Government. In effect we are
swapping cheap and transparent public debt for expensive and
often opaque private debt.
“Highly-leveraged ownership
structures generate large interest expenses which reduce
taxable income. These concerns are heightened by complex
corporate structures spanning jurisdictions like the
Bahamas, Luxembourg, Singapore and the Cayman
“Outsourcing means taxpayer dollars are
helping fund the expansion of private sector capacity. We
need a strategy that ensures public funds are used to build
the workforce, facilities and services of the public health
“The public health system rests on the promise
that if you fall ill, have an accident, need an operation or
have a baby, the public system is there for
“Increasing health privatisation undercuts this
promise. It also undercuts the need for the health system to
reduce barriers and health disparities experienced by
Mฤori, because health care is increasingly driven by
commercial considerations.
“The pace of privatisation
is no longer a creep, privatisation has bolted,” Miller
The report includes nine
recommendations to hold private providers more
accountable, to ensure the Crownโs te Tiriti o Waitangi
obligations to Hauora Mฤori are met, and to build an
equitable, accessible and high-quality public health
About the report
report was commissioned by three health unions: Tลpลซtanga
Tapuhi Kaitiaki o Aotearoa New Zealand Nurses Union;
Association of Salaried Medical Specialists Toi Mata Hauora;
and the Public Service Association Te Pลซkenga Here Tikanga
Mahi, with support from the Centre for International
Corporate Tax Accountability and Research (CICTAR).
was published by Public Futures Aotearoa, a coalition of
unions, community groups and researchers, supporting those
fighting to keep public assets and services in public
ownership of health sectors
– Corporate ownership of the general
practice sector has increased to an estimated 25% in
– Publicly funded elective surgeries in private
hospitals have grown by 93% in four years to more than a
billion dollars in 2024/25.
Diagnostics, imaging and radiology sector is owned by
corporates.76% of aged residential care provision
is publicly-funded, with two of the Big Six providers owned
by offshore private investors.32% of Home and
Community Support Services are provided by for-profit
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Original source: nz