The chapter reports on recent developments in the management of health information in New Zealand and the implications these initiatives have raised regarding individual privacy. Set up in 1993 to implement the country’s health information strategy, the New Zealand Health Information Service (NZHIS) has recently established a national health register. At the heart of this development are three national databases: the National Health Index, the Medical Warnings System and the National Minimum Data Set. These applications and their functions are presented. Also discussed is a number of other health information management initiatives currently being explored. The chapter contends that these initiatives under the guise of advancing the nation’s health may, instead, be infringing the privacy and confidentiality of the nation’s citizens. The chapter further considers the application of New Zealand’s privacy legislation (the Privacy Act 1993 and the Health Information Privacy Code) to the development of centralised health information management systems. It concludes by considering the possibility of hidden agendas despite the provisions of the nation’s privacy rules.