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Speaker 1: There's Business of Health New figures this morning nearly one

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Speaker 1: and five elected surgeries have been canceled and that's because

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Speaker 1: they get bumped due to the acute of emergency patients

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Speaker 1: and great Indeed, now the Health New Zealand's been investigating

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Speaker 1: this particular problem at the request of the Minister, and

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Speaker 1: the Minister is, of course, Sir doctor Shane Ritti, who

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Speaker 1: is with us. Very good morning to you.

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Speaker 2: Good morning, Mike.

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Speaker 1: Have you got any answers?

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Speaker 2: Look, we've certainly got solutions, but this is a key

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Speaker 2: issue that twenty percent to are canceled due to acute surgery.

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Speaker 2: Of course we want that if you're urgent, you do

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Speaker 2: take a priority, but the consequences if you've been planned

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Speaker 2: for weeks, months or whatever, you get bumped off. And

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Speaker 2: so the most immediate solution is a model of care

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Speaker 2: that separates the accuses and electives. That is that one

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Speaker 2: hospital little More, for example, does the acutes, and counties

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Speaker 2: Monakal does the elective. Then you don't get bumped off

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Speaker 2: with what's coming in through the front door. Yep.

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Speaker 1: That's good on a major city like Auckland. What about

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Speaker 1: every other city that doesn't have quite the same facilities

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Speaker 1: as Auckland does.

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Speaker 2: Yeah, so this is part of the models of care

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Speaker 2: that we're looking to roll out across the country. How

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Speaker 2: we can separate either physically or functionally acute from electives

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Speaker 2: so that the electives are not canceled out. There's a

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Speaker 2: number of things to do here. We need to look

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Speaker 2: at that workflow into theater, so your theater utilization. Are

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Speaker 2: we starting on time? Are people turning up with their

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Speaker 2: consents all done? And then of course making sure we've

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Speaker 2: got the right people in theater to do these cases.

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Speaker 2: Six five hundred more cases done to the end of

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Speaker 2: June twenty four, So that's pleasing, but a lot of

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Speaker 2: work to do.

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Speaker 1: Good do you have the facilities and the people And

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Speaker 1: isn't that fundamentally what the problem is.

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Speaker 2: Yes, it is a couple of things. One of the

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Speaker 2: pinch points for the last eighteen months has been something

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Speaker 2: called anesthetic technicians, which are a really specialized group of

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Speaker 2: people that actually were holding up or not enough of them.

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Speaker 2: We're holding up some of our ambitions around planning here,

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Speaker 2: So building up that workforce and then if you say

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Speaker 2: more beds like tot to the Homo, the new building

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Speaker 2: with more beds.

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Speaker 1: Okay, by the way, a couple of things before I

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Speaker 1: forget because I haven't interviewed you since there was a problem.

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Speaker 1: A couple of weekends ago, there was a massive jobs

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Speaker 1: fair for nurses and the queue was a mile long.

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Speaker 1: And there's all these unemployed nurses in this country who

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Speaker 1: have got visas who came into the country, but they

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Speaker 1: can't be employed. How come we got so many one?

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Speaker 1: How many? We got so many people coming into the

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Speaker 1: country on a visa for a career that we're short of,

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Speaker 1: and yet they don't get jobs. How does that work?

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Speaker 2: Yeah? Great question. And in fact from OBAD we asked

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Speaker 2: for briefings and receive some of them around our immigration settings,

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Speaker 2: because if we just don't have places for these iqns,

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Speaker 2: these international qualified nurses, then we shouldn't be offering them

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Speaker 2: pathways through what's now in Oski into New Zealand. Furthermore,

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Speaker 2: the risk we run is that we're then unable to

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Speaker 2: take on our own domestically trained graduates. You know, part

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Speaker 2: of the issue We've got here now, so have got

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Speaker 2: that piece of worker looking at the immigration leaders, looking

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Speaker 2: at the nursing Council leaders, because I think we need

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Speaker 2: to be honest with some of these nurses. There is

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Speaker 2: a place or there is not a place.

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Speaker 1: Yeah, exactly good. Then the next question is this emergency

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Speaker 1: stuff that's bumping electives off? Is it an emergency because

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Speaker 1: they didn't go the GP in the first place, because

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Speaker 1: they can't get to a GP things have got bad,

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Speaker 1: then they're an emergency or are we just getting sicker?

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Speaker 2: It's a combination of both or to the first point, though,

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Speaker 2: I have seen some papers suggesting that it's not always

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Speaker 2: that everyone turning up at ED are people who could

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Speaker 2: be seen in primary care because to your second point,

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Speaker 2: people are presenting much more ill than they previously would.

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Speaker 2: So it is a combination of the b both. There

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Speaker 2: are some who do turn up at ED who could

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Speaker 2: be seen in primary care, and in places where we

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Speaker 2: have a primary care facility alongside the ED, they go there.

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Speaker 2: But it's not quite the answer that people would think, Ah,

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Speaker 2: just turn on more primary care and that'll solve our

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Speaker 2: ED turn ups. Some of them are turning up so

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Speaker 2: ill just the nature of being an older population getting

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Speaker 2: more ill that actually they were unsuitable for primary care

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Speaker 2: as well.

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Speaker 1: Is it just age or are we not looking after ourselves?

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Speaker 1: We're eating too much crap. We're too fat and we're

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Speaker 1: ending up ill and that's going to burden us for

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Speaker 1: years to come.

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Speaker 2: Combination of things, because if we look at all around

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Speaker 2: the world that aging population. As you get older, regardless

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Speaker 2: of the perfect lifestyle, age will be for you and

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Speaker 2: so you will be more susceptible to getting ill. Your

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Speaker 2: immune system naturally runs down. You'll become more susceptible to

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Speaker 2: getting ill and that is more likely to place you

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Speaker 2: in hospital. Undoubtedly, the lifestyle choices that we make can

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Speaker 2: enhance that can further run down your immune system, but

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Speaker 2: age will do that regardless.

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Speaker 1: Okay, Lester Levy, do you have a sense of how

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Speaker 1: he's going.

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Speaker 2: Yeah, making good progress. This is a hard job. Just

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Speaker 2: remember this is the biggest organization in New Zealand and

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Speaker 2: as we've lifted back the covers has been financial surprises,

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Speaker 2: as you'll be aware of. And he's making really good progress.

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Speaker 2: We've appointed the four regional deputy chief executives, so passing

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Speaker 2: those decisions making out of Wellington back into the regions

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Speaker 2: they will been appointed. Most of them have already started,

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Speaker 2: so making good progress. This is a long slow haul

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Speaker 2: to lift this up, fix the holes.

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Speaker 1: Okay, given the size of the problem you face and

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Speaker 1: the money involved, how is it I'm watching the news

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Speaker 1: last night and we're having a debate about toast and

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Speaker 1: pregnant women, and how has it got so bad that

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Speaker 1: toast is a debate.

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Speaker 2: I agree with you, these are adult women who can

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Speaker 2: make choices and a furthermore, toast is an easy comfort

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Speaker 2: food after having a baby. So, as I expressed, too

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Speaker 2: healthy is in seriously reconsider your position on This makes

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Speaker 2: no sense to me.

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Speaker 1: Good nice to talk to you, Appreciate it, Doctor Shane

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Speaker 1: Retti Health Interstance. For more from the Mic Asking Breakfast,

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Speaker 1: listen live to news talks that'd be from six am weekdays,

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Speaker 1: or follow the podcast on iHeartRadio.