The staffing and outsourcing of the marginalised curriculum area Health and Physical Education (HPE) has been an area of growing concern, alongside rising concerns for the decline of students' health due to increased sedentary behaviour and mental health problems, yet there has been little research attention to the staffing and delivery of HPE in Australian schools. This article addresses that gap in understanding with analysis of data from a larger study examining positioning and implementation of HPE in schools. A mixed methods questionnaire was completed by 30% of government schools in New South Wales (n = 556) providing data on staffing, delivery and outsourcing arrangements. Findings suggested that specialist HPE teachers are not in-charge of teaching HPE; and the majority (67%) of schools outsource at least some HPE, with far-reaching impacts on curriculum coverage and student exclusion from lessons evident. Findings also suggested that students experience varied methods of delivery in Physical Education (PE), and Health Education (HE) lessons. Together, these findings raise questions regarding the assurance of quality and equity, with implications for future policy and practice and the health and wellbeing of school children.