> ## Content Index > Fetch the complete content index at: https://www.themaorigreenlantern.maori.nz/llms.txt > Use this file to discover other available public pages before exploring further. # "The Public Pays, The Private Sector Grows" - 27 October 2027 - URL: https://www.themaorigreenlantern.maori.nz/the-public-pays-the-private-sector-grows-27-october-2027/ - Published: 2026-10-27T02:37:10.000Z - Updated: 2026-10-27T02:37:10.000Z - Description: Neoliberalism Does Not Need To Sell The Hospital If It Can Redirect The Spending - Author: Ivor Jones The Māori Green Lantern ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Public_Health_Private_Profit_-_Slide_1.png) Kia ora Aotearoa, > The taxpayer still pays. The patient still needs care. The private sector takes a larger role. > That is not a contradiction in this government’s health policy. It is the direction [Simeon Brown publicly said he wanted](https://www.beehive.govt.nz/speech/speech-businessnz-health-forum?ref=themaorigreenlantern.maori.nz). [Private sector gets 80% of increase in public health funding, unions' report findsEighty percent of the increase in public health funding from the government over the past three years has gone to the private sector, according to a new report.![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/icon/favicon-32x32.bc7fe925-5c9381fc-81e2-4842-9dc1-dd6da5f4ae73.png)RNZRNZ | Te Reo Irirangi o Aotearoa![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/thumbnail/4K7M4YZ_public_health_IN_DEPTH_ONLY_02_jpg-d0e1e519-9255-4520-afff-47ad44b22d1b.jpg)](https://www.rnz.co.nz/news/health/2174189/private-sector-gets-80-percent-of-increase-in-public-health-funding-unions-report-finds?ref=themaorigreenlantern.maori.nz) > My argument is that this is neoliberal government in practice: using public money and public purchasing power to expand private provision of an essential service. Not necessarily by selling a hospital outright. Not necessarily by charging the patient for the operation. Through decisions about who receives public spending, whose services are commissioned and whose role becomes embedded in longer-term arrangements. The immediate trigger is [RNZ’s report that a Public Futures Aotearoa–CICTAR analysis attributes 80% of a measured increase in Health NZ and ACC expenditure to private provision](https://www.rnz.co.nz/news/health/2174189/private-sector-gets-80-percent-of-increase-in-public-health-funding-unions-report-finds?ref=themaorigreenlantern.maori.nz). ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Aotearoa_Health_Spending_Infographic.png) The [original report estimates annual private-provider expenditure rising from $12.4 billion in 2022/23 to $14.8 billion in 2024/25](https://img.scoop.co.nz/media/pdfs/2610/Who%5FOwns%5Fthe%5FHealth%5FSystem%5F%5Ffinal.pdf?ref=themaorigreenlantern.maori.nz). Those figures are not the whole case. They are the starting point. The stronger evidence is the relationship between the reported spending pattern, the minister’s stated ambition and the arrangements Health NZ subsequently implemented. Together, they show why we should examine this as a political programme—not merely a purchasing decision. --- ## Do Not Confuse Public Funding With Public Control ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Public_Health_Private_Profit_-_Slide_2.png) Brown made his preferred direction plain in his published [BusinessNZ Health Forum speech](https://www.beehive.govt.nz/speech/speech-businessnz-health-forum?ref=themaorigreenlantern.maori.nz): > “Long term, I want as much planned care as possible to be delivered in partnership with the private sector, freeing public hospitals for acute needs.” There it is. Not “private providers will help temporarily while we demonstrate the best long-term balance”. His stated ambition was for as much planned care as possible to be delivered in partnership with them. [Brown also emphasised that the system would remain publicly funded](https://www.beehive.govt.nz/speech/speech-businessnz-health-forum?ref=themaorigreenlantern.maori.nz). But “publicly funded” does not answer the ownership question. It does not tell us who controls facilities, employs staff, receives contractual certainty or gains bargaining power. A government can preserve the public obligation to pay while expanding private control over delivery. > That is the distinction I mean when I describe this direction as neoliberal. Public money does not disappear. It becomes the purchasing stream through which private provision expands. The public is told to concentrate on the operation. I want us to examine the system being built around it. --- ## The Deep Dive Podcast Who Really Owns New Zealand Healthcare 0:00 /1212.522812 1× Listen to a lively conversation between two hosts, unpacking and connecting topics in the sources of this essay. I apologise in advance for the AI's very harsh pronounciation of reo. Please dont shoot me, :). ## Youtube Video Like video? Here is a short video suppporting the essay. Again, don't shoot the messenger please because of AI's pronounciation. :) --- ## Follow The Money, But Do Not Manufacture The Accusation The [Public Futures report estimates publicly delivered expenditure rising from $14 billion to $14.6 billion over the same comparison period](https://img.scoop.co.nz/media/pdfs/2610/Who%5FOwns%5Fthe%5FHealth%5FSystem%5F%5Ffinal.pdf?ref=themaorigreenlantern.maori.nz), alongside the larger reported increase in private provision. That is a nominal comparison. It does not establish a precise inflation-adjusted change or care per person. The report’s headline also needs its boundaries attached. Its [broad expenditure measure includes outsourced non-clinical services and acknowledges possible overcounting associated with clinical supplies](https://img.scoop.co.nz/media/pdfs/2610/Who%5FOwns%5Fthe%5FHealth%5FSystem%5F%5Ffinal.pdf?ref=themaorigreenlantern.maori.nz). Its underlying accounts have not been independently reconciled line by line here. Nor is this an official audit. [RNZ identifies the participating unions and reports that PSA and NZNO are campaigning for a change of government](https://www.rnz.co.nz/news/health/2174189/private-sector-gets-80-percent-of-increase-in-public-health-funding-unions-report-finds?ref=themaorigreenlantern.maori.nz). That does not invalidate their evidence. It means their methods deserve the same scrutiny I demand of ministers. I will not turn provider revenue into profit, or every non-Crown organisation into a multinational corporation. A kaupapa Māori provider, a charitable service, a clinician-owned practice and an investor-owned chain are not interchangeable. We must examine their actual ownership, purposes and accountability. The accusation does not need exaggeration. > The documented political choice is serious enough: the minister wants a larger private role, and the public is entitled to ask why that is the preferred destination rather than one option to be tested against alternatives. --- ## Example One: The Eye Operation And The Longer Contract Eye surgery makes the argument concrete. [Health NZ established its national ophthalmology panel from 1 July 2026, with an initial five-year term and a further five-year renewal option](https://www.gets.govt.nz/HEALTHNZ/ExternalTenderDetails.htm?id=33589188&ref=themaorigreenlantern.maori.nz). > This was no longer merely a minister’s speech or an unimplemented tender. An arrangement had been established. Its [panel agreement guarantees neither procedure volumes nor spending, but Health NZ also records separate commitment variations with selected providers and purchasing through accepted statements of work and purchase orders](https://www.gets.govt.nz/HEALTHNZ/ExternalTenderDetails.htm?id=33589188&ref=themaorigreenlantern.maori.nz). Precision matters. That is not a universal guarantee of ten years’ purchases. It is also not an arrangement without binding purchasing mechanisms. The question is what demonstrated advantage justified the longer-term direction. [In April 2026, Health NZ told RNZ that it had not completed a standalone analysis quantifying savings from longer-term versus previous short-term outsourcing contracts](https://www.rnz.co.nz/news/health/592126/health-nz-sending-more-eye-operations-to-private-sector-under-long-term-contracts?ref=themaorigreenlantern.maori.nz). That establishes the position then. It does not prove the analysis remains unfinished now, or that no other analysis existed. > But it exposes the weakness in the sales pitch: the claimed advantage of longer arrangements preceded that completed comparison. > Longer contracts might improve value. They might enable worthwhile investment. If so, demonstrate it. > Do not ask the public to accept “commercial leverage” as a substitute for evidence. The people affected are those needing treatment, the whānau supporting them and the clinical teams delivering it. The potential harm is committing resources without an adequately demonstrated advantage—not a finding that every outsourced operation was wasteful. A practical response would publish comparable whole-pathway costs and outcomes, including complications, follow-up, staffing and the public-capacity alternative. Health NZ should answer for the purchasing. Brown should answer for the political direction. And patients should not have to choose between receiving care and asking those questions. ## Yes, Patients Need Treatment Now This is the strongest defence of outsourcing, and I accept it. [Health NZ told RNZ that outsourced ophthalmology addressed unmet need and had not reduced public provision](https://www.rnz.co.nz/news/health/592126/health-nz-sending-more-eye-operations-to-private-sector-under-long-term-contracts?ref=themaorigreenlantern.maori.nz). [Brown’s stated case also included improving Health NZ’s own performance, reducing reliance on expensive ad hoc purchasing and seeking arrangements beneficial to the public system and workforce](https://www.beehive.govt.nz/speech/speech-businessnz-health-forum?ref=themaorigreenlantern.maori.nz). That case deserves a fair hearing. > But a patient benefiting from an operation does not establish that the government’s preferred long-term organisation of healthcare is best. > Both propositions can be true: the treatment helped, and the contracting direction still needs to prove its value. > The neoliberal argument becomes slippery when immediate need is used to close down scrutiny of the institutions being strengthened to meet it. I reject that manoeuvre. Nobody should be left in pain to make an ideological point. Nobody should be expected to surrender scrutiny because their pain makes a convenient political shield. --- ## Example Two: Who Owns The Practice? The same questions reach into general practice. [Public Futures estimates that public funding supplies 55% of general-practice revenue](https://img.scoop.co.nz/media/pdfs/2610/Who%5FOwns%5Fthe%5FHealth%5FSystem%5F%5Ffinal.pdf?ref=themaorigreenlantern.maori.nz). That public contribution makes ownership and accountability legitimate public concerns. A medical-centre sign does not tell a whānau who controls fees, staffing, service hours or the practice’s future. Different owners can make different choices. What matters is what those choices do. I am not presenting a named acquisition here as proven harm. That evidence has not been established. > I am asking what should be visible when ownership changes. Did fees change? Did staff continuity improve or deteriorate? Were services added or removed? Could patients still enrol and obtain appointments? Did whānau have any meaningful opportunity to influence the changes? Those questions turn ownership from an abstract argument into something people can examine in daily life. > They also expose why “private” cannot be treated as one moral category. A Māori-controlled provider may have a fundamentally different relationship with its community from a business answering to external investors. That relationship must be established through governance and conduct—not assumed from a name. The practical response is transparent ownership and before-and-after assessment of access, continuity and patient experience. Practice owners should explain significant changes. Health NZ should examine what its commissioning purchases. The test is not whether I like the logo. It is whether the service answers to the people who depend on it. --- ## Example Three: Removing An Authority Is Not Delivering An Alternative The argument about neoliberalism cannot stop at money. It must examine authority. Who gets to design the system? Who can redirect it? Whose participation changes a decision? > The [Waitangi Tribunal’s Hauora findings identified Crown failures to design and administer primary healthcare to actively address persistent Māori inequities](https://www.waitangitribunal.govt.nz/en/news/tribunal-releases-report-on-stage-one-of-health-services-and-outcomes?ref=themaorigreenlantern.maori.nz). More recently, the [Tribunal’s official account of Hautupua Part 2 found no meaningful consultation over key replacement arrangements after Te Aka Whai Ora, failure to produce a clear alternative plan in a timely manner, and breaches of Treaty principles](https://www.waitangitribunal.govt.nz/en/news/tribunal-releases-part-2-of-its-report-on-the-disestablishment-of-te-aka-whai-ora?ref=themaorigreenlantern.maori.nz). The [Tribunal also found that Māori had suffered, and would continue to suffer, short- and long-term prejudicial effects](https://www.waitangitribunal.govt.nz/en/news/tribunal-releases-part-2-of-its-report-on-the-disestablishment-of-te-aka-whai-ora?ref=themaorigreenlantern.maori.nz). Those findings concern the conduct and arrangements examined. They are not a ruling that every private health contract is unlawful. > They nevertheless expose a serious failure in the government’s conduct. Dismantling an institution is not the same as demonstrating a better replacement. In [“Brendon Asked Where Power Lives — The Crown Answered By Taking It Back”](https://www.themaorigreenlantern.maori.nz/brendon-asked-where-power-lives-the-crown-answered-by-taking-it-back-4-october-2026/), I examined the difference between mana and institutional power. Whānau possess mana regardless of Crown recognition. The question is whether public institutions give practical effect to their authority. Being invited to comment on a household budget is not the same as sharing control over it. That comparison illustrates a difference in power; it does not define rangatiratanga. The [Tribunal recommended revisiting the option of a stand-alone Māori health authority, extensive consultation and decisions grounded in robust evidence](https://www.waitangitribunal.govt.nz/en/news/tribunal-releases-part-2-of-its-report-on-the-disestablishment-of-te-aka-whai-ora?ref=themaorigreenlantern.maori.nz). A serious response would show what authority Māori hold, what resources support it and how whānau priorities alter decisions. Another round of engagement without influence would not answer the problem. --- ## Tika Is Not A Procurement Slogan ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Public_Health_Private_Profit_-_Slide_4.png) I use Tika, Pono, Tikanga and mauri here as an editorial framework, not universal definitions or a claim to speak for iwi. Tika asks whether the arrangement is right and fit for those it serves. Not simply whether it is lawful to purchase the service, but whether access, need and future capacity have been addressed. ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Public_Health_Private_Profit_-_Slide_3-1.png) Pono demands that the figures and explanations survive examination. It stops me converting estimates into audited facts. It should also stop ministers converting promised advantages into established achievements. Tikanga directs attention to relationships, responsibilities and authority. ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Public_Health_Private_Profit_-_Slide_5.png) In the surgery pathway, that means asking whether whānau involvement is welcomed and practical. In the medical centre, whether continuity recognises the person’s relationships. In governance, whether Māori participation changes decisions. Mana is not protected by a satisfaction survey alone. Whakapapa is not respected by treating people as isolated transactions. Wairua requires space for what the person identifies as spiritually important—not a compulsory cultural performance designed by an institution. Mauri asks what the arrangement sustains: people, relationships and enduring capacity to care. ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Public_Health_Private_Profit_-_Slide_6.png) A system can count an operation while overlooking the burdens surrounding it. Equally, a respectful conversation cannot replace treatment that never arrives. We need both. --- ## The Alternative Must Prove Its Case Too I want stronger public capability and durable Māori authority. That preference does not excuse weak reasoning. [Internal correspondence released by Treasury cautioned that the cited personnel and expenditure figures did not establish that outsourcing had driven up system costs at the expense of personnel spending](https://www.treasury.govt.nz/sites/default/files/2026-02/oia-20250793.pdf?ref=themaorigreenlantern.maori.nz). That warning blocks a tempting shortcut. It should remain in the argument. Nor does Crown ownership automatically deliver good care. The alternative must demonstrate how investment improves access, develops the workforce, supports kaupapa Māori provision and reduces avoidable burdens on whānau. Publish the comparisons. Explain the choices. Report back to the people. Do not cancel useful care to perform ideological purity. Do not make private expansion the default and call every objection impractical. --- ## Why I Recommend Voting Green ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Public_Health_Private_Profit_-_Slide_8.png) The [general election is on Saturday 7 November 2026](https://elections.nz/media-and-news/2026/key-dates-for-2026-general-election?ref=themaorigreenlantern.maori.nz). > My judgment is that the National–ACT–New Zealand First coalition should not receive another mandate for this direction. [Brown’s stated ambition is a larger long-term private role](https://www.beehive.govt.nz/speech/speech-businessnz-health-forum?ref=themaorigreenlantern.maori.nz). The [ophthalmology panel shows longer-term arrangements being implemented](https://www.gets.govt.nz/HEALTHNZ/ExternalTenderDetails.htm?id=33589188&ref=themaorigreenlantern.maori.nz). The [Tribunal’s replacement-arrangements findings identify failures that cannot be dismissed as partisan annoyance](https://www.waitangitribunal.govt.nz/en/news/tribunal-releases-part-2-of-its-report-on-the-disestablishment-of-te-aka-whai-ora?ref=themaorigreenlantern.maori.nz). > I read that pattern as a neoliberal direction: expanding private provision through public purchasing while failing important tests of Māori authority and evidence-led change. > I recommend the Greens because their documented priorities offer a different course. The [Greens promise successive $3 billion health increases at the next four Budgets, a stated cumulative $30 billion, alongside workforce, primary-care and preventive investment](https://www.rnz.co.nz/news/politics%5Felection-2026/2097318/green-party-releases-fiscal-plan-promises-to-increase-health-spending-by-3-billion-each-year?ref=themaorigreenlantern.maori.nz). They have also [opposed longer private-hospital contracts](https://www.greens.org.nz/govt%5Fs%5Fprivate%5Fhospital%5Fcontracts%5Flittle%5Fmore%5Fthan%5Fband%5Faid?ref=themaorigreenlantern.maori.nz) and [opposed abolishing Te Aka Whai Ora](https://www.greens.org.nz/scrapping%5Fm%5Fori%5Fhealth%5Fauthority%5Ftramples%5Fover%5Fte%5Ftiriti%5Fo%5Fwaitangi?ref=themaorigreenlantern.maori.nz). Those are commitments and positions, not accomplished outcomes. [Their fiscal plan involves additional taxes, more borrowing and a later projected return to surplus](https://www.rnz.co.nz/news/politics%5Felection-2026/2097318/green-party-releases-fiscal-plan-promises-to-increase-health-spending-by-3-billion-each-year?ref=themaorigreenlantern.maori.nz). Implementation, workforce capacity and governing negotiations will matter. My recommendation is political judgment, not an objectively proven instruction. If the Greens enter government, they must answer the same questions. Pono does not change colour at election time. --- ## Support Scrutiny That Follows The Money ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/7c446421-13f7-4a16-ad7d-55630c1a53a3-1.png) This mahi is supported through koha, with no corporate support. To support independent scrutiny, accountability and rangatiratanga, you can [give koha](https://app.koha.kiwi/events/the-maori-green-lantern-fighting-misinformation-and-disinformation-ivor-jones?ref=themaorigreenlantern.maori.nz), [subscribe through the website](https://www.themaorigreenlantern.maori.nz/#/portal/support), or use the [Facebook subscription pathway](https://www.facebook.com/Themaorigreenlantern/subscribe/). Bank transfer: Ivor Jones — 03-1395-0099387-000. Only give if you can. Following, subscribing, discussing and sharing also support this work. --- ## Leave Our Mokopuna A Record, Not An Excuse ![](https://storage.ghost.io/c/b1/cd/b1cd2cb0-95e8-4ee7-ad91-84123e3121bd/content/images/2026/10/Public_Health_Private_Profit_-_Slide_9.png) I want readers to open and share this essay because these distinctions are useful—in daily conversations, public debate and democratic decisions. Ask what the spending strengthens. Ask who controls the service. Ask whether consultation changed anything. Ask whether a promised saving was demonstrated. > This should also stand as a record for our mokopuna: warnings were raised, decisions were examined, and silence was not universal. Many others are doing that work too. > The neoliberal direction does not become harmless because the public continues paying. Nor does a successful operation settle whether the government has chosen the best future for the system. Patients need treatment today. Whānau also need enduring capacity, meaningful authority and institutions that answer to them tomorrow. We do not have to surrender one demand to make the other. --- **Disclaimer:** This essay presents my political analysis and opinion, informed by the linked sources. Reported estimates and policy promises are not independently verified outcomes. My recommendation to vote Green is my own judgment, not a guarantee of what any party will deliver.