Insight talks with an ophthalmologist and pioneer in Australia’s private health system about his part in the establishment of Cura Day Hospitals Group, which is now a leading player in the sector.
Forty years ago, when ophthalmologist Dr Keith Zabell returned to Australia after a number of years working in the UK, he saw a glaring gap in the private healthcare landscape.
He had graduated in honours in medicine from the University of Queensland, following that up with a specialist degree at Sydney Eye Hospital and post-grad fellowships at Britain’s Bristol and Moorefields eye hospitals.
But a career on the rise encountered a surprising crossroads when he returned home to find all was not necessarily green and gold in the lucky country.
“The hospitals were insistent that the surgeons purchase any new equipment such as operating microscopes and phacoemulsification machines, even though there was capex and amortisation component in the admission fee from the health funds,” he recalls.
That meant that eye surgeons were forced to use sometimes outdated equipment, unless they chipped in themselves to buy the latest technology.
He and others found this “frustrating”, but Dr Zabell and a colleague decided to do something about it.
After a visit to the US, they started a campaign to build a “day surgery” in Queensland, which would later prove a cornerstone of Cura Day Hospitals Group.
Once operational, this initial facility would help take the pressure off Australia’s public health system and encourage the use of up-to-date equipment.
“I tried to encourage the local hospital to create a free-standing facility, but it was declined,” he says.
Undaunted, they decided to build one themselves.
“We built Toowoomba Surgicentre in 1986 and eventually had 23 surgeons accredited.”
Making this happen didn’t come without a fight, though.
“We were the first day surgery to become licensed in Australia,” he says. “The health funds and hospitals were dead against this occurring – the latter for competition reasons.
“The former’s complaint was obtuse as day surgery would save them inpatient fees.”
That pioneering history in private health and the strong connection with the running of the Toowoomba Surgicentre made Dr Zabell an obvious choice to be chair of the board when Cura Day Hospitals Group was established in 2008.
His Toowoomba facility also became part of a wider private health enterprise.
CEO Mr Peter Freeleagus says Cura, which is majority-owned by London-based investment firm Intermediate Capital Group (ICG), is now the largest private day/short stay hospital group in Australia, with 37 facilities nationally.
“We provide high-quality care to more than 200,000 Australians each year, and we continue to expand our service offerings in response to community need,” he says.
Those 37 private hospitals across six states and the ACT are used by more than 1,100 admitting doctors and provide a broad range of surgical and procedural services, with key specialties including ophthalmology, gastroenterology, plastic and reconstructive surgery, ENT surgery, orthopaedics, urology and gynaecology.
Freeleagus says ophthalmology has always been a fundamental part of Cura’s portfolio, with approximately 50% of Australia’s cataracts in the private day hospital sector performed at a Cura hospital, according to AIHW data from 2023-24.
Dr Zabell has done a number of those himself and fully endorses Cura’s business model, from the surgical suite to the boardroom.
“People have asked me, why do we need free-standing day surgeries? There are a number of reasons; some relate to the patient’s experience, some to nursing satisfaction of personalised care, a lot is related to efficiency and lower and set fees, and finally doctors feeling comfortable in a smaller institution with independence.”
He says that is a feature of Cura hospitals, despite the group’s size and national footprint.
“Part of the Cura model is that it doesn’t have to be involved in how the doctors run their practices,” Dr Zabell says.
“They have complete control of their choice on equipment and prosthetic decisions. The doctor’s fidelity has been a crucial component to Cura success.”
Surgeons, including ophthalmologists, get access to not only the best equipment and nursing staff, but also a small, efficient support and administration team that ensures streamlined workflows and issues are handled quickly.
“Cura constantly monitors outcomes, workflow, the satisfaction of patients, staff and doctors, and costings,” says Dr Zabell.
“Communication and education between all levels ensure a harmonious and safe work environment.”
Surgeons play a key part in that communication.
“When Cura was formed, the business model was underpinned by a mission of trying to create centres of excellence,” he says.
Doctors provide feedback to “ensure we have the most advanced equipment with the best support staff in the best facilities”.
They are also involved in annual surgical advisory meetings that bring board members and other support staff together.
“The support staff must feel valued and have the satisfaction of being in a team that produces safe and satisfying outcomes for patients. Cura can deliver this as surgeon equity and involvement at the ‘coal face’.”
Dr Zabell believes doctors’ independence and the level of communication help set Cura apart from other players in the private day hospital sector.
“Cura can pride itself, historically, on great working environments and few, if any, grievances. This reputation encourages more doctors and nurses to join the organisation.”
But Dr Zabell is not only focused on the history of Cura. He remains on the board because he knows there are plenty of challenges and opportunities in the group’s future.
“I have continued on as there is an ongoing battle in the industry to maintain doctors’ independence from the threat of managed care as well as appropriate reimbursement,” he says.
“The ever-changing nature of healthcare and its issues needs constant illumination to the heath funds and the respective governments.”
Freeleagus acknowledges the private healthcare sector is “dynamic”.
“We do face challenges – including workforce shortages and cost pressures,” he says. “Workforce is a focus for us, and we are investing in developing and retaining our talented clinical teams across Australia.”
But he believes the recent issues between private hospitals and health insurers, including the financial struggles of some hospital networks, reveal the “significant opportunities for the day and short stay hospital model”.
“Patients, doctors and funders are increasingly recognising the benefits of day procedures,” Freeleagus says.
“Cura’s scale and excellent relationships with both doctors and private health insurers position us very well to lead in this space.”
The group’s ownership model works to ensure alignment, clinical engagement, and respect for medical sovereignty.
“This ownership structure fosters professional partnership and ensures that our specialists, including ophthalmologists, have a direct voice in shaping the hospitals where they operate, and can share in the overall success of Cura,” Freeleagus says.
That success included support from Intermediate Capital Group for innovation “at pace”.
“Cura is also committed to staying at the forefront of ophthalmic technology and our strong relationship with key ophthalmic suppliers means our surgeons often gain early access to leading innovations,” he says.
“Cura is the only private hospital group in Australia to secure access nationally across multiple sites for Alcon’s new UNITY Vitreoretinal Cataract System from July 2025.”
Freeleagus says Cura’s future is positive and secured.
“With the support of ICG, and our doctors, we will continue our strong growth trajectory by acquiring and building of state-of-the-art facilities, investments in advanced technology and expanding our clinical offerings to meet local doctor and patient needs,” he says.
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