CAPTIONS BY TOM CLARKE AND BRIGIT KELLY. CAPTIONS WERE MADE WITH THE SUPPORT OF NZ ON AIR. WWW.ABLE.CO.NZ COPYRIGHT ABLE 2025 NAU MAI HAERE MAI, PIKI MAI KAKE MAI, KAI ORA E TE IWI, AND WELCOME TO Q+A. I'M GUYON ESPINER. WHILE YOU'D NORMALLY CATCH ME ON RADIO NEW ZEALAND, TODAY I'M IN FOR JACK TAME. ON Q+A TODAY ` IT'S THE POLICY THAT'S TANKED LABOUR'S ELECTION CHANCES BEFORE. SO WHY IS CHRIS HIPKINS THINKING ABOUT A CAPITAL GAINS TAX? THE STRUCTURE OF OUR TAX SYSTEM, IF YOU LOOK AROUND THE WORLD, NEW ZEALAND IS QUITE UNIQUE IN THE SENSE THAT THE VAST BULK OF THE GOVERNMENT'S TAX REVENUE COMES FROM INCOME TAX OR GST. AND IS THAT FAIR? AND IS IT FAIR? NO, I DON'T THINK IT IS FAIR. AND LATER ON ` HOW ONE MP'S TRAUMATIC BIRTH STORY COULD LEAD TO A LAW CHANGE I WAS LEFT ALONE, QUITE EMPTY, AND THERE WAS PRESSURE TO LEAVE THE HOSPITAL. BUT FIRST WE BEGIN WITH THE STATE OF THE HEALTH SYSTEM. IT'S GROANING UNDER THE PRESSURE OF STAFF SHORTAGES, LONG WAIT TIMES, AGING INFRASTRUCTURE, INEQUITABLE OUTCOMES, FALLING IMMUNISATION RATES, AN AGING POPULATION, AND ON IT GOES. TODAY MARKS SIMEON BROWN'S 44TH DAY AS HEALTH MINISTER. I SAT DOWN WITH HIM YESTERDAY AND BEGAN BY ASKING ABOUT HOW THE GOVERNMENT'S HEALTH TARGETS ARE MEANT TO MAKE THINGS BETTER. YOU SET FIVE HEALTH TARGETS LAST YEAR, OR AT LEAST YOUR GOVERNMENT DID. THESE ARE THINGS YOU WANT TO ACHIEVE BY 2030, BUT WHEN YOU LOOK AT THE NUMBERS, ALL OF THEM HAVE EITHER STALLED OR GONE BACKWARDS, HAVEN'T THEY? WELL, EXCEPT THERE'S SIGNIFICANT CHALLENGES IN OUR HEALTH SYSTEM. THAT'S WHY WE'VE PUT THE HEALTH TARGETS BACK IN PLACE, THAT'S WHY WE'VE PUT THE HEALTH TARGETS BACK IN PLACE, BECAUSE IF YOU LOOK AT ALL OF THOSE MEASURES, THEY WENT BACK SIGNIFICANTLY OVER THE LAST SIX YEARS OF THE GOVERNMENT` THE LAST GOVERNMENT. BUT QUITE SIMPLY, IF YOU'RE NOT MEASURING IT, HOW ARE YOU MANAGING IT? AND SO THAT'S WHY WE'VE PUT THOSE TARGETS BACK IN PLACE, BECAUSE THEY PUT THE PATIENT BACK AT THE CENTRE OF OUR HEALTHCARE SYSTEM, AND NOW IT'S ABOUT MAKING SURE WE ACTUALLY IMPROVE THE DELIVERY AGAINST THEM, AND SO THAT'S WHERE, YOU KNOW, THE SHORTEST STAY IN EMERGENCY DEPARTMENTS TARGET IS SO CRITICALLY IMPORTANT. THAT DROPPED, YOU KNOW, FROM AROUND 90% WHEN NATIONAL LEFT OFFICE IN 2017, DOWN INTO, YOU KNOW, THE 70 PERCENT'S AROUND THERE. WE NEED TO GET THAT BACK UP TO THE 90% OVER THE NEXT NUMBER OF YEARS. IT WILL BE A CHALLENGE. WELL, LET'S` WELL, YOU SAY THAT, BUT ISN'T YOUR TARGET 95%? 95% BY 2030, AND WE NEED TO MAKE SURE WE ARE IMPROVING THAT OVER TIME, AND THE` BUT YOU'RE NOT SO FAR, THOUGH, ARE YOU? BECAUSE THIS WAS AT 71% IN '22, '23. UNDER THIS GOVERNMENT'S WATCH, IT'S NOW AT 67.5%, SO THINGS ARE GETTING WORSE. WELL, WE'VE STARTED MEASURING IT AGAIN, AND THAT'S CRITICALLY IMPORTANT. AND NOW IT'S ABOUT PUTTING THE FOCUS BACK ON OUR EMERGENCY DEPARTMENTS, AND IT'S NOT JUST ABOUT THE EMERGENCY DEPARTMENT. THE TARGET IS EFFECTIVELY IT` IT DETERMINES WHETHER OR NOT THE HOSPITAL AS A AS A WHOLE IS ACTUALLY DELIVERING THERE. THEY ARE EFFECTIVELY THE BEATING HEART OF THE HOSPITAL IS YOUR EMERGENCY DEPARTMENT., BUT IF THERE'S A BLOCKAGE ANYWHERE ELSE IN THE SYSTEM, THAT IS GOING TO BE SHOWN IN THAT EMERGENCY DEPARTMENT STATISTIC. SO THAT'S WHY PUTTING THAT FOCUS BACK ON OUR EMERGENCY DEPARTMENTS IS SO CRITICALLY IMPORTANT. SO WHY HAS IT GONE BACKWARDS UNDER THE FIRST YEAR OF NATIONAL? WELL, WE'VE STARTED MEASURING. WE UNDERSTAND THERE ARE SIGNIFICANT CHALLENGES IN OUR HEALTH SYSTEM. WHY IT GOING BACKWARDS THOUGH? WHY` WE'RE FOCUSING BACK ON FRONTLINE SERVICE DELIVERY. AND IT HAD GONE FOR, YOU KNOW, SIX YEARS OF DECLINE UNDER THE LAST GOVERNMENT; WE HAVE NOW ARRESTING THAT DECLINE. WE'RE STABILISING IT AND YOU'LL START` YOU'RE NOT ARRESTING ARRESTING THE DECLINE THOUGH, ARE YOU? YOU'RE NOT ARRESTING THE DECLINE THOUGH, ARE YOU? BECAUSE IT'S GONE BACKWARDS. WELL, YOU'LL SOON SEE THE, UM, YOU KNOW, AT THE` YOU'LL SOON SEE THE NEXT QUARTER ` THERE WILL BE QUARTERLY RELEASES COMING OUT. YOU'LL` AND THE PUBLIC WILL START TO SEE THAT IMPROVING, UM, AND THE DATA WILL START TO DEMONSTRATE THAT WE ARE SEEING AN IMPROVEMENT AGAINST THEIR STATISTIC. IT WILL TAKE TIME. BUT IF WE'RE NOT MEASURING IT, IF WE'RE NOT MEASURING THESE THINGS, WE WON'T SEE THE FOCUS AND THE RESOURCE GO WHERE IT'S NEEDED THE MOST, WHICH IS MAKING SURE THAT PATIENTS ARE SEEING` GETTING THE TREATMENT THEY NEED IN A TIMELY AND QUALITY MANNER, AND THAT'S THE PRIORITY THAT I'VE GOT AS MINISTER OF HEALTH. LET'S JUST DRILL DOWN INTO A COUPLE OF THOSE NUMBERS WITHIN THE A&E SPHERE. PEOPLE AT WELLINGTON'S CAPITAL COAST AND HEALTH ` ABOUT 54% ARE WAITING MORE THAN SIX HOURS TO GET THROUGH A&E. MIDCENTRAL REGION ` HALF OF PEOPLE WAITING MORE THAN SIX HOURS. IS THAT ACCEPTABLE? NO, IT'S NOT ACCEPTABLE. I AGREE WITH YOU THAT THAT IS NOT ACCEPTABLE, AND THAT'S WHY HAVING THAT TARGET IS CRITICALLY IMPORTANT. AND I'VE BEEN` BUT WHAT ARE YOU GOING TO DO TO ADDRESS THAT? WELL, I'VE BEEN RAISING THESE ISSUES AROUND SOME OF THESE POOR PERFORMING HOSPITALS DIRECTLY WITH THE SENIOR LEADERSHIP TEAM AT HEALTH NEW ZEALAND. THE FACT THAT CAPITAL COAST ` BASICALLY WELLINGTON HOSPITAL ` WAS, I THINK, ONE OF THE POOREST PERFORMING HOSPITALS IN THE COUNTRY, IS OF SIGNIFICANT CONCERN. THEY ARE TAKING ACTION, LOOKING AT WHAT'S REQUIRED TO BE DONE THERE. ARE PERFORMING POORLY OR DO THEY JUST NOT HAVE ENOUGH MONEY IN RESOURCES? THEY'RE PERFORMING POORLY. YOU LOOK AT OTHER HOSPITALS WHICH HAVE SIMILAR CHALLENGES, SIMILARLY SIMILAR DEMOGRAPHIC MAKEUPS ` SIMILARL SIMILAR DEMOGRAPHIC MAKEUPS ` THEY ARE PERFORMING MUCH BETTER AGAINST THOSE TARGETS` DO YOU KNOW WHY THEY'RE PERFORMING POORLY? WELL, THERE'S A RANGE OF REASONS. I'VE ASKED THE SENIOR LEADERSHIP TEAM AT HEALTH NEW ZEALAND TO COME BACK TO ME ON` PARTICULARLY ON CAPITAL COAST AND AROUND PALMERSTON NORTH, BECAUSE THOSE TWO HOSPITALS ARE PERFORMING INCREDIBLY POORLY. IT'S NOT ACCEPTABLE AND IT NEEDS TO` THEY NEED TO FIND WAYS TO IMPROVE THOSE QUICKLY. THE REALITY IS, IF YOU GO TO MIDDLEMORE IN SOUTH AUCKLAND, IT'S PERFORMING IN THE 70 PERCENT'S. AND THAT'S A THAT IS A HOSPITAL UNDER SIGNIFICANT STRAIN, WITH, YOU KNOW, HUGE CHALLENGES IN SOUTH AUCKLAND. IT'S PERFORMING MUCH BETTER THAN THOSE OTHER HOSPITALS, SO THERE WILL BE THINGS THAT NEED TO BE DONE TO IMPROVE THAT, AND I WILL RECEIVE THAT ADVICE, AND WILL CONTINUE TO PUT THE RESOURCE IN THERE THAT'S REQUIRED. BUT THERE ARE SOME HOSPITALS PERFORMING INCREDIBLY, YOU KNOW, A LOT BETTER THAN OTHERS, AND WE NEED TO MAKE SURE THAT WE'RE LIFTING ALL OF THOSE BOATS. WITH ELECTIVES ` PLANNED SURGERY ` YOU WANT 95% OF PATIENTS TO WAIT LESS THAN FOUR MONTHS FOR ELECTIVE TREATMENT. IT'S CURRENTLY SITTING AT AROUND 62% ACROSS NEW ZEALAND, AND HASN'T REALLY CHANGED UNDER YOUR FIRST YEAR OF GOVERNMENT. HOW ON EARTH DO YOU GET IT TO YOUR DESIRED TARGET? WELL, THAT'S AGAIN ONE OF THOSE ONES WHERE, YOU KNOW, WHEN NATIONAL LEFT OFFICE, THERE WAS JUST OVER A THOUSAND PEOPLE WAITING MORE THAN FOUR MONTHS; THAT INCREASED TO 27,000 OVER THE LAST SIX YEARS. I ACCEPT IT HAS` IT HAS INCREASED, UH, FURTHER UNDER OUR GOVERNMENT, AND THAT'S WHY, YES, THIS WEEK I ANNOUNCED WHAT WE'RE GOING TO BE DOING ` PARTNERING WITH THE PRIVATE SECTOR TO LOOK AT HOW WE CAN MAXIMISE THE AMOUNT OF ELECTIVE TREATMENTS AND PROCEDURES ACROSS BOTH THE PUBLIC AND THE PRIVATE SYSTEMS, SO WE CAN GET MORE PROCEDURES DONE. WE NEED TO MAXIMISE WHAT CAN BE DONE IN THE SYSTEM, AND WE NEED TO SEE PEOPLE BEING SEEN SOONER. AND I DON'T THINK THE PUBLIC ACTUALLY CARE TOO MUCH ABOUT WHO'S DELIVERING THE TREATMENT; THEY WANT THE TREATMENT DONE. AND SO, YOU KNOW, THERE WAS A REPORT DONE BY THE LAST GOVERNMENT ` I THINK IT WAS 2022 ` AROUND A PLANNED-CARE TASKFORCE THAT HAD AROUND 100 RECOMMENDATIONS IN IT. I DON'T THINK ANY OF THOSE RECOMMENDATIONS HAVE ACTUALLY BEEN DELIVERED OR ACTIONED UPON, BUT ONE OF THOSE WAS WORKING BETTER WITH THE PRIVATE SECTOR. LET'S DRILL DOWN` TO MAKE SURE WE'RE ACTUALLY OUTSOURCING, BUT ALSO FINDING EFFICIENCIES IN NEW ZEALAND, SO WE'RE ACTUALLY IMPROVING THE OUTPUT AND PRODUCTION OF ELECTIVE TREATMENTS. LET'S FOCUS ON YOUR PARTNERING WITH THE PRIVATE SECTOR, BECAUSE IT'S SOMETHING YOU MENTIONED IN YOUR SPEECH THIS WEEK. DO YOU WANT THE PRIVATE SECTOR TO DO MOST, IF NOT ALL, OF ELECTIVES? I WANT THEM TO DO AS MUCH AS POSSIBLE. THE REALITY IS OUR HOSPITALS ARE DEALING WITH BOTH ACUTE CARE ` WHICH IS PEOPLE ARRIVING AT EMERGENCY DEPARTMENTS WITH A HEART ATTACK, OR THEY'VE HAD AN ACCIDENT AND THEY ARE` AND THEN` AND NEEDING OPERATIONS ` THAT CAN` THAT OFTEN DISRUPTS PLANNED CARE, WHICH IS PEOPLE WHO HAVE ELECTIVE SURGERIES ` HIPS, KNEES, CATARACTS, ALL OF THOSE OTHER TREATMENTS THAT ARE REQUIRED, CATARACTS ` ALL OF THOSE OTHER TREATMENTS THAT ARE REQUIRED, SO WHAT I'M SAYING IS` IS IT YOUR VISION THAT MOST ELECTIVES ARE DONE IN THE PRIVATE SECTOR? WELL, THAT'S WHAT ACC DOES. ACC ALREADY OUTSOURCES` IS THAT YOUR VISION? I JUST WANT TO BE CLEAR. ABSOLUTELY. I'D LIKE TO I'D LIKE TO SEE AS MUCH PLANNED CARE ` THOSE ELECTIVE SURGERIES DONE BY THE PRIVATE SECTOR ` SO THAT WE CAN MAKE SURE OUR HOSPITALS ARE MORE FOCUSED ON ACUTE CARE AND SERVICES. THAT WILL TAKE TIME. WHAT ARE THE IMPLICATIONS OF THAT, THOUGH, MINISTER? BECAUSE WOULDN'T THAT MEAN THAT THE STAFFING AND THE RESOURCES MOVE TO ` MORE AND MORE ` TO THE PRIVATE SECTOR, AND THAT THE SPECIALISTS AND THE DOCTORS MOVE INTO THAT AREA? AND DON'T YOU THEN CREATE A MOMENTUM FOR BASICALLY A PRIVATISED HEALTH SYSTEM? NO, IT'S ABOUT MAKING SURE THAT PEOPLE GET THE TREATMENT THEY NEED IN A TIMELY AND QUALITY MANNER. WHAT WOULD THE IMPLICATIONS BE, THOUGH, ON THE STAFFING AT PUBLIC HOSPITALS? AND THAT'S WHERE I'VE ASKED HEALTH NEW ZEALAND TO WORK WITH OUR PRIVATE HOSPITALS, AROUND HOW WE ACTUALLY COME UP WITH A PRINCIPLED BASIS, AROUND HOW WE SHARE STAFF, AND HOW WE WORK THROUGH THESE ISSUES, BECAUSE AT THE MOMENT IT'S INCREDIBLY AD HOC. THERE'S A LOT OF` THERE IS A LOT OF ELECTIVE SURGERY WHICH IS ALREADY OUTSOURCED TO THE PRIVATE SECTOR, BUT IT'S DONE ON AN AD HOC BASIS, AND THAT MEANS THE PUBLIC, THE TAXPAYER, IS PAYING SIGNIFICANT PREMIUMS FOR THAT SERVICE. SO WHAT I'M SAYING IS WE WANT TO HAVE LONG TERM AGREEMENTS AROUND SO WHAT I'M SAYING IS WE WANT TO HAVE LONG-TERM AGREEMENTS AROUND HOW WE CAN OUTSOURCE ` WE CAN FIND EFFICIENCIES, WE CAN GET VALUE FOR MONEY FOR THE TAXPAYER, BUT ALSO WE MAKE SURE THAT WE ARE SHARING THAT STAFFING RESOURCE. WE'RE NOT JUST COMPETING, WE'RE SHARING IT. WE'RE SHARING TRAINING SERVICES. AGAIN, THESE WERE RECOMMENDATIONS WHICH WERE IN THE 2022 PLANNED CARE TASKFORCE, AND THOSE HAVEN'T BEEN ACTIONED UPON, AND I THINK THEY SHOULD BE. IS THE OVERALL IMPACT, THOUGH, A MOMENTUM TOWARDS LESS FAITH IN THE PUBLIC SYSTEM? WE'RE ALREADY SEEING RECORD NUMBERS OF NEW ZEALANDERS TAKING OUT PRIVATE HEALTH INSURANCE. IT WAS, WHAT, 32% IN 2022. IT'S NOW 37%. DESPITE A COST OF LIVING CRISIS, TENS OF THOUSANDS MORE NEW ZEALANDERS ARE SIGNING ON TO PRIVATE HEALTH INSURANCE. DOES THIS MEAN THAT THERE'S A LACK OF FAITH IN THE PUBLIC HEALTH SYSTEM? NO, WHAT IT'S ABOUT IS MAKING SURE PEOPLE GET THE TREATMENT THEY NEED IN A TIMELY AND QUALITY MANNER. AND WHAT WE CAN DO IS WE CAN ACTUALLY MAKE SURE THAT PEOPLE GET SEEN FASTER AND GET THAT TREATMENT DONE. I` IT WILL ALWAYS BE PUBLICLY FUNDED, BUT IT DOESN'T HAVE TO BE PUBLICLY DELIVERED ` THAT'S THE DISTINCTION THAT I'M TRYING TO DRAW HERE. THE PUBLIC SYSTEM WILL BE PUBLIC FUNDED ` SO EVERYONE HAS ACCESS TO IT ` BUT WHO'S DELIVERING IT IS NOT SOMETHING WHICH, I THINK, MOST NEW ZEALANDERS ACTUALLY CARE TOO MUCH ABOUT. WHAT THEY'RE FOCUSSED ON IS MAKING SURE THEY GET THE TREATMENT THEY WHAT THEY'RE FOCUSED ON IS MAKING SURE THEY GET THE TREATMENT THEY NEED IN A TIMELY, QUALITY MANNER. AND WHEN WE'VE GOT, YOU KNOW, 27,000 PEOPLE OR MORE WAITING MORE THAN FOUR MONTHS FOR AN ELECTIVE PROCEDURE. THAT` AND THAT'S INCREASED BY, I THINK, 2500 PERCENTAGE SINCE 2017. THAT'S NOT ACCEPTABLE TO ME; WE HAVE TO DO THINGS DIFFERENTLY. AND THAT'S WHY I'VE SAID WE WANT TO WORK CLOSELY WITH THE PRIVATE SECTOR TO MAXIMISE CAPACITY, BOTH IN THE PUBLIC SYSTEM AND IN THE PRIVATE SYSTEM. GOT IT. LET'S MOVE TO PRIMARY CARE ` YOU MADE SOME ANNOUNCEMENTS. WE'LL DIG INTO THOSE SHORTLY. BUT WHY ARE THERE NO PRIMARY HEALTH CARE TARGETS IN THOSE MEASURES THAT YOU'VE SET OUT? WELL, THAT IS SOMETHING THAT I HAVE ASKED OFFICIALS TO EXPLORE ` WHETHER THERE SHOULD BE A PRIMARY HEALTH CARE TARGET. WHAT DO YOU THINK? YOU'RE THE POLITICIAN. MY VIEW IS THERE SHOULD BE, BUT IN TERMS OF WHAT THAT SHOULD BE ` I'VE ASKED FOR ADVICE AROUND HOW YOU'D MEASURE THAT. WHAT WOULD THOSE` WOULD IT BE ACCEPTABILITY FOR WAITING TIMES TO SEE A GP OR`? CORRECT. THOSE ARE THE TYPE` THOSE ARE THE TYPES OF TARGETS THAT I'VE ASKED THEM TO COME BACK WITH ADVICE ON. WHAT IS ROUGHLY AN ACCEPTABLE TIME TO WAIT TO SEE A GP? WELL, MY VIEW IS YOU SHOULD BE ABLE TO GET AN APPOINTMENT WITHIN A WEEK. I THINK THERE'S FAR TOO MANY NEW ZEALANDERS WAITING LONGER THAN A WEEK TO GET AN APPOINTMENT, PARTICULARLY IN OUR RURAL COMMUNITIES, AND THAT'S WHY YOU WOULD HAVE SEEN SOME OF OUR ANNOUNCEMENTS REALLY FOCUSED` WE'LL TALK ABOUT THOSE IN A SECOND, BUT I'M INTERESTED` BUT THEY'RE FOCUSED ON RURAL COMMUNITIES IS MY POINT THERE, SO` I'M INTERESTED TO HEAR YOU SAY THAT YOU ARE LOOKING AT A TARGET FOR PRIMARY HEALTH, AND` SO THAT WOULD POSSIBLY BE ONE OF THEM, WOULD IT? THAT A KIWI SHOULD BE ABLE TO SEE A GP WITHIN A WEEK? CORRECT ` THAT IS SOMETHING THAT I'VE ASKED FOR ADVICE ON. BUT LOOK, I WANT TO GO THROUGH A PROCESS TO MAKE SURE I GET GOOD ADVICE ON THAT. BECAUSE, ULTIMATELY, YOU KNOW, OUR GP'S DO AN AMAZING, AMAZING WORK ON THE FRONT LINE. THEY SEE 55,000 PATIENTS EVERY SINGLE DAY IN OUR COMMUNITIES. THEY ARE THE` THEY'RE REALLY THE HEART OF OUR HEALTH SYSTEM IN NEW ZEALAND, AND I WANT TO MAKE SURE THAT THEY'VE GOT THE RESOURCE AND THE SUPPORT TO BE ABLE TO DELIVER THAT. AND IF YOU LOOK AT THE NUMBERS ` AND AGAIN, I MENTIONED THIS IN THE SPEECH THIS WEEK ` OVER THE LAST SIX YEARS, WE'VE SEEN A 51% INCREASE IN FUNDING FOR OUR HOSPITAL SYSTEM, BUT ONLY A 43% INCREASE IN FUNDING FOR PRIMARY AND COMMUNITY CARE, SO WE NEED TO SHIFT THE BALANCE. AGAIN, THAT'S WHY THOSE ANNOUNCEMENTS WERE THERE. YEAH, WE'LL TALK ABOUT THOSE IN JUST A SECOND` WE ALSO WANTED TO MAKE SURE KIWIS ARE GETTING THE GETTING THE DELIVERY FROM THAT INVESTMENT AS WELL. DO YOU HAVE OTHER PRIMARY HEALTH TARGETS IN MIND? NO, LOOK, I THINK THAT'S THE KEY` THAT'S THE KEY ONE AT THE MOMENT. BUT, LOOK, I'VE FOR ADVICE ON THAT. SURE. YOU'VE INTRODUCED, OR TALKED ABOUT, THIS FUNDING FOR A TWO YEAR PRIMARY CARE TRAINING PROGRAM FOR 100 OVERSEAS TRAINED DOCTORS ONCE THEY'VE REGISTERED TO WORK IN NEW ZEALAND. SO WHEN WOULD THE FIRST OF THOSE DOCTORS BE WORKING AND BE AVAILABLE TO NEW ZEALANDERS? SO, THE MEDICAL COUNCIL HAS ALREADY INCREASED THE NUMBER OF EXAMS WHICH ARE AVAILABLE, FROM, I THINK, 60 TO 180. AND THIS FUNDING WILL MEAN FROM THE 1ST OF JULY THIS YEAR, THAT FUNDING WILL BECOME AVAILABLE FOR THOSE GP. BUT THAT'S STILL A COUPLE OF YEARS AWAY, PRESUMABLY? WELL THEY GET` THEY HAVE TO DO A TWO YEAR TRAINING PROCESS. AT THE MOMENT, ALL OF THAT TRAINING HAS TO HAPPEN IN HOSPITALS. THERE AREN'T ENOUGH PLACES FOR THEM IN HOSPITALS, AND SO THESE ARE PEOPLE WHO ARE MEDICALLY TRAINED; THEY CAN'T WORK HERE BECAUSE THEY HAVEN'T DONE THE NEW ZEALAND TRAINING TO BE ASSURED OF THEIR SKILLS. THAT CAN NOW HAPPEN IN GENERAL PRACTICE. AND ONCE THAT TRAINING BEGINS, THEY'LL BE ABLE TO BE` THEY'LL BE SERVING PEOPLE AND PATIENTS IN GENERAL PRACTICE AS THEY ARE UNDER SUPERVISION OVER THAT TWO YEAR PERIOD. ACCORDING TO THE ROYAL NEW ZEALAND` WE'RE DOING IT. ACCORDING TO THE ROYAL NEW ZEALAND COLLEGE OF GPS, NEARLY 40% OF GPS ARE INTERNATIONAL MEDICAL GRADUATES. ARE WE ALREADY TOO RELIANT ON OVERSEAS? WE NEED BOTH OVERSEAS AND WE NEED TO TRAIN MORE IN NEW ZEALAND, AND THAT'S WHERE, AGAIN, THIS WEEK, WE ANNOUNCED AN INCREASE OF 25 SPACES FOR DOCTOR TRAINING AT OUR MEDICAL SCHOOLS. AND THAT MEANS OVER THE COURSE OF THIS GOVERNMENT, WE WILL HAVE INCREASED THE NUMBER OF DOCTOR TRAINING SPACES BY 100 PER YEAR. AND I THINK THAT'S A FANTASTIC STORY TO SAY ` WE ARE TRAINING MORE LOCALLY, BUT ACTUALLY, YOU KNOW, IT TAKES SIX YEARS` IT TAKES SIX YEARS TO TRAIN A GP OR TRAIN A DOCTOR. AND SO THAT'S WHERE THERE'S A` YOU KNOW THERE ARE PEOPLE` WE'RE WHAT, 500 SHORT OR SO? UH, IT'S DIFFERENT` THERE'S DIFFERENT NUMBERS, BUT THAT'S PROBABLY` I THINK THAT'S WHAT THE ROYAL COLLEGE SAYS IN OUR GENERAL PRACTICE. BUT WHAT I'M SAYING IS THERE ARE DOCTORS IN NEW ZEALAND NOW WHO ARE MEDICALLY TRAINED FROM OVERSEAS. THEY CANNOT WORK BECAUSE THEY HAVEN'T BEEN ABLE TO GET A PLACEMENT IN OUR HOSPITALS. WE'RE MAKING THOSE PLACEMENTS AVAILABLE IN GP PRACTICES, SO THEY CAN GET TO WORK STRAIGHT AWAY. WHAT ABOUT THE NEW MEDICAL SCHOOL? WILL THAT GO AHEAD? WELL, AS YOU KNOW, THERE'S A BUSINESS CASE AND A COST BENEFIT ANALYSIS UNDERWAY. THAT'S THE COMMITMENT WE MADE TO THE ACT PARTY AS PART OF OUR COALITION AGREEMENT. THAT WORK IS UNDERWAY. DO YOU THINK IT STACKS UP? WELL, LOOK, I THINK IT'S SOMETHING WHICH, UM, MAKES A SIGNIFICANT DIFFERENCE ` PARTICULARLY FOR TRAINING MORE DOCTORS TO WORK IN OUR RURAL COMMUNITIES. SO YOU'RE BACKING THIS IDEA? WELL, IT` THE NATIONAL PARTY BACKS IT, BUT WE HAVE AGREED WITH THE ACT PARTY THAT WE WILL GO THROUGH THAT PROCESS. THAT WILL THEN GO TO CABINET, AND ONCE CABINET HAS MADE FURTHER DECISIONS, WE'LL THEN MAKE ANNOUNCEMENTS ON THAT. AND HOW FAR AWAY WILL THAT ANNOUNCEMENT BE? WELL, LOOK, WE'RE WORKING THROUGH THAT PROCESS. I'VE JUST BECOME THE MINISTER. THERE'S A LOT OF ISSUES COMING ACROSS MY DESK. THIS IS ONE THAT WE ARE WORKING THROUGH AT THIS STAGE. YOU ANNOUNCED SIGNIFICANT MOVES IN THE DIRECTION OF TELEHEALTH THIS WEEK. HOW MUCH DOES THE GOVERNMENT SET ASIDE FOR THIS 24/7 TELEHEALTH SERVICE? I THINK IT'S ABOUT $140M OVER FOUR YEARS FOR THAT SERVICE, AND THAT'S ABOUT PROVIDING ANOTHER CHOICE FOR KIWIS TO BE ABLE TO ACCESS PRIMARY HEALTH CARE. WHERE DO YOU STAFF THAT FROM, THOUGH, MINISTER? WE'VE JUST TALKED ABOUT THE SHORTAGE OF GPS. WELL, THAT WILL BE GOING` A HEALTH DECISION WILL GO THROUGH A PROCUREMENT PROCESS TO ENGAGE WITH PROVIDERS WHO WILL THEN GO` YOU SURE YOU'RE NOT JUST GOING TO PINCH THEM FROM GP PRACTICES? NOT AT ALL. THIS IS THIS IS NOT` THIS IS NOT GOING TO BE` THIS IS NOT REPLACING GENERAL PRACTICE. THE ADVICE I'VE RECEIVED IS THIS MAY BE UP TO AROUND A MILLION APPOINTMENTS PER YEAR. IN THE CONTEXT ` THERE'S 22 MILLION APPOINTMENTS WITH A GP EVERY SINGLE YEAR IN PRIMARY PRACTICE. SO THIS IS ABOUT PROVIDING ACCESS AND CHOICE FOR NEW ZEALAND` FOR KIWIS ` ANOTHER OPTION. AND I IMAGINE THAT THEY'RE GOING TO GO THROUGH A PROCESS CONTRACT WITH CURRENT PROVIDERS OR NEW PROVIDERS. IT'LL BE ANY NEW ZEALAND-REGISTERED MEDICAL PROFESSIONAL OR DOCTOR OR` THEY COULD BE OVERSEAS. THAT COULD BE SOMEONE OVERSEAS WHO CONTRACTS CERTAIN HOURS BACK TO DO ONLINE CONSULTATIONS IN NEW ZEALAND. AND I JUST LOOK AT IT ` THIS IS ANOTHER WAY OF PROVIDING MORE ACCESS. IF YOUR CHILD'S SICK IN THE MIDDLE OF THE NIGHT, YOU CAN RING UP, YOU CAN GET ONLINE, HAVE AN APPOINTMENT, GET A PRESCRIPTION AND THEN GO AND PICK UP THAT PRESCRIPTION FIRST THING IN THE MORNING. YOU PAY FOR THAT THOUGH, RIGHT? IT WILL BE A PER-PAR` AT THE SAME LEVEL AS GPs IN PERSON? THAT IS YET TO BE DETERMINED, AS THEY'LL GO THROUGH A PROCESS. BUT THE POINT HERE IS IT'S ABOUT PROVIDING MORE ACCESS AND MORE CHOICE FOR KIWIS. IT'S NOT TO UNDERMINE THE REALLY IMPORTANT RELATIONSHIP PEOPLE HAVE WITH THEIR DOCTOR, THEIR FAMILY DOCTOR, BUT PROVIDING MORE ACCESS AND MORE CHOICE FOR NEW ZEALANDERS. AFTER THE BREAK ` MORE FROM HEALTH MINISTER, SIMEON BROWN. WHY ARE HEALTH SECTOR LEADERS DROPPING LIKE FLIES? WELCOME BACK. WE'RE BACK WITH NEW HEALTH MINISTER SIMEON BROWN, AT A TIME OF MASSIVE TURNOVER IN SECTOR LEADERSHIP. MASSIVE TURNOVER IN SECTOR LEADERSHIP. LET'S TALK A LITTLE BIT ABOUT HEALTH LEADERSHIP. THERE'S BEEN SOMETHING OF A PURGE RECENTLY, HASN'T THERE? TE WHATU ORA CHIEF EXECUTIVE MARGIE APA HAS RESIGNED. THE DIRECTOR GENERAL OF HEALTH, THE PHARMAC CEO, THE MINISTER'S CHANGED. THE MINISTER'S CHANGED. I MEAN, THIS SORT OF CHURN AT THE TOP OF AN ALREADY VERY VOLATILE SECTOR, IS THAT HELPFUL? WELL, THAT'S WHY I SAID ONE OF MY PRIORITIES IN MY SPEECH THIS WEEK IS ABOUT MAKING SURE WE STABILISE HEALTH NEW ZEALAND AND GET IT FOCUSED ON DELIVERY, BACK TO BASICS. SO, LOOK, WE WANT TO MAKE SURE WE'VE GOT THE BEST PEOPLE IN EACH POSITION, AND WE WANT PEOPLE WHO FOCUS ON DELIVERY FOR PATIENTS AND PUTTING PATIENTS AT THE CENTRE OF IT. LOOK, I ACCEPT THE LAST FEW YEARS HAVE BEEN INCREDIBLY UNSETTLING FOR HEALTH NEW ZEALAND. THE LAST GOVERNMENT DECIDED TO RESTRUCTURE THE ENTIRE HEALTH SYSTEM IN THE MIDDLE OF THE PANDEMIC. I THINK THAT WAS THE WORST DECISION THEY MADE. HAVEN'T YOU BEEN DOING A BIT OF THAT? YOU'VE GOT COMMISSIONERS, AND YOU'RE SACKING HERE, AND THEN THE BOARDS ARE COMING BACK. NO, NO, IF YOU LOOK AT` IF YOU LOOK AT THE DELOITTE REPORT, WHICH THE COMMISSIONERS RELEASED YESTERDAY, THAT EXPLAINS EXACTLY WHY WE HAD TO PUT THE COMMISSIONERS IN, BECAUSE OF THE LACK OF FINANCIAL CONTROLS AND THE LACK OF FOCUS ON DELIVERY LEFT BEHIND BY THE PREVIOUS GOVERNMENT. SO I HAVE FULL CONFIDENCE IN LESTER LEVY AND THE WORK THAT HE'S DOING, AND I 100% BACKED THE DECISION TO PUT A COMMISSIONER IN BECAUSE WE NEEDED TO MAKE SURE HEALTH NEW ZEALAND WAS DELIVERING WITHIN BUDGET AND DELIVERING MORE FOR KIWIS. SO THAT'S WHAT WE'VE DONE. AND DR LESTER LEVY AND HIS DEPUTY COMMISSIONERS ARE DOING THAT JOB TO MAKE SURE THAT THAT ORGANISATION IS STABILISED. THEY'VE NOW DELIVERED THE DELIVERY PLAN ` THAT WAS ANNOUNCED ON FRIDAY ` WHICH TALKS ABOUT HOW THEY ARE GOING TO MAKE SURE WE ARE NOW REGIONALISED AND PUSHING DECISIONS BACK TO THE DISTRICTS AND REGIONS SO THAT WE'RE ABLE TO MAKE SURE THAT EACH LOCAL DISTRICT HAS A CLEAR BUDGET, A CLEAR OUTPUT PLAN, HAS ACCOUNTABILITIES AND RESPONSIBILITIES AND DECISION MAKING RIGHTS WITHIN THAT SO THEY CAN FOCUS ON THE NEEDS OF THEIR COMMUNITY. SO THAT PLAN HAS NOW BEEN RELEASED, AND IT'S NOW UP TO THE COMMISSIONERS TO MAKE SURE IT'S DELIVERED. OK. HUGE BUDGET PRESSURES ON HEALTH ` ALWAYS WILL BE. HOW MUCH OF THIS COULD BE ALLEVIATED WITH BETTER PUBLIC HEALTH? WE'VE SEEN THIS GOVERNMENT ROLL BACK THE SMOKE-FREE GENERATION POLICIES THAT LABOUR PUT IN, AND FOR THE FIRST TIME IN A DECADE, THE SMOKING RATES ACTUALLY TICKED UP SLIGHTLY AGAIN. THAT POLICY ALONE WAS DUE TO SAVE MORE THAN $1 BILLION IN TERMS OF THE PUBLIC HEALTH SYSTEM. SHOULDN'T YOU BE FOCUSING MORE AT THE AT THE CLIFF AT THE TOP OF THE FENCE? WELL, MY FOCUS IS MAKING SURE KIWIS GET THE TIMELY AND QUALITY ACCESS TO HEALTH CARE THAT THEY NEED. AND THAT'S WHY THIS WEEK, YOU KNOW, A LOT OF THE ANNOUNCEMENTS HAVE BEEN AROUND PRIMARY HEALTH CARE, BECAUSE ULTIMATELY, YOU KNOW, IF YOU INVEST IN PRIMARY HEALTH CARE, IF PEOPLE CAN BE SEEN SOONER AND SEEN BY THEIR FAMILY DOCTOR, THAT IS HOW YOU CAN MANAGE LONG-TERM CONDITIONS. YOU CAN REDUCE HUGE AMOUNT OF BURDEN ON THE PUBLIC HEALTH SYSTEM. ARE YOU INTERESTED IN CRACKING DOWN AT ALL ON ANY OF THESE THINGS? I KNOW YOU'RE NOT` YOU'RE AN ANTI-NANNY STATE GOVERNMENT. YOU'RE NOT GOING TO WANT TO GET IN TOO DEEPLY INTO SOME OF THAT STUFF. BUT IF YOU LOOK AT THINGS LIKE THE DIETS THAT NEW ZEALANDERS ARE EATING AND THE FAST FOOD THAT IS CONSUMED AND THE RELATIONSHIP OF THAT TO THE TYPE 2 DIABETES CRISIS THAT WE ARE WALKING INTO, ARE YOU INTERESTED AT ALL IN REGULATING IN THAT SPACE ` SUGAR TAXES, FAST FOOD REGULATION, ANY OF THAT STUFF? ARE YOU INTERESTED IN ANY OF THAT? WELL, MY PRIORITY IS MAKING SURE THAT THE HEALTH SYSTEM DELIVERS TIMELY AND QUALITY HEALTH CARE FOR NEW ZEALANDERS, AND THAT ACCESS IS CRITICALLY IMPORTANT. YEAH, BUT THAT'S JUST A SLOGAN. NO, NO, NO, NO, BECAUSE ACTUALLY THAT'S WHAT THOSE HEALTH TARGETS ARE ABOUT. THAT'S WHY I'M TALKING ABOUT PUTTING PATIENTS BACK AT THE CENTRE OF THE SYSTEM AND MAKING SURE THAT WE'RE ACTUALLY IMPROVING THE SYSTEM, AND IT'S DELIVERING MORE. YOU ARE RAISING SOME GOOD POINTS. WELL, THESE ARE THESE ARE PREVENTATIVE THINGS. AND IF YOU THINK ABOUT, YOU KNOW, SMOKING, UM, CASEY COSTELLO, SHE'S THE MINISTER RESPONSIBLE FOR THAT. AND THERE'S A HUGE AMOUNT OF WORK WHICH GOES ON AROUND HOW DO YOU PROMOTE ANTI, YOU KNOW, SMOKING MESSAGING? THERE'S A HUGE AMOUNT OF WORK THAT GOES INTO HELPING PEOPLE GET OFF SMOKING. ARE YOU INTERESTED IN REGULATING THE FAST FOOD INDUSTRY AT ALL? NO, NO, NOT AT ALL, NOT AT ALL. I THINK, YOU KNOW, YOU KNOW, PEOPLE DO HAVE TO MAKE CHOICES, AND THERE'S A ROLE TO MAKE SURE WE'RE PROMOTING GOOD, HEALTHY CHOICES, BUT AT THE SAME, YOU KNOW, I'M NOT HERE TO REGULATE OR TO TELL PEOPLE WHAT TO DO. I'M NOT THE HEALTH POLICE; I'M THE HEALTH MINISTER, AND I'M FOCUSED ON MAKING SURE THAT THE SYSTEM DELIVERS THE TIMELY, QUALITY HEALTH CARE THAT NEW ZEALANDERS NEED. THAT'S WHAT I'VE OUTLINED IN MY SPEECH. THAT'S MY FOCUS AS MINISTER. YOU'VE MADE ANNOUNCEMENTS ON BOWEL SCREENING THIS WEEK TOO. YOU'VE LOWERED THE AGE FOR BOWEL CANCER SCREENING FROM 60 TO 58, BUT YOU'VE RAIDED THAT BUDGET THAT WAS SET ASIDE FOR MAORI AND PASIFIKA TO BE SCREENED AT 50. I MEAN, WON'T THIS MEAN THAT THE PEOPLE WHO ARE MOST AT RISK OF BOWEL CANCER ARE GOING TO BE LEFT BEHIND? NO, THIS WILL SAVE MORE LIVES THAN THE PREVIOUS GOVERNMENT'S APPROACH BY LOWERING IT TO 58 FOR ALL NEW ZEALANDERS. BUT WHAT I CAN ALSO SAY IS WE WANT TO GO FURTHER AND FASTER AS ACCESS TO COLONOSCOPIES ALLOWS US TO. YEAH, I GET THAT. LET'S RETURN TO THAT IN HALF A SECOND. I JUST WANT TO PUT THIS TO YOU, THOUGH. THIS IS ON THE BOWEL CANCER NEW ZEALAND WEBSITE AND ANY OTHER NUMBER OF EXPERTS YOU CAN NAME ` THEY SAY THAT AT PRESENT, JUST OVER HALF OF BOWEL CANCER IN MAORI PRESENTS BEFORE THE AGE OF 60, WHEREAS FOR NON-MAORI, IT'S SITTING AT ABOUT A THIRD DIAGNOSED BEFORE 60. SO IF MAORI ARE GETTING IT EARLIER, THEN SHOULDN'T THEY SCREENING BEGAN EARLIER? NO. THE EVIDENCE THAT THE MINISTRY OF HEALTH PROVIDED US AND THE ANALYSIS THAT WAS UNDERTAKEN, IS THAT THE AGE-RELATED INCIDENTS IS THE SAME BASED ON ACROSS DIFFERENT ETHNICITY GROUPS. SO ARE BOWEL CANCER NEW ZEALAND WRONG? THE DIFFERENCE HERE IS WE HAVE LOWER SCREENING RATES IN THOSE COMMUNITIES WHO ARE ELIGIBLE. SO IF YOU GO TO, UH` IF YOU LOOK AT THE SCREENING RATES OF NON-MAORI, EUROPEAN, ABOUT 60% OF PEOPLE PARTICIPATE IN THE SCREENING PROCESS. THAT'S AROUND 50% FOR MAORI, AND I THINK IT'S LOWER FOR PASIFIKA COMMUNITIES. SO WE ACTUALLY NEED TO INCREASE THOSE SCREENING RATES AMONGST THOSE GROUPS, AND THAT'S WHY A BIG PART OF THE ANNOUNCEMENT WE MADE THIS WEEK WAS ACTUALLY AROUND INVESTING $19 MILLION INTO IMPROVING THE SCREENING RATES IN THOSE POPULATION GROUPS TO GET THAT UP TO THE SAME RATE AS THE EUROPEAN SCREENING RATE. BUT YOU'VE EFFECTIVELY RAISED THE AGE OF SCREENING FOR MAORI, THOUGH, EFFECTIVELY, HAVEN'T YOU? SO HOW DOES THAT HELP WITH IMPROVING SCREENING RATES? WELL, WE'VE SAID WE WANT TO LOWER IT TO ALIGN WITH AUSTRALIA, WHICH IS 45, AND WE WOULD DO THAT AS QUICKLY AS WE CAN... WHEN'S THAT GOING TO HAPPEN? ...AND AS CAPACITY IN THE IN THE SYSTEM AROUND COLONOSCOPIES ALLOWS ` AND THERE'S WORK UNDERWAY TRIALLING NEW WAYS` ROUGHLY, WHEN DO YOU THINK YOU MIGHT BE ABLE TO GET 45? I DON'T HAVE A DATE, AND I DON'T HAVE A TIMEFRAME. WHAT WE HAVE ANNOUNCED IS WHAT WE CAN DO NOW. THERE IS WORK UNDERWAY BY HEALTH NEW ZEALAND AROUND HOW THAT CAN BE DONE AND HOW QUICKLY. ONCE THAT ADVICE COMES BACK AND WE CAN MAKE FURTHER DECISIONS, WE WILL LOWER IT FURTHER FOR ALL NEW ZEALANDERS. WE WILL LOWER IT FURTHER FOR ALL NEW ZEALANDERS. BUT THIS ISN'T GOING TO BE ONE OF YOUR TARGETS? WELL, I WANT TO` WHAT I'VE SAID IS WE HAVE CAPACITY TO LOOK AT 58 NOW FOR ALL NEW ZEALANDERS. THAT IS GOING TO SAVE 176 MORE LIVES THAN IF WE'D JUST FOLLOWED THROUGH WITH THE LAST GOVERNMENT'S APPROACH. SO MORE PEOPLE` LESS` SORRY, FEWER PEOPLE WILL DIE FROM BOWEL CANCER BECAUSE OF THE POLICY THAT WE ANNOUNCED THIS WEEK. HOWEVER, WE WILL GO FURTHER AND FASTER AS WE CAN. SO ARE YOU SAYING THAT THIS IS AN EVIDENCE-BASED POLICY, NOT AN IDEOLOGICAL ONE ON PRIORITISING NEED OVER RACE, WHICH WE OFTEN HEAR IN THESE ARGUMENTS? IT'S BASED ON THE EVIDENCE WE PROVIDE` WHICH IS PROVIDED BY THE MINISTRY OF HEALTH, AND THE EVIDENCE SHOWED VERY CLEARLY, BY MAKING THIS DECISION, MORE LIVES WILL BE SAVED. CAN WE SEE THAT ADVICE? HAVE YOU RELEASED THAT? I WILL BE RELEASING IT. WHEN WE LOOK AT THESE PROGRAMMES WHICH ARE TRYING TO REDUCE INEQUITIES IN THE HEALTH SYSTEM ` AND ONE OF THEM IS IN THE WORKFORCE AREA WITH THE MAPAS SCHEME, THE MAORI AND PACIFIC ADMISSIONS SCHEME, DO YOU SUPPORT THAT? WELL, WE'VE SAID IN OUR COALITION AGREEMENT WITH THE ACT PARTY THAT WE WILL REVIEW THAT SCHEME AND MAKE SURE THAT IT'S EFFECTIVE. DO YOU SUPPORT IT? WE'VE SAID` I SUPPORT WHAT'S IN THE COALITION ARRANGEMENT AND THE COALITION AGREEMENT, WHICH WAS NEGOTIATED BETWEEN NATIONAL AND ACT. WE'LL GO THROUGH THAT TO MAKE SURE THAT IT'S AS EFFECTIVE. HAVE YOU HAD A LOOK AT ANY OF THAT MATERIAL YET? I HAVE NOT HAD` I HAVE NOT HAD A CHANCE YET TO HAVE A LOOK AT THAT PARTICULAR ISSUE. WHEN WE LOOK AT THE BIGGER PICTURE IN HEALTH, ARE WE JUST GOING TO HAVE TO ACCEPT NOW THAT THE STANDARDS OF PUBLIC HEALTH CARE THAT WE USED TO EXPECT JUST AREN'T GOING TO BE THERE? NO, I COMPLETELY DISAGREE WITH THAT. YOU KNOW, THIS GOVERNMENT IS INVESTING RECORD AMOUNTS. WE'RE INVESTING $30 BILLION OF TAXPAYERS MONEY EACH AND EVERY YEAR INTO OUR HEALTH SYSTEM. THAT IS RECORD INVESTMENT. WE'VE INCREASED IT BY 16 BILLION OVER THREE YEARS UNDER THIS GOVERNMENT, AND WE'VE SAID WE WILL INCREASE HEALTH INVESTMENT EVERY SINGLE YEAR, AND IF YOU LOOK AT WHAT HEALTH NEW ZEALAND IS DELIVERING, THEY DELIVERED MORE ELECTIVE TREATMENT LAST YEAR. THEY'VE GOT OVER 2000 MORE NURSES SINCE WE CAME TO OFFICE. THEY'VE OVER 6500 MORE FRONTLINE STAFF SINCE HEALTH NEW ZEALAND WAS SET UP. WE HAVE MORE, YOU KNOW` WE'RE PAYING OUR NURSES THE SAME AS IN NEW SOUTH WALES, A STATE OF AUSTRALIA WHICH IS 30% RICHER THAN US. WE ARE INVESTING IN HEALTH SYSTEM, BUT WHAT WE AREN'T SEEING IS IMPROVED PRODUCTIVITY. AND IF YOU LOOK AT THE` WELL, IT'S CALLED THE CASE WEIGHTED PER FTE, THE AMOUNT OF OUTPUT PER PERSON, THAT'S ACTUALLY REDUCED BY 15% OVER THE LAST 10 YEARS. SO WE'VE DOUBLED THE AMOUNT OF MONEY OVER 10 YEARS, BUT WE'RE SEEING 15% LESS BEING DONE AND DELIVERED BY A PERSON WORKING IN THE HEALTH SYSTEM. SO WE ACTUALLY NEED TO IMPROVE THE AMOUNT THAT IT'S DOING. WE NEED TO MAKE SURE WE'RE DRIVING EFFICIENCY AND WE'RE ACTUALLY INCREASING THE AMOUNT OF ACCESS THAT NEW ZEALANDERS ARE DOING, AND THAT'S WHAT WE'VE TASKED THE COMMISSIONERS TO DO. THAT'S WHAT... THE PLAN THAT THEY'VE DELIVERED THIS WEEK IS ALL ABOUT, AND THAT'S WHY MY FOCUS ON THOSE HEALTH TARGETS IS ALL ABOUT DELIVERING MORE FOR NEW ZEALANDERS. JUST A COUPLE OF MINUTES LEFT, BUT I DID WANT TO TOUCH ON THIS APPOINTMENT THAT YOU MADE WHILE ENERGY MINISTER. YOU PERSONALLY ADDED A FOSSIL FUEL LOBBYIST TO THE SHORTLIST OF CANDIDATES FOR THIS ENERGY EFFICIENCY & CONSERVATION AUTHORITY. DOES THAT DISPLAY HIGH MINISTERIAL STANDARDS? THIS IS SOMEONE WHO HAS SIGNIFICANT EXPERIENCE IN THE ENERGY SECTOR. IT'S THE ENERGY EFFICIENCY & CONSERVATION AUTHORITY. WE WANT TO SEE ENERGY EFFICIENT` BUT HE'S A FOSSIL FUEL LOBBYIST. WELL, IS IT ILLEGAL TO HAVE A VIEW IN THIS COUNTRY? I MEAN, HE'S SOMEONE WHO HAS A HUGE AMOUNT OF EXPERIENCE IN THE ENERGY SECTOR. HE IS ON THE ENERGY EFFICIENCY & CONSERVATION AUTHORITY, WHICH IS ABOUT FINDING EFFICIENCY IN HOW WE USE ENERGY ACROSS ALL TYPES OF ENERGY USE, AND HE'S NOW ON THAT BOARD TO HELP SUPPORT THAT AGENDA. BUT, LOOK, ULTIMATELY HE IS SOMEONE WITH INCREDIBLE EXPERIENCE, AND I BACK MY DECISION. YEAH. THIS IS JOHN CARNEGIE, WHO WAS FORMERLY THE PETROLEUM EXPLORATION BOSS. HE HAD CRITICISED ONE OF THE KEY FUNCTIONS OF THE AGENCY, HADN'T HE? THIS IS GIVING OUT GRANTS. I'D RATHER HAVE A DIVERSITY OF OPINION AROUND THE TABLE THAN TO SAY THAT CERTAIN VIEWS ARE ILLEGAL. SURE. BUT HE SAID THAT THESE GRANTS, WHICH WERE SUPPOSED TO HELP COMPANIES GET OFF COAL AND GAS, WERE... SHRINKING DEMAND FOR FOSSIL FUEL. WE NEED TO HAVE EFFICIENT` DO YOU THINK IT'S GOOD TO SHRINK DEMAND FOR FOSSIL FUELS? DO YOU THINK THAT'S WHAT WE NEED TO DO? WE NEED TO MEET OUR 2050 OBLIGATIONS, BUT WE ALSO NEED TO MAKE SURE THERE'S A TRANSITION, AND THAT'S WHERE GAS CAN PLAY A REALLY IMPORTANT ROLE. AND, YOU KNOW, LOOK I'M NOT THE MINISTER OF ENERGY ANYMORE. NO, BUT THESE ARE DECISIONS THAT YOU MADE. I BACK MY DECISION THAT I MADE. IT WAS A CABINET DECISION SUPPORTED BY MY COLLEAGUES. I THINK HE'S SOMEONE WHO BRINGS A PERSPECTIVE, WHICH IS IMPORTANT AROUND HOW WE CAN BE MORE EFFICIENT WITH ENERGY ACROSS ALL ENERGY TYPES. BUT YOU KNOCKED BACK THE OFFICIALS WHO SAID THAT... IT WASN'T AN APPROPRIATE MEMBER TO BE ON THIS BOARD. WELL, IF WE AGREE WITH THE` IF WE JUST` IF WE AGREE WITH EVERYTHING OFFICIALS SAID, LIFE WOULD BE VERY BORING. WELL, WE'RE CERTAINLY NOT IN THAT PHASE, BUT DO YOU STAND BY THOSE ACTIONS OF KNOCKING BACK YOUR OFFICIAL ADVICE, WHICH SAID, 'LOOK, THESE GUYS AREN'T APPROPRIATE FOR THE BOARD'? HE'S SOMEONE WITH INCREDIBLE EXPERIENCE, AND AS I SAID, IF WE'VE AGREED WITH EVERYTHING OFFICIALS SAID, LIFE WOULD BE VERY BORING. HEALTH MINISTER SIMEON BROWN. IF YOU WANT TO CONTACT Q+A TEAM, PLEASE KORERO MAI. FLICK US AN EMAIL ` qanda@tvnz.co.nz. AFTER THE BREAK ` COULD CHRIS HIPKINS EVER WORK WITH WINSTON PETERS AGAIN? DESPITE POST-ELECTION PREDICTIONS, FORMER PRIME MINISTER AND LABOUR LEADER CHRIS HIPKINS HELD ON TO HIS JOB ACROSS THE FIRST YEAR OF BEING IN OPPOSITION. SO FOR THE LARGEST PARTY OF OPPOSITION, ATTENTION NOW TURNS TO WHETHER THEY CAN CONVINCE THE COUNTRY THEY'RE UP TO ANOTHER GO ON THE TREASURY BENCHES, AND THE POLICY SLATE THEY MIGHT TAKE INTO THE ELECTION. CHRIS HIPKINS DELIVERED HIS STATE OF THE NATION SPEECH ON FRIDAY, ALONG WITH A BIT OF A RESHUFFLE OF HIS CAUCUS RESPONSIBILITIES. I SAT DOWN WITH HIM AFTER THAT SPEECH. YOU'VE DONE A RESHUFFLE OF YOUR PORTFOLIOS. JAN TINETTI LOSES THE EDUCATION AND WOMEN'S PORTFOLIOS ` BOTH OF THOSE AREAS SHE WAS A MINISTER IN BOTH OF THOSE AREAS SHE WAS A MINISTER IN. DID SHE FAIL AS A MINISTER? NO. IF YOU LOOK AT THE OVERALL LINE-UP NOW, LARGELY, PEOPLE ARE IN PORTFOLIOS THAT THEY WEREN'T IN WHEN WE WERE LAST IN GOVERNMENT, AND THAT'S A DELIBERATE MOVE. YOU KNOW, WE'RE NOT ASKING TO RE-ELECT` FOR PEOPLE TO RE-ELECT THE LAST GOVERNMENT THAT WE WERE IN 2023. WE LOST THAT. YOU KNOW, WE'RE REFRESHING, WE'RE RENEWING. SO OUR LINE-UP IN 2026 NEEDS TO LOOK DIFFERENT TO WHAT WE WENT INTO THE 23 ELECTION WITH. WILLIE JACKSON LOSES EMPLOYMENT, AND HE LOSES MEDIA. DID HE LOSE MEDIA PARTLY BECAUSE OF THE BOTCHED MERGER OF TVNZ AND RNZ? NO, NO ABSOLUTELY NOT. I'VE ASKED WILLIE TO TAKE ON SOCIAL DEVELOPMENT, WHICH IS A BIG PORTFOLIO, SOCIAL DEVELOPMENT, WHICH IS A BIG PORTFOLIO, AND HE'S STILL OUR SPOKESPERSON ON MAORI DEVELOPMENT. THOSE ARE TWO BIG PORTFOLIO AREAS. REUBEN DAVIDSON'S COMING UP THROUGH THE RANKS IN OUR CAUCUS. HE'S GOT A BACKGROUND IN BROADCASTING, IN MEDIA. I ACTUALLY WANT TO EXPAND THAT OUT. SO I'VE EXPANDED THE PORTFOLIO TO BE BROADCASTING MEDIA AND THE CREATIVE ECONOMY, BECAUSE THERE'S HUGE OPPORTUNITY FOR NEW ZEALAND. IF YOU THINK ABOUT HOW WELL WE'VE DONE IN THE SCREEN SECTOR, FOR EXAMPLE, WITH FILM AND TELEVISION, EXPAND THAT OUT TO GAMING, EXPAND THAT OUT TO THE OTHER CREATIVE DIGITAL SECTORS, MASSIVE OPPORTUNITY TO CREATE NEW JOBS, YOU KNOW, NEW, GOOD, WELL-PAYING JOBS IN NEW ZEALAND IN AN AREA THAT'S CHANGING MASSIVELY AND QUICKLY. SO I WANT TO PUT SOME NEW ENERGY INTO THAT TO, YOU KNOW, REALLY GENERATE NEW IDEAS. IS THIS THE LINE-UP THAT YOU WILL GO INTO THE 2026 ELECTION WITH? I THINK, YOU KNOW, A YEAR AND A HALF, THERE'S BOUND TO BE A FEW TWEAKS HERE AND THERE. BUT YEAH, I'VE LARGELY GOT PEOPLE WHERE I WANT THEM TO BE HEADING INTO THE NEXT ELECTION CAMPAIGN. YOU TOLD THE AUCKLAND BUSINESS CHAMBER ` WHERE THIS SPEECH WAS ANNOUNCED ` THAT, QUOTE, 'WE AREN'T GOING TO SPEND OUR FIRST YEAR 'BACK IN GOVERNMENT PAUSING, CANCELLING AND REVIEWING EVERYTHING.' 'EVERYTHING.' SO SURPRISE US. WHICH OF THE CURRENT GOVERNMENT'S POLICIES ARE YOU GOING TO HANG ON TO? I THINK THERE'S A BIT OF A DIFFERENCE BETWEEN RHETORIC AND REALITY SOMETIMES, BUT IF YOU LOOK AT WHAT THEY'RE SAYING ON INFRASTRUCTURE, WE NEED A MORE STABLE INFRASTRUCTURE PIPELINE WHERE WE CAN ACTUALLY JUST GET AHEAD AND BUILD THINGS. AND THE PRIORITIES DON'T ALWAYS CHANGE EVERY TIME THERE'S A CHANGE OF GOVERNMENT. I ACTUALLY AGREE WITH THAT APPROACH. I THINK THEM COMING IN AND CANCELLING, PAUSING, YOU KNOW, THINGS LIKE SCHOOL REBUILDS, HOSPITAL REBUILDS, EVEN SOME OF THE TRANSPORT PROJECTS WE HAD UNDERWAY, THAT WAS HUGELY DAMAGING FOR OUR OVERALL ECONOMY. THERE'S 13,000 FEWER PEOPLE WORKING IN BUILDING AND CONSTRUCTION TODAY THAN THERE WERE ON ELECTION DAY, AND THE GOVERNMENT DIALLING BACK WORK IN THAT AREA IS ONE OF THE REASONS FOR THAT. I DON'T THINK THE COUNTRY CAN AFFORD TO KEEP DOING THAT. SO I'VE SAID THAT, LOOK, IF THEY'VE GOT WORK UNDERWAY, EVEN IF IT'S NOT NECESSARILY STUFF I WOULD HAVE PUT AT THE TOP OF THE LIST, IF IT'S ALREADY UNDERWAY, WE'LL KEEP IT GOING, BECAUSE I DON'T THINK THE COUNTRY CAN AFFORD THE STOP-START MENTALITY WHEN IT COMES TO THINGS LIKE INFRASTRUCTURE. SO I ACTUALLY DO AGREE WITH WHAT THE GOVERNMENT ARE SAYING IN THAT AREA. UNFORTUNATELY, THEIR ACTIONS DON'T MATCH THAT. BUT IF THEY FOLLOW THROUGH, THEN SO WILL WE. LET'S TALK ABOUT THE ECONOMY. WILL YOU CAMPAIGN ON A CAPITAL GAINS TAX? WE'LL CAMPAIGN ON TAX REFORM, AND WHAT YOU HEARD ME SAY TODAY, NOW, THE EXACT NATURE OF THAT, IT'S NOT JUST A SIMPLE ISSUE OF THIS ONE TAX OR THAT ONE TAKES. I THINK THE ISSUE THAT WE'RE TRYING TO ADDRESS HERE IS WE'VE GOT TO REJIG THE TAX SYSTEM SO THAT THE BURDEN OF TAXATION IS MORE EVENLY SPREAD, BEARING IN MIND, AS YOU KNOW, WE'VE ALL GOT A RESPONSIBILITY TO CONTRIBUTE TO THE PROSPERITY AND WELL-BEING OF THE COUNTRY. AND AT THE MOMENT, THE TAX SYSTEM DOES REWARD SPECULATIVE INVESTMENT ` THINGS LIKE GOING AND BUYING RENTAL PROPERTIES ` MORE, AND ENCOURAGE MORE OF THAT, THAN INVESTING IN PRODUCTIVE BUSINESSES THAT CREATE JOBS. AND THAT DOES NEED TO CHANGE. SO YOU WILL CAMPAIGN ON A CAPITAL GAINS TAX. I MEAN, YOU DON'T NEED TO GIVE US THE DETAILS, BUT YOU HAVE SPENT YEARS AND YEARS AND YEARS LOOKING AT THAT. SURELY YOU CAN TELL NEW ZEALANDERS TODAY THAT, 'YES, WE WILL CAMPAIGN ON A CAPITAL GAINS TAX. 'I'LL TELL YOU THE DETAILS LATER,' BUT SURELY THE TIME HAS COME FOR YOU JUST TO SAY YOU'RE GOING TO DO IT. WE'RE GOING TO BE ANNOUNCING OUR TAX POLICY THIS YEAR. I KNOW THAT PEOPLE WANT TO HAVE PLENTY OF TIME TO THINK ABOUT THAT. AND YES, IT WILL BE A REJIG OF THE TAX SYSTEM. BUT I'M NOT ASKING YOU` THE IMPORTANT QUESTION IS NOT JUST WHAT NEW TAX WE WOULD HAVE, BUT WHERE WILL THAT MONEY GO? I'LL DECIDE WHAT THE IMPORTANT QUESTIONS ARE FOR TODAY. FAIR ENOUGH. AND MY QUESTION IS ` WILL YOU CAMPAIGN ON A CAPITAL GAINS TAX? I'M NOT ANSWERING THAT TODAY BECAUSE WE HAVEN'T LOCKED DOWN OUR POLICY ON THAT, AND INCLUDED IN THAT WILL BE CONSIDERATION OF IF WE INTRODUCE ANY NEW TAXES, WHERE THE MONEY WILL GO. WE'LL TALK ABOUT THAT IN A SECOND, BUT WHO'S DRIVING THIS POLICY? I MEAN, ARE YOU IN CHARGE OF THIS PARTY? ABSOLUTELY. AND DO YOU WANT TO GO AHEAD WITH A CAPITAL GAINS TAX? THAT'S A PRETTY EASY QUESTION. IT IS. AND WHAT'S THE ANSWER? IS THE ANSWER YES? I'M TELLING YOU I'M NOT GOING TO I'M NOT GOING TO GIVE YOU THE ANSWER TODAY BECAUSE I'M NOT ANNOUNCING OUR TAX POLICY TODAY. I KNOW EVERYONE'S OBSESSED ABOUT TAX. CERTAINLY THE CURRENT GOVERNMENT ARE OBSESSED ABOUT TAX. BUT NOT ALL ROADS LEAD TO TAX. WHATEVER YOU DECIDE ON TAX ` AND THIS IS THE REASON WHY I'M NOT ANSWERING IT TODAY ` WHATEVER YOU DECIDE ON TAX HAS TO FIT WITHIN A BROADER ECONOMIC PLAN THAT INCLUDES WHERE THAT MONEY GOES. IF YOU'RE RAISING NEW TAX REVENUE, WHERE DOES IT GO? DOES IT GO TO OFFSETTING ` I.E. REDUCING TAXES IN OTHER AREAS OR DOES IT GO TO NEW SPENDING? AND THOSE ARE PRETTY FUNDAMENTAL QUESTIONS. AND WE CAN UNPACK SOME OF THAT AS WE GO. BUT YOU ARE GOING TO CAMPAIGN ON TAX REFORM. YOU TOLD ME THAT. ABSOLUTELY. YEP. OK. SO THERE WILL BE CHANGES TO THE TAX SYSTEM, NOT JUST THE INCOME TAX RATES. THAT'S CORRECT. ABSOLUTELY. SO YOU ARE GOING` WE ARE GETTING SOMEWHERE, AREN'T WE? YOU ARE GETTING SOMEWHERE. LOOK, THE STRUCTURE OF OUR TAX SYSTEM, IF YOU LOOK AROUND THE WORLD, NEW ZEALAND IS QUITE UNIQUE IN THE SENSE THAT THE VAST BULK OF THE GOVERNMENT'S TAX REVENUE COMES FROM INCOME TAX OR GST. AND IS THAT FAIR? IS IT FAIR? NO, I DON'T THINK IT IS FAIR. OK. AND WHAT ARE YOU GOING TO DO ABOUT IT? WELL, WE WILL ANNOUNCE THAT IN A FEW MONTHS. BUT IS IT FAIR IF I WORK AS A CLEANER AND GET $60,000 A YEAR, I PAY TENS OF THOUSANDS OF DOLLARS IN TAX TO THE GOVERNMENT, AND IF I FLICK AN INVESTMENT PROPERTY, I PAY ZERO TAX? IS THAT FAIR? NO, I DON'T THINK THAT'S FAIR. AND ARE YOU GOING TO DO SOMETHING ABOUT THAT? YES. OK. WELL, THAT'S PRETTY MUCH A CAPITAL GAINS TAX, ISN'T IT? WELL, YOU'RE JUST` I'M NOT ANNOUNCING OUR TAX POLICY TODAY, BUT, YOU KNOW, YOU GET THE DIRECTION OF TRAVEL. WE DO WANT TO SEE THAT SPECULATIVE INVESTMENT, YOU KNOW, SPECULATIVE OF DECISIONS THAT ARE PAYING THEIR FAIR SHARE OF TAX, THE PEOPLE MAKING THEIR MONEY OFF THAT ACTIVITY ARE PAYING THEIR FAIR SHARE OF TAX, BUT IN OTHER AREAS, ACTUALLY WANT TO ENCOURAGE MORE OF CERTAIN THINGS. WE WANT TO ENCOURAGE MORE SAVINGS. WE WANT TO ENCOURAGE MORE INVESTMENT IN BUSINESSES AND IN PRODUCTIVE ENTERPRISE THAT ACTUALLY CREATES JOBS FOR KIWIS. OK. CAN YOU RULE OUT A WEALTH TAX? OH, AS I'VE SAID, I'M NOT MAKING OUT` I'M NOT ANNOUNCING OUR TAX POLICY TODAY. SO THAT WAS QUITE A SPLIT WITH LABOUR LAST TIME THOUGH, WASN'T IT? YEAH, AND WE'RE WORKING THROUGH THAT ALONG WITH THE TEAM. YOU DON'T SUPPORT THE WEALTH TAX, DO YOU? WELL, LOOK, I'M NOT ANNOUNCING OUR TAX POLICY TODAY. I'M ASKING YOU TO NOT TO ANNOUNCE IT, BUT TO RULE THAT OUT. AS I'VE SAID, WE'LL ANNOUNCE OUR TAX POLICY IN DUE COURSE. IT WILL BE THIS YEAR. YOU NEED TIME TO BED IT IN BEFORE AN ELECTION, DON'T YOU? THAT'S RIGHT. AND THAT'S WHY I'VE SAID WE'LL ANNOUNCE IT THIS YEAR. AND ALSO, YOU KNOW, YOU NEED TIME TO BASICALLY, I GUESS, COUNTER THE MISINFORMATION THAT OFTEN GOES WITH TAX CHANGES, AND SO THAT'S WHY I'VE SAID THAT WE'LL DO IT THIS YEAR. DO YOU THINK THE APPETITE IS THERE NOW? WE'VE SEEN SOME HEAVY HITTERS COME OUT IN SUPPORT OF IT ` THE HEAD OF THE LARGEST BANK, THE TREASURY, THE WORLD BANK, THE IMF. IT'S HARD TO FIND SOMEONE WITH MANA AND ECONOMICS WHO DOESN'T SUPPORT IT. WELL, I'M GLAD THAT YOU THINK THE MINISTER` THE CURRENT MINISTER OF FINANCE DOESN'T HAVE ANY MANA IN ECONOMICS. I AGREE WITH YOU. NO, I DIDN'T SAY. I AGREE WITH YOU. NO, I DIDN'T SAY THAT. NO, BUT ACTUALLY THE ONLY PEOPLE WHO SEEM TO BE VOCIFEROUSLY ARGUING AGAINST CHANGES IN THIS AREA, IN THIS BROAD AREA, ARE THE PEOPLE WHO MAKE UP THE PRESENT GOVERNMENT. LET'S TALK ABOUT ANOTHER COUPLE OF ECONOMIC ISSUES BEFORE WE MOVE ON. LABOUR HAD A DUAL MANDATE FOR THE RESERVE BANK WHERE THEY TARGETED INFLATION BUT ALSO LOOKED AT EMPLOYMENT. NATIONAL HAS GONE, 'OK. ONLY GOING TO FIXATE ON THE INFLATION NUMBER.' ARE YOU GOING TO BRING THE DUAL MANDATE BACK? WOULD THAT BE YOUR INTENTION? I HAVEN'T MADE DECISIONS ON THAT. ACTUALLY, IF YOU LOOK AT THE ANALYSIS OF WHETHER THE MANDATE WAS STILL THERE OR NOT THERE, THE ARGUMENT OVER THE LAST FIVE YEARS, THE CONCLUSIONS THAT I'VE SEEN OVER THE LAST FIVE TO 10 YEARS, IS THAT IT DIDN'T REALLY MAKE MUCH DIFFERENCE EITHER WAY. SO YOU'RE NOT GOING FUSSED ABOUT IT? SO AT THE MOMENT I'M REASONABLY AMBIVALENT ABOUT THAT, BUT WE HAVEN'T FINALISED OUR POLICY ON THAT YET. DO WE DESERVE TO KNOW WHY ADRIAN ORR RESIGNED? YES, I THINK WE DO. I HAVE A LOT OF RESPECT FOR ADRIAN ORR AND IN FAIRNESS TO HIM AS WELL, HE WAS LEADING THE RESERVE BANK THROUGH A REALLY, REALLY CHALLENGING PERIOD GLOBALLY. HIGH INFLATION AND THEREFORE HIGH INTEREST RATES IS NOT JUST SOMETHING THAT'S HIT NEW ZEALAND. IT'S HIT ECONOMIES AROUND THE WORLD. A COUPLE OF MORE ECONOMIC ISSUES. THE INTEREST DEDUCTIBILITY FOR LANDLORDS, THE LANDLORDS TAX BREAKS AS THEY'RE COLLOQUIALLY KNOWN, $3 BILLION NEARLY ON THAT. ARE YOU GOING TO BRING THEM BACK? I THINK THAT COMPLETELY, YOU KNOW, THAT'S ONE OF THE REASONS WHY WE'RE WORKING THROUGH OUR TAX POLICY CAREFULLY, COS IF WE... IF WE WERE TO DO SOMETHING IN THE CAPITAL GAINS TAX AREA, THEN OF COURSE THAT HAS A BEARING ON WHAT WE WOULD DO AROUND THINGS LIKE INTEREST DEDUCTIBILITY. THOSE TWO DEBATES ARE ABSOLUTELY LINKED. SO THOSE ARE THE ISSUES THAT WE'RE WORKING THROUGH. WHAT WE DID DO ` I THINK THIS WAS MISUNDERSTOOD THOUGH ` IS WE STILL HAD FINANCIAL INCENTIVES THROUGH THE TAX SYSTEM FOR PEOPLE TO BUILD MORE HOUSES. SO IF YOU WERE A LANDLORD AND YOU WANTED TO BUILD MORE HOUSES, YOU'VE STILL GOT INTEREST DEDUCTIBILITY ON THOSE THINGS IF YOU'RE BUYING EXISTING HOMES THOUGH, WE DID CHANGE THE TAX SYSTEM SO THAT IT DIDN'T INCENTIVISE THAT, AND THAT'S BECAUSE WE WANT FIRST-HOME BUYERS TO BE IN THE FRONT OF THE QUEUE FOR BUYING EXISTING HOMES. WILL YOU BRING BACK THE BAN ON OIL AND GAS EXPLORATION? AGAIN, WE HAVEN'T MADE A FINAL CALL ON THAT, BUT ULTIMATELY, I DON'T SUPPORT THE REMOVAL OF IT. SO THAT'S PROBABLY GIVES YOU A FAIRLY BIG, YOU KNOW` A BIG HINT IN THAT DIRECTION. AND I DON'T THINK THAT OIL AND GAS EXPLORATION IS PART OF NEW ZEALAND'S ENERGY FUTURE. WE HAVE SUCH AN ABUNDANCE OF RENEWABLE ENERGY. RENEWABLE ENERGY ACTUALLY HAS THE POTENTIAL TO PROVIDE US WITH CHEAPER ENERGY, AND THAT'S GOING TO BE BETTER AND MORE ECONOMICALLY COMPETITIVE FOR NEW ZEALAND TO DO THAT. SO THAT'S A YES. WELL, MORE OR LESS, YEAH. SO YOU WOULD REINTRODUCE THEM. WELL, WE HAVE SAID THAT. YOU KNOW, WE HAVE SAID THAT WE ARE ABSOLUTELY OPPOSED TO THE REMOVAL OF IT. OK. LET'S MOVE ON TO TRADE AND DEFENCE AND SECURITY. DONALD TRUMP, DEPENDING ON WHICH DAY IT IS, THE TARIFFS ARE GOING TO BE ON MEXICO. THERE ARE TARIFFS WHICH ARE BEING TALKED ABOUT BEING IMPLEMENTED WORLDWIDE ` SOME OF THOSE COULD HIT NEW ZEALAND. IF NEW ZEALAND IS HIT BY U.S. TARIFFS, SHOULD WE RESPOND AND HIT BACK? NO, I DON'T THINK NEW ZEALAND` IT'S GOING TO BE IN NEW ZEALAND'S BEST INTERESTS TO BE ENGAGED IN A CONSTANTLY ESCALATING TARIFF WAR. NO, I DON'T THINK NEW ZEALAND` IT'S NOT GOING TO BE IN NEW ZEALAND'S BEST INTERESTS TO BE ENGAGED IN A CONSTANTLY ESCALATING TARIFF WAR. SO WE SHOULD TURN THE OTHER CHEEK? WELL, IT'S NOT GOING TO BE IN OUR BEST INTEREST TO START APPLYING TARIFFS ON GOODS THAT ARE COMING INTO NEW ZEALAND. I THINK IT'S EVEN` SO EVEN IF THE U.S. HITS US, YOU WOULDN'T HIT BACK. WELL, THE U.S. HAS BEEN ONE OF OUR FASTEST-GROWING EXPORT MARKETS. I DON'T THINK WE CAN BE BLIND TO THE FACT THAT TARIFFS ARE LIKELY TO AFFECT NEW ZEALAND EXPORTERS GOING INTO THE U.S., BUT WE SHOULD BE TRUE TO OUR VALUES. NEW ZEALAND HAS OFTEN STOOD APART IN TERMS OF OUR COMMITMENT TO FREE TRADE INTERNATIONALLY. IT HAS ACTUALLY BEEN VERY GOOD FOR NEW ZEALAND TO HAVE THAT POSITION, AND I THINK WE SHOULD CONTINUE TO MAINTAIN IT. DO YOU THINK THAT PHIL GOFF SHOULD HAVE BEEN SACKED FOR WHAT HE DID IN TERMS OF ASKING WHETHER DONALD TRUMP UNDERSTOOD HISTORY? I'VE SEEN THE VIDEO NOW. I HADN'T SEEN THE VIDEO THE OTHER DAY, AND I DO THINK HE OVERSTEPPED THE MARK IN TERMS OF WHAT YOU WOULD EXPECT FROM A DIPLOMAT, BEARING IN MIND HE'S NOT A POLITICIAN. HE IS A DIPLOMAT. A POLITICIAN SAYING THOSE REMARKS RIGHT NOW, IN THE CURRENT CONTEXT, I DON'T THINK WOULD` HE'S NOT A DIPLOMAT TO THE U.S., THOUGH, IS HE? HE'S A DIPLOMAT IN LONDON. YEAH. BUT YOU STILL HAVE TO BEHAVE IN A DIPLOMATIC WAY. SO I THINK OVERSTEPPED THE MARK. YOU COULD ASK ME THE QUESTION ` IF I WAS THE PRIME MINISTER AND IT WAS JOHN KEY MAKING THOSE REMARKS, WOULD I REBUKE HIM FOR DOING SO? YES, I WOULD. WOULD YOU HAVE SACKED HIM? WOULD I COMPLETELY REMOVE HIM FROM HIS JOB? I'M NOT SURE THAT I WOULD GO THAT FAR. SO YOU'VE` AND THIS ISN'T A CRITICISM, BUT YOU'VE CHANGED YOUR MIND, BECAUSE I HEARD YOU A LITTLE BIT EARLIER IN THE WEEK SAYING` WELL, I HADN'T ACTUALLY SEEN THE FULL CONTEXT OF IT. I HADN'T ACTUALLY SEEN THE VIDEO. I'VE NOW SEEN THE VIDEO. SO YOU WOULDN'T HAVE SACKED HIM? I'M SAYING I WOULD` I'M NOT` IT'S` ULTIMATELY IT'S WINSTON PETERS' JUDGEMENT, BUT I'M NOT SURE THAT I WOULD HAVE GONE THAT FAR. ARE YOU WORRIED THAT WE'RE IN A WORLD WHERE PEOPLE ARE JUST SO SCARED OF SAYING ANYTHING ABOUT DONALD TRUMP? YES. I THINK NEW ZEALAND SHOULD CONTINUE TO STAND UP FOR NEW ZEALAND'S VALUES, AND A LOT OF WHAT DONALD TRUMP IS PROMOTING AT THE TOTAL OPPOSITE OF THE THINGS THAT NEW ZEALANDERS CARE ABOUT. YOU KNOW, IF YOU WANT AN OPEN ECONOMY, IF YOU WANT, YOU KNOW, A TRUSTING DEMOCRACY, IF YOU WANT AN INCLUSIVE COMMUNITY ` THESE ARE THINGS THAT ARE IMPORTANT TO NEW ZEALANDERS, AND, YOU KNOW, MANY OF THE THINGS DONALD TRUMP IS DOING ARE GOING AGAINST THOSE. IS STRAIGHT TALKING IMPORTANT TO NEW ZEALANDERS? YES, I THINK IT IS. YEAH. DO YOU TRUST DONALD TRUMP? LOOK, I'VE SAID THAT I'M AVOIDING THAT QUESTION. I STILL HAVE A RESPONSIBILITY TO BE A LITTLE DIPLOMATIC. DO YOU SEE THE IRONY IN YOUR LAST TWO ANSWERS? I STILL HAVE A RESPONSIBILITY TO BE DIPLOMATIC. COME ON. I MEAN, YOU'VE GOT A GUY IN THE WHITE HOUSE WHO'S COMPLETELY HAPPY TO SPEAK HIS MIND, AND PEOPLE ARE RESPONDING TO THAT, RESONATING TO THAT. THEY WANT ` AS YOU'VE JUST TOLD ME ` THEY WANT STRAIGHT TALKING FROM THEIR POLITICS. I DON'T THINK INSULTS ARE GOING TO BE THE` ARE THE ANSWER TO THAT. I DIDN'T ASK FOR AN INSULT. I ASKED WHETHER YOU TRUSTED HIM. WHEN YOU START SAYING THAT YOU DON'T TRUST SOMEONE, YOU'RE KIND OF GETTING INTO PERSONAL TERRITORY. I THINK NEW ZEALAND` YOU WERE QUITE HAPPY TO SAY THAT ABOUT A LOT OF NEW ZEALAND POLITICIANS. I THINK NEW ZEALAND` WELL, THEY'RE MY OPPONENTS, AND ULTIMATELY I DON'T HAVE TO WORK CLOSELY WITH THEM IN THE WAY THAT WE'D HAVE TO WORK WITH WHOMEVER THE UNITED STATES CHOOSES TO ELECT. BUT NEW ZEALAND'S INDEPENDENT FOREIGN POLICY MEANS WE SHOULDN'T BE AFRAID ON ISSUES RATHER THAN PERSONALITIES. WE SHOULDN'T BE AFRAID TO DISAGREE, INCLUDING WITH OUR FRIENDS, AND THE UNITED STATES IS STILL ONE OF OUR CLOSEST FRIENDS. WE SHOULDN'T BE AFRAID TO DISAGREE WITH THEM. YOU'VE SAID NO TO AUKUS, PILLAR 2 OF AUKUS, THE NON-NUCLEAR MILITARY SHARING AGREEMENT. IF NATIONAL SIGNS UP IN THE NEXT, YOU KNOW, REMAINING MONTHS IN OFFICE, WOULD YOU PULL OUT? THAT'S A HYPOTHETICAL QUESTION. I DON'T THINK THAT'S GOING TO HAPPEN. I MEAN, IF YOU LOOK AT WHAT THE AUKUS PARTNERS THEMSELVES HAVE SAID, THEY DON'T THINK THAT THAT'S IN ANY WAY IMMINENT. THERE'S NO DECISIONS ABOUT THAT IMMINENT. YEAH. BUT IF WE WERE PART OF IT, WOULD YOU ACTUALLY TAKE THAT STEP OF PULLING OUT? WELL, I THINK IT'S HIGHLY UNLIKELY THAT THINGS ARE GOING TO GET TO THAT POINT. I MEAN, THERE ARE THREE PARTIES IN AUKUS AT THE MOMENT ` THE U.S., THE UK, AND AUSTRALIA ` I THINK ARE STILL GRAPPLING WITH WHAT THE CHANGE IN ADMINISTRATION IN THE U.S. MEANS FOR THE PARTNERSHIP THAT THE THREE OF THEM HAVE SIGNED UP TO. I THINK THE IDEA THAT ANYONE ELSE WOULD BE JOINING THAT AT THE MOMENT IS QUITE A DISTANT QUESTION. COULDN'T WE BE LEFT BEHIND IN TERMS OF MILITARY TECHNOLOGY IF WE DON'T GET INVOLVED WITH SOMETHING LIKE THIS? I MEAN, IF YOU LOOK AT UKRAINE, SOMETHING LIKE 70% OF THE DEATHS AND INJURIES ON THAT BATTLEFIELD ARE FROM DRONES. NOW, WHO KNOWS WHAT THE NEXT ITERATION OF MILITARY TECHNOLOGY IS GOING TO BE? BUT YOU WOULD DOUBT THAT NEW ZEALAND WILL BE BUILDING IT THEMSELVES AND WOULD HAVE THE CAPABILITY TO BE ENGAGING IN THAT SORT OF TECHNOLOGY. DON'T WE RISK BEING LEFT BEHIND? LET'S BE CLEAR ABOUT NEW ZEALAND'S POSITION HERE ` WE'VE GOT TO BE 'EYES WIDE OPEN' TO THE FACT THAT WE'RE LIVING IN A VERY VOLATILE AND MUCH MORE RISKY WORLD, BUT IS JOINING AN ARMS RACE THE BEST WAY FOR NEW ZEALAND TO, YOU KNOW, TO CONFRONT THAT REALITY? NO, I DON'T THINK IT IS. WE DO NEED TO BE CONSIDERING WHAT THE KIND OF DEFENCE FORCE CAPABILITY NEW ZEALAND NEEDS FOR OUR FUTURE IS, AND YES, WE'RE GOING TO HAVE TO SPEND MORE MONEY ON THAT. IF YOU LOOK AT OUR NAVAL FLEET AND VARIOUS OTHER THINGS, WE'RE GETTING TO THE POINT WHERE WE'VE GOT SOME BIG DECISIONS COMING. BUT WE ALSO HAVE TO ASK THE QUESTION, IF THERE IS INTERNATIONAL CONFLICT, IF THERE IS A NEED FOR NEW ZEALAND TO PLAY A ROLE IN THAT, WHAT'S THE BEST ROLE THAT WE CAN PLAY? BUT ALSO INCLUDING, YOU KNOW, LOOKING AT OUR OWN GEOGRAPHY AND THE FACT THAT WE'RE OFTEN GOING TO BE A LONG WAY AWAY FROM THOSE CONFLICTS. SO WE HAVE OFFERED LAND-BASED FORCES TO OTHER INTERNATIONAL CONFLICTS, MOST RECENTLY IN AFGHANISTAN, FOR EXAMPLE, AND NEW ZEALAND NEEDS TO BE AWARE THAT WE MAY BE CALLED UPON TO DO THAT AGAIN IN THE FUTURE. SHOULD WE BE TARGETING 2% OF GDP FOR DEFENCE SPENDING? THE PRIME MINISTER HAS INDICATED THAT WE SHOULD BE MOVING IN THAT DIRECTION DOES HE HAVE YOUR SUPPORT ON THAT? HE HAS OUR SUPPORT IN TERMS OF LOOKING AT WHAT WE NEED IN OUR MILITARY CAPABILITY. YEAH, BUT THAT'S A DIFFERENT` BUT IT'LL COST WHAT IT'LL COST, AND IT WON'T BE EVEN ALL THE TIME. SO IF YOU LOOK AT IT, FOR EXAMPLE, UNDER LABOUR, DEFENCE SPENDING WENT UP SIGNIFICANTLY. WHY DID IT GO UP? BECAUSE WE HAD TO REPLACE THE ORIONS, WHICH WERE ALMOST` I THINK THEY WERE OLDER THAN ME. SO WERE THE HERCULES. WE REPLACED THEM. THAT MEANT THERE WAS A BIG LUMP IN THE SPENDING. THAT'S THE NATURE OF A SMALL MILITARY, WHICH WE HAVE. IT'S GOING TO BE A BIT LUMPY. SO YOU DON'T THINK IT'S USEFUL TO TARGET A 2% OF GDP NUMBER OR SOMETHING LIKE THAT? NO. I THINK THE QUESTION IS, WHAT DO YOU NEED? WHAT'S THE CAPABILITY YOU NEED, AND HOW MUCH DOES THAT COST? RATHER THAN HOW MUCH SHOULD YOU SPEND? WHAT WOULD BE AT THE TOP OF YOUR LIST? CERTAINLY THE NAVAL FLEET. YOU KNOW, WE'VE GOT TO LOOK AT WHAT KIND OF CAPABILITY WE NEED THERE. THE FRIGATES ARE GOING TO HAVE TO BE REPLACED AT SOME POINT. WE'RE GOING TO HAVE TO MAKE DECISIONS ON THAT IN THE NEXT DECADE. AND WHATEVER WE DO THERE, WE'RE GOING TO NEED TO GET SOME BIPARTISAN AGREEMENT ON THAT BECAUSE IT'S GOING TO, YOU KNOW` YOU'RE TALKING ABOUT OVER A DECADE OR TWO DECADES. IT'S GOING TO SPEND MULTIPLE GOVERNMENTS. WE HAVE TO WORK CONSTRUCTIVELY TOGETHER. WE'VE GOT TO LOOK AT THE GAPS IN WHAT WE'VE GOT IN OUR NAVAL FLEET ` FOR EXAMPLE, WE DON'T HAVE ANY ICEBREAKING CAPABILITY, YET WE'RE RIGHT ON THE SOUTHERN OCEAN. SHOULD THAT BE PART OF OUR NAVAL FLEET CAPABILITY? SO THESE ARE THE KIND OF STRATEGIC CONVERSATIONS WE SHOULD HAVE, AND I DON'T THINK THEY SHOULD BE A POLITICAL FOOTBALL. I THINK THE COUNTRY'S TOO SMALL FOR THIS SORT OF STUFF TO BE A POLITICAL FOOTBALL. ARE YOU COMMITTED TO FIVE EYES? YES. WHY? IT'S REALLY IMPORTANT TO NEW ZEALAND'S SECURITY THAT WE'RE PART OF THOSE INTELLIGENCE-SHARING OPERATIONS. THAT DOESN'T MEAN WE CAN'T DISAGREE WITH THE OTHER PARTNERS IN THE FIVE EYES ` AND WE DO REGULARLY. YOU'VE GOT A NATIONAL DIRECTOR OF INTELLIGENCE IN THE U.S., TULSI GABBARD. YOU'D BE HAPPY FOR INFORMATION, INTELLIGENCE SHARING INTO THAT ENVIRONMENT? THERE STILL PREDICTIONS AROUND WHAT INTELLIGENCE WE SHARE THROUGH THAT EXISTING ARRANGEMENT. I'M VERY MINDFUL ALWAYS WHEN I TALK ABOUT THIS, YOU KNOW, NOT WANTING TO GIVE TOO MUCH AWAY OR NOT WANTING TO GIVE AWAY INFORMATION THAT I SHOULDN'T, BUT I AM CONFIDENT THAT THERE'S A ROBUSTNESS IN THAT FIVE EYES COUNTRY` WITH OUR COUNTRY'S RELATIONSHIP AROUND THE FIVE EYES, AND IT'S STILL IN NEW ZEALAND'S BEST INTEREST TO BE PART OF IT. LET'S FINISH TALKING ABOUT WHAT IT MIGHT LOOK LIKE IF YOU WERE TO RETURN TO THE TREASURY BENCHES. IS YOUR PREFERENCE FOR A LABOUR-GREEN-TE-PATI-MAORI GOVERNMENT? MY PREFERENCE IS TO GET AS MANY VOTES FOR LABOUR AS I POSSIBLY CAN. AND LET'S BE CLEAR, IT'S MMP. THE STRONGER THE BIGGEST PARTY IN GOVERNMENT IS, THEN OBVIOUSLY THE MORE` THE LESS YOU HAVE TO GIVE AWAY IN NEGOTIATION. SO I WANT TO GET AS BIG A SUPPORT FOR LABOUR AS I POSSIBLY CAN. IS COALITION OR SUPPORT PARTY ARRANGEMENTS, ARE THEY A REALITY UNDER MMP? YES, OF COURSE THEY ARE. COULD WE WORK WITH THE GREENS? YES. CAN WE WORK WITH TE PATI MAORI? YES, WE CAN. IS IT YOUR PREFERENCE ` THOSE TWO PARTIES? I'LL SET OUT MY POSITION ON THAT CLOSER TO THE ELECTION. PARTLY THAT'S GOING TO DEPEND ON WHAT KIND OF THINGS THEY DECIDE TO PRIORITISE IN THEIR ELECTION CAMPAIGN. SO IT WILL MAKE A DIFFERENCE. I'VE ALREADY SAID, FOR EXAMPLE, IN THE CASE OF TE PARTY MAORI, ONE OF THE PROPOSALS THEY PUT UP AND SAID WAS GOING TO BE A PRIORITY FOR THEM IS NOT SOMETHING THAT WE WOULD AGREE TO. I'M NOT GOING TO AGREE TO HAVING A COMMISSIONER OVERTURNING THE LAWS THAT ARE PASSED BY A DEMOCRATICALLY ELECTED PARLIAMENT, BUT WE'RE OPEN TO MORE CHECKS AND BALANCES ON WHAT THE PARLIAMENT CAN DO. IS THAT YOUR PREFERENCE, THOUGH, FOR A LABOUR-GREEN-TE-PATI-MAORI COALITION? WELL, I THINK THE CLOSEST WORKING RELATIONSHIP WE'VE GOT AT THE MOMENT IS WITH THE GREEN PARTY. THE RELATIONSHIP WE HAVE WITH THE TE PATI MAORI IS AN EVOLVING ONE. COULD YOU APPOINT THEIR MPS AS MINISTERS? IN TERMS OF THE GREENS? NO. TE PATI MAORI. I THINK THAT'S STILL` WE'RE STILL A WAY OFF HAVING TO EVEN MAKE JUDGEMENTS ON THAT. AND AGAIN, IT'S GOING TO DEPEND PARTLY ON THE POSITION THEY TAKE GOING INTO THE ELECTION CAMPAIGN. WOULD YOU WORK WITH WINSTON PETERS? I RULED THAT OUT AT THE LAST ELECTION, MANY WOMEN WHO GIVE BIRTH, THE EXPERIENCE CAN BE AMONG THE MOST TRAUMATIC THINGS THEY GO THROUGH IN THEIR ENTIRE LIVES. AND WHILE THEY'RE ENTITLED TO TWO NIGHTS FUNDED STAY IN HOSPITAL AFTERWARDS, SOME DON'T KNOW THEIR ENTITLEMENTS AND FEEL PRESSURE TO GET OUT THE DOOR TO FREE UP THE BED. FOR THIS WEEK'S MEMBER'S BILL FEATURE, WE MEET TUKITUKI MP CATHERINE WEDD, WHO WANTS TO CHANGE BOTH WHAT NEW MOTHERS ARE ENTITLED TO AND HOW THEY'RE MADE AWARE OF THEIR RIGHTS. I'M CATHERINE WEDD, THE MEMBER OF PARLIAMENT FOR TUIKITUKI, HAWKE'S BAY, AND MY PRIVATE MEMBER'S BILL IS THE PAE ORA HEALTHY FUTURES THREE-DAY POST-NATAL STAY AMENDMENT BILL. THIS BILL WILL PROVIDE 72 HOURS OF POST-NATAL CARE FOR NEW MUMS AND FAMILIES, AND IT WILL ENSURE THAT THAT MUM KNOWS HER ENTITLEMENT TO THE 72 HOURS THREE-DAY STAY. I'M A MOTHER OF FOUR YOUNG CHILDREN, AND MY FIRST BIRTH WAS QUITE A TRAUMATIC BIRTH. I HAD ALL OF THE SPECIALISTS AND DOCTORS, BABY GOT STUCK, AND THEN AFTER I'D HAD A BABY, SHE WAS WHISKED AWAY TO SCBU, TO THE SPECIAL CARE UNIT, AND I WAS LEFT ALONE, QUITE EMPTY, AND THERE WAS PRESSURE TO LEAVE THE HOSPITAL. AND IF IT WASN'T FOR MY AMAZING, INCREDIBLE MIDWIFE WHO REALLY STOOD IN OUR CORNER AND STOOD UP FOR US, IT COULD HAVE BEEN QUITE A DIFFERENT EXPERIENCE. IT'S EARLY IN THE PROCESS AT THE MOMENT, AND THE MODELLING FOR THE FUNDING IS CURRENTLY BEING DONE, AND THAT WILL BE PRESENTED, I'M SURE AS WE GO THROUGH THE PROCESS OF IMPLEMENTING THIS LEGISLATION. I THINK IT'S REALLY IMPORTANT THAT IT'S AN ENTITLEMENT IN LEGISLATION SO THAT MOTHERS KNOW THAT THEY HAVE A LEGAL ENTITLEMENT TO THREE DAYS POSTNATAL STAY. WE KNOW AT THE MOMENT THAT THE MAJORITY OF WOMEN ARE NOT HAVING THE 48 HOURS POSTNATAL CARE, AND SO THIS WILL ENABLE AND ENTITLE 72 HOURS IN LAW OF POSTNATAL CARE, WHICH WILL PROVIDE THE NECESSARY SUPPORT THAT NEW MUMS AND FAMILIES NEED. NATIONAL MP FOR TUKITUKI CATHERINE WEDD WITH HER MEMBER'S BILL. SO YOU KNOW, AS WELL AS WATCHING OUR SHOW LIVE YOU CAN CATCH US ON TVNZ+, WHERE YOU CAN FIND ALL OF Q+A'S WORK PLUS THE BEST OF TVNZ'S NEWSROOM. STAY WITH US, Q+A WILL BE BACK AFTER THE BREAK. BEFORE WE GO, Q+A ISN'T JUST ON TVNZ 1 AND TVNZ+. WE'RE ALSO A PODCAST, SO IF YOU'D RATHER LISTEN TO THE SHOW THAN WATCH IT, YOU CAN CHECK IT OUT ON ALL MAJOR PODCAST PLATFORMS. KUA MUTU, THAT'S Q+A FOR THIS WEEK. FROM THE Q+A TEAM, THANKS FOR WATCHING AND NG? MIHI KI A KOUTOU. HEI TERA WIKI. JACK TAME WILL BE BACK WITH YOU NEXT SUNDAY AT 9am. CAPTIONS TOM CLARKE AND BRIGIT KELLY. CAPTIONS WERE MADE WITH THE SUPPORT OF NZ ON AIR. WWW.ABLE.CO.NZ COPYRIGHT ABLE 2025