Having the right debate this election

Having the right heath debate this election

NZ Herald 8 October 2026

Chris Roberts, Chief Executive NZ Private Surgical Hospitals Association

Health issues are always front of mind for Kiwis and no more so than during an election campaign. Health is consistently one of the top issues for voters, and political parties are responding with competing spending promises to "fix" the health system.

But are we having the right debate?

In this election, health should not be a spending contest. As a country, we can’t afford to keep spending more on health. Rather, we must focus on the outcome we want: New Zealanders getting timely access to the treatments they need.

We don’t necessarily need to spend more. We need to spend smarter.

That means putting patients ahead of ideology. Health policy should focus on delivering the best outcomes, not old arguments about public versus private healthcare.

New Zealand has always had a mixed health system. Public services alone have never been able to meet all healthcare needs.

Primary care is mostly delivered by the private sector, as are most diagnostic and testing services.  ACC depends heavily on private providers and private hospitals have been delivering planned care for more than a century. The needs of many older New Zealanders are met by private facilities and services.

To have the right debate about healthcare, we need to challenge some common myths.

Myth: Private hospitals are just for the rich.

The facts: Private hospitals treat people from all walks of life. 35% of New Zealand adults (1.5 million people) have health insurance, many through their employer. More than 90% of ACC-funded surgeries are performed in private hospitals, so if you’re injured and need an operation, chances are it will happen in a private facility. For those on elective surgery waiting lists, around one in five will have their operation in a private hospital.

Myth: Treatment  in private hospitals costs more.

The facts: Using private hospitals is a cost-effective way to deliver timely care. Public hospitals must manage emergencies, which can delay planned surgeries. Private hospitals focus on scheduled procedures, so patients are treated sooner, reducing pain, stress and time off work. When the wider economic and social costs of delayed treatment are considered, private hospitals are a highly efficient option.

Myth: Using private hospitals for public patients is part of a secret plan to privatise the health system.

The facts: Private hospitals have been an essential part of New Zealand’s health system for more than 100 years. Governments of all stripes have used them to help reduce surgical waiting lists and improve access to care. This is a practical solution putting the patient first, not a plan to privatise healthcare.

Myth: Private hospitals only do the ‘easy stuff’.

The facts: Private hospitals perform a wide range of planned surgeries, from routine operations to highly complex surgery, including cardiac and neurosurgical procedures. Decisions about where patients receive treatment are made by clinicians to ensure the best match of patient, surgeon and facility. Fewer than one in 250 privately treated patients require transfer to a public hospital for ongoing care after surgery.

The challenge ahead

New Zealand's health system faces a simple reality: demand is growing faster than the capacity to deliver care, and as the population ages, that pressure will only increase.

An ageing population requires more diagnostics, more surgery, and more ongoing treatment. Demand is increasing for surgical procedures commonly associated with older age, such as cataracts, joint replacements and urological treatments. Public hospitals are overcrowded, and health workforce shortages remain a challenge across many parts of the country.

Building a sustainable health system will require making full use of existing facilities, equipment and clinical expertise wherever they are available. Patients waiting for treatment are not concerned with who owns the hospital building. They want timely access to safe, high-quality care.

Meeting this demand will require strategic decisions about how surgical capacity is developed and used across both public and private sectors. Those decisions should be guided by patient outcomes and cost-effectiveness, not political doctrine.

Public surgery waiting lists are starting to reduce through targeted use of outsourcing, but more can and should be done. Private hospitals from Whangārei to Invercargill have available capacity that can be used to treat patients sooner.

The real health debate this election should focus on how to deliver sustainable, high-quality healthcare for a growing and ageing population with increasingly complex needs. Success should be measured not by how much money is spent, but by whether New Zealanders can access the care they need when they need it.

To achieve the best outcomes for patients, every part of the health system must work together. Greater collaboration, longer-term planning and funding certainty will create a more productive, responsive and resilient health system, delivering better results for patients, taxpayers and New Zealand as a whole.

Private hospitals do not have all the answers, but they are unquestionably part of the solution.