Photo: RNZ/Rowan Quinn
A new private hospital has opened in central Auckland and there are significant expansions planned for others in the city.
The increase comes as a large new public surgical building sits empty at North Shore Hospital, and an expert says demand for private care will keep growing in the face of public waiting lists.
Kākāriki Hospital is a four-theatre, 40-bed hospital in the central suburb of Greenlane.
Hospital management declined to be interviewed but said it was fully staffed and had been operating for more than two weeks in a "soft opening".
It was building up to full capacity.
Its website said the hospital was an elective surgery centre with 20 beds for recovery and 20 inpatient rooms.
It would provide bariatric, ear nose and throat, orthopaedic, paediatric, plastic and reconstructive, spinal, urology, vascular and general surgery procedures, the website said.
The hospital was dwarfed by the expansion underway at Mercy Hospital in nearby Epsom that was expected to be operating by next year.
The long-established facility was adding 10 new operating theatres, 17 beds for post-operative care, six intensive care beds, a six-bed high dependency unit, 20 single inpatient rooms and four double ones.
South Auckland's only private hospital, Ormiston, was also in the middle of a $38 million dollar expansion, adding rooms for endoscopy procedures such as colonoscopies, and the potential for extra services later.
Southern Cross was planning a significant upgrade to its Brightside Hospital in Epsom but that had been delayed by court action in a dispute with neighbours.
The director of Otago University's Centre for Health Systems and Technology Robin Gauld said the expansions were a sign of the times.
Kākāriki Hospital's website says it has 20 beds for recovery and 20 inpatient rooms. Photo: RNZ/Rowan Quinn
"There is an inevitable momentum in this direction being driven by the perception that the public sector is not going to be able to deliver on your needs and then people's experiences of not being able to get the treatment that they are requiring," he said.
Most of the procedures were either paid for by patients out of their own pockets, or health insurance or ACC, he said.
About a third of New Zealanders now had health insurance.
Surgeons tended to work a mix between private and public hospitals, something they had been doing since the public health system first began, he said.
That was usually a good arrangement because they could get more than double the pay working privately, but could train and do challenging, interesting cases in the public system, he said.
However, if the number of private hospitals continued to rise, it could upset the balance.
"If you've got 100 specialists and they're split 50/50 and then they go 55/45 private/public then you're taking ability to treat out of the public sector. And that's possibly being represented in this new hospital that's not being properly staffed in Auckland at the moment," he said.
The new hospital is an elective surgical facility that is part of wider North Shore Hospital but had not opened as planned this month, partly because of a lack of staff and operational funding.
When working, it would do some of the surgery being outsourced to the private hospitals by the public system to try to clear planned care/elective waiting lists.
Nationally, there were other private hospitals being built or with expansions planned including in Dunedin, Wellington, Hamilton and Tauranga.
While the private system allowed people to get care quicker, it was also increasing inequity because it was used mostly by those who could afford insurance or afford to pay, while others had to wait - often much longer - for public care, Gauld said.