Health Minister Tony Ryall says an ongoing highlight of his job is getting outside Wellington to visit hospitals and health services and talking to people who are really "making a difference".
He peppers his conversation with examples he has seen of services making improvements to the way they are working for the benefit of patients.
Discuss the way community health care is going to be delivered in the future and he says there will be some dramatic changes in the next 10 years as more care is delivered closer to where people live.
This will include diagnostic testing, where technology is moving so rapidly that eventually much of it will be able to be provided outside the hospital setting.
He cites the example of the Mid Central District Health Board, where echocardiograms, once provided in the main hospital, are now being delivered in clinics "at a local church hall".
(An echocardiogram is a test that uses sound waves to create a moving picture of the heart.
The picture is much more detailed than an X-ray image and involves no exposure to radiation. )He approves of the moves in Otago and Southland towards replacing nine primary health organisations (PHOs) with one and hopes it will lead to clinicians having much more say in service provision.
"I think that the people of Otago and Southland will see it as a positive move when it delivers less bureaucracy and better services for patients. If that can't be delivered, people will think, `Was it worth it?"'
Mr Ryall's public profile in the south was probably at its highest in late January and February as a result of his decision to sack Otago board chairman Richard Thomson as a " matter of accountability" following the conviction of former employee Michael Swann on charges relating to a $16.9 million defrauding of the board.
The sacking provoked much negative public comment from those who saw it as unfair.
Mr Ryall said he had not spent any time thinking about the decision since and he had developed good relationships with both southern board chairmen, Errol Millar and Paul Menzies, and clinicians in the south.
More recently, Mr Ryall called for the Otago board to provide an urgent report on concerns raised by general practitioners through South Link Health about access to colonoscopy services.
Mr Ryall said a few weeks before the Otago Daily Times published the story about the concerns, he had asked the Ministry of Health to do a stock-take of colonoscopy waiting times around the country.
It was very difficult to get a grip on it, he said.
There was a need to get better capacity if there was to be a national bowel cancer screening programme.
He hoped to have a better picture of the situation by the end of the month.
Referring to issues affecting Otago and Southland, Mr Ryall said the district health boards, which were both running deficits, were facing some big challenges, including serving a large area, populations which were not growing and providing services from buildings which had become run down.
The boards were doing a "good job" getting public feedback on the suggestion they should merge and their progress would be watched with great interest.
Many of the real savings in health would come from reorganising back-office functions.
Funding would be tight in the near future and while there would not be cuts, there would be smaller increases because there was so much pressure on Government spending.
He is keen to see hospitals continue to work on ways of improving their efficiency.
There were plenty of small examples where hospitals used "lean thinking" methods to improve productivity - "we have to do a lot of that to get more value".
Ask him about private-public partnerships in health and he tells the story of visiting the public hospital in Masterton, which has a private hospital wing.
When he asked how that had happened, he was told the hospital did not tell anyone about it.
What the move had done was encourage retention of staff there.
Surgeons and nurses who were able to spend a day on private work could supplement their incomes, which kept them working in Masterton rather than being attracted to work elsewhere.
He supports private and public partnerships, but only if their purpose is to maintain and improve the public service.
This would include longer-term contracts with private hospitals, which would mean more people had treatment and more staff were retained who might be working in both settings.
Mr Ryall acknowledged the swine flu outbreak was a hectic time for his ministry, and he felt the health system had done "a pretty good job".
For the first 10 days it was a matter of trying to get to grips with the situation and it had been a very uncertain time.
It had also showed how understanding the public could be if the health service officials were "up front" about the situation, which included letting people know when they did not know the answer to something.
The experience showed the value of the pandemic planning which had been done in earlier years.
The personal highlight of the year for him had been the impact of the decision to fund 12-month Herceptin treatment for women with early stage Her-2-positive breast cancer.
Mr Ryall said he had met many women and their families for whom this had made a huge difference.
While there was still controversy over the decision, which went against the advice of drug-buying agency Pharmac, Mr Ryall said it was "definitely the right thing to do".
The Government had made a decision to put an extra $40 million into Pharmac funding.
It had recognised the frustration of people who felt New Zealand drug funding was falling behind that provided in similar countries.
