Kia ora Spencer

 

Thank you for your request under the Official Information Act 1982 (the
Act), received by the Ministry of Health on 5 November 2025. You
requested:

 

I request the following information in the public interest. Recent
international examples, such as the UK’s Private Finance Initiative (PFI)
schemes, have highlighted significant long-term financial risks and equity
concerns in public hospital financing, including billions in locked-in
debt and interest payments to private entities. In New Zealand, amid a
reported $20 billion hospital infrastructure backlog and ongoing system
reforms, there is growing public concern about the potential expansion of
PPPs and private ownership models. This request seeks transparency to
inform public debate on protecting equitable access to health services, in
line with the Pae Ora (Healthy Futures) Act 2022 and Te Tiriti o Waitangi
principles.

Please provide the following information, covering the period from 1 July
2019 (post-abolition of DHB capital charges) to the present (5 November
2025), unless otherwise specified. Where data is aggregated or anonymized
for commercial sensitivity, please provide summaries or redacted versions
with justifications under sections 9(2)(b) or (i) of the OIA.

PPP and Private Financing Models in Hospital Infrastructure:
A list of all current or proposed PPP arrangements (including
build-operate-transfer, design-build-finance-operate, or service
outsourcing contracts) for public hospital infrastructure or major
projects (e.g., Dunedin Hospital Redevelopment, Christchurch Hospital, or
Taranaki Base Hospital). For each, include:
Project name and scope.
Private partners involved (e.g., companies, consortia).

Total contract value, including any projected long-term payments (e.g.,
over 10-30 years).
Breakdown of financing sources (public equity/loans vs. private
debt/equity).
Any risk assessments conducted on long-term costs, including interest
equivalents or penalties.

Copies of any internal or external evaluations of PPP performance against
key indicators (e.g., infection rates, waiting times, bed occupancy, cost
efficiency), drawing from models like those prioritized in international
studies (e.g., clinical outsourcing, BOO).

Historical Capital Charges and Legacy Impacts:
Total capital charges and interest on Crown loans paid by District Health
Boards (DHBs) or Te Whatu Ora from 1 July 2016 to 30 June 2022, broken
down by DHB/region.
Post-2019 waiver: Details of any “legacy” financial burdens from
pre-waiver charges (e.g., deferred maintenance costs, deficits linked to
asset depreciation).

Evidence of how the abolition of capital charges has affected
infrastructure spending, including underspend variances (e.g., against the
$14 billion 10-year forecast) and any resulting safety/equity risks (e.g.,
hospital-acquired infections or access disparities for Mâori/Pasifika
communities).

Ownership Structures and Private Sector Involvement:
Current ownership breakdown for public hospital assets (e.g., buildings,
equipment) valued over $10 million, including any private stakes
(for-profit, not-for-profit, or foreign-owned).
Details of contracts with private providers for elective services or
infrastructure support (e.g., 2024-2025 national agreements), including
total spend, private owners (e.g., Southern Cross, offshore investors),
and any cost-shifting from private to public sectors (e.g., complications
handling).

Policy documents or briefings on trends in primary/community care
corporatization (e.g., shifts to larger for-profit entities like Green
Cross), including risks to continuity of care or equity.

Foreign Ownership and Risk Mitigation:
Any instances of foreign-owned entities (e.g., US, Australian, or other
multinational companies like UnitedHealth equivalents) holding stakes in
public hospital projects, financing, or service contracts.

Government Policy Statement on Health (2024-2027) implementation reports
on private investment safeguards, including equity impact assessments for
high-needs populations.
If any information is held by another agency (e.g., Treasury,
Infrastructure Commission), please transfer or direct this request
accordingly under section 16 of the OIA.

I request responses in electronic format (e.g., PDF/Excel) where possible,
and within the 20-working-day timeframe. If withholding information,
please provide clear reasons and consider partial releases in the public
interest (section 9(2)(a)).

This request supports informed public discourse on sustainable, equitable
health financing, avoiding pitfalls like those in the UK’s PFI (e.g.,
£21.1 billion in locked-in payments). Thank you for your assistance.

 

The reference number for your request is H2025075088. As required under
the Act, the Ministry will endeavour to respond to your request no later
than 20 working days after the day your request was
received: [1]http://www.ombudsman.parliament.nz/

 

If you have any queries related to this request, please do not hesitate to
get in touch ([2][email address]).

 

 

Ngâ mihi 
 
  

OIA Services Team

Ministry of Health  | Manatû Hauora 

M[3]inistry of Health information releases 

 

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