The health system is in crisis, and surgeons are being forced to decide which patients to treat, and which need to wait.

Counter to Te Whatu Ora’s statement that 73% of planned surgeries had been delivered in the year to date, surgeons are saying its closer to 50% or less.

High-profile colorectal surgeon Frank Frizelle joined Kerre Woodham Mornings to discuss the situation.

LISTEN ABOVE

The health system is in crisis, and surgeons are being forced to decide which patients to treat, and which need to wait.
Counter to Te Whatu Ora’s statement that 73% of planned surgeries had been delivered in the year to date, surgeons are saying its closer to 50% or less.
High-profile colorectal surgeon Frank Frizelle joined Kerre Woodham Mornings to discuss the situation.
LISTEN ABOVE

Join Kerre Woodham one of New Zealand’s best loved personalities as she dishes up a bold, sharp and energetic show Monday to Friday 9am-12md on Newstalk ZB. News, opinion, analysis, lifestyle and entertainment – we’ve got your morning listening covered.

Kerre Woodham Mornings Podcast

Frank Frizelle: Colorectal surgeon on the surgical crisis

Do you have to get your car serviced by the dealer to avoid voiding the warranty?  

While you don't necessarily have to, manufacturers require specific equipment and supplies to be used during the servicing process, and using alternatives can impact the warranty.

The independent mechanic also has to adhere to the servicing schedule and keep complete documentation. 

Motor Trade Association Dealer Expert Larry Fellowfield told Kerre Woodham that while dealerships often cost more than independent mechanics, it comes down to the specific training and equipment they’re required to have.  

LISTEN ABOVE  

Do you have to get your car serviced by the dealer to avoid voiding the warranty? &nbsp;
While you don't necessarily have to, manufacturers require specific equipment and supplies to be used during the servicing process, and using alternatives can impact the warranty.
The independent mechanic also has to adhere to the servicing schedule and keep complete documentation.&nbsp;
Motor Trade Association Dealer Expert Larry Fellowfield told Kerre Woodham that while dealerships often cost more than independent mechanics, it comes down to the specific training and equipment they’re required to have. &nbsp;
LISTEN ABOVE &nbsp;

Larry Fallowfield: Motor Trade Association Dealer Expert on whether you have to service your car at a dealer to maintain your warranty

https://api.omny.fm/orgs/7784f840-c291-422a-924b-ad9000bbad71/clips/faf7b016-cae8-430c-9ac7-b43b0018e91b/transcript

The topic of tax has been in the news recently and it will stay in the news. It’s set to become an election issue with one of the few policies that Labour's actually committed to being a Capital Gains Tax – possibly more taxation/revenue measures. Watch the politicians dance on the head of a pin in the lead up to the election. The Fitch report, which looks at New Zealand's ability to pay its bills, said that a Labour Party coalition with the Greens and Te Pāti Māori would emphasise revenue measures as a means of making ends meet. The authors of the report said the National Party-led coalition would focus on expenditure constraint. There's been all sorts of argy bargy and we can go into that a little bit later, but already, even when we start talking about tax and about Labour introducing a Capital Gains Tax and more tax, it's said like it's a bad thing. Like it's a dreadful thing to contemplate more tax. 

And yet, how else are we going to pay for the sort of country that we want, that we used to have, that we hear mythical stories about around the fireside from our forebears? Liam Dann has a column in the New Zealand Herald, Inside Economics, and in the column this morning, a correspondent writes that on a tax per capita basis, New Zealand is running materially behind Australia – roughly $13.6 billion annually. Now obviously, Aussies earn more, so their governments are going to take more tax. If you earn more, there's more to take on a percentage basis. But the correspondent writes that even closing a fraction of the tax would meaningfully shift the balance of our books into a positive light and it would change the way we talk about infrastructure and services. Even a tiny bit of that $13.6 billion would make a huge difference.  

The correspondent is a blogger and, in his blog, he also writes that one of the reasons why Aussies are prepared to pay more in tax is that they have accepted a basic truth: the country they want costs more to run. And I don't know that we are willing to accept that basic truth. We are still living like some crusty old goat on our former glory. Like the Bruce Springsteen song of 'Glory Days'. We used to be somebody. We used to have a great country. We used to have a country where Jack was as good as his master, where there were no huge extremes between wealth and poverty, where if you worked reasonably hard, if you lived a good life, if you obeyed the rules, you had a great life. You could be assured of a future; your children could be assured of a future. And we're still living on the glory days. 

Now obviously not everything that has happened in New Zealand is as a result of what New Zealand has done. We're a global economy now and the winds of change and fortune affect us without our politicians having to do anything at all. But over the years, successive governments have failed to invest in basic infrastructure, and the chickens are coming home to roost – Wellington's Moa Point is a metaphor for the entire country. Our politicians are to blame for a lack of political courage and a lack of political foresight, and we as voters are to blame because as soon as anybody mentions tax, we throw up our aprons and run for the hills. Never! I work hard for my money! I've paid my way, I pay more than enough, have a look at those bludging people on the dole, sort them out first! You can make all the excuses in the world, but are we willing to accept a basic truth that the country we want costs more to run than we're willing to pay. 

The topic of tax has been in the news recently and it will stay in the news. It’s set to become an election issue with one of the few policies that Labour's actually committed to being a Capital Gains Tax – possibly more taxation/revenue measures. Watch the politicians dance on the head of a pin in the lead up to the election. The Fitch report, which looks at New Zealand's ability to pay its bills, said that a Labour Party coalition with the Greens and Te Pāti Māori would emphasise revenue measures as a means of making ends meet. The authors of the report said the National Party-led coalition would focus on expenditure constraint. There's been all sorts of argy bargy and we can go into that a little bit later, but already, even when we start talking about tax and about Labour introducing a Capital Gains Tax and more tax, it's said like it's a bad thing. Like it's a dreadful thing to contemplate more tax.&nbsp;
And yet, how else are we going to pay for the sort of country that we want, that we used to have, that we hear mythical stories about around the fireside from our forebears? Liam Dann has a column in the New Zealand Herald, Inside Economics, and in the column this morning, a correspondent writes that on a tax per capita basis, New Zealand is running materially behind Australia – roughly $13.6 billion annually. Now obviously, Aussies earn more, so their governments are going to take more tax. If you earn more, there's more to take on a percentage basis. But the correspondent writes that even closing a fraction of the tax would meaningfully shift the balance of our books into a positive light and it would change the way we talk about infrastructure and services. Even a tiny bit of that $13.6 billion would make a huge difference. &nbsp;
The correspondent is a blogger and, in his blog, he also writes that one of the reasons why Aussies are prepared to pay more in tax is that they have accepted a basic truth: the country they want costs more to run. And I don't know that we are willing to accept that basic truth. We are still living like some crusty old goat on our former glory. Like the Bruce Springsteen song of 'Glory Days'. We used to be somebody. We used to have a great country. We used to have a country where Jack was as good as his master, where there were no huge extremes between wealth and poverty, where if you worked reasonably hard, if you lived a good life, if you obeyed the rules, you had a great life. You could be assured of a future; your children could be assured of a future. And we're still living on the glory days.&nbsp;
Now obviously not everything that has happened in New Zealand is as a result of what New Zealand has done. We're a global economy now and the winds of change and fortune affect us without our politicians having to do anything at all. But over the years, successive governments have failed to invest in basic infrastructure, and the chickens are coming home to roost – Wellington's Moa Point is a metaphor for the entire country. Our politicians are to blame for a lack of political courage and a lack of political foresight, and we as voters are to blame because as soon as anybody mentions tax, we throw up our aprons and run for the hills. Never! I work hard for my money! I've paid my way, I pay more than enough, have a look at those bludging people on the dole, sort them out first! You can make all the excuses in the world, but are we willing to accept a basic truth that the country we want costs more to run than we're willing to pay.&nbsp;

Kerre Woodham: The country we want costs more than we're willing to pay

https://api.omny.fm/orgs/7784f840-c291-422a-924b-ad9000bbad71/clips/bb080b01-df28-427e-a631-b43b0010e525/transcript

The headline in the Herald read “New Zealand population bombshell” – but is the news really that much of a bombshell? We know we have an ageing population. We know that we're not replacing ourselves with babies. And we know that there's going to be a real crunch when it comes to finding sufficient workers in the next 20 odd years.  

According to a report that the Herald quotes from Sir Peter Gluckman and Emeritus Professor Paul Spoonley, their new report People, Place and Prosperity says the colliding trends of a slowing population growth and a reliance on immigration to drive workforce and population growth, an ageing population requiring more public services, and growing ethnic diversity presents both opportunities and challenges. The opportunities include making the most of the skills, innovation, and creativity that such diversity can offer, but this can be undermined by political populism appealing to xenophobic tendencies – looking at you New Zealand First.  

We've known for some time now that we're not having enough babies to replace ourselves. In the late 19th century, women settlers had on average seven children, but this rate halved by the early 20th century. Births per women doubled after the Second World War, then dropped in the 1970s. By December 2017, it had fallen to an average of 1.81 live births per woman, below the 2.01 average maintained between 1980 and 2015 and now annual population growth has dropped from 1.7% in 23/24 to 0.7 in 24/25 and it’s projected to remain below 1% in the coming decades.  

Emeritus Professor Spoonley said the total fertility rate was at replacement level a decade ago, but last year it was the lowest it's ever been. You can't really blame young couples for not having families of five or six. I mean, what was normal a couple of generations ago seems aberrant now. Student loans, cost of housing, cost of living, an uncertain world. It's hardly surprising that families are restricting, that young couples are restricting their families. But the fact remains that even if AI fills some of the worker shortages, we're still going to need real life people to keep the country going. And if we're not making those people ourselves, then we're going to have to import them. And that's where Professor Spoonley says we have to have a reasonable, sensible discussion about what that will look like. 

“Let's have an adult conversation about this. Let's not descend to pointing fingers or making jokes or you know this is a serious issue. So I think we should all be involved and interested in this debate and let's try and keep it up. We're going to need a lot of workers in the future because our population is turning at this point because of declining fertility and ageing. So we're getting people exiting out of the workforce at the top end and we're getting fewer entering the workforce at the bottom end. So immigration becomes super important. I mean you and I rocking up to a hospital today, 40% of our nurses, I don't know what the number is for doctors, are overseas trained.” 

 Yes, quite. I mean what would we do with a number of the essential services without our migrant workers? So less of the not particularly clever jibes from Shane Jones and a bit more respect for the people who do choose to come here and contribute to our country and our wellbeing. Because remember, other countries are facing the same issue, or the same issues – an ageing workforce, a declining population. So we will be in competition with them for migrant workers.  

And it's no good thinking we can bribe or blackmail or entice or lure young women into filling their wombs. That's been tried overseas and it hasn't worked. Poland introduced a zero-income tax law for families with two or more children. Hungary, mothers who have four or more children are exempt from personal income tax. Hungary also offers a state subsidised family housing loan that provides low interest mortgages and partial debt forgiveness for married couples who commit to having children. Imagine. France, anyone who has two or more children receive a means adjusted payout depending on the number of children. Italy, Estonia, Turkey, I mean you name it. South Korea, Japan, they've all tried to entice women, couples to have more babies and it's not working.  

I don't know. Certainly talking to couples in their mid 30s, they would have more children if they felt they could afford them. Would zero income tax do it for you? Low interest mortgages? Would that do it for you? Is it an uncertain world that's putting you off bringing children into it? What is it that has meant that you have stopped at the children you have or chosen not to have children at all? Is it simply a matter of money? And when it comes to enticing people to come and live here, sure AI might fix some of the shortages, we're still going to need people, and we need to welcome them. Otherwise we really will just be a poorly serviced retirement village at the bottom of the South Pacific and that's all we will be. 

The headline in the Herald read “New Zealand population bombshell” – but is the news really that much of a bombshell? We know we have an ageing population. We know that we're not replacing ourselves with babies. And we know that there's going to be a real crunch when it comes to finding sufficient workers in the next 20 odd years. &nbsp;
According to a report that the Herald quotes from Sir Peter Gluckman and Emeritus Professor Paul Spoonley, their new report People, Place and Prosperity says the colliding trends of a slowing population growth and a reliance on immigration to drive workforce and population growth, an ageing population requiring more public services, and growing ethnic diversity presents both opportunities and challenges. The opportunities include making the most of the skills, innovation, and creativity that such diversity can offer, but this can be undermined by political populism appealing to xenophobic tendencies – looking at you New Zealand First. &nbsp;
We've known for some time now that we're not having enough babies to replace ourselves. In the late 19th century, women settlers had on average seven children, but this rate halved by the early 20th century. Births per women doubled after the Second World War, then dropped in the 1970s. By December 2017, it had fallen to an average of 1.81 live births per woman, below the 2.01 average maintained between 1980 and 2015 and now annual population growth has dropped from 1.7% in 23/24 to 0.7 in 24/25 and it’s projected to remain below 1% in the coming decades. &nbsp;
Emeritus Professor Spoonley said the total fertility rate was at replacement level a decade ago, but last year it was the lowest it's ever been. You can't really blame young couples for not having families of five or six. I mean, what was normal a couple of generations ago seems aberrant now. Student loans, cost of housing, cost of living, an uncertain world. It's hardly surprising that families are restricting, that young couples are restricting their families. But the fact remains that even if AI fills some of the worker shortages, we're still going to need real life people to keep the country going. And if we're not making those people ourselves, then we're going to have to import them. And that's where Professor Spoonley says we have to have a reasonable, sensible discussion about what that will look like.&nbsp;
“Let's have an adult conversation about this. Let's not descend to pointing fingers or making jokes or you know this is a serious issue. So I think we should all be involved and interested in this debate and let's try and keep it up. We're going to need a lot of workers in the future because our population is turning at this point because of declining fertility and ageing. So we're getting people exiting out of the workforce at the top end and we're getting fewer entering the workforce at the bottom end. So immigration becomes super important. I mean you and I rocking up to a hospital today, 40% of our nurses, I don't know what the number is for doctors, are overseas trained.”&nbsp;
&nbsp;Yes, quite. I mean what would we do with a number of the essential services without our migrant workers? So less of the not particularly clever jibes from Shane Jones and a bit more respect for the people who do choose to come here and contribute to our country and our wellbeing. Because remember, other countries are facing the same issue, or the same issues – an ageing workforce, a declining population. So we will be in competition with them for migrant workers. &nbsp;
And it's no good thinking we can bribe or blackmail or entice or lure young women into filling their wombs. That's been tried overseas and it hasn't worked. Poland introduced a zero-income tax law for families with two or more children. Hungary, mothers who have four or more children are exempt from personal income tax. Hungary also offers a state subsidised family housing loan that provides low interest mortgages and partial debt forgiveness for married couples who commit to having children. Imagine. France, anyone who has two or more children receive a means adjusted payout depending on the number of children. Italy, Estonia, Turkey, I mean you name it. South Korea, Japan, they've all tried to entice women, couples to have more babies and it's not working. &nbsp;
I don't know. Certainly talking to couples in their mid 30s, they would have more children if they felt they could afford them. Would zero income tax do it for you? Low interest mortgages? Would that do it for you? Is it an uncertain world that's putting you off bringing children into it? What is it that has meant that you have stopped at the children you have or chosen not to have children at all? Is it simply a matter of money? And when it comes to enticing people to come and live here, sure AI might fix some of the shortages, we're still going to need people, and we need to welcome them. Otherwise we really will just be a poorly serviced retirement village at the bottom of the South Pacific and that's all we will be.&nbsp;

Kerre Woodham: The matter of New Zealand's shrinking working population

https://api.omny.fm/orgs/7784f840-c291-422a-924b-ad9000bbad71/clips/ab06e943-1b47-4807-85eb-b43a000a802a/transcript

Frank Frizelle: Colorectal surgeon on the surgical crisis

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