The Z man (hat tip to Woodpile Report) notes that there is no honour left. There is only virtue signals, and the results no longer care for the managers. Which means we have an managerial elite who are not merely without honour. They have embraced evil.

The key thing about the modern sociopath is the ambivalence toward the truth. They think saying something is the same as doing something. What matters is if the words get the listener to do what the sociopath wants them to do. Standing in front of crowd, making false claims, is fine if it causes people to buy product. If the truth sells more product, then the truth is better. From the perspective of the modern sociopath, the difference is about the results, not the accuracy of the statements. The truth or a lie, whichever works.

Now replace “sociopath” with “politician” and “product” with “votes” and you have the modern managerial democracy. It’s not that our politicians lie. It’s that for them, a lie is indistinguishable from the truth. That’s why they seem so utterly shameless. Shame requires a sense of right and wrong, a knowledge that what you said or did is intrinsically wrong. For the people who rule over us, right and wrong only exist in the context of their own ambitions. Something is “right” if it benefits the person in the moment.

And the results of this… locally.

Dunedin Hospital’s emergency department is once more being stretched to its limits and many patients are waiting on beds in corridors to be seen by medical staff.

Hospital managers cannot single out one factor behind the high number of patients visiting the emergency department, although Dunedin was busy with events and students were returning to the city for the start of the academic year.

“However, these populations do not seem to be directly leading to an increase in presentations,” department charge nurse manager Janet Andrews said.

“Rather, we are seeing high numbers of people from across our community experiencing medical emergencies.

“The emergency department has been consistently busy recently, and we are working hard to ensure our patients are seen as soon as possible.”

On Thursday, patients were waiting more than three hours to be seen, and staff were using the resuscitation area and corridors as impromptu consulting rooms.

At one point, five beds with people waiting to be taken into a cubicle were just inside the ambulance bay entrance. Ms Andrews said emergency staff were doing their best to avoid patients waiting too long.

“We have increased our medical and nursing staff during this time and ensure that patients are triaged by senior staff … to help start patient care and treatment as soon as possible,” she said.

Rhetroic cannot deal with the facts on the ground.

Levy said that in the past five years the population had grown at 9.4 per cent but emergency department attendances had increased 18.8 per cent; in-patient discharges by 15 per cent; and spending on services for older people by 14.4 per cent.

The population of people aged over 65 was going to double in the next 20 years. If Auckland grew at medium projections over the next 20 years there would be 560,000 more people; if it grew at high projections, as it had been doing, there would be 780,000 more people in 20 years.

Waitemata District Health Board chief executive Dale Bramley said the three DHBs had reached new peaks of emergency department attendances that would normally occur in winter.

He also talked about bids for three capital projects that were before the Ministry of Health capital committee.

One included a $500 million upgrade at North Shore where some wards had six patients to a room.

Counties Manukau chief executive Gloria Johnson said levels of demand were “so unprecedented and so extreme that we are actually no longer managing.”

“We really became aware of it over the summer of 2016 -17 when acute surgical demand peaked then failed to drop off.

“That meant our services were already overstretched by the time we got into winter.

“Our medical demands during the winter were extreme.”

The DHB had periods when on every week day the acute beds were running at 120 per cent occupancy.

In short, you can virtue signal. But if you don’t fund a service properly, things do not go well.

Your actions trump your words.