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Health NZ’s elective surgery plan sees training shortfall warning

Published

1 year ago

May 26, 2025

Outsourcing more elective surgeries will limit training opportunities for future surgeons, the Health Minister has been warned.

Health New Zealand aimed to perform more than 30,000 elective surgeries in the 15 months to June 2026 in a bid to reduce waitlists, including by outsourcing thousands of more straightforward cases to private hospitals.

Documents obtained by RNZ under the OIA show Health Minister Simeon Brown was told in March that outsourcing more elective operations to private hospitals will worsen training opportunities.

“That’s because outsourced procedures are usually of lower complexity, which often makes them suitable for training,” Health NZ wrote in a briefing.

Some doctors agree with the ministry’s warning.

Hawke’s Bay head and neck surgeon Christopher Kennel, who worked in both the public and private sector, said his trainees were already missing out on learning, because the public sector only had the capacity to deal with the most severe cases.

Outsourcing would only make it worse, he said.

“The registrars are already having a biased training towards more complex cases. I don’t know how people who go through training here are going to be prepared to function privately because they’re not going to have the background to do common, but less urgent cases, because the public system is under-resourced.”

To mitigate this, Health NZ was exploring more national agreements to train more doctors in private hospitals, starting with radiology and pathology. Health NZ said significant work was underway to get an agreement for obstetrics and gynaecology, while briefing papers said otorhinolaryngology (ear, nose and throat) and plastic surgery could also be targeted.

Health NZ was also considering making training a requirement of private hospitals’ outsourcing contracts.

This raised ethical and practical questions, Dr Kennel said.

“If trainees are helping me earn money privately, then who’s paying them?

“Is it fair for the public side to pay them to operate with me privately when registrars could be seeing public patients in clinic instead?

“The other thing is that on any given day when I’m operating privately, I might do a public contract case, and I might treat a privately insured patient. How does the registrar know how to schedule their day? Because if they’re going to be with me for like 2 hours of a public contract case, what do they do when I’m operating on just a privately insured patient?”

Auckland radiologist and Auckland University Faculty of Medicine associate professor Colleen Bergin said she wants to see details and assurances on how robust training systems in private hospitals would be.

“There are systems in place in the public hospital, there’s a structure. Everyone on that day is involved in teaching those students. But moving to a private system, there’s no details on that kind of process.”

Orthopedics was the only surgical speciality currently allowed to train doctors in private hospitals nationally, as much of its work was ACC related and done privately. Health New Zealand said it also had training agreements with some specialities at a local level.

New Zealand Orthopedics Association chief executive Andrea Pettett said the 16-month-old scheme was “working extremely well” and a “win-win”.

“All parties are very happy with the system. Our trainees are employed by the public hospital and they are released for one or two private runs. They go to the private hospital often with the public surgeon. And it’s entirely up to the private surgeon whether they want to train them.”

She saw no issue with publicly-paid trainees working in private hospitals, as private surgeons were also giving up their time to teach.

“Obviously in a perfect environment, our public hospitals would be better placed if they could do the full suite of acute and elective surgery, but they can’t. So this is a pragmatic way to ensure that New Zealanders get access to elective surgery.”

Speciality Trainees of New Zealand president Jordan Tewhaiti-Smith, an obstetrics and gynaecology registrar, was involved in setting up a training agreement between private hospitals and the Royal Australasian College of Obstetrics and Gynaecology.

He expected a deal to be announced soon but there were some details that still needed to be worked through.

“It’s making sure we are medico-legally protected in those spaces because public registrars aren’t employed by the private sector, so that’s a grey area.”

Ultimately, allowing private hospitals to train public doctors was a “needs-must” situation, he said.

“These are people that are going to be the future specialists of tomorrow and the people that are operating on you in 5-6 years time. If they aren’t trained to a good standard because we’ve dropped the ball in the public sector then it comes at a cost to everyone.

“Some people might snub their noses at the fact that we’re supporting the private sector by outsourcing all these cases, but actually it’s a much bigger lens that I think we should look through.”

The Royal Australasian College of Surgeons said it was speaking to private hospitals about training future surgeons, but ideally all training would happen in an appropriately resourced public health care system.

In a statement, Health NZ said a pre-requisite of any agreement is that training in private hospitals would not compromise the public system.

“We are working with the private sector towards common expectations for how medico-legal, quality and financial issues are managed, as well as with professional medical colleges and unions to build consensus,” Health NZ Clinical Lead Planned Care Derek Sherwood said.

RNZ

Latest News

Police say person who fired gun at officers still at large

Published

3 days ago

November 12, 2026

News Staff

Police say a person who fired a gun at officers in Napier is still at large.

Eastern District Commander Superintendent Joel Lamb said Police tried to stop a vehicle in the Pirimai Area at about 10pm on Tuesday.

He said someone in the back seat pointed what was presumed to be a firearm at officers pursuing the vehicle.

“Staff have then heard two distinct gunshots as the firearm was discharged.

“Fortunately, neither of our officers were injured, and the patrol vehicle did not sustain any damage.”

He said hours later, the vehicle was seen travelling north on the Waikato Expressway towards Auckland.

Police seized the vehicle at an address in Manurewa, but they had not found the alleged offender.

Lamb said people who lived at the Manurewa address were engaging with Police.

He said Eastern District and Counties Manukau Police were making enquiries.

“Presenting a firearm at a Police officer is a serious escalation that puts our staff and the wider community at risk. This behaviour is entirely unacceptable.

“We are taking this incident extremely seriously and will be pursuing all lines of enquiry to locate the offender and hold them accountable.”

Police asked anyone who witnessed the incident to contact Police on 105 or online using the reference number 261111/3764.

Information could also be provided anonymously via Crime Stoppers on 0800 555 111.

rnz

Latest News

New Zealand sides named for RLWC finals

Published

4 days ago

November 11, 2026

News Staff

The players tasked with ending Australia’s Rugby League World Cup dominance have been named.

The Kiwis and Kiwi Ferns have announced their squads for this Sunday’s World Cup finals in Brisbane.

Both sides are chasing their first titles since 2008, and both are looking to end their opponents run of three crowns in a row.

“Our Kiwi Ferns have been so dominant in years gone by, and we want to bring dominance back to this jersey, so I think it will be a case of who wants it more,” said co-captain Georgia Hale of the impending clash.

The Kiwis get a major boost for the final as they welcome back Ronaldo Mulitalo after he served a one-match ban for a high tackle against Fiji Bati.

Mulitalo replaces Charnze Nicoll-Klokstad, who moves to the six-man bench, which again includes utility Te Maire Martin, middle forwards Naufahu Whyte, Erin Clark and Xavier Willison plus fullback Keano Kini.

Loose forward Joseph Tapine will make his 30th Test appearance in a familiar pack again, including second-rowers Isaiah Papali’i and Briton Nikora, and props James Fisher-Harris and Moses Leota.

Winger Jamayne Isaako is on the cusp of claiming the New Zealand record for most Test points.

His five goals against Tonga lifted his career points tally to 225 – level with Shaun Johnson – while centre Casey McLean goes into the final with 16 tries in just eight Tests.

Fisher-Harris will again captain the team.

Fullback Ponga said the goal of the group was clear.

“We have high expectations around what we want to achieve, and obviously winning a world Cup is one of them.”

Meanwhile, Ricky Henry has selected a settled side to take on the Jillaroos, led by their lethal centre combination of Stacey Waaka and Mele Hufanga.

Veteran Apii Nicholls takes the number one jersey, Leianne Tufuga and Mackenzie Wiki on the wings.

Henry has stuck with his halves pairing of Chantay Kiria-Ratu and Raecene McGregor with Alexis Tauaneai, Georgia Hale and Otesa Pule up front.

Rounding out the starting pack is Shaniece Monschau, Kaiyah Atai, and Angelina Teakaraanga-Katoa.

“We have been building well throughout the tournament; we understand the Jillaroos side, and will give it our all to make New Zealand proud this weekend,” said Henry.

RLWC Finals:

Kiwi Ferns vs Jillaroos- 6.10pm

Kiwis vs Kangaroos – 9.35pm

Sunday November 15

Suncorp Stadium, Brisbane

Live blog updates on RNZ

Kiwi Ferns:

1. Apii Nicholls 2. Leianne Tufuga 3. Mele Hufanga 4. Stacey Waaka 5. Mackenzie Wiki 6. Chantay Kiria-Ratu 7. Raecene McGregor 8. Alexis Tauaneai 9. Georgia Hale 10. Otesa Pule 11. Shaniece Monschau 12. Kaiyah Atai 13. Angelina Teakaraanga-Katoa.

Interchange: 14. Ashleigh Quinlan 15. Annessa Biddle 16. Shannon Mato 17. Ivana Lauitiiti.

Reserves: 18. Brooke Anderson 19. Zahara Temara 20. Brianna Clark 21. Abigail Roache 22. Tenika Willison.

Kiwis:

1. Kalyn Ponga, 2. Jamayne Isaako, 3. Dane Gagai, 4. Casey McLean, 5. Ronaldo Mulitalo, 6. Kodi Nikorima, 7. Jahrome Hughes, 8. James Fisher-Harris (c), 9. Jeremy Marshall-King, 10. Moses Leota, 11. Isaiah Papali’i, 12. Briton Nikora, 13. Joseph Tapine (v/c).

Interchange: 14. Te Maire Martin, 15. Naufahu Whyte, 16. Erin Clark, 17. Xavier Willison.

Reserves: 18. Keano Kini, 19. Phoenix Crossland, 20. Charnze Nicoll-Klokstad, 21. Scott Sorensen, 22. Leo Thompson.

rnz

Latest News

Parliamentary Service working on extra chairs and offices for increased number of MPs

Published

4 days ago

November 11, 2026

News Staff

The chief executive of the Parliamentary Service is confident there will be enough room to accommodate the increased number of MPs and their staff coming into Parliament.

On current numbers, up to 131 MPs could be sitting in the Chamber following the election, brought on by a record overhang result.

Clerk of the House of Representatives Dr David Wilson told the Spinoff that currently the debating chamber had enough chairs to seat 124 MPs – including the Speaker of the House – and work was being done to accommodate more by altering the seating arrangement.

In a statement, Parliamentary Service chief executive Rafael Gonzalez-Montero said planning for a larger Parliament had been going for “some time”.

“Now that the election results have confirmed an increase to the number of members we are looking at several options.

“We are confident we will be able to accommodate all members within the Chamber.”

Chief Executive of the Parliamentary Service Rafael Gonzalez-Montero appears before select committee. — Parliamentary Service chief executive Rafael Gonzalez-Montero.

VNP / Phil Smith

Gonzalez-Montero said office accommodation for members and their staff would be “stretched” for a short time, but the new Members’ Building was only a few months away from “practical completion”.

That building – located behind Parliament – was due to be ready to occupy in April next year and had capacity to accommodate around 30 backbench MPs.

“All members should be in fit-for-purpose accommodation from that point,” Gonzalez-Montero said.

Following the 2023 election, 123 MPs sat in the Chamber – a record number at the time. That decreased to 122 following the resignation of National MP Judith Collins.

Collins held the seat of Papakura and stepped down in May and Parliament voted against holding a by-election because it was too close to the election.

The election result also meant high-ranking National Party MPs like Chris Bishop, Paul Goldsmith, Nicola Willis and Gerry Brownlee – Speaker of the House and an MP for 30 years – would likely not make it back into Parliament.

Only resigning or retiring MPs were permitted to give a valedictory speech meaning none of them would get the chance to give a valedictory statement.

Asked if their would be special allowances for valedictories, Wilson said in a statement that normally only MPs were allowed to speak in the House but the House could suspend its own rules or temporarily alter them.

“It could do so to allow former members to address the House.”

Wilson said no such arrangements could be made until the next Parliament opened and members sworn in.

rnz