In June 2025 an Official Information Act request revealed the Minister of Health [Privatisation], Simeon Brown, had directed Health NZ to "prioritise medium-term (circa three years) agreements with private providers prior to moving towards longer-term agreements (circa ten years)" to "improve the cost-effectiveness of delivery" and "provide clear investment signals" to the private sector.

The View From Inside Hospitals

As doctors pointed out, the only cost-effectiveness here is higher profits for the private sector; the Government will pay more to perform these operations there. And critically, the private sector only takes straightforward surgeries, which are critical for training new doctors in the public sector. Doctors also know how many frontline vacancies aren't being filled, despite the weasel-word denials of overpaid senior management.

I've spent a lot of time visiting hospital wards lately, and joined staff picket lines when I could, where we get heaps of friendly toots from the majority of passing drivers. And it's encouraging to see doctors are now more willing to speak out for better services. For staff who know their hospital intimately, it's obvious that repeated annual budget cuts are adding up to long term systemic decline.

And on patient visits, I saw the rising pressures on the health system play out in the complexities of real-world care. For example, there are still signs requesting visitors to wear a mask, as there should be when ten patients had covid in the last ward I visited. But policy is not to upset visitors by asking them to protect patients, so most visitors don't wear masks in this ward which treats mainly elderly patients with stroke recovery, terminal pain management, dementia and pneumonia.

And one patient had terminal cancer, the result of refusing surgery because the hospital couldn't guarantee his blood transfusions wouldn't contain covid vaccine traces. Claiming he buried many friends who died from the vaccine, he still had energy to abuse the staff and insist his bed was shifted to the window. Another grey-haired gent, aged somewhere north of 80 with a law-and-order bent, felt it his duty to confront this badly behaved chap while clasping an odd-looking metal bar he'd found somewhere in the ward. Lucky me got to stand in the middle, convincing them both it was just a little confusion until nurses arrived to calm them.

The parents of another younger patient showed their management skills, holding the doctor back from his round as they restated in multiple highfalutin ways their belief that the doctor should give more than standard treatment to their daughter. I can't remember the words, I hate that manipulative crap, but the gist of it was that what they wanted was what the doctor wanted, though it clearly wasn't. They just kept talking until they got it.

Meanwhile in the opposite bed, another very working-class chap who was so sick he mostly slept peppered his conversations with a long-winded politically-correct doctor with "what?!" and "I can't understand a word!" And all this craziness has roots out in the crazy world we live in today. The mostly migrant staff stayed mostly cheerful, dealing kindly and professionally with the chaos. But there were regular difficulties for nursing staff getting all their critical cares done during their shift. This was clearly a system under pressure.

Signalling The Future, One Way Or Another

This Rightwing Government providing "clear investment signals" to the private sector is a clear message to the public too. The Coalition will keep reducing spending on public health. They care most about creating new sources of profitable investment in the private sector, so the wealth they take from reducing taxes and increasing landlord subsidies has somewhere to go, making them ever richer. They don't care about public health because they have private insurance.

The Right is now the radical party. They break things deliberately, because big moves are harder to fix when they fall out of Government. The centrist Left still thinks incremental change will make a difference. The Right is clearly winning. We really, really, really don't want to live in a dysfunctional privatised health system like the USA, the richest nation in the OECD (Organisation for Economic Cooperation and Development) and spending twice the OECD average on health care - to have the lowest life expectancy and the highest rates of maternal, infant and avoidable deaths. Either we get more involved in creating a better world, or we live the American Nightmare. It's a no-brainer!

Watchdog - 169 August 2025