19 December 2025
Spencer Jones
[FYI request #32744 email]
Tēnā koe Spencer
Your request for official information, reference: HNZ00103034
Thank you for your email that was transferred on 10 November 2025 to Health New Zealand | Te
Whatu Ora (Health NZ), for the following under the Official Information Act 1982 (the OIA):
Under the Official Information Act 1982 (OIA), 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 bil ions in locked-in debt and interest payments to private
entities. In New Zealand, amid a reported $20 bil ion 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 bil ion 10-year forecast) and any
resulting safety/equity risks (e.g., hospital-acquired infections or access disparities for
Māori/Pasifika communities).
Ownership Structures and Private Sector Involvement:
Current ownership breakdown for public hospital assets (e.g., buildings, equipment) valued
over $10 mil ion, 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). This one might also cover procurement & supply chain
and/or HSS.
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.
Response
For clarity, we wil address each question in turn.
PPP and Private Financing Models in Hospital Infrastructure:
1.
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:
a.
Project name and scope.
b.
Private partners involved (e.g., companies, consortia).
c.
Total contract value, including any projected long-term payments (e.g., over 10-30
years).
d.
Breakdown of financing sources (public equity/loans vs. private debt/equity).
e.
Any risk assessments conducted on long-term costs, including interest equivalents
or penalties.
We have identified two areas within the scope of this aspect of your request, Hawke’s Bay Linear
Accelerator Project and a contract held by Ventia for the delivery of all hard services at Palmerston
North hospital and Whanganui Hospital.
Hawke’s Bay Linear Accelerator Project
Health NZ is currently engaging the market on options for Hawke’s Bay Linear Accelerator Project.
The project scope comprises two LINAC bunkers and supporting radiation oncology facilities
(Stage 1) and Medical Oncology/Chemotherapy facilities (Stage 2). LINAC machines are used in
delivery of radiation treatment for cancer patients.
It is Health NZ’s intent to receive market information and registrations of interest on different
delivery models for establishing the services (Stage 1 and stage 2), to ensure the proposed
delivery model offers the best value for money and fastest delivery timeframes for services in
Hawkes Bay. Health NZ will consider registrations of interest in public capital-funded models and
privately funded models.
1. Capital-funded:
• Design and construct delivery – Health NZ procures the design finalisation and construction
of the facility and delivers radiation oncology services.
2. Privately funded:
• Strategic lease – Health NZ leases a privately funded and developed facility in Hawkes Bay
(either on the Hospital Campus or on a site proposed by the Proponent) and Health NZ
operates a public radiation oncology service; or
• Service purchase – Health NZ accesses radiation oncology services through a private
provider in the Hawke’s Bay, delivered in a privately established facility.
Health NZ may consider alternative models to those outlined above where they offer clear value for
money benefits.
A Registration of Interest (ROI) has been issued to test market appetite and identify capable
private-sector participants for both capital-funded (design and construct) and privately funded
(strategic leasing or service purchase) transaction structures.
Following assessment of registrations and a decision on a preferred approach, Health NZ intends
to invite detailed proposals (Request for Proposals, RFP) against the selected capital-funded or
alternative private financing and outsourced delivery model in early 2026.
Service outsourcing contract
Ventia NZ Operations Limited holds a contract with Health NZ to provide all hard services at
Palmerston North Hospital and Whanganui Hospital (the provision of hard services
involves managing and maintaining a building's essential physical infrastructure, such as HVAC,
electrical, plumbing, and fire safety systems). The contract was signed in September 2020 for a 5
five-year term. The contract is currently under review and continues to operate under its existing
conditions while that exercise is being completed.
We have provided the above summary in accordance with section 16(e) of the OIA, as releasing
further information within the scope of this aspect of your request would invoke the following
sections of the OIA:
• 9(2)(b)(i ) to avoid prejudice to the commercial position of the parties involved;
• 9(2)(h) to maintain legal professional privilege;
• 9(2)(i) to avoid prejudice to the commercial position of the Crown;
• 9(2)(j) to avoid prejudice to negotiations; or
• 18(e) as the information does not exist.
Any internal or external evaluations of PPP
2.
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).
We have not identified any information within the scope of this aspect of your request, therefore
this part is refused under section 18(e) of the OIA, as the information does not exist.
Historical Capital Charges and Legacy Impacts:
3.
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
The information you seek under this aspect of your request is set out in the Annual Reports of the
respective entities it relates to. You can access these reports here:
Te Whatu Ora Publications –
Annual Reports
4.
Post-2019 waiver: Details of any “legacy” financial burdens from pre-waiver charges (e.g.,
deferred maintenance costs, deficits linked to asset depreciation).
Health NZ inherited Crown EECA loans and Finance leases; the associated interest expense for
Health NZ is published in its annual reports linked above.
5.
Evidence of how the abolition of capital charges has affected infrastructure spending, including
underspend variances (e.g., against the $14 bil ion 10-year forecast) and any resulting
safety/equity risks (e.g., hospital-acquired infections or access disparities for Māori/Pasifika
communities).
Capital charges have not been abolished, and we continue to pay this. We are unable to provide
evidence of impacts arising from an abolition that did not occur. Therefore, this aspect of your
request is refused under section 18(g) of the OIA, as the information is not held by Health NZ.
Ownership Structures and Private Sector Involvement:
6.
Current ownership breakdown for public hospital assets (e.g., buildings, equipment) valued
over $10 mil ion, including any private stakes (for-profit, not-for-profit, or foreign-owned).
Public hospital assets valued over $10 mil ion are Crown-owned. The only exceptions are certain
finance leases for equipment and vehicles, as well as property leases for community bases,
offices, and occasional y car parking. While the combined value of finance leases may exceed $10
mil ion, no single item of equipment reaches that threshold.
7.
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).
Please find attached as
Appendix One the Surgical Services Panel Agreement. Appended to this
agreement are: - Service Specifications Standards and Reporting Surgical Outsourcing (appendix
A) - Clinical Pathways – Surgical Services (appendix B).
Some information has been withheld under section 9(2)(a) of the OIA, to protect the privacy of
natural persons. Additionally, we are withholding each specific agreement under section 9(2)(b)(i )
of the OIA, as it contains prices per procedure that would create a commercial disadvantage to
providers if this information was released.
Other than to the extent outlined in our response to question 1, Health NZ does not deal with
private providers in respect of infrastructure, as we manage our own portfolio. We have not
identified any information within the scope of this aspect of your request, and therefore this part is
refused under section 18(e) of the OIA, as the information does not exist.
8.
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.
We have not identified any information within the scope of this aspect of your request, and
therefore this part is refused under section 18(e) of the OIA, as the information does not exist.
Foreign Ownership and Risk Mitigation:
9.
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.
Other than to the extent outlined in our response to question 1, Health NZ does not deal with
private providers in respect of infrastructure, we manage our own portfolio. We have not identified
any information within the scope of this aspect of your request, and therefore this part is refused
under section 18(e) of the OIA, as the information does not exist.
Your request also appears to seek details on foreign ownership across major PPP’s or outsourced
services. Health NZ does not maintain a comprehensive record of foreign ownership across all
hospital projects and service contracts. Compiling such information would require creating a new
dataset. Therefore, this part of your request is refused under section 18(g) of the OIA, as the
information is not held.
10.
Government Policy Statement on Health (2024-2027) implementation reports on private
investment safeguards, including equity impact assessments for high-needs populations.
We have not been able to identify any information within the scope of this aspect of your request,
therefore this part is refused under section 18(e) of the OIA, as the information does not exist.
The Government Policy Statement on Health 2024-27 is prepared by and monitored by the Ministry
of Health. Health NZ must give effect to the GPS via the New Zealand Health Plan (s50(3) of the
Pae Ora (Healthy Futures) Act 2022. The current New Zealand Health Plan (NZHP) was published
in August 2025 and can be found her
e https://www.tewhatuora.govt.nz/corporate-
information/planning-and-performance/new-zealand-health-plan. Actions in the NZHP that relate to
digital and physical infrastructure can be found on pages 29-32. Health NZ is currently preparing
an annual report for 2024/25 on its progress towards delivery of the actions in the NZHP. This
annual report wil be published in early 2026. Health NZ’s quarterly reporting for 2025/26 wil
include updates on progress against NZHP actions.
As required under section 9(1) of the Act, we have considered the public interest in releasing the
information withheld. We do not consider that the public interest considerations favouring the
release of this information are sufficient to outweigh the harm identified above at this time.
How to get in touch
If you have any questions, you can contact us a
t [email address].
If you are not happy with this response, you have the right to make a complaint to the
Ombudsman. Information about how to do this is available at
www.ombudsman.parliament.nz or
by phoning 0800 802 602.
As this information may be of interest to other members of the public, Health NZ may proactively
release a copy of this response on our website. Al requester data, including your name and
contact details, wil be removed prior to release.
Nāku iti noa, nā
Danielle Coe
Manager (OIA) – Government Services
Health New Zealand | Te Whatu Ora
