Well, kia ora, good afternoon, everyone. Can I just thank all of those of you who accompanied me to Vietnam and say I trust the jet lag hasn’t been too bad and you’ve recovered upon your return. Of course, the reason for visits like Vietnam is that we want to expand our exports. In doing so we drive our economic growth and as a result we’re able to invest in better public services, like healthcare.
Today it’s good to be joined by the Minister of Health, Simeon Brown. As most Kiwis understand, our healthcare system is facing some significant challenges, and it’s important the context and the problem definition, I think, is well understood. To give you a feel for it, we already spend around $28 billion on health each and every year, and on top of that the Government has made a record $17 billion investment into Health New Zealand over three years. So, I do want to be crystal clear that health spending is at record levels. We are spending more on health and no Government, in fact, has spent more in the history of New Zealand on healthcare.
And while we have workforce challenges in some particular parts of the healthcare system, I think we’ve also made some good progress on the health workforce. A good example, for example, would be nurses. In the last year we have actually increased nursing staff by almost 2,000 nurses—or a 6% increase—to 29,500 FTEs. Also, remuneration for nurses has improved dramatically and disproportionately compared to other Kiwis. Since 2014, average salaries for nursing and midwifery staff have increased by almost 70 percent. The average salary of a registered nurse is now currently around $127,000, including overtime and allowances, and that is on par with what nurses are paid in New South Wales despite New South Wales being 30 to 35 percent wealthier than New Zealand.
But despite all of that funding and despite all of that workforce growth, we are not seeing the results that we have invested in. Productivity, as measured by the number of cases per employee, has declined almost 20 percent and it has not kept pace with that increased funding and workforce growth. And that is totally unacceptable because how it translates is that it means that Kiwis are finding it harder to get access to a GP, they wait longer in emergency departments, and for first specialist appointments and for elective surgeries. Those wait times are all too long and we don’t want that, as our goal has to be about providing timely access to quality healthcare for all Kiwis.
To be clear, we have the best doctors and nurses who do an absolutely amazing job helping their fellow Kiwis in need, and everyone who interacts with them will tell you of their positive experience. But it is the system that is letting them down and their patients down: a system dealing with botched health reforms, layers of bureaucracy, poor governance, management, and financial controls, loss of regional and local decision making, outdated infrastructure, and inefficient ways of working.
What we need is a system that puts patients first and is relentlessly focused on lifting performance against the health targets that matter most to Kiwis. Quality and timely primary healthcare is the cornerstone of an effective and efficient healthcare system, and improving primary care access and choice for Kiwis is a top priority for this Government. And that’s why Simeon will be making an important speech later on this week, on Friday, about the healthcare plan in general, and we’ll be making a series of announcements around improving primary care in New Zealand in the coming weeks and months. And with that, I’ll now hand over to Simeon to make the first of those announcements.
Well, thank you, Prime Minister. I’ve been the Minister of Health now for five weeks and have had the privilege of being able to spend a significant amount of time visiting hospitals, doctor clinics, and many other medical professionals around the country. I’ve also had the opportunity to meet with the most important people in our health system, the patients. We do have a healthcare system which is under significant pressure. But as the Prime Minister has also made clear, we’re a Government which has invested more than any other Government in healthcare and will continue to do so, with the Government investing $17 billion into Health New Zealand over three Budgets.
This Friday I will be giving a keynote speech in Auckland to outline the direction that I’ll be taking as Health Minister and the focus that I’ll be bringing to the role, but today I want to talk about primary healthcare. One of my key focus areas as Minister of Health will be to ensure New Zealanders have better access to doctors and nurses in primary healthcare settings. All healthcare is local and there is nothing more important than the family GP practice, which serves over 50,000 New Zealanders on a daily basis and who help keep our communities healthy and, importantly, keep Kiwis out of hospital through prevention and management of patients in the community.
Primary care is the cornerstone of our health system. When people can see a doctor or nurse quickly, we can prevent small issues from becoming major problems, and that benefits everyone. But right now, too many New Zealanders can’t get the care they need when they need it, and that’s why the Government is taking action. I’ll have much more to say about primary healthcare over the coming weeks, but today I’m pleased to announce a number of key commitments and announcements to support Kiwis to be able to see their doctors quicker and in a timely manner.
Firstly, Cabinet has agreed that we will fund and support 100 internationally trained doctors to be registered in New Zealand to work in primary care. Even though we need more doctors, we have overseas-trained doctors living in New Zealand who want to work in primary care but can’t because of barriers to registration and training. It doesn’t make sense that these people are out there doing other jobs when we have a desperate need for doctors in our doctor clinics today, and we’re fixing that. We’ll fund a new two-year primary care training programme for up to 100 extra overseas-trained doctors, ensuring they can join our primary care workforce as soon as possible.
Secondly, we’ll be funding more nurses into general practice. Under our plan, we will incentivise primary care to recruit up to 400 graduate nurses. This is about making sure that we can have more nurses in our primary care clinics in our communities and in—particularly in our rural communities. We’ll be incentivising those primary care practices with payments of up to $15,000 in urban environments and up to $20,000 in rural environments to hire those nurses into primary practice. This will help attract essential healthcare staff where they’re needed most, particularly in our rural communities.
Thirdly, we’ll be investing to establish a new digital healthcare service, giving New Zealanders access to 24/7 video consultations with New Zealand-registered GPs and nurse practitioners. For some people this will be game-changing. Digital 24/7 healthcare will mean access to a GP or nurse practitioner anywhere and any time, with the ability to have prescriptions issued and tests to be ordered, and this will be available for all New Zealanders. Health New Zealand expects to have the service up and running by the middle of this year, providing more access for Kiwis to healthcare professionals.
Finally today, I’m also announcing that Health New Zealand has agreed to deliver a $285 million performance-based uplift in funding over three years for general practice from 1 July 2025. This is made possible due to the Government’s record $16.68 billion investment in health and is in addition to the capitation uplift general practice receives on an annual basis. This will be an incentive payment for GPs to offer enhanced access for patients, including opening their books to new patients, achieving key Government health targets such as increased immunisation rates, or supporting family doctors to undertake minor planned care services and to see patients in a timely manner. We know this additional funding will make a real difference in helping New Zealanders access their GP in their community. I’ll pass over to you, Prime Minister.
Thank you, Simeon. Look, these initiatives are just the first steps in our commitment to improving primary care and strengthening our healthcare system. This is about delivering real change for New Zealanders: not reports, not restructures, but actually results that matter, like access to a doctor when your kid falls ill at midnight. We will continue to build on today’s announcement to ensure every New Zealander has timely access to quality healthcare that they deserve, and Simeon will have more announcements in the coming weeks ahead.
Just before we go to some questions, the week ahead. This week, Niue’s Prime Minister, Dalton Tagelagi, will visit New Zealand. New Zealand deeply values its relationship with the Government and people of Niue. I’m looking forward to catching up with Prime Minister Tagelagi again, after being with him in Niue last year on the 50th anniversary of Niue’s self-government in free association with New Zealand, and having caught up with him a few times in Wellington and also previously Auckland. The Prime Minister will also meet with Minister Peters, Minister Collins and senior leaders from New Zealand’s Ministry of Foreign Affairs and Trade, and national security agencies.
And in House business, this week in the House we will consider further stages of the Sentencing (Reform) Amendment Bill, and the Customer and Product Data Bill. On Thursday morning we will have all remaining stages of the Te Korowai o Wainuiārua Claims Settlement Bill. Thank you. And with that, happy to take any questions you may have.
They will be—so they’ve got to pass their exam, but they will immediately start their training in GP practices, and so that is a two-year programme. Normally, doctors have to do the training in hospital settings. This will allow them to do their training in GP practices under supervision, and so they’ll be able to immediately start serving New Zealanders in that setting. And as they train there they’re more likely to stay in those settings, serving New Zealanders.
Well, look, ultimately this provides a 24/7 service for all New Zealanders. It’ll be New Zealand-trained GPs and nurse practitioners. Some of them will be— most—many of them will be from New Zealand. Some of them may be GPs working— registered in New Zealand but working offshore, able to support that service. Health New Zealand will go through a procurement process to procure those providers for that. Look, we have invested significantly in our workforce and we will continue to do so. We’ve increased the number of doctors being trained on an annual basis by 75 placements every year in our—in our universities and we’ll continue to invest in making sure we’ve got the doctors and nurses New Zealanders need.
I think it’s about—it’s about providing another option for Kiwis and that’s why today’s announcement is about saying, look, there’s 100 doctors; we’re going to train them to work in GP practices. Currently, some of these people are—you know, we hear the stories— driving Ubers when they should be actually practising medicine, which is what they’ve been trained to do, but they’ve done it in a—trained in a different country. So this announcement today is about more doctors and nurses in GP practices, plus it’s about providing another option that New Zealanders will have to be able to access those important services in the way that works for them.
[Inaudible] record funding in health. You may have seen the survey [Inaudible] where the overwhelming [Inaudible] was that the frontline is suffering and that the [Inaudible].
—more frontline staff working in Health New Zealand over the last two years. There’s over 2,000 more nurses. We have invested significantly in frontline services and we will continue to do so. And that’s where we want the investment, not in the bureaucracy, and the Public Service Association represents the bureaucracy.
So I accept—I accept that they are doing what unions do, but they are led by a failed Labour Party candidate who is simply just trying to oppose what this Government is trying to do to make healthcare more accessible for Kiwis.
Look, I think they had about 1,000 responses from—there’s—like, 90,000 people work for Health New Zealand. It’s a very small number of people in a self-selected survey. So all I’d say is that is a—the PSA union doing what the PSA union does. We’re here talking about the good things this Government is doing: investing in healthcare, hiring more doctors and nurses, focusing on frontline service delivery. That’s what matters to Kiwis and that’s what I’m focused on.
And I think—can I just add—can I just add, Craig, you know, the key thing is that we want to get rid of the bureaucracy and we have to. You know, we are tipping more money in than we’ve ever tipped in before, we have more, you know, workforce growing and more workforce going in the frontline parts of our system, and yet we’re getting poor results and so we need those results to be stepped up. And, yeah, the reality is we know we’ve got a low-performing organisation and we need to turn it around.
Sorry? No. No, no. You go look at—go back to 2014 and look at our results today on emergency wait times, first access to specialist appointments, elective surgeries, cancer treatment times. All of that has gone backwards over the last six/seven years. And what we’ve got to do is say: look, we’ve got enough money going in. When you’ve actually hired 2,000 more nurses, when their salary is now, on average, $127,000 and it’s on par with the equivalent folk in New South Wales, we have made a huge investment. But when you see case weights per employee tracking down by almost 20 percent, that says to me that we’ve got a massive system and organisational problem.
Now, this is a large organisation. It’s got up to 95,000 employees in it. It’s a complex system, I get it. But it’s not just a money issue, it is actually we have to ask the question: if you want better health outcomes and you want to be patient first and focused—which we do want to do so—then you’ve actually got to say these are clearly what we’re shooting for as targets. Now let’s organise around making sure we deliver for those targets. There’s enough money, there’s more resources going in, and there’s more workforce growing well.
So Health New Zealand’s going to work with GPs around that, but ultimately they fund on an annual—they provide an annual uplift every year. This will be part of that. But it’ll be about them meeting certain criteria, so making sure they’ve got their open books, making sure that people can be seen in a [Inaudible]. It’s about—it’s about making sure that as we increase funding, which is really important for our GPs, they’re also making sure they’re providing that access that New Zealanders need.
Well, that is part of it. I think, you know, there’s a—there’s a—Health New Zealand is looking at the capitation model to make sure that it is fit for purpose. It hasn’t been looked at properly since 2002. But this is actually saying: look, a third of GP books are currently closed. We want to encourage those GP books—those GP clinics to open their books. There will be increased funding available for those GP clinics who have their books open, who are able to provide that access to those services in a timely manner for Kiwis.
Well, ultimately, we’re putting more money into general practice. Health New Zealand is putting more money into general practice to encourage them and encourage doctors to be more accessible to their patients. And that will mean they’ll be able to hire more staff, they’ll be able to invest in more resource to be able to provide more access for the patients who are on their books, as well as to be open to—
No, it’s both. I mean, ultimately they need more funding. And also what we’re doing here today is providing more staffing resource as well, by saying 400 nurses being funded to be able to be—do their training and start their careers in general practice. And we know that if they start there they’re more likely to stay there, which is fantastic outcomes for Kiwis.
Well, it’ll—yeah, it’ll be better resourced. This will be doctors and nurse practitioners. They’ll be able to prescribe. They’ll be able to refer you for tests, for other things as well. So these will be not just providing advice, but that’ll be just like going to a doctor and having an appointment. So that’s going to be the benefit of the 24/7 service. It’ll be available for all New Zealanders to be able to access and provide more choices.
And can I just say, I think that is a really exciting development because when you look at our healthcare system and you think about the modes of care and delivery, actually leveraging the technology that we know is sitting there with massive innovation that can actually disrupt the system—that actually means that you can talk to, say, a nurse practitioner who can actually prescribe medicine for you at 11.30 on a Friday night when you know, you know, what you need to get sorted—is actually really good. That’s what we’ve got to be doing to make sure we deliver the goal, which is timely, quality access to primary care. So I think, you know, there’s a lot—there’s a lot of disruption that’s actually—by starting up this way, you could see this taking off quite well in the coming years ahead. Sorry?
Yeah, look, it’ll be a digital service but I mean that’s providing more choices. That’s ultimately what we’re doing here, is providing more choices for Kiwis to access primary healthcare, and that’s a really important thing, 24/7, around the clock. So that’s about providing peace of mind to many New Zealanders as well.
Well, look, I mean this is a thing which—you know, people also go to work during the day and so being able to access healthcare at a time that works for them means they’re able to do that.
Well, ultimately that’s when they can—I mean, if you think about the choices, this is providing people choices. Doctor clinics aren’t open all the time. Pharmacies aren’t open all the time. But it’s about providing more choices as to when you can access that primary healthcare, a time which works for people, and people live different lives than just simply a 9 am to 5 pm. So it’s about actually providing more access and more choice for Kiwis and meeting the needs that they have.
And also, if that means—if that means an appointment that is, you know, having to be scheduled in a 9 to 5 with a—with a normal GP is done outside of those hours and processed in a different way, that’s a slot that’s not taken up. That’s taking people one or two weeks before they can actually get in to their GP. So, you know, again, we’ve got to think about how we can actually deal with a number of appointments that actually come off the load of GP practices right now. That clogs up and you end up waiting two weeks, you know, at worst case for an appointment. If you can access that quicker, get relief quicker, that’s all good.
Well, it won’t—sorry, it’s not a free service. So it will be a user pays service, similar to going and seeing your GP. Obviously, if you’ve got a concession, a Community Services Card or you’re under 14, all of those same concessions will apply. More detail will be announced closer to the middle of this year, when it is launched, in regards to that. But again, it’s about providing more choice for New Zealanders to be able to access primary healthcare.
No, it’s about supporting the business and the GP clinic to be able to take on those nurses. They obviously have to—there’s training. There’s supervision required as they—as they graduate. So it’s supporting them to transition into primary healthcare. It’s up to the business, up to the GP clinic, as to how they—what they do with that. But ultimately it’s about saying to them: in urban environments, $15,000, and a higher payment in rural communities where we know the—we know how more challenging accessing GPs can be in, you know, rural communities. So it’s about encouraging and incentivising that for our GP practices.
Sure. That’s—well, that’s a measure of our hospital performance. So that’s looking at our—at our case weight across the hospital system and looking at what’s happened over the last 10 years. And it’s effectively to say: look, we’re putting more resource in, more people in, but we’re not seeing the same amount done. And so, look, there’s a range of—there’s a range of factors behind that, but ultimately Kiwis are waiting too long to get service and get access.
And for the last few years, since Labour decided to restructure the health system in the middle of a pandemic, the system’s been focused on structure rather than on delivery of services to patients. And so that’s what we’re getting it back to, and we expect those—we expect, you know, all parts to be focused on serving the patient, putting patients first, delivering against those health targets. I think last year there was around—Health New Zealand did deliver around 10,000 more surgeries than the year before, which was great. We have to go—we have to go further because we need to get on top of those waitlists.
It was a pretty tough watch, you know. It was definitely a tough watch. You know, both parties have said they could have gone—you know, could’ve handled it or gone better. The bottom line is very simple for us: nothing’s changed in our position and support for Ukraine. Ukraine’s doing an exceptionally—you know, and President Zelensky’s doing an exceptionally good job as a wartime leader, as a leader of a small country that was invaded by a bigger country, and we stand with Ukraine.
And so we continue to, with our defence forces, train Ukrainian soldiers, in partnership with our UK friends, in the UK. We—as you saw on the third-year anniversary—added another $3 million into the Ukraine relief fund. And, importantly, we’ve increased and cranked up the sanctions even more against Russia. So, you know, the reality is we want the US and Ukraine working through a proper peace plan. But, yeah, it was tough, tough watching.
Well, again, what we want is we want a just and lasting peace, and for that to happen we need the US and Ukraine and Europe to be involved in actually developing that peace plan. And, you know, that’s what we all want to see. But, again, we are a country of values and we stand up for nations as sovereign states. We stand up for freedom of navigation. We stand up for the rules-based system. And, you know, that’s what Ukraine has done well. Just remember it was Russia that invaded the Ukraine and they were the aggressor, and Ukraine was the victim of that. And so we stand with them.
Yes. But as I’ve said globally, and I’ve said for some time over the last year, I continue to advocate for the rules-based system because I think, you know, in many ways our world order is breaking down from rules to power. You know, that is one of the things that we’ve got to guard against, and so we’ve got to continue to make the case. You know, we have an independent foreign policy. I, as Prime Minister, act in New Zealand’s national interests. And yes, there’s no doubt about it, it’s a more difficult geopolitical environment out there in the world, as you’ve seen in events over the last few weeks. But for us, we have a strong partnership with the US. There’s lots of collaboration and there’s lots of things that we can do together.
Well—no disrespect—I don’t take foreign policy advice from the Greens. But what I would say is that there’s nothing that’s changed in our AUKUS position. We continue to explore whether that’s in New Zealand’s national interest, and we’ll continue to do so. Audrey.
No, I mean I haven’t been sounded out, but yes, it is still my position. I’d be very open for New Zealand participating in a peacekeeping mission, but obviously we need to have a peace secured first and foremost, and we’re—it seems like we’re a wee way away from that. So that’s why we want to encourage all the parties to develop that peace plan. That means that Ukraine has to be at the table as part of that conversation. And, you know, they’ll be ultimately choices for Ukraine, but we need to be able to support them and if there—if there was, we’d be very open to considering any peacekeeping mission. As we—as we do—you know, we have a fantastic—you know, our troops are well respected and they have participated in very—they're still in very difficult parts of the world doing peacekeeping missions as we speak.
Well, I mean, as we’ve seen, they are acting completely within international law and that’s important. Our issue was around the live firing rounds, which were—you know, we felt good practice would have been 24 to 48 hours’ advance notice and potentially not doing it in the middle of a trans-Tasman air route. But, you know, they’re completely within the confines of international law, the UN Convention on the Law of the Sea. Those are the same laws that we rely upon with the freedom of navigation that we expect when we move around the world as well. So, you know, that’s their decision. As to why they’re doing it, as to where they were going—you know, we’re not informed in advance of that. But, you know, as I’ve said, no doubt about it: a much more contested world and, you know, certainly not a benign environment.
We, Sunday a week ago, raised the concerns with the Chinese at an official level, and I know it was raised in Minister Peters’ meetings in China as well.
Well, I think you have seen us, you know, back Ukraine. I mean, we’ve announced, you know, as I said, more funding, as we’ve been putting into the Ukraine Relief Fund. You know, we’re very comfortable with our troops continuing to work with the British troops to train Ukrainian soldiers and extending that. We’ve certainly, you know, been cranking up sanctions against Russian interests as well, and we’ll continue to do so. So, you know, I can’t be any clearer: our values are with Ukraine and with the Ukrainian people and with President Zelensky.
It’s not a discussion that we’ve had at this point. I appreciate we’re a long way away and our resources are somewhat small. But more importantly for me, it’s about a principles and a values thing. It’s that if you’ve got principles and values that you talk about, you’ve actually got to back it up, and that’s what you’ve seen us do. And I spoke about this strongly in opposition at the time when the war started. It’s an illegal war. The quickest way to stop it is actually for Russia to stop it. And we continue to entertain—and I’ve spoken with President Zelensky several times and met with him at least once, in a very comprehensive way. We’ll continue to—if there’s anything else that’s needed, we’ll continue to consider it.
I mean, I’ve—you know, David Seymour has spoken with me and given me an update of the issues that he’s facing, but I’ve got every confidence that as a senior capable Minister he’ll be able to sort it out.
I haven’t put a deadline on it, but I know he’s taking it very seriously. He’s—it’s got his full attention and he’s working through the issues, you know, day by day. So, I mean, I expect him to sort it out and solve it, and I know he will.
Well, I mean, I think all—you know, the reality is, you know, there’s some pretty frustrating experiences. There’s some very good experiences, to be honest, as well, and they probably don’t get reported upon. But, again, you know, David is all over it. He understands what’s required, he’s in the detail of it all and he’s working the issue, and so, you know, I’ve every confidence David will get it sorted.
[Inaudible] than other parts of the country. Key, big New Zealand [Inaudible] in other parts of the country than in Wellington. How widespread is this and how much of a concern is this for a Government [Inaudible] infrastructure, Water Done Well, [Inaudible]?
No, I think—I mean it’s a good question. I mean, the bottom line is I haven’t seen all the details, but the detail I’ve seen is unacceptable. Wellington Water is a total basket case. It has been for some time. It’s not a proper CCO like we see in other parts of the country, it’s a rather unique corruption that’s been built up over a number of years, and the reality is that, you know, they need to professionalise the management of the water assets here in this region. And, you know, that’s been a—it’s not—you know, people call it a CCO. It’s not a proper CCO that has balance sheet separation, proper governance, proper management. It’s sort of at the whim of how much each of the different mayors can throw into the kitty, and that is not a way to manage long-term water assets. And that’s why they need to adopt the Local Water Done Well models that we have presented and that Simeon presented as Local Government Minister and Simon Watts is advocating strongly for now, and get a proper structure in place.
No, no, as a—as a—as a configuration of—you know, like the way that it’s organised as an organisation, sorry. The way that it’s organised is not how our water assets are managed in CCO structures around—outside of Wellington. So it’s—there’s often, I notice, here in the bubble of Wellington—
No, I didn’t mean—as a configuration of an organisation, it is clear that it’s not the same—it is not configured on the same basis that we would have CCOs configured in other parts of the country. You good folk here in Wellington often refer to it as a CCO. I don’t think of it in those terms. I don’t think of it as properly structured, and as a result it’s a total basket case.
Yeah. Well, it’s very concerning because that’s—the bits that I have read, that is what is worrying about me—worrying about this, is that—what is actually going on with respect to what people are being charged and what is fair and, you know, what is happening.
What it warrants is for Wellington to focus seriously on improving its water assets. For that to happen, it needs to adopt one of the many models that have been positioned around Local Water Done Well, put a proper governance structure in place, get proper balance sheet separation, make sure long-run assets are properly debt funded, and actually have proper management controls around the spending and the asset management that needs to take place.
Yeah. Well, I mean, the key action I want to see is I want Wellington to move to a proper organisation that actually deals with the management of its water assets. And we’ve seen some good models of that, you know, whether it’s been the Watercare model—which I appreciate was, you know, a unique vehicle for Auckland. But when you saw Auckland Council proposing a 26 percent increase in rates and it ended up ending up with a 7 percent increase in rates because of the way it did the balance sheet separation and the funding and financing of those water assets, which is exactly strategic and long-term, and exactly what professional, modern countries should be doing, rather than what you see here—is everything’s just loaded up onto a ratepayer as a result.
So, you know, the reality is we’ve got major challenges, as we’ve seen, with the performance of, you know, the council. We’ve got challenges here with Wellington Water. We can be so much better and we must be so much better than this. The Local Water Done Well model is what we need applied quickly into Wellington and I expect, you know, that’s something the Local Government Minister will be focusing on.
Yeah. Well, I mean, we’ve got a series of options that Simeon can talk to from his previous experience in local government, where we basically went to the ratings agencies and rather than spending $1.2 billion, like the last Labour Government did and got nowhere, we went and spent, you know, an insignificant—you know, a relatively small amount of money to get clarity on which models would actually drive and create balance sheet separation so they could borrow assets—you know, borrow proper long-term debt funding for long-run assets. So the models are all there. But what we’re seeing today is just—is not professional, not gripped up, you know, and it’s lacking in proper management controls and governance controls.
Yes. We know it’s difficult, we know it’s challenging, but we continue to consider that. And we’ve got a number of announcements in the healthcare space, as I’ve foreshadowed, in the coming months ahead, and I’m sure that’s something that Simeon and his team will duly consider.
There’s been no hold-up, we’re just—we’re working at pace to deal with the challenges that we’ve got in our healthcare system. And right here, right now, when you just tip an extra $17 billion in, when you hire 2,000 more nurses and your productivity continues to slide, we have a major organisational problem that needs to step up. And that’s why we’ve made the changes we have around the Commissioner, initially, that’s why we’ve made—you know, that’s why we need, you know, a management structure and team in place that actually can deliver the results that we want to see for better patient outcomes.
Well, just hang fire. I’ve said to you we’ve got a range of healthcare announcements, but we are sequencing and working our way through the most pressing issues. And right now, when you have waitlist times in emergency departments because actually the primary care system is failing and, as a result, people go straight through and clog up hospitals and emergency—you know, emergency departments, that’s not cool. That’s the issue we’ve got to try and focus on and solve. It’s a big problem.
It is for sure, but also actually having access to a GP and actually having access to primary care, so that you don’t actually end up going into an emergency department because you’ve actually been dealt with in the primary care system, is also very important. So it’s a complex system but we have to work our way through it. Because the money’s in, the workforce is growing and the remuneration of the workforce is growing, but the productivity is poor, and that says we’ve got an organisational problem which we need to sort out and get fixed.
Look, it’s just—we actually meet more regularly as he passes through Auckland. I often meet with him in Auckland. It’s really just a chance for us to touch base, check in, see how everyone is, what’s going on with each other, share what’s happening in our respective countries, and it’s just a courtesy call. So it’ll be very informal, very friendly, and it’s a chance for him and I just to catch up and talk about a range of issues in the Pacific and across the region. I’ll come back to you, Glenn.
Helen Clark has questioned our involvement with the Five Eyes [Inaudible] concerns about the Oval Office, about Donald Trump’s views aligning with Russia. Do you think New Zealand should remain part of it?
Absolutely. It’s in New Zealand’s national interest to remain part of it. And I’d just say to you as Prime Minister I see our current intelligence reports, not ones from 20 years ago, and I’d just say to you that it is right that we are very much part of the Five Eyes network.
Well, as I say, New Zealanders should be—should know that we have an independent foreign policy, a Government and a Prime Minister that will act in their national interests and New Zealand’s national interests. And we understand, you know, if we drive more prosperity and security—those two issues are linked. And there’s a range of considerations that we make, as you’ve seen, around supporting Ukraine, being part of the Five Eyes network and the Five Power Defence Force Arrangements that we have in South-east Asia, for example. So we will continue to act in New Zealand’s national interest. And it’s no longer a benign environment, as I said. It might have been 20 years ago but it’s not today. And so we are taking the right course of actions, and we get tremendous value from being—in the intelligence sense, from being part of the Five Eyes network.
But I’d just say to you we have to find a peace in Ukraine, and Ukraine working with the US and Europe is really important, and I think you’ve seen a huge effort from leaders all around the world actually working towards that. You’ve seen that particularly from the European leaders. But I—you know, we—for a peace to happen, we’ve got to have Ukraine at the table and the US involved as well.
Yes, I do. I trust the—I trust the President and I trust—I trust the American system, and that we can work well with the American system. I will continue to act in our own national interests, as you would expect me to do, but I think we can work well—we work well with a number of leaders and partners around the world.
[Inaudible] was talking about the mission creep of Five Eyes. Are you comfortable with how [Inaudible] the mission of the Five Eyes has become, or could you see a scenario in which New Zealand [Inaudible] with other countries within the Five Eyes, especially if Canada [Inaudible]?
Well, we have—there’s a lot of hypotheticals in that question and I’d just say to you that, you know, I think there is a recency issue in terms of, you know, I am seeing our intelligence reports here and now, versus, as I say—with all respect—20 years ago. And, you know, the intelligence network that we have is a really important one. It actually is in New Zealand’s national interest to be part of that and we benefit from being part of that. Equally, we benefit from being a Five Eyes—Five Power Defence Force Arrangements in South-east Asia. We benefit from a whole range of other arrangements that we have with—bipartisan arrangements between different countries, as well as obviously in collectives as well. The IP4 is another example of that. So, you know, it’s—you know, there’s a range of things that we do to act in New Zealand’s national interest and we’ll continue to do so, and that’s one of them. OK.