Eighty percent of the increase in public health funding from the government over the past three years has gone to the private sector, according to a new report.
The figure equates to $2.4 billion of a total $3b increase.
The report was produced by Public Futures Aotearoa, a coalition of healthcare worker unions, including the New Zealand Nurses Organisation (NZNO), the Association of Salaried Medical Specialists (ASMS) and the Public Service Association (PSA), alongside the Centre for International Corporate Tax Accountability and Research (CICTAR).
It claims, in 2024/25, the private sector received almost half of all public health spending at 46.4 percent.
The PSA and NZNO are both campaigning for a change of government.
The report used data from Health NZ and ACC to show more public funding was now flowing to healthcare providers, which might be 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," it said.
Report author and CICTAR researcher Edward Miller told RNZ the trend was a scaling-up of private-sector healthcare, while growth in public delivery had effectively stalled.
"There was a $3 billion increase [in ACC and Health NZ funding] and 80 percent of that went to the private sector," he explained.
That was compared to the increase for publicly delivered healthcare (through Health NZ and ACC) - $600 million, from $14 billion to $14.6 billion, in the same period.
"The pace of privatisation is no longer a creep - privatisation has bolted," Miller wrote.
General practice one of the biggest recipients of public funding
Doctors' practices were privately owned and, according to this report, public funding now accounted for 55 percent of general practice revenue, up from below 50 percent in the past two years.
According to a 2026 estimation, a quarter of all GPs were now owned by corporations, up from 14 percent in 2022.
Private hospitals also received a lot of public money
The report said more than a billion dollars went to private hospitals for publicly funded surgeries in 2024/25 - that's a 93 percent growth in the four years to 2025.
Public funding now made up an estimated 45 percent of private hospital revenue, up from 35 percent five years ago, and just three entities controlled 70 percent of private hospital beds, it said.
Large amounts of public money also went to diagnostics and imaging, where public funding accounted for about 65 percent of the sector's revenue, and aged residential care, where it accounted for an estimated 76 percent of revenue - some of which went offshore to international owners.
Home and community support services received nearly all their revenue from public sources, at 94 percent, according to the report.
Why is this a problem?
Miller told RNZ it showed the health system had to increasingly rely on the private sector to deliver care - the result of years of underinvestment.
"The problem with that... as Health New Zealand's internal advice shows, outsourcing is more expensive than insourcing," he explained. "It also means we end up using public dollars, taxpayer funding, to build up the capacity of the private sector rather than... the public sector."
Borrowing was also more expensive for the private sector than the government - a like-for-like hospital built by the private sector would cost more than one built by the public sector - and there also tended to be less transparency in private sector spending, he said.
A spokesperson for Health Minister Simeon Brown's office told RNZ he did not respond to reports commissioned by unions that were actively campaigning to change the government.
However, on background regarding elective surgeries, they pointed out Health NZ delivered 43,819 outsourced procedures in 2025/26 - many for patients who would otherwise still be waiting.
About 14,200 fewer people were waiting longer than four months for elective surgery than at the peak.
Health NZ had originally planned for 39,155 procedures as part of the Electives Boost, making it now 11.9 percent ahead of target.
The government's total health spend would be $34.2 billion in the 2026/27 financial year, according to the most recent Budget.
