New Zealand’s private surgical hospitals: What can we do better?
The healthcare system in New Zealand is experiencing significant pressure due to rising costs and increased demand for services. To address these challenges, publicly funded surgeries are outsourced to private hospitals. This trend aims to alleviate the burden on public hospitals and reduce waiting times for elective surgeries.
Outsourced healthcare services have seen substantial growth, driven by the increasing demand for surgical procedures. In 2022, the New Zealand Private Surgical Hospitals Association (NZPSHA) reported a 7% increase in surgical discharges, with 220,029 surgeries conducted annually, including 25,981 procedures contracted by Te Whatu Ora (Health New Zealand). This rise highlights the private sector's critical role in supporting the public health system. Private hospitals now perform 67% of all elective surgeries in New Zealand, a 7% increase from the previous year.
The collaboration between public and private sectors has demonstrated its effectiveness, especially during the COVID-19 response in 2020. This partnership approach is seen as a viable solution to address the growing demand and financial constraints within the healthcare system. Private hospitals bring not only capacity but also capital, ensuring that facilities and technologies remain up-to-date without impacting government budgets.
Workforce development is another critical area where private hospitals contribute significantly. New Zealand faces clinical workforce shortages, and private hospitals have the potential to increase training capacity by up to 50%, supporting the growth of a sustainable health workforce. This collaborative effort includes training for nurses, allied health professionals, and medical specialists, boosting the overall capacity of the healthcare system.
Despite these advancements, challenges remain, particularly in addressing disparities in surgical outcomes among different ethnic groups. Māori and Pacific peoples have higher rates of postoperative mortality compared to other ethnicities, with various factors such as access to care, socioeconomic deprivation, and comorbidity burden contributing to these inequities.
The increasing reliance on outsourced healthcare services reflects the growing demand and financial pressures on NZ's public health system. While the public-private healthcare partnership in NZ has been beneficial, several improvements can enhance efficiency and equity: developing integrated health information systems for seamless patient data transfer and better resource allocation; investing in preventive health measures to reduce the overall demand for surgical procedures, allowing healthcare facilities to focus on more complex cases; and implementing equity-focused policies to improve surgical outcomes for Māori and Pacific populations, including better access to care and culturally competent services.