Episode 19: Dr. Jonathon Coleman

This week our guest is the former Member of Parliament and Minister of Health, Dr. Jonathan Coleman.

Dr. Coleman spent almost 13 years as the MP for Northcote, and during that time was a key member of the inner circle in John Key’s National Party led government. During his parliamentary career he held Ministerial responsibility for health, broadcasting, sport & recreation, immigration and state services.

His early career saw him practising medicine in New Zealand and overseas and he even had a stint as a doctor on Australia’s Royal Flying Doctor Service.

During the Leaders Getting Coffee podcast, he speaks to Bruce about the importance of local communities, why centralising health decision making is wrong, and the newly announced funding for Pharmac.

As a former Minister of Health, Coleman has a unique perspective on the state of our health services, the things we do well and the areas where we under-perform. He openly discusses the financial constraints in the health sector and  the challenges of recruitment in the international marketplace for talent.

 Finally, he discusses the decision to go from the top job in the Health Ministry, back to life as a suburban GP.

 As someone who once put his hand up to be Prime Minister, in the wake of John Key’s resignation, we hear what he would do, if he was PM for a day.

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:15):
Hi everyone.

Speaker 2 (00:16):
My name is Bruce Cotterill and it's great to welcome
you back to Leaders Getting Coffee. Thanks for joining us
for this episode number nineteen. As many of you will
know by now, this podcast operates with the support of
the great team it ends head me who helped me
put it together each week, and of course they also
run my articles on their channels through the New Zealand

(00:36):
Herald and News talk S EDB and you might be
interested in checking out the latest couple of columns.

Speaker 1 (00:41):
One appeared in the New Zealand Herald.

Speaker 2 (00:43):
The headline read Government six months report card is the
Coalition on the right track. I think the Coalition is
doing pretty well, but we mustn't underestimate how much there
is to do in order to return us to that
little country that boxes above its weight. And so I've
expressed a few thoughts that column that you might want
to have a look at. The other column that ran
is on Newstalk ZEDB plus and the headline there is

(01:06):
the Remuneration Authority is tone death. I just can't believe
that the Remuneration Authority is recommending remuneration increases for our
parliamentarians over the next three years at a time when
the economy is under so much pressure and when we
have an austerity drive across government departments. It's enough to
make a man write a column in the heat of
the moment, and that's what I did. So go and

(01:27):
check out my view and please feel free to let
me know your view. You can find the columns as
I mentioned, at The Herald or on zb plus sites
or at dub dubdub dot Brucecottel dot com, forward Slash
blog and as I say, let me know what you think.

Speaker 1 (01:45):
Thanks again for being with us.

Speaker 2 (01:46):
This week's guest is someone I've been very keen to
have on the podcast since the very beginning, and now
it's finally happening and I'm very excited. So we'll be
with you for this long awaited discussion, very very short,

(02:09):
welling back to leaders getting coffee. As I said, I've
been wanting to have a conversation about the health system
for some time, and today we'll do that.

Speaker 1 (02:16):
But we will also do a whole lot more.

Speaker 2 (02:18):
Because our guest today has such a broad range of
leadership experiences, there's just a heck of a lot to
talk about.

Speaker 1 (02:24):
His name will be familiar to most of you.

Speaker 2 (02:26):
He is doctor Jonathan Coleman, former Member of Parliament, former
Health Minister and to this day of practicing GP out
there in the suburbs of Auckland.

Speaker 1 (02:36):
A few links to some.

Speaker 2 (02:38):
Of our previous guests on Leaders getting coffee between this
man and them, and partly he's an old boy of
Auckland Grammar School, and some listeners will recall that current
headmaster Tim O'Connor being one of our guests a few
weeks back in episode fifteen, So that's one of the links.
Back in nineteen eighty four Jonathan Coleman was the head
prefect of that school and he went on to study medicine.

(03:01):
He completed his medicine degree at the University of Aukland
Medical School and subsequently completed a diploma of Obstetrics. He
earned membership of the Royal College of General Practitioners in
the UK in nineteen ninety seven and practiced medicine in
New Zealand and overseas. Those experiences in included a stint

(03:22):
in GP practice in London and at the Royal Flying
Doctor Service based at Brokenhill in Australia, and we might
talk about that a little bit later on. Not content
with an education like that. He then went on to
complete an MBA at London Business School, which led to
stints at consulting firms booz Allen Hamilton and p WC

(03:43):
before he embarked on a memorable political career, which kicked
off at the age of thirty nine. In two thousand
and five, he became the Member of Parliament for Northcote
and he stayed in Parliament for thirteen years from two
thousand and five to twenty eighteen.

Speaker 1 (03:58):
In two thousand and eight, he.

Speaker 2 (04:00):
Became the Minister of Immigration and the Minister of Broadcasting,
the Associate Minister of Tourism and the Associate Minister of
Health in the first term of the National John Key
lead government, and in twenty eleven in the second term
he became Minister of Defense, State Services and the Associate
Minister of Finance, and finally, in his third term as

(04:20):
a minister, the Minister of Health and the Minister of
Sport and Recreation from twenty fourteen to two thousand and seventeen.
He left politics in twenty eighteen and became the CEO
of a Curity Health Group, a private healthcare company predominantly
based in the Lower North Island, with one thousand employees,
one hundred and thirty million dollars of revenue and nine
hospitals and clinics around the country. He left that role

(04:43):
in twenty twenty, although he did remain a director for
a further two years, and in a move that would
probably suppose surprise many of us, he went back to
practicing medicine as the local GP on Auckland's North Shore.

Speaker 1 (04:55):
He obviously likes being busy.

Speaker 2 (04:56):
He was until recently the director a director of the
North Help I have a rugby union. And he's currently
a board member of Rosmondy College, a director of MetLife
Care and a board member at the New Zealand Olympic Committee.
And there's another link to a formal guest on our podcast,
of course, as we had Nicky Nicol in the episode eighteen,
the CEO of that of that organization. He has a
couple of teenage kids to keep him busy. He's pretty

(05:18):
keen on his golf. I have seen him across the
fairways at the wad Amount of Golf Club. He loves tennis, golf, boating, fishing,
cycling and rugby. And so it is my long overdue
pleasure to welcome to lead us getting coffee doctor Jonathan Coleman.

Speaker 3 (05:31):
Hi, Gariss, it's great to be here.

Speaker 2 (05:34):
It's great, it's great to have you. Gee, that's a
long introduction. You've been a busy fellow, haven't you.

Speaker 1 (05:39):
Ah.

Speaker 4 (05:39):
Yeah, but look, you know you have different stages of
your life, and yep, I do like to keep busy.

Speaker 3 (05:43):
But there's been plenty of good times and plenty of
leisure as well.

Speaker 4 (05:46):
So look, I basically can't complain and I've enjoyed every
minute of it pretty much.

Speaker 2 (05:51):
Good stuff. You were here, boy of Auckland Grammar. What
do you remember about your school days?

Speaker 4 (05:57):
Look, came to grammar was a great experience for me
because my father had died shortly beforehand when I was twelve,
and Mum sent me off out of his own off
to walk and grammar school down the road from Meadowbanks, who.

Speaker 3 (06:09):
Were just outside the z own.

Speaker 4 (06:10):
I just remember a tremendous structure there, inspirational school teachers
and great leadership from one of the iconic headmasters I
think in New Zealand education actually in.

Speaker 3 (06:23):
The twentieth century, John Graham.

Speaker 4 (06:26):
And great mates, you know, I mean, the friends I
made there have remained friends for life. And it also
emphasides to me, I think one of the most important
things about education, you know, it's the peer group you're with.
And I think if kids are with a great peer group,
they're going to do all right. And then I was
lucky to be surrounded by some great guys who have
gone on to do some really interesting things and some

(06:48):
of the people you have heard of. So yeah, it
was certainly a great period of my life and I
feel very lucky to have been accepted out his own there.

Speaker 1 (06:56):
Didn't you were you just an academic Gord?

Speaker 2 (06:59):
Did you play plenty of sports at school or do
end up in the debating team or anything like that.

Speaker 3 (07:04):
So, look, I'm one of these people who have had
to play sports for the love of it.

Speaker 4 (07:07):
As John Major once said, I've always thoroughly enjoyed sports.

Speaker 3 (07:11):
So I wasn't a first.

Speaker 4 (07:12):
Fifteen player or a first or eleven cricketer, but I
played rugby and cricket right through. I was in the musicals. Yep,
I did do debating in my final year. Look, I
had to go at everything, really and I just loved school.
And look, a big part of that, I think was
that it was such a stimulating environment, and you know,

(07:32):
the opportunities were great. They're probably even greater now because
the facilities were that fantastic. But you know, it was
an environment that encouraged people to participate, to have a
go at things and do their very best.

Speaker 3 (07:46):
So yeah, I definitely kept busy. And you know, I think.

Speaker 4 (07:49):
Looking back, when you see how kids today are glued
to their phones and their laptops, I think one of
the great things about that era was that it afforded
so much opportunity to get involved and stuff and you
didn't have to be good to.

Speaker 3 (08:03):
Just head to have it go.

Speaker 2 (08:04):
Yeah, exactly. I think I think that opportunity is still there.
You're on the board of Rosmondy. I was on a
school board, as you know. I think I think we
still see the kids who want to get involved and
everything can still get involved in everything. And you can
be in the band and the choir and the water
polo team and the basketball team.

Speaker 1 (08:23):
So there's no shortage of opportunities for kids.

Speaker 2 (08:26):
They've probably got to be pushed away from their phones
in order to participate in some of that stuff.

Speaker 4 (08:31):
Well, I think that's the issue. And look, I think
the opportunities that are greater than ever. I mean, my
daughters just had a fantastic tender experience on the spirit
of adventure, you know, and what.

Speaker 3 (08:41):
An opportunity that was for her.

Speaker 4 (08:44):
So the opportunities are there, but the destructions are greater
than ever.

Speaker 3 (08:48):
There's more to worry about, Bruce.

Speaker 1 (08:50):
There is what made you decide to go to med school.

Speaker 4 (08:55):
Look, I had been exposed to some real good role
models when I and my teenage years. I was looking
for something where I could make a real contribution in
terms of you know, just doing something that felt worthwhile.
And I was lucky enough to talk to doctors and

(09:16):
hear what they were doing. I thought, well, that sounded
pretty interesting. And you know, I was in an environment
where people were encouraged to go as hard and high
as they could academically, and that led to those sorts
of opportunities.

Speaker 3 (09:30):
So it looked like a very rewarding, varied career.

Speaker 4 (09:34):
But of course, when you get into any career, you know,
when you're an eighteen year old, you know quite appreciate
the reality of it. But look, it was a good
decision and it's given me a vocation, which, as you said,
I've come back to and you know, one of the
great things that Metzine gives you is the ability.

Speaker 3 (09:51):
To make yourself useful.

Speaker 4 (09:53):
If nothing else, you know you're doing something, you're actually
helping people.

Speaker 3 (09:57):
There's a real demand obviously for.

Speaker 4 (09:59):
Doctor and as my own doctor said to me recently, look,
there's not too many jobs where you can sit here
all day and get to check such a wide and
interesting variety of people. Of course there's a lot of
work you're going to do as well. Yeah, but you know,
it really has been worthwhile. So but initially it was
like talking to doctors and I thought, you know, that
sounded I couldn't be pretty interesting, And it has been.

Speaker 2 (10:22):
It's a it's a commitment to a lifetime of study
in a way once you once you decide to.

Speaker 1 (10:28):
Go to med school. First, first of all, you've got
to do well enough upfront to get into med school.

Speaker 2 (10:33):
And then many like you get through the medical qualifications
and decide to specialize in your case and obstetrics, and
then you, in your case you went on to MBAs
and other things. So is a lifetime of study the
way it's panned out, or do you feel like it's
it's a constant quest for being more and more knowledgeable

(10:55):
on the topics.

Speaker 3 (10:57):
A couple of things.

Speaker 4 (10:57):
That first thing is, I'm not actually no obstetrician, but
in those days you did nine months of obstetrics to
become a GP.

Speaker 3 (11:03):
There'sn't the days when GPS delimited. Baby. The second thing
is every doctor I speak.

Speaker 4 (11:08):
To says, gosh, I wouldn't give in the mid school
these days, it's just way too up. We all agree
that we wouldn't make the bar. I mean, it's just
become impossible. But look, I think, like everything, you know,
if you want to stay relevant in the economy, you've
got to keep reinventing yourself. You've got to keep learning
new skills. So I would say that yeap. Obviously, there's

(11:30):
a huge amount of study in med school and you're
there from you know, if you go straight from school
from the age of eighteen to twenty four, it is
incredibly intense. But in every profession or vocation you've got
to keep up skilling right through. You know, the challenges
that you make tea new stuff. So yep, it is
life long study. But nothing's ever as intense as those

(11:50):
six years of med school unless you know people who specialize. Yep,
that is another level again. But you just got to
keep going.

Speaker 2 (11:59):
You you finally finished studying and got out into the
big wide world. You had a stint in the UK
working at a GP clinic. But the thing that intrigues
me about your background that I never knew about until
I started preparing for this discussion was that you had
a spell on the Australian Royal Australian I should say,
Flying Doctor Service.

Speaker 1 (12:18):
Tell me about that.

Speaker 3 (12:20):
Yeah, well that was interesting. I mean, I've been in
the UK for a few years. I've done my GP.

Speaker 4 (12:24):
Training and I made mine was working out and broken
help and he said, look there's a job out here
if you want to come out, and thought, well, that's
a new experience.

Speaker 3 (12:31):
I've done a lot of travel by that stage.

Speaker 4 (12:35):
I've just actually been through South Africa following the All
Blacksitas from Darus Salam down to the Victoria Falls and
then flew down to Cape Town. So you know, I
was in sort of wander boat. I wasn't ready to
come back to Auckland. There was more stuff I wanted
to do overseas, So anyway, I went to Brokenhell, and man,
that was an insight into life in the Australian outback.

(12:57):
I mean, it was a holiday job in some senses.
I spent probably about four months there in total. But
what I can tell you is the difference between the
cities on the coast of Australia and the bush.

Speaker 3 (13:10):
It's like Earth in Mars. You know, it really is
a environment, harsh environment.

Speaker 4 (13:16):
You see some of the challenges actually that Indigenous people
of Australia have faced there, and some of the social challenges,
all the challenges that that government agencies face in delivering
health care and services to those communities.

Speaker 3 (13:34):
You know, there's stuff that happens there that scarcely believe.
It's a harsh place. To the outback an interesting place.

Speaker 4 (13:40):
I mean, it was amazing flying off to these remote clinics.
But you know there's no caricature of the outback posie
that could be too outlandish. You know, everything you see,
you know in the movies, you read in the media. Yep,
you'll find those characters in the outback. So it was
a very rich experience. It's a real eye on them.

(14:02):
But it actually made me realize I'm a city person.

Speaker 1 (14:04):
At other health challenges different out there.

Speaker 3 (14:09):
I yeah, look hugely different.

Speaker 4 (14:11):
I mean, you know this is back in the late
nineties and it was before mental health had.

Speaker 3 (14:15):
Really become a big mainstream topic.

Speaker 4 (14:19):
But you know, the isolation out there for people living
in the outback and the mental health challenges, it's massive.
And then the challenges of delivering healthcare to those indigenous
communities where you know, the cultural divide is just massive.

Speaker 3 (14:35):
You know, we get these calls.

Speaker 4 (14:36):
In the middle of the night saying that you know,
an Aboriginal man out in will Kenya, which is one
of the toughest towns in Australia, had seen a vision
and he was going to die that night, and basically
you know, suicide out there, all sorts of groom stuff.

Speaker 3 (14:53):
Yeah, it makes it difficult to deliver.

Speaker 4 (14:57):
Healthcare in a way that really reaches peace people. So yeah,
you know, I mean we've got challenges in this country.
They've certainly got some big ones in Australia. So not
everything is rosy on the other side of the test.

Speaker 2 (15:08):
And I can tell you no, absolutely, So the wanderlust
didn't leave you. You then took off to London Business
School a couple of years after.

Speaker 1 (15:17):
That and did an MBA.

Speaker 4 (15:19):
What prompted that, Well, I've got interested in bigger system
issues around healthcare and yet I have come back to
healthcare as farther if they do now in terms of
the hands on aspect. But I was far more interested
at that stage in you know, the bigger picture rather
than just the patient in front of me, issues around

(15:40):
how we could improve healthcare delivery, improve systems. And you know,
I'd spent some time, as a lot of key wes
do in London, meeting different people, and you know, I
heard about this degree in the NBA, which seemed actually
a great way for someone who hadn't had any business
background to learn a whole new set of skills and
transition and across into a new environment. So yeah, I

(16:03):
went off to London Business School, which was truly international environment.

Speaker 3 (16:07):
Maybe realize too business school.

Speaker 4 (16:09):
You know, we often think that everything's better overseas, and
certainly that business school is a top class business school,
and I spent some time at Wharton in Pennsylvania. But
actually I actually realized that we produce great people in
New Zealand.

Speaker 3 (16:22):
Who are just as good as anywhere in the world.

Speaker 4 (16:24):
And I think we realize that now, but probably in
the nineties we were probably a little bit you know,
understated and humble and maybe sometimes didn't think we were
quite as good as everyone else. But you know, we're
just dis good at every regard. But yeah, I would
thoroughly recommend for those who have the opportunity postgraduate study
overseas because you know, some of the experiences you had there,
especially in the US, some of the people that came

(16:47):
to campus and some of the people you get to
look pretty amazing.

Speaker 2 (16:50):
Yeah, eko, that I just I didn't do a full NBA,
but I did a summer school program at Stanford in
the nineteen nineties and went, I e those sentiments, we
underestimate the capability of our own people in this country.
That's a big, wide world out there, but there's a
lot of people who are aren't as good as us.

Speaker 1 (17:12):
Did the NBA push you out of your comfort zone?

Speaker 3 (17:15):
I sure did. Yeah, it really did.

Speaker 4 (17:17):
But especially in those quantitative those hard skills, your corporate finance,
that was probably the hardest one.

Speaker 3 (17:26):
I mean, the soft on one.

Speaker 4 (17:27):
Did make me realize, though, is that a lot of
people who have the quantitative background, they might come from
hard finance backgrounds, didn't necessarily have the softer skills.

Speaker 3 (17:37):
And so the stuff that I took for granted and medicine.

Speaker 4 (17:41):
Getting on with people, working in teams is actually is
a big part of working life. A lot of people
who came to business school who have just been consultants
or or more specifically worked in finance really struggled with
so that wasn so in the end, you know, although
the corporate finance in the the numbers were hard, the

(18:03):
softer disciplines like marketing, like you know, anything to do
with working with people, more abstract concepts I found actually
made some more of the bad preparation for it overall
good stuff.

Speaker 2 (18:16):
Where with doctor Jonathan Coleman, and we'll be back in
a moment that with former Health Minister, doctor Jonathan Coleman. Gee,
it's an epic career path. Your career reads like something

(18:37):
out of a Jeffrey Archer novel, really, doesn't it. Sort
of head boy at one of the top boys schools,
medical school, practice medicine around the world, flying doctor service
for a summer job mba top four consulting firm, and
then for some reason you go to politics.

Speaker 1 (18:53):
What made you go into politics?

Speaker 3 (18:55):
Ah, well you should be my pr agents. It's not
as glamorous as it myself quite really.

Speaker 4 (19:02):
But look on the political front, you know, I've lived
overseas for a long time and I've got to this
state where I.

Speaker 3 (19:09):
Definitely wanted to come back and put something into New Zealand.

Speaker 4 (19:12):
I mean, I've always felt that, you know, countries like
the UK and the US, they've got plenty of people
to make that country.

Speaker 3 (19:21):
Better, or but those countries better.

Speaker 4 (19:23):
But I wanted to actually make my working life contribution
back here in New Zealand because you know, that's just
where I felt my strong connection. And as part of that,
I've been looking at these big system aspects of health
systems through my MBA, and then I thought, well, actually

(19:46):
looking at the state New Zealand was in at that
period of time, the early two thousands, I felt very
strongly motivated to be part of making the country better.
And frankly I looked at it and thought, well, some
of these guys who labor ministers can do this job.

Speaker 3 (20:04):
Why can't I know these country why not get involved yourself?
I mean, in some ways I was a bit naive.
I think it was a mess of risk going to
politics and it might not have paid off.

Speaker 4 (20:16):
I was lucky enough that it did in the sense that,
you know, I had a long misterial career. But it
was really a motivation to put something back.

Speaker 3 (20:25):
In New Zealand, into New Zealand, but also be involved
in the.

Speaker 4 (20:28):
Bigger picture and you know, help govern the country so
that we should motivation.

Speaker 2 (20:36):
So two thousand and five comes, you become the MP
for Northcote, you win, you win your electorate, you turn
up on the first day, what happens.

Speaker 4 (20:48):
It's a long time ago, Bruce. But there's a lot
of induction stuff, you know, but really you just sort
of get on with it. I mean, one of the
things with politics is there is no blueprint. It's a
real sink or swim environment and you cannot predict how
people are going to go. I mean, there's been many
people who've come in with big raps because they've done

(21:09):
well in various fields of endeavor outside.

Speaker 3 (21:13):
But you don't know how people are going to react
till they get there.

Speaker 4 (21:16):
So you basically you get given your office, you get
to select a PA, and you're suddenly getting into.

Speaker 3 (21:22):
Caucus meetings and you just have to find your own way.

Speaker 4 (21:27):
And you know, there's a lot of early getting to
know other people, certainly getting to know the system.

Speaker 3 (21:34):
But look, having said that, there weren't any massive shocks
for me really, you.

Speaker 4 (21:38):
Know, because I've looked at what politics involved, but it's
just such an unpredictable life politics.

Speaker 3 (21:44):
There's an XMP actually from the.

Speaker 4 (21:47):
Left said to me, you know, about the time I
became an MP, you know, look, politics, actually it's not
a long term career. And that sort of changed my
thinking on it a little bit because I thought when
I went in there, look I'd be there for.

Speaker 3 (22:00):
The rest of my career. But actually, and I think
many people do think that when they go there because
it's all on the appsling you've just got elected.

Speaker 4 (22:09):
But as time goes on, things do change in politics
and you get something to achieve which you wish to achieve,
and then you know, other things don't necessarily happen. But look,
I can say I've felt thoroughly privileged to have twelve
and a half years as an MP. And one of
the things I enjoyed the most actually was the local representation.
You know, you really get deeply into a community as

(22:30):
an electric MP.

Speaker 3 (22:32):
I don't think I would have.

Speaker 4 (22:33):
Wanted to do it just as a list MP, and
you know, still feel very strong connection to the area
I represent it.

Speaker 2 (22:41):
Yeah, interesting do we the general public have any idea
of what goes on behind the scenes in government.

Speaker 4 (22:48):
Well, there's more and more scrutiny now, but I think
there's a lot of assumptions on what happens in cabinet
meetings and behind closed or some of it's more dramatic
than you think.

Speaker 3 (22:59):
Something of it's less dramatic. I mean a lot of what.

Speaker 4 (23:03):
Happens in politics is based on the relationships between the
players being able to actually make things work, and I
think that's going to be really important in this coalition,
you know.

Speaker 3 (23:15):
I mean you've got in.

Speaker 4 (23:17):
Politics, you get alignment of incentives, but you've also got
to have a bit of chemistry to make things work.

Speaker 3 (23:24):
So you definitely need allies in politics if you get it.

Speaker 2 (23:27):
Sure, that's that's interesting, isn't it Because you're in amongst
a whole range of people, not just the people that
you're governing with, but people with opposing political Viewsody does
everybody get on or is it quite a high tension environment?

Speaker 3 (23:43):
Well? Look, it's the thing is with politics, even amongst
your own party.

Speaker 4 (23:46):
You know, it's great when things are going swimmingly well,
but everyone's in a bit of a competition. Unless you've
got absolutely no ambition to go further at all, and
some people don't have that ambition. But you know, I'd
say most politicians. Look, you come out with some friendships,
but on the whole people are political colleagues. I mean,
my career was a bit unusual because you know, I

(24:08):
only had three years in opposition and once you've become
a minister you don't really have time to build those
relationships to the same extent, so I didn't have a
lot to do with opposition members. I've got to know
one or two, you know, I've got to know actually
Shane Jones my first term in the Parliamentary reck Quick Team.
But the rest of the time, once you're a minister, honestly,

(24:31):
you've got to make an effort to keep in touch
with your own caucus, which is really important because you
know what happens in caucuses.

Speaker 3 (24:39):
To get anything through, you've got to have caucus support.

Speaker 4 (24:43):
In what people can lose sight of is everyone has
an equal vote and a caucus from their.

Speaker 3 (24:49):
Most stellar MP to you know, someone who may not
be highly rated, but you know, everyone gets to cast
the vote on things.

Speaker 2 (24:57):
Sure, so we've seen it's interesting talking about the environment
we've seen a few sort of high profile falls from grace,
particularly over the last couple of years of the last
government of MPs just collapsing for whatever reason. Is that
about pressure of work, or is it the pressure of
the public eye, or is it just their own capacity

(25:18):
for work in competence?

Speaker 1 (25:19):
What makes people crumble in that environment?

Speaker 4 (25:23):
Yeah, Look, I think it's a combination of things. I
think there's more scrutiny than ever on politicians. I think
it's a far less attractive thing for people to go
into now, and that's why you probably see a lot
of people who you know would actually make great political
leaders at various levels to say that's not for me.
I mean, it's become such a media gotcha game and

(25:45):
that's not really attractive for people. I mean it's gone
of the days when you know, Rob Muldoon could do
whatever you like down on Wellington.

Speaker 3 (25:53):
I mean no one cared because it wasn't covered or
in Holyoacs shame.

Speaker 4 (25:57):
Actually, the Prime Minister's office used to write the political
news and added to the NZBC each day, so.

Speaker 3 (26:04):
That's part of it. I think, though, you know, a lot.

Speaker 4 (26:08):
Of it is about the resilience of the individuals and
a lot of you know, some of these ones who
do just implode. I mean, look, some of them can
be unlucky, but some of them may not be equipped
I think for the demands of the job. And I think, look,
when you're in those high profile monasterial jobs, you've got
to have everything stable in other areas of your life.
So if stuff's not going well at home, there's just

(26:32):
no time to put you in a meaningful way to
managing other really probably you know, areas of your life
which really need attention.

Speaker 3 (26:40):
I mean, if you're lucky, you've got enough time to
really maintain your family relationships well. And that's what most
people obviously want to focus on. So it's a combination.

Speaker 4 (26:52):
Look, the workload is high, but this is what I
said that it's that you know, it's a sinker swim environment.
You've got to put it out pretty quickly.

Speaker 3 (27:00):
How to deal with that?

Speaker 4 (27:02):
That's workload. I mean Tim Grosser had some great perspectives
on this. You know, he was a specialist in trading
and said, look, I don't need to know about anything
else about trade. He just focused on that.

Speaker 3 (27:14):
He delivered on that.

Speaker 4 (27:15):
He didn't have a clue what was going on with
a lot of the other stuff. By his own admission,
I don't think he'd necessarily mind me saying that.

Speaker 3 (27:21):
The other point, Tim used.

Speaker 4 (27:22):
To make us look, so many people are obsessed with it,
missing a news bulletin. The really important things are the
big picture, longer trends.

Speaker 3 (27:33):
It's not what happens on a day to day basis. Look,
where's the economy going, We're our international relations going.

Speaker 4 (27:39):
And I think some people struggle to maintain that bigger
picture perspective and focusing though of the things they're responsible
for that are really important.

Speaker 1 (27:48):
It's interesting I'd like to talk about the health sector.

Speaker 2 (27:53):
It's to me it's one of the big three challenging
ministerial portfolios, alongside Law and order and education.

Speaker 1 (28:02):
You have a unique perspective.

Speaker 2 (28:04):
You you were an Associate Minister of Health before you
were a Minister of Health, so you you did have
plenty of time in that in that ministry.

Speaker 1 (28:13):
What are the things that you think we do well
in health?

Speaker 3 (28:18):
Well, Look, I think we do acute care really well.

Speaker 4 (28:20):
I mean, if you've got a problem, if you're out
in a car crash, something traumatic happens to you, you're
going to get pretty much immediate access to world class care.
Now that can be limited by geography. I mean, you're obviously,
you know, going to be in a far better position
if you have your trauma, you know, in the middle

(28:43):
of Auckland, where you've got best facilities in the country,
as opposed to stuck somewhere on the east coast.

Speaker 3 (28:49):
So what we do that really well.

Speaker 4 (28:52):
Where we struggle, I think though, is with the elective care,
with managing waiting lists, with getting people the.

Speaker 3 (29:00):
Non life threatening.

Speaker 4 (29:04):
But actual actually really important quality of life issues getting.

Speaker 3 (29:08):
Those treated for people. So you know, like we've got
huge variability around the country.

Speaker 4 (29:14):
Still in joint replacement times now if you need a
New York place, that really messes with your life, right.

Speaker 3 (29:21):
Some people in the county Smanikaw people.

Speaker 4 (29:23):
Awaiting years at the moment we're hearing through the media,
whereas other parts of the country it's very quick, so
that's a big difference. We're getting an increasing problem with
people getting access to primary care.

Speaker 3 (29:38):
I mean, I've got patients literally all around the country
that's take.

Speaker 4 (29:41):
To become a problem. People are ringing up from christ
Church or Queenstown or man of Watu Taupo for their
prescriptions and saying, look, you've got to actually get in
here so I can see you face to face. But
people in some of these regions are not able to
get into a doctor. So look, the primarque aspect of
things has got difficult, and I think we've lost what

(30:04):
We've become very focused on the bureaucratic arrangements in the
health system. Obviously there's the major structural changes by the
last government, but I can tell at the front line,
I'm not noticing any difference, and.

Speaker 3 (30:15):
I think what it's going to take is a huge amount.

Speaker 4 (30:18):
Of flexibility in how we start doing things and who
does them in the health system, in terms of how
we empower different workers in the health system to deliver
parts of care if we're going to actually get the.

Speaker 3 (30:33):
Resources focused in the right place.

Speaker 4 (30:35):
So I would argue as a GP, look, having me
seeing people with COFs and colds doesn't really make sense when.

Speaker 3 (30:42):
There's a whole lot of people with more serious things
who do need to be seen.

Speaker 1 (30:47):
Yep, it's interesting.

Speaker 2 (30:49):
I was probably reasonably outspoken through some of my columns
about the last government's centralization of the administration of the
health service or their formative plans and to do so,
they never really gathered much steam. I suppose in the
end as it played out, but I've never seen anything

(31:11):
get better when you take decision making away from the customer,
and in the case of health, the customer ultimately is
the patient.

Speaker 1 (31:20):
Am I on the right track or.

Speaker 2 (31:23):
Or do you think the centralization experiment should have been
sort of continued for a while?

Speaker 3 (31:30):
Well?

Speaker 4 (31:31):
Look, I mean, in fact, we still do have Health
New Zealand, and I think it was a mistake to
go there hard and radical in the first place.

Speaker 3 (31:39):
I think actually the old system.

Speaker 4 (31:42):
I'm not suggesting we have further structural change like re
instituting twenty dhvs, but actually looking at the needs of
local communities, devolving the funding locally and letting people like
Mary health providers, you know, provide services appropriate for their community.
You know, essentially that model works pretty well. Whereas having

(32:04):
Wellington tell everyone you know what they need and trying
to create this uniformity throughout the country, it just doesn't work.
And I can tell you this has gone in cycles
through the health system. Over time, you get these periods
of consolidation, then theoution, and I think we will end
up over time having more devolition of services and funding

(32:25):
but at the moment, I think there's this huge health
fatigue and will structural change fatigue within health and people
are saying, okay, look, let's just put the handbrake on.
Let's look at some things which really don't make sense,
like that Maorhealth Authority. I mean, no one's been able
to explain what that does or how it's going to

(32:47):
make things better. So that does need change, and the
government has said, you know, it's folding it back within
the Ministry of Health, but actually constantly changing the lead
ahead doesn't improve the quality of service.

Speaker 3 (33:00):
So the big challenges we've got. Workforce is a huge issue, and.

Speaker 4 (33:06):
There are priorities other than once again making more structural change.

Speaker 3 (33:11):
But I think it was a big mistake book that
last later government did it, and I.

Speaker 4 (33:15):
Don't think understood what they were doing frankly by creating
Health New Zealand.

Speaker 1 (33:19):
Thank you you've vindicated the view I took in my columns.

Speaker 2 (33:25):
I noticed in your CV you were a Health Minister
for a full term and before that you were the
Associate Health Minister for a full term. One of the
changes I think we've seen over the last few years
is a lot of chopping and changing of ministerial roles.
And again, as an outsider looking in, I would imagine
there is value in having consistency of representation at a

(33:49):
ministerial level. You've already mentioned Tim Grosser, who only really
wanted to focus on trade. Is the scope for us
to be much more consistent in terms of that ministerial
representation across government departments.

Speaker 3 (34:04):
Well, look, I think if you look at those big portfolios.

Speaker 4 (34:09):
They do tend to put in people for sustain periods
of time, and one of the reasons for that is
it takes a while to get to grips with some
of the issues in these portfolios. I mean, Tony Roll
was very successful in Healthy because you know, you get
a good three years in opposition and he really had
to learn the portfolio before he became minister. When I

(34:31):
got the portfolio, I was actually lucky that I had
the medical background, because I think without that to be
rushed straight into it, it would be very difficult.

Speaker 3 (34:38):
But if this constant change, not only did the minister's
grapple struggle to get to grips with the.

Speaker 4 (34:47):
Issues, but they might be thrust into portfolios where actually
they didn't have an agenda to start with, and it's
really bible. One of the key things as a minister
is to have an agenda and know what you want
to achieve. But you know, constant change means the officials
can start running the ministers rather than the other way around.
And it is very interesting when you get into government.

(35:07):
It takes the officials, I reckon a good year to
understand the government has changed and things.

Speaker 3 (35:13):
Are done differently.

Speaker 4 (35:14):
And I can remember, you know, in some portfolios when
I first became a minister, you know officials really pushing
for the continuation of work that had been done by
the last government. And you know, Steven Joyce was great
on this. He was just saying, look, we're just telling
them it's changed, we are stopping.

Speaker 3 (35:32):
This, this is not continuing and they get that message
in the end.

Speaker 4 (35:35):
So to ask you a question, look, look that there
obviously have to be changes in lineups at times, but
the experience does count and more time in the portfolio
that obviously the more experienced people have become.

Speaker 2 (35:51):
If you look at the health system now your National
Party Health Minister successor Shane Retti another doctors and they're
trying to deal with that. Now, what are the are
the constraints funding, Is it talent, is it facilities?

Speaker 1 (36:07):
Is it access to drugs?

Speaker 2 (36:08):
What are the things that stop us because we spend
we seem to spend plenty of money on it, What
are the things that prevent us from having a world
class health system?

Speaker 1 (36:18):
Again, Well, look.

Speaker 4 (36:21):
There's a number that have been identified there. I mean,
the funding has improved. Whether it's getting through to the
right places, you know that that is a valid question.
And you know, having worked back in primary care general
practice for a while now, that's certainly been a big
issue getting it to the front line there. But look,

(36:43):
you've also got this huge bureaucracy that has developed over time,
and we turned it around during our stint of government,
but you know, it's started springing up again.

Speaker 3 (36:53):
I mean it's become a massive issue.

Speaker 4 (36:56):
And in terms of driving through the mist as a gender,
you know, you've really got to actually have officials.

Speaker 3 (37:03):
Who are pushing that down into what used to be
the DHV, spit down into the front line. Look for
little facilities. I mean there's been considerable investment in them.

Speaker 4 (37:18):
Yep, we could probably always do more in that point
of view, but I mean we're in a capital constrained environment.
But really it's a combination of things. Workforce is definitely
a huge issue. I think there's an inflexibility now around
qualifications of specialists. So we've got lots of people sitting

(37:39):
around with excellent specialist qualifications from overseas who are driving taxis,
were going through a very tortuous process to get their
registration when an actual fact, you know, they've got excellent
skills and could be.

Speaker 3 (37:55):
Pushed into the front line now. So the problem is.

Speaker 4 (37:58):
Though, you know, for any government, we can only deal
with so much at a time. And I think probably
the medical colleges, you know, well they've controlled the flow
of people into specialist.

Speaker 3 (38:10):
Training that have been.

Speaker 4 (38:12):
Very jealous of guarding entry for people to practice from
overseas into those specialties.

Speaker 3 (38:19):
There's a lot of hoops there.

Speaker 4 (38:20):
And as a consequence, you know, we're running short in
the workforce in many parts of the country, and you know,
general practice has become a much less attractive proposition for
people because of the way the nature of the job
has changed.

Speaker 2 (38:35):
Yeah, look, I often wonder whether we should be making
greater use of those international talents.

Speaker 1 (38:44):
A few weeks back, I had a case of vertigo vertigo.

Speaker 2 (38:47):
I'd never had vertigo before, but I shot down to
a and E saw a London trained Indian doctor who
was absolutely outstanding and did all did all the tests
that I didn't even know applied in such circumstances. But
I but I left with a very positive view of

(39:08):
that experience and a very positive view of that of
that doctor. And equally, I've struck the odd the odd
doctor or even specialist driving a taxi in this country,
and you shake your head in disbelief at times and say,
you know, why can't we get these people through the
system and whatever requalification they need to do here, why

(39:28):
can't we do it more quickly?

Speaker 1 (39:30):
What holds it up?

Speaker 4 (39:32):
Yeah, well, look, I do think it is this particular
attitude by many of the medical colleges.

Speaker 3 (39:36):
And that's something that government's including the government, is a
part of.

Speaker 4 (39:39):
We have just left it to the colleges to determine
who will be able to practice at what level of medicine. Now,
I look, obviously, you know we have to ensure people
are safe. But you know, sure if you look at look,
the nursing situation has actually improved in the past year,
but two years ago we were very short of nurses.

(40:01):
The organization on a board member of MetLife Care. We
just couldn't get people. We could get people in from
the Philippines as caregivers. They've been registered nurses over in
the Philippines, but then you know they're making that transition
to nursing. You know, it takes quite some time to
meet the standards here. We're in actual fact they're already
up to the job. So look, I think given the

(40:23):
attraction for international healthcare graduates of other markets, especially in
our case Australia, we're going to have to really think
about this much more strategically and really get real about,
you know what the type of people we want working
in our health system and whether we're making it just

(40:44):
way too hard for those people to do that.

Speaker 2 (40:46):
Well, as you've touched on, we lose plenty of doctors
and nurses and specialists to overseas opportunities, more money, arguably
in some cases better lifestyle. How do we win the
war for talent when we haven't got the money? Do
we have to be better at selling New Zealand as
a destination or selling the New Zealand Health Service is

(41:07):
a place to make a difference because we won't compete
on money, will we?

Speaker 4 (41:12):
No? But I think there are things we can make
easier for people, like in terms of the transition to permanent.

Speaker 3 (41:19):
Resident status here.

Speaker 4 (41:21):
And you know, there have been some changes under the
new government to put nurses onto that talent list so
they can get a faster track here.

Speaker 3 (41:29):
But just removing the bureaucracy.

Speaker 4 (41:31):
I mean, if it's going to be harder here than
in Australia to come here and work and actually get
families settled and get some surety about what future holds,
you know, it's obvious that the choice that people are
going to make. But also I think, you know, quite frankly,
we have had quite a gloomy view of ourselves here

(41:58):
since COVID probably you know, which whereas other countries have
bounced back. But you know, I do think we've been
talking New Zealand down a bit. I'm not talking about
the government. I don't think they have, but I think
in general people haven't been feeling good about New Zealand.
And look, there are some real challenges, but I think
we actually have to bounce back and display some of

(42:21):
that resilience. And actually, you know, if we're not saying
this is a great place to be, why would other
people want to come here especially people have got other options,
because we'll end up here in the wrong sort of
when I say the wrong we won't get people with
the skills that we need here if we don't feel
great about it ourselves.

Speaker 1 (42:41):
I could not agree with you more.

Speaker 2 (42:43):
We're just not very good at skouting us kiwis and
our big nighbor next door does that better than we do.

Speaker 1 (42:49):
Where with Doctor.

Speaker 2 (42:50):
Jonathan Coleman, former Minister of Health and thirteen year member
of Parliament, will be back in a moment, Back with
doctor Jonathan Coleman.

Speaker 1 (43:11):
Jonathan, you just mentioned COVID and I.

Speaker 2 (43:15):
Think we did pretty well to get forty two minutes
into the conversation about health before we mentioned COVID. By
the time COVID nineteen came around, you were on the
outside of the parliamentary system, you'd been out for three
years or so. What did you make of our response
as a country and what would you have done differently
if you were still on the inside.

Speaker 4 (43:37):
Well, Look, the first thing is it's always easy in retrospect,
and you know what a tough challenge was that was
for the whole country. Look, I think the initial response
was good. I mean, I do we needed to have
those early lockdowns, but I think it just went too far.
I mean, and once again it's easy in retrospect, but

(44:00):
we weren't.

Speaker 3 (44:00):
Quick enough to get people vaccinated and then we closed
down for way too long. You know that August did see.

Speaker 4 (44:07):
The lockdown at Auckland in twenty twenty one was just
grossly excessive and certainly I think that was the major
factor in the last government losing the election.

Speaker 3 (44:19):
But you know it's David Kirk said in an article
when he was here last year.

Speaker 4 (44:24):
In New South Wales, the emphasis was on keeping things
open to preserve people's mental health, and here it was
on closing things down at all.

Speaker 3 (44:35):
Costs to try and preserve physical health.

Speaker 4 (44:39):
And there's no doubt the early lockdowns they did work,
but it just went on way too long. And I
think it's going to be really interesting how that plays
out in the long term. You know, when you're looking
at the effect on kids and some of the things
that they missed out.

Speaker 3 (44:56):
You know, people who were at school of their.

Speaker 4 (45:00):
Period twenty twenty to twenty two, social isolation.

Speaker 3 (45:06):
You know what is that going to mean? And no
one knows. Look, it might not end up actually meaning
too much, but no.

Speaker 4 (45:12):
Doubt that kids had a very different experience in those
years in terms of their schooling and interaction.

Speaker 1 (45:19):
Yeah, I agree, particularly six and seven formers. That's sort
of the highlight of your school life in a lot
of ways.

Speaker 2 (45:26):
And some people made national secondary school supports sports teams
and never got to play, never got to assemble.

Speaker 1 (45:33):
Others had other opportunities a school ball missed or.

Speaker 2 (45:36):
Whatever, and those are all things that we all have
fond memories of as we reflect back on our school days.

Speaker 1 (45:42):
And it's sad that there's a generation of kids who
missed out on that.

Speaker 4 (45:45):
Yeah, it definitely was, and it all seems a bit
surreal now. It's hard to believe what we all need through,
but's not you know. I mean, it's tough with leaders
have to make those decisions, but I think in the
end it you know, if you would debate that it
went on way too long, and I think that the
slowness to vaccinate and actually thinking that other countries weren't

(46:09):
going to try and get as much COVID vaccine as
quickly as they could for their own populations was a
bit well, it was naive. But look, you know that
there's no doubt vaccination works. I think that was a
huge factor in our ultimately our low earth rates. I
think those early lockdowns you know, were necessary, but we're not.

Speaker 3 (46:34):
Way too long.

Speaker 1 (46:35):
Yeah, yeah, I think most of us would agree with you.

Speaker 2 (46:39):
As we look forward now, like I said at the start,
you're back on the tools in healthcare.

Speaker 1 (46:44):
What are the big changes we talk about AI, we
talk about all other.

Speaker 2 (46:48):
All sorts of other things out there as we consider
the future of most sectors. What are the big changes
you see coming in health?

Speaker 3 (46:58):
Well, look, the first thing is the patients are different.
It's the same people, but with more complex problems. I mean,
they're living longer, but they're living more years, probably in
the compromise state of health.

Speaker 4 (47:11):
I mean, there's no doubt that mental health issues, you know,
are huge, and so I think the burden on the
health system is just becoming more complex and heavier as
time goes on. Patient expectations at the same time are
really increasing. Other changes that are coming, I mean, look,

(47:32):
there's always improvements and increases in technology.

Speaker 3 (47:36):
They always have been, and that's a big drive of
health inflation.

Speaker 4 (47:39):
So the health care is going to become more expensive
and it's going to become more difficult to deliver the
health care that frankly people need and deserve.

Speaker 3 (47:51):
For the money available.

Speaker 4 (47:53):
I mean it's always outstripped CPI, and there's just no
doubt about AI.

Speaker 3 (47:57):
Is going to be interesting, you know. I mean there'll be.

Speaker 4 (48:00):
Parts of healthcare that just won't be able to be
replaced by AI.

Speaker 3 (48:05):
But anything that's repetitive.

Speaker 4 (48:07):
And involves analyzing recurrent patterns, I think it's going to
be at risk. So if you look at X ray
reports currently looked at by radiologists, I mean there's been
change in that over time. A human being will look
at that, but they might now be in London or Australia,
you know, looking at x rays performed somewhere in New Zealand.

(48:28):
What may happen over time? And you know there's a
lott of work going into it as they just feed
all those X rays into a pool that's analyzed by AI,
which spits out a result.

Speaker 3 (48:40):
Now that that's sort of the most obvious example of
what may happen. But look, essentially, healthcare does rely on
the human touch.

Speaker 4 (48:51):
You know, it's underpinned by science, but there's an art
to it as well, and I don't think it will
ever be totally replaced.

Speaker 1 (48:59):
It's interesting thing. The human touch component, I think is interesting.

Speaker 2 (49:03):
And there are places around the world, countries around the
world that are increasingly doing medical care by zoom call,
and I'm not convinced that that's that's long term good
for the health of people.

Speaker 4 (49:18):
No, And look, you can take that only so far.
But I'm in a patients and examining patients and they look.
One of the big challenges now though, is that actually
there's such a pressure on the on the GP workforce
that people are struggling to see the same doctor to.

Speaker 3 (49:35):
Consults in a row. So yes, you know that there
is a whole.

Speaker 4 (49:39):
Emphasis on looking at how you do things differently, how
can we deliver services differently?

Speaker 3 (49:44):
Yet sure till the health and zoom will be part
of that. You know, we've got used to that.

Speaker 4 (49:48):
During COVID, but hasn't been a substitute for really a
doctor and a patient sitting down together.

Speaker 3 (49:53):
So I can't see.

Speaker 1 (49:57):
I think I agree with you far Mac New Zealand.

Speaker 2 (50:00):
We've seen recently the government make a decision about extra
funding another one point seven billion dollars over four years.
Does that amount of money allow us to fund new
treatments or are we really just catching up on on
the years of neglect.

Speaker 3 (50:16):
Well like it depends, so you.

Speaker 4 (50:19):
Listen to I see the CEO of Farmac saying, oh,
it's just going to keep the lights on. I don't
know for that's the statement that being visable for CEO
to make. But look, you know that there's always going
to be pressure for more drugs, but more money is
definitely going to help.

Speaker 3 (50:36):
I mean, you'd have to look.

Speaker 4 (50:37):
Into it pretty Forenzo Claes, I'm sure Paula Bennett is
going to be doing this is I mean, that's going
to be a big job sharing Farmac. But look, you're
never going to be able to meet everyone's demands. I mean,
I can remember when Ice Minister and we had huge
pressure of fund Contruder, which you know in the end
we were able to fund. But it's one of the

(50:57):
challenges in politics, things that you actually want to do
but you don't necessarily have the resources to do.

Speaker 3 (51:04):
So to ask you a question, really, look.

Speaker 4 (51:06):
Drug funding is going to be a modernless pit and
you know, Farmac's being predicated on doing the greatest good
for the greatest number of people, and it's done a
pretty good job on that.

Speaker 3 (51:16):
But you can do more of that with more money,
there is no question about it. So this is a
really good funding announcement, especially.

Speaker 4 (51:25):
When you look at the times wherein and the austerity
that has been faced across the economy.

Speaker 3 (51:34):
Will it provide everything that everyone needs? It's just that
it can't. That's the reality of funding of drugs.

Speaker 1 (51:46):
Your decision to quit politics lead you back to life
as a GP. That's about as full circle as it's
possible to go. I think you could have.

Speaker 2 (51:57):
I'm sure with your background you could have taken on
anyumber of stimulating roles, either locally or internationally.

Speaker 1 (52:03):
What made you go back on the tools.

Speaker 3 (52:06):
Well, it's a couple of things. You know.

Speaker 4 (52:09):
I've been involved with this hospital problems for company security
for a couple.

Speaker 3 (52:14):
Of years and as you and stayed on the board.
But I mean there was a number of things that
I was keen to do.

Speaker 4 (52:19):
I was king to do some more governance as well,
so I got involved with MetLife Care more recently gone
on to the New Zealand and a.

Speaker 3 (52:26):
Little bit committee. So going back into medicine, Look.

Speaker 4 (52:30):
It was a skill that I have which I was
just by the skin of my teeth able to resurrect
yet been out of it for a long time, and
I thought this is something worthwhile doing.

Speaker 3 (52:42):
It's something that I enjoy. I hadn't anticipated necessarily being
able to go back to that, but.

Speaker 4 (52:47):
An opportunity arose to be mentored at a practice on
a level. Actually, you know, when I look at the
combination of interests I have, it would be good to
have clinical.

Speaker 3 (52:57):
Medicine as part of that.

Speaker 4 (52:59):
Again, because I don't remember variety of different things at
one time, and you know how consuming an executive job
can be. I certainly wanted to stay in New Zealand
as well, and you know, I wanted to make sure
that I had the flexibility.

Speaker 3 (53:14):
Of time to spend a good amount of time with
my children as well.

Speaker 4 (53:17):
So for a number of reasons, the ability to actually
use the skill of God to actually help people, but
also with the way it fits with the other things
I want to do in my professional and personal life.

Speaker 3 (53:29):
It's been a good choice.

Speaker 1 (53:31):
Has it been a tough transition?

Speaker 3 (53:34):
Well, I'll tell you what it was. For the first
few months. Yeah, it was a bit like an alien
our body experience action.

Speaker 4 (53:42):
The first patient I saw after I having picked up
a step of scope, since I was about fifteen years.
To be honest, brush, you know, I thought, man, this
feels really weird. But actually there's an element to medicine.
I don't want to sound complacent here, because I'm not,
but there's an element of things to general practice.

Speaker 3 (54:02):
Which is like riding a bike, and yeah, because we're.

Speaker 4 (54:05):
Well trained to get back into it, but then there's
a whole lot of new stuff you've got to learn
as well. You know, there's a whole lot of medications
which are just changed completely. So it was, you know,
really getting to grips with that took a while, but
I was lucky. I've been in a practice where I've
had a very good mentor, and without her support, I

(54:25):
would have struggled to do it.

Speaker 3 (54:28):
And I think not many practices would take on someone
who'd been out for so long. But I went back
and I've got my.

Speaker 4 (54:36):
Last August completed my full vocational registration. So I'm a
fully vocationally trained as we call it GP. And so
that's a bit like having your c if you're an accountant. Sure, yeah, yeah,
So I'm enjoying it. And look, it's as I say,
I've got flexibility to do other things as well, which
is great.

Speaker 2 (54:58):
Do you have moments we you know, you're out there
at the cold face and you're dealing with the outcome
of decisions you made when you were sitting at the
top of the tree in the in the health ministry.

Speaker 4 (55:10):
Does that happen, Well, I'll have to think about that,
Bruce there. Look, I think what can happen as a
minister is that it's hard to know what's happening in
every look and cranny of the system at any one time.
You know, you're getting a big picture of you and
so when you're down in the weeds dealing with things

(55:31):
you can you can sometimes think we shouldn't know this
at the time. But look, as a minister, you can
drive big thing through.

Speaker 3 (55:39):
A system you know, and then you have to get
other people to implement them.

Speaker 4 (55:43):
But I certainly think that, you know, we've got to
make primary care and working in the community in healthcare
a more attractive place.

Speaker 3 (55:55):
For people to be.

Speaker 4 (55:56):
But I never had a moment when I think, gosh,
you know, I really made stuff doing that. But yeah,
there wouldn't be a day goes by when someone doesn't.

Speaker 3 (56:06):
Come in and talk about politics, which is it is
pretty interesting.

Speaker 2 (56:11):
I would imagine that to be the case where with
doctor Jonathan Coleman, former Minister of Health of course, and
we'll be back in a moment, back with doctor Jonathan Coleman. Jonathan,

(56:31):
you're also a former Minister of Broadcasting, So moving on
from health for a moment, and of course broadcasting is
an area that's been getting a lot of attention at
the moment.

Speaker 1 (56:40):
Media companies are under pressure.

Speaker 2 (56:42):
Do you think the government should be supporting in the media,
independent media companies or do they need to stand on
their own two feet in a in a changing and
adaptive world.

Speaker 4 (56:52):
Well, you know, the issues are the same as they
were fifteen years ago broadcasting and basically.

Speaker 3 (56:57):
People have been consuming me You're in a very different
way for a long long time. So if you look at.

Speaker 4 (57:07):
T TV three News of I mean, you know, the
company was losing thirty million dollars a year and that's
just not sustainable for any private business. So you've got
to look at why is that happening, And clearly there's
something there that's not appealing to the customers, not appealing
to the advertisers, and I think of it as just

(57:28):
a structural change in the media. Look, it would be
great to have them still producing news there. I think
it's sad that they've gone, but it's hard to see
what a government's role is in supporting that. I mean,
you know, there is money in New Zealand on air
which they could look at different criteria for the distribution

(57:49):
of that.

Speaker 3 (57:50):
But you know, the media of.

Speaker 4 (57:53):
Love talking about themselves and while it's a it's a
real showing. Those people are losing their jobs, no question
about that. But there's people losing their jobs in many.

Speaker 3 (58:04):
Different sectors and the adaptation just has not been quick enough.

Speaker 4 (58:09):
And I think you know, when Warner Brothers Discovery bought
that company, you know they have no vested interest in
anything other than making a profit. They're not here for
the betterment of the New Zealand media landscape, for better
or worse. That's a reality. It's a private, overseas own company.
So if the if the money wasn't being made, they

(58:32):
were probably always going to make changes.

Speaker 3 (58:35):
So I feel a little bit sorry for you know, well,
how can I say this?

Speaker 4 (58:42):
You know, it's hard to see what the leaders of
government might be in salvage and the media landscape.

Speaker 1 (58:50):
Yeah, I think I agree with you. I think it
is tough.

Speaker 2 (58:55):
I think media companies around the world of have adapted
way too late to the changes in media consumption, and
I don't think it's right to expect governments to bail
them out. I do believe there is a need for
a strong fourth estate, and I think we've seen limitations
in some sectors, and as a result of those limitations,

(59:17):
the fourth estate is not as strong as as as
a foundation of democracy as perhaps it once was, and
in my.

Speaker 1 (59:28):
View it needs to be.

Speaker 2 (59:29):
Which probably leads to a question about the debate around
our public broadcasters TV in z and Radio New Zealand.
A lot of people would say they both have an
important role to play. Do you have a view on
whether they should be one organization or two organizations, whether
they should be commercial or government funded, all of those

(59:50):
sort of all of those sort of things.

Speaker 3 (59:54):
Well, look, I think once again there's structural change I
think would be a mistake. I mean as too completely different. Oops.
You know TVNS it's been commercial for decades now.

Speaker 4 (01:00:03):
The down New Zealand is not the last government looked
at merging those things. I think there's much more important
things for the current government to be focused on.

Speaker 3 (01:00:12):
And you know it's not even on their agenda. To
look at it, nor should they.

Speaker 4 (01:00:19):
Whether there is some room for cooperation around you know,
the similar news coverage and then you know, distributing it
through different channels, you know, and whether you know some
of the New Zealand and Air funding can help enable that.

Speaker 3 (01:00:36):
You know, I think that's where the question might be.

Speaker 4 (01:00:38):
But actually turning back the clock to establish them honor
if I just don't think it's the way to go. Look,
you know, people don't watch the TV news. That's the
sad reality of it. You know, they might watch snats,
they might you know, fast forward, but if you missed
the news a couple of days in a row, you're
not going to miss too much.

Speaker 3 (01:00:58):
Because a lot of it's already been on your news feed.

Speaker 4 (01:01:02):
However you might get it, whether that's social media or
stuff or ZiT here or website. It's not often there's
something that bigger and breaking occurs on the six thirty news.

Speaker 3 (01:01:13):
So that was news.

Speaker 4 (01:01:15):
So yeah, I just think, you know, as in so
many areas, the government can't be the answer to everything.

Speaker 3 (01:01:22):
They can enable some things.

Speaker 4 (01:01:23):
Yes, there might be some funding which can be put
up competitively, but in the end it's the media strategists
need to work out how they're going to actually deliver
their product in an evolving environment, which in a way
that enables them to be commercially viable.

Speaker 1 (01:01:40):
Yeah, good common sense from this listener's point of view.

Speaker 2 (01:01:45):
At least, Jonathan, you've had a leadership career that would
be the envy of many across many different environments.

Speaker 1 (01:01:53):
What do you think has been your most important leadership lesson.

Speaker 3 (01:01:58):
Well, look, I think it's very important to have an
agenda to set clear direction for those reporting to you.
That would be the first thing. I think it's very
important that you bring teams together.

Speaker 4 (01:02:13):
You don't necessarily have to be popular to be an
effective leader, and I think.

Speaker 3 (01:02:19):
It's probably more important that.

Speaker 4 (01:02:22):
Your views are respected rather than that you know you're
pleasing everybody.

Speaker 3 (01:02:27):
But one of the most important leadership lessons.

Speaker 4 (01:02:31):
I've learned or heard it's from a guy called Mark Donaldson,
who won a Victoria Cross for Australia and he's written
a great decade called Crossroads. So he might want a
b C in Afghanistan and he said, look, you can
lead from anywhere on the field, and I think that's important.
I mean, I don't think leadership is about getting a

(01:02:52):
title or being appointed to a position. Obviously we want
people and send your positions to be good leaders. But
I think there's there's the capability in everyone to show
leadership at whatever level they are at an organization or
a charity, of sports club or a family you know, so,
and that comes back to empowering the people to make decisions.

Speaker 3 (01:03:15):
Obviously, we don't want people going.

Speaker 4 (01:03:17):
Off peace and readically departing from what the core mission
for any one organization might be.

Speaker 3 (01:03:22):
But you do want people to be able to show initiative.
And that's why you know, John Keith was a great
guy to work for because he laid out the direction.

Speaker 4 (01:03:30):
You knew what the agenda was, but then he empowered
people to go out and do their stuff to lead.
And you know that style of leadership I really like fantastic.
Do you remember your best day?

Speaker 3 (01:03:47):
Oh, well your miss day and yeah, miss day.

Speaker 4 (01:03:52):
Well, I mean certainly some of the local election victories
were fantastic. Really enjoyed those, you know, leading to teams
locally to pull off results. Delivering the pay equity settlement
two billion dollars for some of the lowest paid workers
in New Zealand, the care workers.

Speaker 3 (01:04:11):
That was fantastic day.

Speaker 4 (01:04:14):
You know, and some of the big budget wins we
had around defense funding, you know, they were pretty important.

Speaker 3 (01:04:21):
So you know that there's been a lot over time.
I mean, I don't look back.

Speaker 4 (01:04:25):
Too much, but yeah, no, definitely there are some great
days when things go well and you know you've hit
something that you were looking to pull off and it
does actually happen. Certainly, some of the wins we head
around health, and you know, I mean health's always highly debated,
but the fact was we were able to deliver greater

(01:04:46):
access to elective surgery and it was something that Tony
role started and then after his departure we carried on.

Speaker 3 (01:04:52):
So, yeah, there's always good stuff, but some wins, what's that.

Speaker 1 (01:04:57):
We've got to have a few wins and we've got
to celebrate them.

Speaker 3 (01:05:00):
Yeah.

Speaker 1 (01:05:01):
What if as you look back and your your leadership
career is.

Speaker 2 (01:05:05):
By no means finished, You're still a young man, but
as you look back, what's been the biggest challenge of
your career?

Speaker 4 (01:05:14):
Well, I think the biggest challenge in your career is
actually to stick to your guns and.

Speaker 3 (01:05:21):
Keep on going in the face of.

Speaker 4 (01:05:24):
You know, some pretty weathering public criticism at times, and
you know, just maintaining that resilience, and you know, I
think that's challenging for anyone in the in the public eye.
So you know, there's a huge temptation in politics to
be popular all the time. Of course, everyone loves being popular,
but sometimes you have to make some decisions that.

Speaker 3 (01:05:46):
Not everyone that's going to agree with, and certainly in
as Minister of Health.

Speaker 4 (01:05:50):
And I can remember sitting down on day two as
Minister of Health and reading somebody's letters sent and by
constituents all over the country, you know, with real need
for medications and pretty dire situations, and you know, just thinking, gee,
this is going to be a hard job. And so
I guess the challenge of doing your best but no

(01:06:12):
knowing they're you're not going to be able to meet you.

Speaker 3 (01:06:14):
Know, everyone's needs is pretty tough at times. Yeah.

Speaker 2 (01:06:18):
So yeah, and I imagine in politics you're constantly up
against the battle of meeting the expectations of every single constituent.

Speaker 1 (01:06:29):
Oh yeah you are, yeah, which is impossible.

Speaker 4 (01:06:32):
It is. But the funny thing about politics is politics
have a politicians. You know, if you took a poll
of your people probably aren't keen on it, but they
seem to like their own local MPs in general.

Speaker 2 (01:06:45):
Well, Dr Jonathan Coleman, I have to ask you the
final question that I ask every one of our guests
on leaders getting coffee, and of course in this case,
I'm actually asking the question of a man who wants
threw his hat in the ring for the prime minus
role in New Zealand back when John Key resigned. So
my question for you today is, if you could be

(01:07:06):
the prime Minister for a day in twenty twenty four,
what's the one thing you'd like to do.

Speaker 4 (01:07:13):
Well, Look, from my experience on school boards, I'd actually
like to see our kids in school a heck.

Speaker 3 (01:07:19):
Of a lot more than they are. Be a big
thing for me and as a parent, you know, I
just think more.

Speaker 4 (01:07:28):
Engagement in education for longer could only be good for
our kids. And when you look at the way some
of our education standards are declining and compare that to
countries where they're improving, I think actually time in the.

Speaker 3 (01:07:43):
Class room, time learning really does count. But look, I
think we've got some great teachers in New Zealand.

Speaker 4 (01:07:50):
It would be great to be able to pay them
more and encourage more people into the profession and.

Speaker 3 (01:07:55):
To stay for longer. But I fully understand the fiscal
constraints that.

Speaker 2 (01:07:59):
Government fantastic and I don't think you'll get too many
people disagreeing with the need to have more kids in
school for more time. I think our education system is
clearly one of our big challenges, and it's one that
will take a long time, possibly even.

Speaker 1 (01:08:19):
A generation of kids, for us to get back to
where it should be.

Speaker 2 (01:08:23):
Doctor Jonathan Coleman, it's been absolutely an absolute pleasure having
your leaders getting coffee. As I said it in the introduction,
I've been looking forward to this discussion for a long
time and it certainly didn't disappoint. The only disappointment really
is that I haven't got time to continue, So thank
you for your time. Congratulations on that boy's own career

(01:08:45):
that I referred to earlier. It really is a spectacular career,
and you're still a young man, so I'm sure there's
plenty of time for another chapter.

Speaker 1 (01:08:54):
In your career.

Speaker 2 (01:08:55):
But today you've contributed to the country in a very
unique way, something that you've clearly set out to do,
and on book half of all New Zealanders.

Speaker 1 (01:09:02):
I thank you for that, and I thank you for
joining us on Leaders getting Coffee.

Speaker 3 (01:09:06):
Thanks first look, I really enjoyed it. A great conversation,
so thanks for having me on.

Speaker 1 (01:09:11):
Thank you, Jonathan.

Speaker 2 (01:09:12):
And finally, folks, my leadership tip of the week. It
is highly relevant to the guest we've just been listening to,
and it's a quote. In fact, it comes from Sir
Richard Branson, the founder of the Virgin group of companies,
and of course he's been attributed to a few pretty
good one liners, but this one is highly relevant to
today's conversation, and it goes like this. If you don't

(01:09:33):
try to make a difference in the world, you've wasted
your life. If you don't try to make a difference
in the world, you've.

Speaker 1 (01:09:39):
Wasted your life.

Speaker 2 (01:09:40):
And of course we've just been listening to one such person,
someone who has done and who continues to make a
difference in the world.

Speaker 1 (01:09:48):
That's it for another couple of weeks.

Speaker 2 (01:09:49):
Thanks for joining us on leaders Getting Coffee episode number
nineteen with doctor Jonathan Coleman. If you have any feedback,
please get in touch it info at leaders Getting Coffee
dot com.

Speaker 1 (01:09:59):
Remember that our favorite charity.

Speaker 2 (01:10:00):
Is Blake for Bloats dot co dot Nzen and we'll
see you soon with another New Zealander with a leadership
story to share.

Speaker 1 (01:10:06):
Until then, have a great couple of weeks, and we'll
catch you next time.