As the saying goes, an ounce of prevention is worth a pound of cure.

And in the context of our health system, prevention looks like a strong primary care service that’s focused on keeping you healthy and out of the emergency department. The problem is though, Primary Care, as we know it, is broken.

Our current funding model has driven GP practices to the brink of insolvency. Many are forced to close down or are selling out to profit driven corporates, who want to make your sickness work for their shareholders. By overenrolling patients and pushing doctors to see more people in a day, we will see a two tier Primary health care service beginning to form. Where the days of knowing your local GP might be reserved for those that can afford the premium service.

And at the same time, our fascination with medical specialists has relegated the humble medical generalist to the bottom of the pile. Fewer and fewer doctors are interested in pursuing pathways in generalist fields and instead are opting for more lucrative, but highly niche specialties. We know how important primary care is for keeping people healthy, but why aren’t we prioritising it? It seems like we have things backwards.

On the latest episode of Revolving Door Syndrome, I kōrero with the energetic power duo that is Dr Marcia Walker (Whakatōhea/Ngāti Porou) and Dr Buzz Burrell. Both passionate about the power of primary care, brimming with real ideas about how we can tackle these issues head on.

Cults have come and gone but for the survivors, the trauma remains. Most every day people think that they'd be immune to a cult and could never fall for something as silly as a cult.

The reality is that anyone can end up falling into a cult willingly or unwillingly whether as an adult or child. It is important that we equip ourselves with the skills to identify cult-like behaviours before we fall into the worst kind of echo chamber of groupthink.

This is a reminder for us to not take freedom of expression and freedom of speech for granted. We must extend our empathy to survivors and people who are still in these cults where informed concept becomes a foreign concept.

Joining me on this episode is Dr Caroline Ansley where we deep dive into the cultiverse and learn about the madness of groupthink and coercive control.

How have we ended up in both a housing and productivity crisis?

Why can't we seem to just get on with maintaining and building more housing and infrastructure?

Why does it feel like inequality is getting worse, not better?

Joining me on this episode of Revolving Door is Sam Stubbs, founder and CEO of simplicity, a not-for-profit kiwisaver and investment provider.

Late stage capitalism and an economy based on selling houses to each other is failing our younger generations. I ask Sam if it is possible to make capitalism work better for our young people. Us millenials and zoomers are struggling to get on the housing ladder. How easy is it to hold down a job when your landlord sells up your home? How easy is it for kids to get good education if they keep having to move schools? What effects will the stress of housing insecurity have on our health outcomes?

If we can't get housing right, can we really solve any of our other problems?

When we talk about addressing the mental health issues in society, we often hear that if only we had more psychologists, more psychiatrists, more psychotherapists and counsellors, we'd be able to fix the problem. Hamish William's is a host of NewstalkZB's show, The Nutters Club. He has a different perspective on the issue, given that every Sunday night he listens to real stories from real people facing very real mental health challenges around the country. For his listeners, The Nutters Club has become a beacon of hope and a network of support forged through the airwaves. We kōrero about building communities that become self supporting and self healing. Hamish also explores his own experience as a step father and the challenges faced with raising a teenage son in the age of Andrew Tate and the Manosphere.

Imagine a future where healthcare looks more like the tiers of a Netflix subscription. Where if you can afford it, your premium, gold-plated health service gets you your own personal family doctor. Meanwhile, those on the ‘free tier’ still get access to healthcare, but it’s delivered via algorithm and internet. In the eyes of Melissa Clark-Reynolds, this could one day be a reality. An Officer of the New Zealand Order of Merit, a futurist and a company director. Melissa is a thought leader and a game changer always at the edge of technological innovations. She uses her experiences and knowledge about human behaviour and technology to guide companies and people to a better future.

Healthcare services around the world are reeling from the consequences of a pandemic. We have news media and social media that are full of discontent with the provision of these core services and we hear the word crisis so regularly, sometimes it's easy to forget what normal is

So much of our healthcare system is devoted to the treatment of disease, rather than wellbeing and prevention. So much so that we are seeing our hospitals full of patients with worsening amenable disease with ultimately worse health outcomes.

Joining me today is Dr David Galler, retired intensive care doctor, health leader and author of the book Things That Matter to talk about his experiences in the intensive care unit. He shares with us his insights of working both as a clinician with our sickest people as well as the difficulties of trying to drive change as a leader within the bureuacracy. If we only focus on improving our treatments, will we continue to chase our own tails by refusing to focus on the real drivers of poor health?

Can we fix our mental health epidemic with a drastic change in what we eat? That's the question posed by Professor Julia Rucklidge. She's a psychologist and the director of the Mental Health and Nutrition Research Group at the University of Canterbury. Her research has focused on the impact of nutrition on brain metabolism, gut microbiome and how our mental health is directly tied to the gut-brain axis. We kōrero with Julia about the findings of her studies and expose the barriers she's faced challenging the status quo, with Scientific institutes unwilling to publish and promote research on the basis that it questions the existing treatments.

The issues of health, education and welfare can often feel intangible and immovable. Despite feeling like we are slipping backwards on these issues, we often look to the government, expecting them to drive change. Yet, in our focus on government as an omnipotent force, we might overlook the organic source of change at the grassroots. Charities, NGOs and Community organisations often serve as the safety net for the most vulnerable among us. However, they struggle due to insufficient funding, resources, and the means to measure their impact. Social Investment is an initiative that aims to promote and resource the grassroots programs that are working. Joining me to talk more about this is former Prime Minister of New Zealand, Sir Bill English. Today his organisation Impact Lab helps charities and NGOs better measure the impact they have. You might notice that the audio quality of this episode isn’t up to our usual standard. Unfortunately we had some issues with the recording and have had to do our best with a backup. So please bear with us, we promise it’s a conversation worth listening to.