Data release
One in five publicly funded operations now happens in a private hospital, and public hospitals do 10,250 fewer than in 2018
Source: NZPSHA, Elective Surgery 2018-2025
Health NZ paid private hospitals to do 30,539 planned operations in FY2025. That is 20.0% of everything it funded, nearly double the FY2018 share, and public hospitals did 10,250 fewer operations than they did in FY2018.
By Henry Smith · Health system · 2026-01-06
What this means for you One in five publicly funded operations now happens in the same private theatres that insurers and ACC book, so insured patients are sharing that space with a much bigger public buyer. Publicly funded planned surgery per person is still 5.6% below FY2018 even after the FY2025 recovery, which keeps pushing planned surgery toward privately funded care.
Private hospitals now do one in five of the operations New Zealand's public health system pays for. Seven years ago it was one in ten.
The operations in question are elective ones. That means planned surgery: hips, knees, cataracts, hernias, some heart procedures. These are the cases that sit on a waiting list rather than arrive by ambulance.
Health NZ funded 152,622 elective operations in FY2025, and private hospitals did 30,539 of them (NZPSHA, 6 January 2026, retrieved 20 August 2026). That is 20.0% of the total, up from 10.8% in FY2018. Neither percentage appears anywhere in the source. Both are ours.
Public hospitals are also doing less than they used to. They delivered 122,083 publicly funded operations in FY2025, against 132,333 in FY2018 (NZPSHA, retrieved 20 August 2026). That is 10,250 fewer, seven years later.
Over the same seven years the country got bigger. New Zealand's population grew 9.0%, from 4,885,300 to a provisional 5,324,700 (Stats NZ, 14 August 2018, and Stats NZ, 19 August 2025, both retrieved 20 August 2026).
One word about what is being counted. A surgical discharge is one completed hospital stay that included surgery. It is the unit every chart in the source uses, and this piece calls it an operation throughout.
Where these numbers come from
The New Zealand Private Surgical Hospitals Association is the industry body for private surgical hospitals. On 6 January 2026 it released a four-slide data pack called Elective Surgery 2018-2025. It names its sources as "Health NZ Statistics on publicly funded elective hospital discharges, and NZPSHA member survey on elective discharges" (NZPSHA, retrieved 20 August 2026).
Slide two counts public patients treated in private hospitals. These are waiting-list cases that Health NZ pays a private hospital to handle. The count runs 15,967 in FY2018, dips to 18,252 in FY2022, then reaches 30,539 by FY2025 (NZPSHA, retrieved 20 August 2026).
Slide three counts all surgery done in private hospitals, split between Health NZ patients and "Other". The Other line is surgery paid for by anyone except Health NZ. It runs from 163,958 in FY2018 to 201,784 in FY2025 (NZPSHA, retrieved 20 August 2026).
Slide four counts everything Health NZ funded, split by where it happened. Public hospitals fall from 132,333 in FY2018 to a low of 105,748 in FY2022, then recover to 122,083 by FY2025, with the outsourced work stacked on top (NZPSHA, retrieved 20 August 2026).
That is the whole document. It shows counts and nothing else. It never divides one line by another, never adds up a year, and never adjusts for population growth. So every calculation below is ours. Every raw number is theirs.
One in five publicly funded operations now happens in a private theatre
Slide four gives two stacks for FY2025: 122,083 operations in Health NZ's own hospitals, plus 30,539 it bought from private ones (NZPSHA, retrieved 20 August 2026). Add them and the public system funded 152,622 elective operations. Divide, and private hospitals delivered 20.0% of the lot.
Run FY2018 the same way and the private share was 10.8% (NZPSHA, retrieved 20 August 2026). It has nearly doubled in seven years.
The climb was not smooth, and the peak has already passed. The share jumped from 14.7% to 19.5% in FY2023, then peaked at 20.8% in FY2024. It eased back to 20.0% in FY2025, because public hospitals recovered output faster than outsourcing grew (QuoteHub arithmetic on NZPSHA, retrieved 20 August 2026).
Chart: QuoteHub calculation from NZPSHA, Elective Surgery 2018-2025 (6 January 2026, retrieved 20 August 2026). Each bar divides slide two's outsourced count by the sum of slide four's two series for the same year.
| Year | Public facilities | Private facilities | Total Health NZ funded | Private share |
|---|---|---|---|---|
| FY2018 | 132,333 | 15,967 | 148,300 | 10.8% |
| FY2019 | 123,113 | 19,531 | 142,644 | 13.7% |
| FY2020 | 112,778 | 19,797 | 132,575 | 14.9% |
| FY2021 | 127,321 | 21,167 | 148,488 | 14.3% |
| FY2022 | 105,748 | 18,252 | 124,000 | 14.7% |
| FY2023 | 106,915 | 25,981 | 132,896 | 19.5% |
| FY2024 | 113,070 | 29,696 | 142,766 | 20.8% |
| FY2025 | 122,083 | 30,539 | 152,622 | 20.0% |
Facility counts from NZPSHA, Elective Surgery 2018-2025 (6 January 2026, retrieved 20 August 2026). The total and share columns are QuoteHub arithmetic.
Public hospitals are doing fewer operations than in 2018
Public hospitals did 10,250 fewer publicly funded operations in FY2025 than in FY2018. That is a drop of 7.7% (NZPSHA, retrieved 20 August 2026).
The whole publicly funded programme, public hospitals and outsourcing together, grew 2.9% over those seven years, from 148,300 to 152,622 (NZPSHA, retrieved 20 August 2026). That is 4,322 more operations in total. FY2025 is the first year to clearly beat FY2018. Only FY2021 came close, and it edged ahead by 188 operations.
Now put the population beside it. Stats NZ counted 4,885,300 people in New Zealand at 30 June 2018 and a provisional 5,324,700 at 30 June 2025 (Stats NZ, 14 August 2018, and Stats NZ, 19 August 2025, both retrieved 20 August 2026). That is 9.0% more people to treat.
Publicly funded elective surgery per 1,000 people fell from 30.4 to 28.7 over the same period, a drop of 5.6% per person (QuoteHub arithmetic on NZPSHA and Stats NZ, both retrieved 20 August 2026). The public system did not keep up with the country it serves, even in its recovery year.
The split of the growth is starker again. The public system's net gain since FY2018 is 4,322 operations. Outsourcing to private hospitals grew by 14,572 over the same years (NZPSHA, retrieved 20 August 2026).
So private hospitals supplied 3.4 times the entire net growth of publicly funded surgery. That extra private work covered two things: all of the system's growth, and the 10,250 operations public hospitals stopped doing (QuoteHub arithmetic on NZPSHA, retrieved 20 August 2026). Every additional operation the public system has bought since 2018 ran through a private theatre.
Most planned surgery in New Zealand is already private
Slide three's "Other" line is surgery paid for by anyone except Health NZ. It grew 23.1%, from 163,958 in FY2018 to 201,784 in FY2025 (NZPSHA, retrieved 20 August 2026).
Set that against what public hospitals produce. Private hospitals did 201,784 privately funded operations last year. Public hospitals did 122,083 publicly funded ones (NZPSHA, retrieved 20 August 2026). That is 1.65 private operations for every public one.
Here is the whole FY2025 system in one table.
| FY2025 elective operations | Count |
|---|---|
| Public hospitals, paid by Health NZ | 122,083 |
| Private hospitals, paid by Health NZ | 30,539 |
| Private hospitals, paid privately | 201,784 |
| Every elective operation in New Zealand | 354,406 |
Counts from NZPSHA, Elective Surgery 2018-2025 (6 January 2026, retrieved 20 August 2026). The total is QuoteHub arithmetic.
Private hospitals hosted 232,323 of those operations. That is 65.6% of all planned surgery in the country, up from 57.6% in FY2018 (QuoteHub arithmetic on NZPSHA, retrieved 20 August 2026).
Private money paid for 56.9% of that surgery, up from 52.5% in FY2018 (QuoteHub arithmetic on NZPSHA, retrieved 20 August 2026). Public hospitals' share moved the other way, from 42.4% to 34.4%.
The deck does not say who is behind "Other". In practice that money is health insurers, ACC and people paying their own bills.
A private majority is not new. It already stood at 52.5% in FY2018 (QuoteHub arithmetic on NZPSHA, retrieved 20 August 2026). What the seven years changed is the size of the margin, and the public system's reliance on private theatres for a fifth of its own work.
What does this mean if you have health cover?
If you hold health insurance for planned surgery, these counts say something blunt. You are not buying a fallback to the public system. You are buying access to the majority of it.
Three things follow.
First, there is only one pool of private operating theatres. Insurers, ACC and Health NZ all buy from largely the same facilities. Health NZ's purchases nearly doubled between FY2018 and FY2025, from 15,967 to 30,539 (NZPSHA, retrieved 20 August 2026). Insured patients now book slots alongside a public buyer nearly twice the size it was.
Second, fewer funded operations per person is the arithmetic behind waiting lists. If you rely on the public route alone, the queue is longer than it was seven years ago. Our research on treatment costs and waiting times tracks that procedure by procedure.
Third, the 201,784 privately funded operations (NZPSHA, retrieved 20 August 2026) show how many New Zealanders already pay for planned surgery each year, through insurance, ACC or their own savings. Our treatment costs tool shows what the private route involves for common procedures.
What we could not check
The source is a slide pack from the private hospitals' own industry body (NZPSHA, retrieved 20 August 2026). That is worth holding in mind.
The publicly funded counts are credited to "Health NZ Statistics", but the deck gives no link. We could not find a Health NZ publication with those exact numbers, so we are taking slide four on trust. The private "Other" counts come from NZPSHA's survey of its own members, and there is no official series to check them against at all.
The data covers planned surgery only. Emergency surgery, which fills much of public theatre time, is left out. So nothing here says most New Zealand surgery overall is private.
A discharge is also not exactly one operation. A single hospital stay can include several procedures, and the rules for counting day cases can shift. No series here adjusts for how hard the operations are, either. Outsourced work tends to be high-volume and simpler, so 20.0% of discharges is not 20.0% of surgical work by cost or difficulty.
The deck never says what months its financial years cover. We assume July to June.
The 2018 population figure comes from an older Stats NZ series, which was later revised upward after the 2018 Census. The 2025 figure is still provisional, so Stats NZ can change it (Stats NZ, retrieved 20 August 2026). Either revision would move the per-person figures slightly. Neither would change the direction.
Finally, the deck does not split "Other" between insurers, ACC and self-payers. So we cannot say how much of the 201,784 is paid by insurance.
Sources
- Elective Surgery 2018-2025, NZPSHA, 6 January 2026
- National population estimates: At 30 June 2025, Stats NZ, 19 August 2025
- National population estimates: At 30 June 2018, Stats NZ, 14 August 2018
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