I asked Health NZ to prove private surgery outsourcing delivered value. It couldn’t – Ottilie Stolte

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New Zealand Private Surgical Hospitals Association chief executive Chris Roberts has argued that concerns about this trend are overstated. Yet information released by Health New Z…

Dr Ottilie Stolte works at Waikato Hospital in Hamilton. Photo / Mike Scott

Debate continues over the growing role of private hospitals in publicly funded healthcare.

New Zealand Private Surgical Hospitals Association chief executive Chris Roberts has argued that concerns about this trend are overstated.

Yet information released by Health New Zealand Te Whatu Ora paints a less straightforward picture. Waikato data suggest some privately delivered cardiac procedures may have cost substantially more than their public equivalents, while efforts to evaluate the true value of outsourcing are often frustrated by limited and inconsistent information. That raises broader questions about how Health NZ assesses and demonstrates value for money when outsourcing care.

On the surface, the case for outsourcing appears straightforward. If private hospitals can treat publicly funded patients more quickly, both patients and the public stand to benefit. But determining value is more complex than waiting times or targets. Any meaningful assessment must also consider the longer-term effects on workforce development, specialist training and the sustainability and capacity of the public health system.

The key questions are when should outsourcing have a role, and whether there is sufficient evidence to determine if it represents good value for patients and the health system.

Through a series of Official Information Act (OIA) requests, I sought information about publicly funded cardiac procedures outsourced to private hospitals in the Waikato region. As discussed in a previous article, Health NZ data showed that spending increased almost tenfold over two years, while the cardiac procedures being outsourced were, on average, less complex than those performed in public hospitals. Nonetheless, many questions remained unanswered because the data received excluded some outsourced costs and provided little information about differences in case complexity or contracting arrangements.

Most strikingly…

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