The Green Party is warning that New Zealand’s public healthcare system is moving towards an American-style model, following the release of a new report revealing that almost half of public health funding is now flowing to private-sector providers.
Green Party Co-leader Chlöe Swarbrick has accused the National-led Government of undermining public healthcare by directing increasing amounts of taxpayer funding towards private providers rather than strengthening publicly operated health services.
The criticism follows the release of Who Owns the Health System?, a report by Public Futures Aotearoa examining corporate ownership, private investment and the growing role of commercial providers in New Zealand’s health sector.
The report has reignited debate over the future of public healthcare, the influence of private corporations and whether taxpayer funding is delivering the best outcomes for patients.
$14.8 BILLION IN PUBLIC HEALTH FUNDING GOES PRIVATE
According to the report, 46.4 percent of combined Health New Zealand and ACC health expenditure, equivalent to $14.8 billion, went to private-sector providers in the 2024/25 financial year.
The report also found that private providers received approximately 80 percent of the $3 billion increase in combined health spending since 2022/23.
Researchers examined the growing concentration of corporate ownership across general practice, radiology, pathology, private hospitals, aged residential care and community support services.
The findings have raised questions about how public funding is distributed and whether increased contracting of private services is reducing the capacity of publicly operated healthcare facilities.
GREENS ACCUSE GOVERNMENT OF AMERICANISING HEALTHCARE
Swarbrick says the findings demonstrate a concerning shift towards greater reliance on private healthcare.
The Greens argue that the Government’s approach risks creating a system in which commercial providers play an increasingly dominant role while public hospitals and health services face continuing pressure.
The party has compared the direction of healthcare policy with the United States, where private insurance and commercial healthcare providers have a substantial influence on access to treatment.
However, the comparison is a political interpretation rather than a finding that New Zealand has adopted the American healthcare model.
New Zealand continues to operate a predominantly publicly funded healthcare system, and payments to private providers do not necessarily mean patients are being charged privately.
The Government has supported contracting non-government providers to deliver publicly funded treatment, including elective procedures, as a way of increasing capacity and reducing waiting times.
The central disagreement is whether that approach strengthens access to healthcare or weakens the public system over the longer term.
CORPORATE PROFITS AND OWNERSHIP UNDER SCRUTINY
The Public Futures Aotearoa report also highlights the increasing profitability of the wider healthcare and social assistance industry.
It found that the sector generated approximately $4.5 billion in surplus before income tax in 2025, compared with $2.2 billion in 2020.
Researchers have raised concerns about the growing influence of private equity investors, pension funds and asset managers in healthcare businesses.
The report estimates that corporate ownership of general practices has reached 25 percent, while approximately 75 percent of the diagnostics, imaging and radiology sector is corporately owned.
It also identifies a 93 percent increase over four years in publicly funded elective surgeries delivered through private hospitals, with spending exceeding $1 billion in 2024/25.
The researchers argue that these trends warrant greater scrutiny of ownership structures, financing arrangements and how taxpayer funding is used.
However, the wider sector’s profits cannot automatically be attributed to public healthcare contracts, and private providers include both commercial and non-profit organisations.
THIS MEAN FOR MĀORI HEALTH?
For Māori, the debate raises important questions about equitable access to healthcare, culturally appropriate services and the Crown’s responsibilities under Te Tiriti o Waitangi.
Māori continue to experience significant disparities in health outcomes and access to timely treatment.
The report’s researchers warn that greater commercialisation could make it more difficult to address those inequalities if financial considerations take priority over community health needs.
However, Māori healthcare providers also operate outside directly government-run services.
Many kaupapa Māori organisations deliver publicly funded primary healthcare, mental health, disability and whānau support services through contracts with government agencies.
These providers are an important part of the health system and should not be confused with large corporate healthcare businesses simply because they are classified as non-government organisations.
For Māori communities, the key issue is whether funding arrangements support effective, culturally responsive healthcare and improve outcomes for whānau.
The report includes recommendations addressing accountability, public sector capacity and the Crown’s obligations to hauora Māori.
GREENS CALL FOR GREATER PUBLIC HEALTH INVESTMENT
The Green Party is campaigning for an additional $3 billion in annual public healthcare funding.
The party says increased investment is needed to strengthen frontline services, improve workforce capacity and reduce the pressures facing patients and health professionals.
Its position is that public healthcare should be strengthened rather than relying increasingly on commercial providers.
The debate comes amid ongoing concerns about hospital staffing, waiting times, access to general practitioners and the affordability of essential healthcare.
General Practitioners Aotearoa has also urged the Greens to ensure any additional funding is directed towards frontline primary healthcare, highlighting the need for investment to address pressures experienced by patients and practices. <Cite refs={[“turn940807search0″,”turn940807search3”]}/>
PUBLIC FUNDING, PRIVATE DELIVERY — WHO BENEFITS?
The findings of Who Owns the Health System? raise broader questions about how New Zealand should organise and fund healthcare.
Supporters of private-sector involvement argue that contracting additional providers can improve access to treatment and make use of available capacity.
Critics warn that long-term reliance on outsourcing could make it harder to recruit and retain staff, invest in public facilities and maintain public control over essential services.
There are also questions about transparency, with researchers calling for greater scrutiny of corporate ownership and the financial arrangements behind publicly funded contracts.
Ultimately, the impact on patients depends on whether services are accessible, affordable, safe and delivered in a timely manner.
HEALTHCARE BECOMES A MAJOR ELECTION ISSUE
With the November 7 general election approaching, the report has added another dimension to the political debate over the future of New Zealand’s health system.
For the Greens, the findings support their argument that greater investment in public healthcare is needed to prevent further dependence on commercial providers.
For the Government, the use of private providers forms part of an approach intended to increase treatment capacity and improve access.
The question facing New Zealanders is whether billions in taxpayer funding are building a stronger healthcare system for the future, or creating greater dependence on private businesses to deliver essential services.
For Māori whānau and communities already experiencing barriers to healthcare, the most important test will be whether the system delivers timely, affordable and equitable treatment, regardless of who provides it.
As the election approaches, the future balance between public healthcare and private delivery is set to remain a significant issue for voters.
Sources: Green Party media release, 27 October 2026; Public Futures Aotearoa, Who Owns the Health System?; Public Service Association commentary on the report.
Original Green Party statement
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