Department of Health

Public Hospital Board Director Selection Webinar (Session 4) November 2020

  • 09 December 2020
  • Duration: 1:07:34
  • Public Hospital Board Director Selection Webinar Transcript

    Good afternoon everyone and welcome to this webinar. I’m Dr Jo Flynn and I chair the Board Ministerial Advisory Committee to help support the process for selection and appointment of people to public health service and public hospital boards and tonight we're focusing on the selection process for public hospital boards and also including multi purpose services and early parenting centres.

    The format tonight was really to walk you through the process and allow an opportunity for questions and discussions. Before I start, I'd like to acknowledge the Traditional Custodians of all of the lands where people are participating from this evening, and particularly recognising that it's Naidoc week to acknowledge the Traditional Custodians of land, skies and waterways across Victoria and pay respects to their Elders, past and present acknowledging them as the holders, protectors, and educators of Aboriginal and Torres Strait Islander culture.

    The format, as I said, is a series of presentations. So the first presentation will be Dr George Braitberg who is the clinician member of the BMAC and a former director on the Barwon Health Board and George will be talking about the role of the registered clinician on a health service or hospital board.

    Then, Mr Dipak Sanghvi, who's the chairperson of Monash Health, will be talking about diversity on boards and the importance of diversity and John Maher who's also a Boards Ministerial Advisory Committee member and was formerly the chair of Southwest Healthcare. He will be talking about advertising and recruiting and then you'll come back to me talking about shortlisting and interviewing.

    There are a number of resources available to support you in your role and if you haven't already had access to them, you will be sent a link to find them. You'll also be given a link to all of the slides that we use this evening.

    Just to alert you to the fact that there's a question and answer function for this webinar and you're very welcome to post questions as we go along. We will run through the presentations end on end, but we hope that we will have about half an hour for discussion when we get to the end of the meeting. So please, I hope you enjoy the webinar. The downside of doing these presentations this way is you don't get an opportunity to actually meet people and to network, but the upside is it's very convenient and allows many people to participate readily.

    We are also aware that there are some selection committees that haven't yet been constituted, and so this webinar will be made available to selection committees who need to either look at it for the first time or refresh themselves between now and the end of the process.

    The role of being a director of a public hospital or health service is a critical one. It's a very rewarding experience to be on a board with people who are very committed to good patient care, good outcomes for their communities to good culture in their health service and a healthy staff who enjoy coming to work.

    To make that all happen requires a lot of things, including obviously a good CEO and management team, but leadership and oversight from a board, a board comprising a multitude of skills working cohesively together, and so our role really is to try to help you ensure that that's what you deliver for your boards through this selection process. In this work we are supported by a team of people from the Department of Health and Human Services who are also supporting this webinar and it's really important that you know you can reach out for support and help or direction to whatever resource you need, should you need that.

    So what I'd like to do first of all is to hand over to Dr George Braitberg who will take you through the role of the registered clinician. Thanks George.

    Thank you, let me just share my screen and I will put this into screen share mode. Thank you so my name is George Braitberg. I am an Emergency Physician and currently Executive Director of Strategy, Quality and Improvement at Melbourne Health and have been fortunate to be on the boards of Barwon Health and Ambulance Victoria.

    What I'd like to do is take you through the definition of the registered clinician on a board and perhaps come back later on for discussion if there is any questions. The definition we have provided you is an applicant must possess appropriate qualifications in a relevant clinical field, i.e. medicine, nursing, midwifery, allied health and have worked in a public health system and/or had exposure to quality and safety processors in the public health context.

    The applicant must hold a current registration with the Australian Health Practitioner Regulation Authority or agency AHPRA and that active practice registration with AHPRA is defined as practitioners who do not have a non-practicing status with not being suspended or otherwise have a condition or undertaking or notation that stops them or restricts their practice. So I guess in general the focus of the registered clinician is to understand, help the board understand the clinical systems in a public hospital to have and share their experience in a multidisciplinary environment; to assist other directors in understanding the clinician’s perspective of hospitals and the work that clinicians do within the hospital and is practising clinicians maintain currency through maintenance of professional standards.

    Often the role of the clinician is to assist the board in almost a translation piece for some of the presentations, particularly in the quality and safety space that presented to the board and particularly in looking at clinical performance indicators and discussions around clinical priorities and clinical practice but I must also say that the clinician isn't limited to those discussions.

    The clinician is another equal member of the board and can participate in all other aspects and discussions of the board from clinical governance through to corporate governance, risk and financial discussions that the board may undertake so I think there are, it's that specific role that provides some of those competencies that the board may look for and often it's the clinician that chairs, for example, the board Quality and Safety committee but not exclusively so. The clinician is also a member of the board and contributes to all the discussions of the board and through that provides that richness of the multidisciplinary nature of any sort of public hospital or public health board. So that's really the clinician in a nutshell.

    I'm going to end the show and stop my screening, my sharing of the screen when I can work out how to do that and I might require. There we go - stop presenting. We should be back now. So as I said, I'm happy to take any questions about that afterwards. Thank you.

    Thanks very much George. Thank you for that. So just a few reminders for those who may have logged in a little bit late. The slides will be available after the show. They'll be posted and you'll be sent a link to be able to find them and secondly, just to alert you to the question and answer function which is available to you to post a question. But there's also an opportunity for you to vote for a question so if there's a question that you're particularly keen to see answered, you can give it a thumbs up and we'll make sure that we address it, but we're going to run the parts of the presentation end on end and then come to the presentations.

    So now I need to share my screen and talk to you about board diversity and why diversity is important. Let me just talk through the slides for you then. So why is board diversity important? Board diversity is important because boards should broadly reflect the diversity present in Victoria’s communities. Diversity brings new perspectives and makes sure that we don't engage in groupthink when like-minded people discuss issues and make decisions together. And it's as much about the attitude and experience as it is about getting the numbers of people right.

    The Victorian State Government has a commitment to diversity in relation to gender and it's an absolute requirement that boards meet the requirement of making sure that at least 50 per cent of new appointments to boards in Victoria Government boards are women, except in the situation where you already have a board where the gender balance is predominantly women already. So just as it is inappropriate to have a board that's all men, it's inappropriate to have a board that's all women so that you need is a minimum of a third and we aim for a 50/50 representation.

    It's also important, though, to think about the community that you’re serving and what sort of groups so that raises issues about age, about ethnicity, about whether in an area where there's a higher Aboriginal Torres Strait Islander community it's possible to recruit somebody from an Aboriginal background and there are all other sorts of diversities, but it's basically important that when your community looks at a photo of your board, they can think of themselves as being represented in that group and it's not just bringing people from the same sort of background.

    There are not mandated targets in Victoria for anything other than gender mix, but it is really important that we try and ensure that we meet the mandated targets for gender mix, but we keep in mind the need for diversity so I'd now like to introduce to you Dipak Sanghvi, who's the chair of Monash Health to talk about what diversity brings to a board. Thanks. Glenn, if you could swap us over.

    Thank you. I would like to start off with acknowledging the Traditional Owners of the land on which we are and pay my respects to their Elders, past, present and emerging. Good afternoon everybody. It has been said that if everybody is thinking alike, then somebody isn't thinking. The powerful questions that the boards ask as well as the decisional processes used by the board task it from the board to executives to senior leaders and middle managers.

    This helps to ensure good decision-making throughout the organisation. At Monash Health the effectiveness of the questions are and the decision-making processes applied are all influenced by the diversity of our board members. I believe there are different types of diversity. Firstly, surface level diversity which includes gender, ethnicity, nationality, culture, education, professional backgrounds and some more. This surface level diversity influences the next level of diversity. That is deep level diversity. The mental framework that individual board members rely on to work through board papers, issues and problems.

    It is this mental framework that results in robust discussion. No one person on Monash Health board, no matter how smart can offer the breadth and the depth of perspective to make the best decision. It is the combination of the mental frameworks applied to an issue that delivers question-analysis and decisions on our board.

    I'm proud to say that Monash Health has a rich and diverse board, including echo skill mix, gender, age, Aboriginal representation and ethnicity. In terms of gender, we're exceeding the state government legislated 50 per cent gender requirement with five units out of our 9 board members.

    We have a member with Aboriginal heritage and members with very ethnic backgrounds. This is critical in representing the MultiCare cultural demographics of the Southeast catchment of Victoria. We have a diverse skill mix represented on our board, including clinical, including myself as a pharmacist. We have research, finance, governance, risk, legal and not for profit sector and a non-health private industry such as digital technology and water.
    Board member diversity has many benefits and research has shown there is a direct correlation between board diversity and improved organisational and community outcomes. Let me give you two examples of a board member with Aboriginal heritage help us to launch Monash Health Aboriginal Reconciliation Action Plan in partnership with Aboriginal communities supporting closing the gap, while the other board member with technology background was instrumental in our understanding more about implementations of the EMR in the risk.

    So we had very good support in making decisions from these board members and there are many examples. Boards that want to maximise their effectiveness need to do more to ensure that different perspectives are regularly elicited and integrated into the board’s work. Board diversity benefits include being representative of the community the board is serving; more equitable outcomes of the benefit to the wider community; diversity of ports to ensure healthy well informed discussion, particularly with complex issues leading to better risk based decision-making.

    Innovation, for example, an organisational practice in the mining industry may have also benefited in a health service context. Mining industry has a very strong occupational health and safety practices and culture of calling out practices. Such this culture norm would be benefits in health service context.

    Adaptability to changing environments, particularly in the context of the COVID-19 pandemic and of course the financial statements. Cultural intelligence helps to view issues from prospective diversifying consumer groups and employees at Monash Health. There are some challenges. How could we consistently tap into the diversity of thinking in the room? How to manage biases that pushes us towards the stethoscope group thinking?

    There is a caveat though. Diversity is important, but will not fill any gaps in domain knowledge, experience and competence. As a chair, what do I do to support diversity? I like to be inclusive in inclusive leadership, that is leading from the middle of the circle rather than from the top. I genuinely believe that each member brings value to our conversation and decision-making and I aim for my board members to feel noticed, seen, heard and valued. On our board, everyone has a voice. I encourage inputs from all. That helps developing psychological testing so that the board members feel safe contributing their diverse viewpoints.

    We have an in-camera session before each meeting and feel comfortable about talking about what could be the issues during the board. We have end of the meeting review where we determine what we did well, what can we do better from individual and group insights. We have monthly get togethers to delve deeper connections and trust.

    There is an open door policy. They can call me anytime and I would listen and I promise to consider your views using the language that guides the board to consider issues from an analytical and holistic perspective. Managing conflict constructively - I don't let things fester and incorrect staring differences.

    Let me conclude by saying that if a board is truly committed to pulling its role and responsibilities effectively improving diversity in the boardroom, both demographically and cognitively and fostering a culture that welcomes diverse perspective must be made a priority. In today's dynamic and competitive environment, ensuring that the board is performing to the best of their abilities and able to help health services respond to challenges.

    The principle argument in favour of a diverse board is a wide range of perspective that each individual will bring to the board boardroom table. Thank you. That concludes my presentation. I'll wait for the questions later on, I suppose.

    Thanks very much Dipak. Sorry about that. It takes a minute or so for the changeover and it takes takes an extra few seconds if I forget to come off mute.

    So we'll have some questions I'm sure later. So just to remind everybody that there is a question function and as you bring your questions through we are able to post those questions so that they can be seen and you can vote for the questions that you're most interested in. Somebody has asked again will the slides be shared afterwards and they certainly will. Our next presenter is John Maher who is a member of the Board Ministerial Advisory Committee and previously the chair of the Southwest Healthcare Board and John's going to talk about the process of recruitment in advertising. And then I'll speak about shortlisting and interviews. So if we can hand to John now, please.

    Thanks very much for that Jo. During recent discussions I had with quite a number of board chairs, there seem to be similar concerns raised by smaller regional and rural health services around filling of vacancies and how do you attract new and the right new directors. I'd like to touch on the advertising and attracting applicants outside your catchment area and the ability, some occasions to attract some skills that you have a shortage in your skills matrix, particularly around ICT and law.

    Advertising director vacancies - DHHS has compiled an extensive set of guidelines for advertising board vacancies and building interest for people to join the board within your community and that will translate, hopefully into applicants for director positions. The Advertising Director Vacancies Guidelines are a resource to assist you as board directors and also board chairs.

    It is necessary under the Health Services Act 1988 that public hospitals place an advertisement in a newspaper circulated generally in the area where the hospital is situated. The advertisement is to your town. Really you’ve got to look at attracting people from within your total catchment area or large adjoining areas and I'll come back to that shortly. It is recommended that there are certain aspects in your advertisement. You should really outline the number of vacancies. You should outline the frequency of your board meetings; the usual time, duration and the location of your meetings; the closing date for your applications. Reference the Get on Board website for further information and also the health service website where applicants can obtain further information.

    This action should be undertaken the first week of the appointment period and if possible one week before the closing date. No later than that, you're getting too late. As I said before, maximise your exposure. Place the ad in the news section of the newspaper. If you put it into the public notices and the other advertisements, they generally just get lost in the clutter. So if you can get your advertisement up front in the news area it will be of immense benefit to you. Try to include all newspapers that service the towns within your catchment area. Multiple advertisements in multiple towns are encouraged.

    Include as I said before, advertisements in major rural and sub regional locations. The major business precinct that services your health service so you go outside your normal comfort zone into other areas. Social media is another magnificent area to try and attract new directors or interest in your health service. I know some board chairs are frightened of it but seek help from your CEO’s executive assistant. They should be able to help you in that area. Use Linkedin. Use Twitter, Instagram, Facebook to liaise with people who have community-focused Facebook groups. Make sure these sites are also referenced on your health service website.

    Ensure someone within the health service is monitoring these sites so that they can respond to any enquiries or questions that are posed. The department's Media Coordination Unit will also provide assistance or they also provide advertisements, and they've put it in ad in place and it's probably on the screen there now. An example of what they do.

    I talked there before about the concerns some health services had in tracking the right people. Community engagement is critical for your health service. Encouraging applicants for the board is a year round event. A year round activity and really it's a good idea to think about delegating a couple of directors to put together a plan of how you’re going to go about the advertising and the work necessary to track people that you have a shortage on your skills matrix.

    So they could start working on that six months before. I know it's a bit late this time but think about that for the next round. Your Community Engagement Committee, and I think most health services have a Community Engagement Committee is an excellent vehicle for getting input from the community and also for you to give advice back to them on what you're seeking.

    Boards are also encouraged to engage with their communities throughout the year. To publicise your activities, individual directors can also use their personal networks to publicise the activities that are happening within your board and encourage others to consider offering themselves for appointment as directors.

    Some places, particularly those small regional areas, country health services find it difficult to attract people, particularly ICT and law. Some of the things that you might think about doing is to liaise with other major health services around your catchment area. They may be able to help or give advice where they know someone who was interested in it who has those skills.

    Another area to look at is the local government area that's in your catchment area. They sometimes have IT specialists or even law specialists working within their organisation who may be interested in joining the health services as a board director. And if you can't get them and if you have difficulty and they're not available, as a board look at buying in that expertise on a need’s basis. As said, have some form of contract that you can get that expertise whenever necessary. So I hope that just gives you some help. Thanks Jo.

    Thanks very much John. Just to remind people to think about the questions that you might like to ask and putting them up on the Q and A part of the webinar.

    I'm now just going to talk about the process of shortlisting and interviewing applicants. Next slide, please. Ok, so John referred to a guide that has been developed by the Department of Health and Human Services. The shortlisting and interview guide. It's a resource to assist selection committees and panels. It talks about the role of the committee, the shortlisting process, how to conduct interviews and what needs to happen after the interviews and I'm just going to walk through headlines of that. First of all, it's important to constitute your selection committee and be clear about who that needs to be.

    Obviously any director who's eligible for reappointment is not able to be part of the selection process during the year that there appointment is up. Normally a selection committee would be three people, occasionally four, so usually directors who are not up for reappointment and sometimes an external member. There are reasons why it can be good to have somebody from outside your district or outside your board and there are some avenues for you to seek people through the department recommending some people to you. If you need some additional input to your selection process. It's important to note that the health service in the hospital staff can provide administrative assistance for the process, but they can't be a member of or influence the committee decisions.

    So the first thing that a committee needs to do is to review the board composition and to identify skills to gaps. So the next slide please, Glenn. So as you know, I'm sure there are a group of skills that are considered to be essential in the makeup of health boards called tier 1 skills and essentially we're aiming to make sure that all of the tier 1 skills are covered by the board if that's at all possible. It's also important to think about the context of your health service at the moment. If you got a major capital works plan going on? Have you got some really big strategic issues that are facing you? Have you got significant financial issues? Have there been quality and safety concerns and to have that at the top of your mind when you're thinking about shortlisting.

    It's very important that the process is fair so that all applications are reviewed in the selection committee sees the CV and any other letters or documentation provided. It's important to develop a shortlist, which essentially means a group of people that you're going to interview, including directors who are reapplying and new applicants and you need to have that shortlist approved by the department through the Board Ministerial Advisory Committee.

    So you need to have a rationale for the shortlist. Now clearly if the person that you're putting forward has a skill that's clear gap, that's easy for the rationale. If you're seeking to produce to recruit people with the same skills that you already have on the board, but it's important to be thinking about whether what's the reason for that, do you think you need more strength in that area? Is it about succession planning?

    It's very helpful to the BMAC Committee if we understand your thinking. So the clearer you could make your documentation the easier that makes us and obviously once this shortlist is approved then you need to schedule and conduct the interviews.

    Moving on to the next slide. It's important to make sure you've got more people on your shortlist than you've got vacancies and as John has identified that's a task for the board to be thinking of all the time and to be talking to people that you think would be keen and to be reaching out to other organisations when you think that you've got a gap coming up and it's not obvious to you how you’re going to fill it.

    And when you are going through that process of shortlisting as you look at somebody’s CV and their application, it's important to be thinking about: are there particular questions you need to ask them? Do you need to be clear about any conflicts of interest and how they might be managed? Do you need to be checking out whether somebody's commitments are going to enable them to fulfil the role in a way that will be satisfying for them and provide what the board needs.

    So the more you've prepared, the better the process will go. At the interview itself, obviously, that's an important time for you to get to understand the applicant and their skills, but also it gives the applicant a chance to assess the board and whether they believe that would be a group of people with whom they could work. So in a way, you’re putting your best foot forward through that process. As I said before you don't need a terribly large panel, but three or four people and again, you need to try and ensure that you've got a gender mix and a mix of skills in that panel.

    Interviews follow a semi-structured format, so with a few major questions allocated between the panel and then follow up questions and then for people with particular areas of expertise you may want to delve into that further for the registered clinician to make sure you've got a good understanding of what their clinical governance experience is. For people with finance or audit background, some have a better understanding of what sort of work they've actually done and what skills they bring. You can vary the questions according to the applicant.

    But overall it needs to be a fair and logical process. And of course, it's really important to give the applicant an opportunity to ask their own questions and to tell them what you can about how the process actually will flow and what happens after the interview. And of course to ensure that when they leave the interview, they've got a good clear understanding of what the expectations will be for them if they are appointed a board director. There's nothing worse than somebody being appointed and then finding themselves unable to participate because they didn't really understand when the meetings were held or what the expectations are.

    At the end of the process, it is important that the interview panel reach consensus decision on their applications. So we're up to the next slide. Thanks Glenn. And there's an interview summary template which you'll need to return to the department which basically indicates whether the minimum competencies have been achieved. And that includes giving the applicants a score for the skills they've nominated, to be clear about whether you're recommending them for appointment and again, to have a rationale for your decision, which should be objective and you need to be mindful that you're creating a written document and it should be carefully worded to ensure that it's not discriminatory or based on any grounds that would not be defensible.

    And then it's important that the interview summary is actually signed, either physically or electronically by all members of the committee. Next slide thanks. It's also as I said before, important to recognise the department's here to support you and on the screen there are the names of the people in each area who are the key contact areas and key contact people and the email address of the health service governance team who are very willing to help you, whether it's a small question or a large question, either by email or by a follow up phone conversation if necessary. So thanks. If you could take the slides down.

    So that brings us to the end of the slides and the presentations and we're now happy to answer questions and I'll direct the questions to different members of the panel as appropriate.

    So the first question is about registered clinicians and the question is for you George about how do retired clinicians fit within the requirement for a registered clinician.

    Thanks Jo. Look a registered clinician needs to have a current AHPRA registration and maintenance of professional standards certification. So for a retired physician it would be whether they were still undergoing their specialist college maintenance professional standard accreditation process so they may be retired from public hospital, but may still be activate within their profession.

    Thanks, George. So just to be clear, the person needs to have active registration and that ensures that they are still keeping up to date through appropriate continuing professional development. Now, that doesn't mean they have to be working actually in clinical practice. They need to be registered and doing their continuing professional development.

    There's a question here John that I'm going to direct to you which is about what can a board do if they can't find an applicant with the particular skills, either as a clinician or legal or ICT or clinical governance. How do you suggest that they approach that?

    Thanks Jo. Look I think in the first instance you should talk to the major health service that gives you advice or you go to for advice and guidance to see if they can assist in any way, who might be around. If you're looking for clinicians, it is sometimes very difficult in a rural area and I think through your regional office they should be able to talk to various health services in the areas to find out if anyone is there. I think we've all been working with Zoom and Teams and other such technology over the last eight to nine months. Now you need to be looking outside your own health catchment area to find some of these expert people that you're looking for.

    Meetings do function quite effectively online and you can utilise Teams; utilise other forms to have your meeting and those directors are quite prepared generally to come along to a meeting face to face a few times a year. If you're really stuck, look outside your area and if you can't find it, what I said before particularly in law and maybe in IT, look at buying in that expertise.

    Thanks for that John, and I'll just ask George to comment on what a board selection committee can do to try and attract or find a registered clinician when they're having difficulty with that.

    Thanks for the question Jo. I think there's actually been an increasing interest amongst registered clinicians in applying for board positions and I guess if you're not getting any direct applicants I'd sort of mirror what John said that you could approach a larger organisation and just make them aware that you were looking for registered clinicians on your board.

    Many of the positions in the metro area are difficult to come by so registered clinicians would be quite interested in going out to regional or rural areas to get experience into and also assist in those smaller hospitals to gain that experience so I think that it shouldn't be a big problem, but certainly if there is any ongoing concerns, I’m sure by contacting BMAC we could probably put you into contact with some people that might be interested in starting out their career on a board.

    Thanks for that George. There's also the Rural Doctors Association Newsletter which has been used and could be used in future to alert people to opportunities for clinicians on health service and hospital boards, particularly in rural areas.

    A couple of other questions that I'll come to, but again, just to prompt people if you have questions to put them up. Somebody's asked a question about whether it's ok to share the board advertisement on your personal Facebook page. That's absolutely fine. It's a public process. I wouldn't suggest that you put any editorial comment except perhaps to encourage people, something that says this might interest you, being mindful of that. The more that the word can get out the better so by all means use whatever networks you can.

    There's also a question about the interview process again which is a very important question about how much does this selection panel / selection committee share information with other members of the board who are not part of the selection committee. So essentially the selection process is for the selection committee to do and there are elements of that process that ought to remain confidential. It's appropriate to have a discussion with the chair of the board about what their views are, but that becomes more awkward when the chair is actually up for reappointment, but it's generally not appropriate to be sharing information about applicants.

    It's a common sense question about what would the applicant expect about the information that they provided for a particular purpose. That information is only being used for that purpose. Now I can't see any other questions. Have I missed any?

    There's something else that's come up now I think. There is a question about the desirability of having an external member on the selection panel. Can I ask you to talk about that John? You've carried out that role sometimes.

    Thanks Jo. Yes I have sat on some interview panels with health services. Don't feel afraid to ask for a board director from another health service if you feel you need that skill of someone to sit there on the panel for the interview. Do seek that help at any time. I don't see any issue with having another board director or someone from the department or someone from BMAC sitting on an interview panel if necessary.

    So I've got a few other questions now. I think the first question just to talk about is about what are the expectations for people who are not locals in terms of attending face to face. Now, of course that's being very, very different during this year, and we’re all fervently hoping that we will return to something more like normal next year. But it has given us a much better sense of what's possible and how groups can function and do their work effectively using technology. I think that's going to be something that boards need to work out over time. In terms of what works best and I suspect that what will happen is people will go to a mixture of some face to face meetings and some meetings held by technology.

    It clearly presents significant challenges for public hospitals in the more remote parts of the state in terms of travel times and costs, whether that's opportunity cost in terms of taking people away from their normal day job or whether it's actual cost in terms of the need for funding for mileage or accommodation if you have a lot of people on your board who are from a long way away. On the other hand, there is considerable benefits in having input from a wider selection of people both in terms of skill and experience and perspectives, but also there is a risk in smaller areas that you can get a level of insularity and that's good to bring some different insights into that and coming back also to the point Dipak made earlier about diversity, people having different understandings of what's possible. What might have worked in other places. So I think that's an area, it's important that the director can function effectively. They need to therefore understand the health service and so they will need to be made familiar with it, preferably by visiting and getting to know people face to face. But I don't think it's going to be part of the expectation of the future that all meetings are conducted face to face.

    There's another question about whether it's better to have locals or people outside the district. And again, we've referred to that. It's important to have both. It's important to have external perspectives, but it's also important that your community feels as though there are people on the board who understand the community and its needs. And of course, many situations there are services that operate from more than one site, more than one location and all of those perspectives need to be able to be heard.

    Dipak, feel free to comment here.

    Just to reflect on the question of whether you have external people coming in or not, you got to be mindful that sometimes the board members are also emotionally attached to the area and the decision is sometimes not the right decision because of the emotions and that’s why it might be useful to have somebody from outside coming in and making sure that they look at it from a different angle. At the end of the day, you want to make the right decision that provides the right type of services and we'll look after the patient’s will. So in small towns and things like that, I mean I'm a pharmacist, a head pharmacist in a small town and there are issues about getting the right staff and the right type of services so I understand the issues with that, but I think it is very important to get the right people for some of the critical areas that is run well. For example, finances. If you don't have anybody with expertise in there that you think is, then you get it from outside. At least I can guide you and help you in making sure you make the right decisions. Thank you.

    A few other questions here now. One is about how to handle the situation where a candidate is known by the majority of the selection committee members and so there may be some conflicts of interest within the selection committee. Would you like to talk to that John?

    I think that is relevant in a lot of very small rural communities. I believe that the selection panel would probably have a close knowledge of the bulk of the applicants, particularly those who reside within their catchment area would have a good understanding of them. If you feel that you have some doubts around an applicant, but you know there are other directors who haven't been on the selection committee who may know them more, I don't see any difficulty that selection committee talks to another director on the board to gain a little bit more knowledge about the person that has applied. If you feel you need to seek that information, do it. Thanks Jo.

    Thanks John, but it's also a situation where if you think that the people on the selection committee may just be too connected in the community, that's a good situation where having an external member of the panel can be really helpful and particularly sometimes where you might have to make some tough calls about people who might have an expectation about being appointed. To have somebody from outside can really help with that.

    Somebody asked a question about the workplace manslaughter Act. There were a series of webinars done as orientation for people who had joined public health services and public hospital boards in this round starting in July. Those are available on the website and we will send you the link to those, but one of them dealt extensively with legal responsibilities of directors, including occupational health and safety, and the Workplace Manslaughter Act.

    Somebody’s asked a question about do we need to make sure that everybody joining a board has a set of basic skills in IT. I think the answer to that is yes, it's not a core competency, but there are some general human attributes that you need amongst your directors. You need people who are diligent. You need people who have good written and oral communication skills. People who are able to handle the technologies of email and video conferencing, people who will be able to function effectively and so we don't select people for those skills. But there are basic levels of competence that are required. It's important, as I say that though to recognise that we also need to be able to make our environments an environment where people with disabilities can function effectively, so if there are people who have specific disabilities we need to facilitate their participation so it needs to be made possible for people who might have a hearing impairment or recite impairment or a mobility issue or any other form of disability to be able to participate providing that have the skills that we are requiring, but their disability itself shouldn't be a barrier.

    John, there's a question there about buying in expertise, but that's lead somebody to the question about a comment do we think that health service and hospital directors are adequately remunerated? Do you wish to address that question or refer it to the Minister.

    Interesting one. I suppose it could be argued that whether or not health directors get adequate remuneration, I suppose that's only now for about three years that they have been remunerated. For many years before that they weren't. Look, you will never get a satisfactory answer to say yes everyone is remunerated correctly and properly. There's always going to be someone who believes they should get a lot more, but in general principle I think they the remuneration now is quite good, but as Jo said that's an issue I think that needs to be taken up between the department and the Health Minister if you’re seeking higher payments.

    So I think I'm passing the buck there pretty quick getting away from that one and working on a clue. But I should say don't be afraid to seek legal advice if you need legal advice. There's nothing worse than a board that thinks it might have expertise in the legal area and a major issue comes up through a redevelopment or selling of a piece of your property. Don't be afraid to go out and buy in that advice and have the legal person come like your auditors do come and sit in in front of the directors and talk to them about the legal aspects that you're facing in those areas.

    Thanks John and just a few questions we will go through quickly, so there's a question about setting the number of vacancies. Normally a board aims to be about nine. There are capacity for additional directors in some circumstances. You know how many people are up for reappointment that year. That is the number of vacancies. So some of the people maybe reapplying, but nonetheless that's a vacancy so that in your ad you should state how many positions will be vacant. Now there are some boards that are at the moment a bit light on due to resignations or other issues.

    There were some boards which actually have 12 or I think occasionally even more members than that because the boards be constituted after an amalgamation so you need to bear in mind that we are aiming for about nine and be clear about what you expect the vacancies to be, but that it does count directors who have applied for reappointment, that is a vacancy.

    Can I also make a comment?

    Please do Dipak.

    I think it is very important for the chairs to understand who is coming for reappointment. You do not want, if you have nine board members you do not want more than three per year. That is rotational so that at least you do not lose the continuity. Sometimes it happens, so it just be mindful of that and you need to be mindful of the skill sets that you might be losing and for example I knew 1.5 years before that I had was going to lose somebody for finance so I had to make sure I had somebody there. I mean, we're lucky being in metro that we get better choices, more choices but it is very important for the chair to plan ahead to make sure that they're not caught off guard. Thank you.

    Thanks Dipak.

    There are a couple of other questions. One is about is it appropriate to select a candidate who is an existing member of a health service board who is an existing board member of a health service in a different region. That's fine and sometimes that cross fertilisation can be really useful. It's trickier if it's a health service in the same region, because there may be some conflicts of interest.

    There’s a question about can we confirm that a clinician appointment cannot be from your own health care organisation. That's absolutely true. There is a conflict of interest and we don't have board directors who are employees of the health service and there are sometimes some conflict of interest around ex-employees as well with people need to be aware of.

    The question about people who are reapplying, do they have to be re interviewed? Yes, it is standard practice to re interview those who are reapplying, really so that you can have them in the mix when you're considering the new applicants. There is a comment about reducing the number of vacancies where there's a board who has 12 and that is something that makes sense and requires some discussion with the department to make sure that that's ok. But as a general proposition when you've had an amalgamation, it's reasonable to look to decrease the size of your board.

    Can I also comment on reappointment? The reason why you would want to interview is not only because you want them, which is good but also gives you an opportunity to look at other potential applicants that might be interested in and keep them in mind, just in case.

    Thanks Dipak. So I think we've come to the end of the questions and I'll just go around each of the presenters and ask for ask any final comments. So starting with John, then George, then Dipak and then I'll finish off. So to you, John.

    I haven't got any further comments Jo. I think it's been very good information for board directors and board chairs and I think the questions have been very good.

    Thank you and to you George.

    As I said, I think that it's from a clinician's perspective it's really exciting to be on a board, to be able to get that concept of how organisations work. Often clinicians work within their own craft groups, their own departments and necessarily give an opportunity through the whole service perspective and I think once they do, it's a very enlightening experience and I think that adds value to the whole system as well. I think that their contribution in clinical governance and interpretation and also previously someone mentioned about IT skills, but a good board also needs to be able to have some data analytics skills. There’s a lot of data that comes through the board’s papers every month, whether it's financial data, whether it's performance data, trying to understand what NEAT and NEST means and those sorts of things.

    So I think having the clinician at least to help with the clinical guard sets are very important and also to provide some questions through the presentations that they have about benchmarking and how their hospital performs amongst other hospitals in their procedures, amongst other procedures so that I provide that to the board, but they I think that's more in return from being part of a dynamic board in terms of their professional growth as well.

    Thanks for that, George and any final comments from you Dipak.

    Yes, I think it's a very important process and we help but don't talk much about culture so regardless of the knowledge that the candidate might help, I think it is very important to understand the culture of your board and culture of what your organisation is and to lead that because one toxic person can actually destroy the board and destroy the organisation. So just be mindful of that.

    And the more diverse and more time you spend on making sure you got the right candidate makes it easier and enjoyable actually to work at the board and it is actually fun, even though it can be sometimes hairy when you got COVID and things like that coming through. But it is fun. So I just want you to leave it with that thought. Thank you.

    Thanks for that Dipak. I think that there are two very important reminders. One is the importance of culture and understanding the sort of culture that we want to create in health and that obviously is based on respect on people taking due care and diligence and people being able to work effectively together.

    But it's also important to recognise that it is despite the fact that the remuneration is not fantastic and there are considerable risks in terms of reputational risks and things that can give people grey hairs or send their hair falling out more prematurely, it's an incredibly rewarding occupation to be part of something that's providing good health care to our community and working with people who are committed to doing that.

    There is one final question that I'll address before wrapping up. And that's a question about how the interview panel should handle somebody who's reapplying. Should you take them as a blank slate or draw on their previous experience with the board? You should absolutely draw on their previous experience, what have they learned, what are their current thoughts about the issues that are facing the health service, what do they think the challenges are. It should be a real process, not an artificial process so by all means draw on their experience and what about them and equally, if you do know another candidate who's applied, it's important to discuss that and draw on the experience that they bring to the interview as well.

    So just some final housekeeping. I'd like to thank the team at DHHS who supported the webinar. I would like to thank the presenters, my colleagues on the Boards Ministerial Advisory Committee, John Mayer and George Braitberg and thank Dipak Sanghvi and also just remind you that you will get all the resources and that there is a kit there. The department is here to help and the Boards Ministerial Advisory Committee is here to support you and wish you every success and that you may get a good pool of applicants in your bag and make wise recommendations. Thank you very much everyone goodnight.

The fourth webinar on Public Hospital Board Director Selection was held on 12 November and was again facilitated by Dr Joanna Flynn, Chair of the Boards Ministerial Advisory Committee (BMAC). Presentations were made by Prof. George Braitberg, BMAC member and former Director, Barwon Health, Mr John Maher, BMAC member and former Chairperson of South West Healthcare and Mr Dipak Sanghvi, Chairperson, Monash Health. 

Reviewed 09 December 2020


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