While New Zealanders largely support having a public health system, today almost half of all public health spending takes place in public health spending over the last three years has been funnelled into the private sector. And, while the private health sector remains a mix of both corporate and not-for-profit structures, we are witnessing increasing corporate consolidation across key sectors including general practice, home and community support services, pathology and imaging services, elective surgeries and aged residential care. Public funding is crucial to this expansion, as it provides a stable and scalable revenue base.
The privatisation of healthcare has traditionally been characterised as a creeping phenomenon, long-considered a growing threat to the sustainability of health funding and service delivery in Aotearoa New Zealand. The pace of privatisation is no longer a creep; privatisation has bolted. Almost half of public health spending – 46.4% in 2024/25 – is now being consumed by the private sector. A growing share of public spending is being channelled to privately owned service providers that increasingly operate under commercial ownership structures. These structures are legally and contractually obligated to prioritise shareholder returns, creating incentives that can conflict with the delivery of high-quality, accessible, and equitable health services.
In many cases, public funding now flows to healthcare providers controlled by asset managers, pension funds, private equity funds, and multinational corporations. There is a real concern that public health dollars are now being used to service financial obligations such as debt repayments, investor yields, corporate acquisitions, and portfolio growth. In some instances, the entry and expansion of private providers has been a response to the failings of government officials and policymakers who have underfunded or undermined public service capacity for financial or ideological reasons. Regardless of how we got here, the growing extraction of profits and financial costs from publicly funded health services and from Aotearoa New Zealand raises fundamental questions about efficiency, accountability and value for money.
This report investigates to what extent public health funding is flowing into the private sector and was commissioned by by Public Futures Aotearoa, a coalition of unions, community groups and researchers who support those fighting to keep public assets and services in public hands.
