Call for weekend surgery

NZ Herald 5 November 2026

Junior doctors have asked health authorities to normalise the use of public hospital theatre space during weekends to claw back the number of routine surgeries outsourced to the private sector.

The increasing number of cases pushed to private hospitals are generally high-volume, straightforward surgeries like hip, knee or hernia operations – procedures critical for training the next generation of specialists.

The Resident Doctors’ Association (RDA) national secretary Deborah Powell, who represents registrars, house officers, interns and clinical students, wrote to Te Whatu Ora Health New Zealand with a proposal last week.

In the letter, provided to the Herald, Powell said the loss of training opportunities in public hospitals was a “significant issue”.

The RDA’s pitch sought to perform elective surgeries in public hospitals outside the current Monday to Friday, 9am to 5pm surgical roster.

“Instead of funnelling funds into private sector outsourcing, we should redirect those resources toward standing up 7-day services and providing elective surgeries over the weekend in public hospitals,” she told the Herald.

“It’s starving us of the cash to build our infrastructure and workforce.”

She said junior staff were “absolutely” keen, and she was confident the workforce was available if the proposal was done in a phased manner.

Health Minister Simeon Brown said he had set “very clear” expectations that Health NZ make better use of weekends, and that more out-of-hours surgeries were being done as a result.

He said this had helped with the training of junior doctors.

Health Minister Simeon Brown says he's had constructive talks with the RDA on the issue.

“I’m supportive of any initiative that continues to bring wait lists down while also building their skills.”

Powell said while some surgeries happened at weekends, it was ad hoc and the RDA wanted it to be a business-as-usual arrangement.

“We are talking about every weekend - and normalising it,” she said.

The Government has a target of having 95% of patients wait less than four months for scheduled surgeries by 2030.

As part of that drive, it’s paying private providers to pick up significantly more cases.

The Herald revealed on Tuesday that a Health NZ briefing to its board showed the agency wasn’t sure whether an increased number of private surgeries was a good use of public money.

The briefing, sent to the board in July, showed some high-volume procedures such as shoulder, knee and hip replacements cost less in private.

Other urology procedures and laparoscopic gall bladder surgery cost more, the document said.

However, the price comparison data came with a caveat.

“Price comparison provides some insight but is not enough to assess value for public investment. It doesn’t take account of patient outcomes, or availability of the appropriate facility and workforce to guarantee timely care,” the briefing said.

Powell said relying on outsourcing – despite uncertainty about its value for money – was risky.

“It throws taxpayer dollars at a temporary band-aid solution rather than investing in a sustainable public health system,” she said.

Powell said there was capacity to do weekend elective surgeries at “most” public hospitals and gave the example of Wellington Hospital where 11 operating theatres “sat idle” at weekends.

“Transitioning to 7-day surgical services generates true cost-effectiveness by unlocking unused hospital capacity, bolstering our public health system, and stabilising medical pipelines.”

She said the proposal sent to Health NZ suggested a pilot at Wellington Hospital begin early next year.

Chris Roberts, the New Zealand Private Surgical Hospitals Association (NZPSHA) chief executive, was “very confident” private hospital outsourcing was the most cost-effective solution if all factors were considered, including rescheduling delays in public and the cost to patients who took extended time off work while they wait.

“NZPSHA challenges Health NZ to undertake the research [to determine the costs],” he told the Herald.

Health NZ currently pays orthopaedic surgical trainees to train on a limited number of runs in private hospitals.

However, Roberts said such agreements are not in place for other specialties such as general surgery and ear, nose and throat surgery.

Roberts said private hospitals were open to training other disciplines but said Health NZ “would not engage”.

Health NZ told the Herald it does work with some private providers to support training in areas including orthopaedics, cardiothoracic surgery, urology, general surgery, ENT, dental surgery and gynaecology.

“These arrangements are based on local training needs and are not required in every district or specialty. The majority of RMO surgical training continues to take place in public hospitals,” the agency said.

It encouraged the NZPSHA to contact Health NZ about the issue.

Powell argued training should happen in public where operating theatres were available rather than Health NZ paying for it to happen in private.

She said it was “unethical and wasteful” to have public theatres unused while patients languished on treatment waitlists.