It comes as something of a surprise to hear that Starship Children's Hospital is included in the report of hospitals which are beyond their life expectancy and 'not fit for purpose' which includes Auckland Hospital.

Now Auckland Hospital is the lead training hospital in the country, now if it's facilities are as lacking as we are lead to believe then we are surely in trouble.

That takes me back to root cause. Could I be so bold as to suggest the root cause for this is the way the system is structured through management?

It's top heavy, too much money goes into management, there are too many people in management and they are getting paid too much money both as individuals and collectively.

Which means there is less money going into what hospitals are supposed to do.

Now, if you're in hospital management you might take issue with me but that's the impression I get, it's the one I've had for some time.

But nevertheless, it still surprises me that this has risen to the surface at the moment and that there are a number of hospitals that don't measure up.

What does it say?

What it says, and I hate to say this, what it says is it confirms something someone said years and years ago...if you think New Zealand is a first world country the first place you will realise it isn't, is the health system.