Board Director Induction Training Webinar Series - 2023 - session 2

Induction training for board directors: Health Service Board Director Induction Session 2 - Organisational Culture, Leadership and Legal Responsibilities

Date: 15 August 2023

Facilitator: Joanna Flynn, Chair, Boards Ministerial Advisory Committee

Introduction and host welcome - Dr Jo Flynn, Facilitator and Chair of Boards Ministerial Advisory Committee

Jo Flynn - host: Good afternoon, everybody, and welcome to this second in the series this year of induction training for board directors in the health system. My name is Jo Flynn and I chair the Board Ministerial Advisory committee.

As we start this afternoon, I'd like to acknowledge the traditional custodians of the lands on which we were all gathered. I'm on the land of the Wurundjeri people, and I pay respects to all Aboriginal and Torres Strait Islander people acknowledging their continuing custodianship of the land, skies and waterways across Australia. 

This afternoon we're focusing on integrity, on the duties and obligations of board directors, and on organisational culture and leadership. Our three presenters this afternoon are Brigid Monagle, who's the Commissioner of the Victorian Public Sector Commission, Bill Brown, who's the Chair of Grampians Health, and Robyn Batten, who's the Chair of Western Health.

The format will be three presentations one after the other, followed by about 20 minutes of Q&A. There's a lot of material that we cover in these sessions, and we send the slides to all those who've registered for the session and for anyone who's registered the live webinar will be available, and it's subsequently posted on the Department of Health website in the board governance section.

We've got about 150 people registered for the webinar tonight and I expect about half of them will be joining us live and half of them following up later.

It's helpful if you can publish your questions as they occur to you in the Q&A section so we can see what sort of questions are coming and I'd encourage you to keep an eye on that, and also to give a question that you're particularly interested in a thumbs up and that way we can make sure that we deal with the questions of most concern to people.  

So, we'll get underway shortly. But just again a reminder that we send out the slides, the webinar is available to look at again, and please post your questions as we go.

Our first presenter this afternoon is Brigid Monagle, who is the Commissioner in the Victorian Public Sector Commission, and she's going to be talking about integrity for board directors,  directors’ duties and the Code of Conduct that applies to all of us in the Victorian public sector. Welcome, Brigid.

Integrity for public board directors – Brigid Monagle, Commissioner – Victorian Public Sector Commission

Brigid Monagle: Thank you so much for that. Good afternoon, everyone. I too would like to acknowledge traditional owners. I'm on the land of Wurundjeri, like to pay my respects to elders past and present.

And thank you all for having me today to speak to you about this really important topic. For some of you the content, of this presentation will be quite familiar, I imagine. But if you're new to working in the public sector, it's very important to familiarise yourself with these requirements and if you've been around before to refresh that knowledge. 

So, the Victorian Public Sector Commission we exist to strengthen the capacity and the capability and the integrity of the public sector. And one of the ways we fulfill these objectives is proactively supporting public boards to govern themselves professionally and with integrity, and you in health boards are so important in the public sector, so it's great to be here today.  

A little bit of context, so across Victoria at the moment, our records show that there's about 32,000 public board members.  So, there is quite a significant number and we've got over 3,500 boards across a range of different diverse industries. So that is quite a lot of boards but one thing you all have in common on those boards is you've got an obligation to act in the public interest.  

And to help understand our responsibilities, it's really important, I think to start with the difference between public and private boards, because I think you know, those of you who are new, sometimes it can be a little bit tricky to understand the difference.

So first of all, I would say we've got some similarities there .The public boards have a particular role which is to help and shape influence government decisions and services and some governance principles do apply to both public sector and private boards, including duties to exercise a reasonable degree of care, diligence and skill, to act honestly and in good faith, to not misuse position and information and disclose interest where conflict arises. 

However, private boards act in the best interests of shareholders or company members while public boards have a duty to act in the best interests of the public, steer the board on behalf of the Minister, and consult the relevant departments and Ministers on major issues.  

For those who want to know more about the differences between public and private boards, there's a dedicated section on the website: boards.vic.gov.au. 

So, the roles and responsibilities of boards and directors.  So, you can see on this slide it outlines the types of responsibilities and obligations expected of boards and board directors, individually.

[Slide 4 ]

And you can see there what they're different respects are in terms of, in particular for health service boards. It's really important that you are aware, too, of any specific governance responsibilities and requirements that your particular organisation or board has so there are a range of different requirements. These ones are consistent for all boards, but as health service boards you may have unique or tailored responsibilities that are in your enabling act and so I'm sure that you've already been informed of those, but if you're unaware, encourage you speak to the Chair or your contact in the Department.  

So, you can see there on this slide, there's a range of different responsibilities and some of them will be really straightforward to you, especially if you're an experienced board member.

[Slide 5]

But some of them can be a bit more left to judgment and a bit grey sometimes. For instance you know inform the Minister of major issues of public concern like people might have different interpretations of what major issues are and you can and you can get into some tricky challenges in working that through and that's where if you've ever got any questions, I encourage you to speak to experienced board members or err on the side of checking with your Departmental contact. 

But one of the key things I want to talk to you about today is about the code of conduct, which is comes with being on a public board. Now, as a board member, you must comply with the code of conduct for directors of Victorian public entities. So, on the VPS website this is, there are two different codes of conduct. There's one for Victorian public entities, for board members, and then there's also one for public sector employees. So, it's important to note that there's different code of conducts.  But the two are absolutely linked and they share the same values and this code of conduct, the one for public entities, is based on the code of conduct for public sector employees.  

And at the heart of it is the seven public sector values.  Now these are described in the Public Administration Act, which is the foundational document for the public sector in Victoria. And you can see there all the seven different values, and it's really important we've got a little caution with the exclamation mark, which seems a little bit dramatic but at  one end of the spectrum, if you do fail to behave in a way that could, to behave in a way that aligns with the public sector values and could be considered misconduct or in serious cases, it could lead to a suspension and a removal of you from the office.  I would really, really encourage you to read the code of conduct and become really up to date on what the different meanings of those different values are. 

And then, one of those things that you need to be aware of is with the conflicts of interest and duties and this is where it also the difference between public and private boards can come into play in more clarity. So as a board director you the duty to place public interests above your own interests, a conflict of interest can arise where you have a private interest that could improperly influence or be seen to influence your decisions or actions in the performance of your duties.

And then also your there's also a potential conflict of duty which can arise where a director is required to fulfill a duty to another public or private organisation that conflicts with your duty as a board director.  And particularly these can be common in regional areas where some of you may sit on a number of different boards or organisations or work for organisations that sometimes are linked more closely to the board of the organisation. 

Now what I really want to stress to you though is that these conflicts of interests or conflicts of duties aren't, they're not rules. You don't have to avoid them, it's just about being really conscious, open and honest and transparent about it.  

So, for instance, if you are on a board and the CEO of that organisation is your old friend. Now you've got that role on your board without being connected to, the CEO hasn't been involved. Still, because it could be a perceived conflict of interest whether it's real or not, it's really important that you declare it.  

Anything that sort of makes you think is that a public is that a potential conflict of interest or not, just declare it, because if you're questioning whether you've got a potential conflict of interest, it probably means that other people will perceive whether it exists or not.

So that's a, the friendship is a direct private interest, but you could have an indirect interest where members say, and this is probably not so much the case for that your roles, but in another role, if a member of your family has shares in a business that's providing training for that entity or is employed by that entity. So that's an indirect interest and it's really important to declare those as well.

So, you've got to declare and record, and in some cases then you need to manage the conflict of interest as well.  So, there's five ways that a board can manage a conflict of interest, so you can see those there. They all start with R.  So you can, record and monitor them, which is really important in some occasions you might want to restrict yourself or sort of remove or potentially remove yourself from discussions and decision makings if you think you’ve got a perceived conflict of interest or a real conflict of interest. In some cases, just say it's you're in a local area and you that one of your best friends can apply for a job and they could be a really strong candidate. Just when you recruit, get a third person, third party to do the recruitment and step back from that relinquish or resign potentially as well at the more pointy end. But again, I would really encourage you if you ever question in your brain is that a conflict of interest, just declare it. 

And one of the things that we do in the Commission and also across the public sector too, is we also just did any board meeting we regularly say anyone got any conflict of interest issues and just normalise those discussions so it's just part of everyday.  

Another area that might become a bit thorny for you is gifts, benefits and hospitality. And so as public officials it's important that how we respond to gifts, offers of gifts, benefits and hospitalities it's really critical to earning the trust and sustaining the trust of the communities we serve. Accepting gifts could give the impression that a public official will favour a particular person or an organisation when making decisions or taking action.

So we do have, have guidance that you can accept token offers worth $50 if, they don't create a conflict of interest or reputational damage. And sometimes it's more likely to get a reputational damage if you're refuse a small token of a gift as well; so it's about balancing that. But you can only accept non-token offers worth more than $50 if they are to help the organisation, the public sector or government to achieve it's goals.

So if you are lucky enough to be on the public sector board for the MCG, you might get offered a range of tickets. Sometimes that might be absolutely appropriate because it's about helping the government achieve its goals, sometimes it may not. So that's the sort of questions that you need to ask yourself. 

So we've got some guidance then about what to do with gifts, benefits and hospitality.  Some of your boards might require those to be recorded so that you've got a clear list of all of those that have happened when the public sector and the sort of in the public sector have to record all gifts and offers of benefits and hospitalities as well.

And then I think public comment is the next issue that is really important to be aware of in terms of taking on this role as well.  So the code of conduct for directors of Victorian public entities doesn't explicitly deal with public comment, but there are several items in it that are relevant. And I draw your attention to section 2.1 which says that it's really important as a board member to manage the public entities’ reputation. And it's so important that it's to not allow your personal or professional interests or relationships to affect your, to influence your judgment and therefore potentially go against the best interests of the public entity itself. 

Now I know that this can be a bit tricky sometime when you're on a board, you're on a public board. It's a small part of your life, a relatively small part of your life. You might be on other private sector boards, but always when you're making public comment on social media or otherwise just have a think about “would me putting this public comment out potentially damage the reputation of our entity?”.  And if you're in any doubt, talk to your Chair, because sometimes you might not understand the full scope and scale of what those impacts might be.

And so I always, I mean as the Commissioner, I never comment on social media, actually, I just lurk on social media. I never. I'm too scared to put anything up on it. But it's you're in a role just if you, you are making a comment, think about, “should I caveat this by saying this is, my personal capacity?”. So there's a lot of different things you can do and again, talk to your Chair, talk to people in the Department who can help you with this.

And then finally, I'll end on proper use of information. And I think you'd all be aware of this.  So this has been in the news a lot lately about the use of information that you gain in the course of your board duty should only be used for it, it's intended purpose. So that's really important.  You must not use the information including sensitive information to obtain advantage for yourself and that's a really important reminder as well.  

So just quickly to bring all of that to life, I thought that just take you or refer you to two case studies you might want to look at.

So one, you'll all remember there was a review of Ambulance Victoria done by VEOHRC recently. I'd really encourage you, if you've got the time to read VEOHRC’s report. Because what it talks about in there is despite having a really well working board, they weren't necessarily getting the information that they needed to understand the scale of the issues in Ambulance Victoria. And there's a lot of recommendations in there that I think is, would help you understand that sometimes really complicated role between Ministerial presence, a board, a CEO. So I'd recommend you to look for in a case study.

And I also just wanted to use this opportunity to draw your attention to guidance I recently issued around commenting on the referendum and how as a board member that applies to you, but how you can also balance that with your private entitlements to express your opinion as well. And so that's a really, that can be a really grey area for people on public boards where you're committed to a personal position whether it's yes or no on the referendum.

But as a public entity it's not appropriate for the public entity to take a position because it's a political issue that has support on one side or the other of the political environment. And so balancing that between your right to express yourself and also not impede on the public entities’ apolitical or impartial reputation can be a little bit tricky to walk sometime. And again, so I would encourage you to look at that guidance and have a read and use it not only to inform yourself about that particular issue, but more generally about impartiality and apolitical nature of the public service as well. That's it for me.

Jo Flynn - host: Thanks very much, Brigid. Some really important things there to consider to help us manage conflict of interest, to help us manage the issue of gifts and hospitality.

But also just to add to the case , studies, so I am on the board of Ambulance Victoria. I'm now in my ninth year and the VEOHRC report is very sobering reading for anyone on the board of any organisation, and I would support and endorse Brigid’s recommendation to you to read it.

The other report that I think all board directors in the health system in Victoria need to read, if you haven't already done so, is the Operation Meroo IBAC report from a few years ago which was in relation to a small rural health service, but showed what can happen when issues like conflict of interest and close relationships are not managed appropriately and would have been a very, very uncomfortable read for people on that board either historically or at the time that the board the report was handed down.  

Just a couple of bits of housekeeping for those who've joined us since we started the webinar. All of the slides will be circulated after the webinar. We recognise that some of the slides particularly in the next section are quite dense, but we hope that provides a handy resource for you for information.

The link to the webinar will be available for those who are registered immediately afterwards and the webinar itself be posted on the department website in about four weeks’ time.

Can I encourage you also to post some questions in the Q&A section and also keep your eye on that and indicate any questions of particular interest to you as we go.

So now I'd like to introduce Bill Brown. Bill is a very experienced chair who's mostly worked in the rural sector in Victoria and is currently the chair of Grampians Health. He is a lawyer by background and he's presenting on director’s legal responsibilities. Bill.

Director's Legal Duties and Enabling Legislation – Bill Brown, Chair, Grampians Health

Bill Brown: Thanks, Jo and thanks Brigid for that presentation on matters relating to integrity and I had hoped to avoid being described as a lawyer because that often sends people off to get a cup of tea and read the papers later.

But I welcome you all to this presentation and particularly those that have just joined for the first time a health board. I've been on health boards for quite a while now and I must say I continue to learn. I think that's a good and dare I say it a healthy thing to continue to learn.  

And as Jo said, it is a time now to go a bit legal. I know there are an immense number of slides to follow and I'm gonna go through them pretty quickly, but as Jo said, they'll become available later, so take your time later to read those.

[Slide 15]

But before I do launch into that, I want to stress that you, you're not expected to remember all this. It's not something that you have to remember or expected to remember. There's two things I'd suggest you do if you have any doubts or questions.

One is to look at the resources that will be made available to you today in particularly the last slide which Jo will refer to you. There's a number of clear and concise resources available to you.

The second thing is to talk to your fellow directors. Ask the questions of your fellow directors, not only on your own board, but of other boards. And there are an immense number of people who are in this sector, who are always willing and glad to help. So don't ever be afraid to ask. There's no dumb questions in this particular sector, in my view.

And as I go through these slides as I say, I'm trying to break it down into individual accountability.

[Slide 16]

Your accountability as a director, and then we'll talk a little bit about organisational accountability, which as a steward, as a director, you vicariously become liable.

So we'll talk about that a bit later, but I want to first deal with the individual accountability and as I said, I'm not gonna read everything here. But the one thing that I would like you to focus on is that is the phrase Good Faith. Good faith, it's hard to define, but it's in contradistinction to bad faith. And I think most of us know what bad faith is. Got a good feel for that.

Good faith is done for a proper purpose, when things are done for a proper purpose, and I think it's always useful to remember that in the discharge of your duty is you have an obligation to act in good faith. And in doing so, you should also not, not only hold your fellow directors to account in relation to acting in good faith, but always reflect internally on you holding yourself to account and remembering that you have to act in good faith.

And as well, don't bring a closed mind to your obligations as a director, but also come with an open mind, a fresh mind; a mind that's open to new ideas and new ways of thinking. And read the information that's given to you and be curious about it. Be brave enough to be curious about it. If I could go to the next slide, thanks.

[Slide 17]

And in doing that, Brigid's talked about issues of integrity. But beyond that, it's your job and it is expected of you to demonstrate leadership and champion a productive and ethical culture of your organisation. For those of you who in who were new to boards and those of you have been on boards, you understand that people are watching you as a director. How you behave, how you talk, the manner in which you deliver your messages and believe it or not, they are watching. That's not only your executive, but it's everyone you meet around the organisation and in the community. What you do matters and how you go about it is really important.  

And in doing that, it's clearly a need to approach everything with a fair and open mind. Be impartial. Don't bring your prejudices. Leave your prejudices your biases at the door. Be impartial and be objective. Clearly, in doing so you'll achieve many of the responsibilities that you have. And the last thing I'll mention on this slide is to manage risks.

[Slide 17]

The, when I say manage risk, it doesn't mean you go out and roll your sleeves up and actually deal with all your risk treatment plans and everything you do to mitigate risk. It's making sure that your organisation has an appropriate risk management framework in place; a policy and procedures that support a good, strong, robust risk management policy. Because it's only in the delivery up to you at board level of what the key risks are that you can give appropriate guidance that are strategic. And sometimes at an operational level, guidance around what your team needs to do and what direction the organisation should go in.

I'll leave that and move on to the next slide which deals with governance and management and I mentioned liability and the three first dot points of pretty important and lawyers love this sort of stuff, so I'll try and make it as practical as possible.

[Slide 18]

Your entity, your organisation, your health service has liability. You, as an individual, have liability. And I've talked about a couple of those already, and as has Brigid, in relation to your personal obligations, duties and responsibilities and functions as a director.

Now, how do those two things tie and that's through the concept of vicarious liability. That means that an entity which is an inchoate thing that doesn't have physical presence is responsible for the people that employs, for the services it provides and the link there is that if the entity conducts itself in a way that's illegal or contravenes the law, then who's responsible? Through that vicarious liability responsibility, that can be you as a director.

So the link is that while an entity has obligations who is called to account for that, and that's you as an individual in most cases, and other officers of the company. Don't think it's all on the board, it isn’t.  And a really strong and strident example of that sort of liability can come at the criminal type end under the OHS occupational workplace health and safety obligations, you'll see there. There's a couple there, and they mentioned the employer must create a safe workplace for its staff. The employer isn't you as a director, the employer is your organisation. But through the actions of the people who do things for the organisation, you as a director can become personally liable.

Now I don't want to scare you, because hopefully you've got all the right systems in place to make sure that your system is safe. Your workplace is safe, and I'm sure you do. But be mindful that if it isn't, it can become, it can come back to you and you can be personally accountable and liable.

So I won't dwell on that too much and I'll just go to the next slide if I may, to deal with the roles and responsibilities for the board and the relationships with other people within the organisation.

[Slide 19]

This pyramid type structure is one way to graphically represent the different roles and relationships that exist in a health service. The key thing is the for us today is the board that provides leadership and governance and the functions set out there in the right hand box. And again, I'll leave you to read those and think about those. But the legislative backing for these functions is in the Health Services Act. It's one of our enabling acts, which I'll come to shortly, but those functions are very clearly set out in the enabling legislation for public entities and they're pretty clear once you read them.

So whilst they're summarised there in that slide with functions, it's important always- the be all and end all is the legislation.

[Slide 19]

So don't forget the legislation, but this is a good guide and the good guide out of this is that the board doesn't do the work. The board delegates to the CEO in particular and the staff that are employed to perform all the actions and all the things that have to be done to provide health service.

And if we go to the next slide, this is another representation of the different roles of the board and management.

[Slide 20]

And one of the great challenges of a board, any board, I think, but particularly health service boards, is that the role of the board is pretty clear in my mind but I'm a lawyer and it's not always clear to everyone, including me, by the way, that am I overreaching my role as a director and putting my hands into the operation of the business and the organisation generally.

I'll take you to the bottom of those there, which is delegate powers and under your by-laws and other government structures, you will delegate an immense amount of power and authority to your CEO and others who might be included in your instrument of delegation. What that means is that you are giving an immense amount of your power through delegation to the management of the organisation and your expectation is that they'll accept that responsibility and report back to you. That brings to mind the word oversight and when I break that down, oversight, “over” looks at something above, and “sight” means looking but not touching. So it's important that you oversight, but don't get involved in management.

If we can go to the next slide, I'm getting a warning that I haven't got that much longer in time.

[Slide 21]

It's just completely slipped away from me. Board processes, I'll leave that for you to look at later.

The next slide really then takes me to the legal obligations and this is where I start to really rush.

[Slide 22]

But I urge you to I am go to the pack once it comes. There's a an ever growing list of legislation that's there and I'll move on to the next slide which talks about the enabling legislation in terms of roles and responsibilities and your obligations and liabilities as a director.

[Slide 23]

This is where it begins and doesn't end here, but it begins.  

And you'll see there that there are different enabling pieces of legislation for the different health entities. I'd expect that most people on online today would be directors of public hospitals or public health services, but there are other entities, types of entities. And in those enabling legislations, your functions as a director are clearly, clearly articulated.

And overriding that is Brigid has talked about is the “Public Administration Act” where your duties, your particular duties as a director, again very clearly articulated. If you ever forget or have cause for concern to wonder about what your duties and your functions are, those that is the source that is the beginning and the end of it for all directors in those pieces of legislation. And I urge you to look at them.

I'm moving through now to some further slides.

[Slide24]

[Slide 25]

There's lots of obligations in the enabling legislation. There are some there in the particular ones for health services are the need to take into account the needs and views of your consumers and the community, generally. If you're from the private sector, that isn't always the case. It may not ever be the case with some companies that find themselves in trouble. But in the health sector, it's so important that you take the needs of the public and the- your community into account.

And the other obligation that I want to point out here, as Brigid mentioned, is the obligation to inform your, the Minister, your Minister and the Secretary, of issues of public concern or risk. I think they'll be obvious to you and if fingers crossed, they don't ever happen to you, report, at least ask if when you whether you should report.

Moving through the next few slides.  

[Slide 26]

Again, more obligations which I won't go into detail. They've covered, been covered, fairly well already, I think.

Moving again to the Public Administration Act, the next few slides have a number of particular sections of the Public Administration Act there.

[Slide 27]

And if I can go to the next slides.

[Slide 28]

[Slide 29]

[Slide 30]

The one that always intrigues me is that-- if I may go back.

[Slide 30]

Sorry, I went too quickly there-- is the reference to the Minister’s power to injunct which I'm not sure the Minister, in my knowledge, has ever used. But remember it's there, and if you're engaging in any activity that contravenes the law the Minister can get a court order to stop you doing it.

Now all these obligations are balanced. If we go to the next slide, in some way there are immunity provisions under the enabling legislation that give you a defence.

[Slide 31]

You won't be personally liable if you carry out your functions in good faith and discharge those duties and that takes me back to that phrase “good faith” that I mentioned at the front here and it's so important to make sure that you act in good faith, they're indemnities available to you, much in the private sector and there's insurance, again much in the private sector. But again, that there are limitations there and you have to act within the confines of your responsibilities.

I’ll go now to the next slide.

[Slide 32]

Here’s some administrative stuff, you've got to give attestation reports under the Financial Management Act, the ministerial standing directions, are particular, talk to your Finance and Audit chair or committee to understand them in a bit more detail and your by-laws. As I mentioned, those already most will have by-laws, they're there to govern the way you operate and make decisions and handle yourselves so make sure you're aware of those, as well.

Moving through the next slide, we've got lots of legislation.

[Slide 33]

I'll go on to the next slide.

[Slide 34]

There's much, but don't be daunted by it. If I could go into the next slide. Again, remembering that these obligations are not necessarily on you personally, but on the organisation, generally.

Going to the next slide, there's a list of key regulatory bodies and of course up the top there, the Commission, where Brigid’s from.

[Slide 35]

But the next slide, the IBAC is a very important body as a check on everyone's behaviour in this state and a public entity.

[Slide 36]

And I was going to mention the IBAC report on Operation Meroo, but Jo beat me to the punch and I think that for me I've had reason to read that from time to time. It's a, although it's targeted at the CEO, mainly, the board was asleep at the wheel. And the things that are mentioned in that report that relate to putting in place effective tested systems and procedures is absolutely gold for any director who needs to be reminded of their obligations.  

And if I could go to the next slide. There's a there's a final slide here that I'll conclude on which is the Statutory Duty of Candour which came in last year through amendment.

[Slide 37]

Whilst it doesn't impose specific individual obligations it is a wonderful piece of legislation that codifies a practice that wasn't as well implemented, but not always as well as it could be. And this obligation became a statutory obligation and it's on your organisation to provide patients with information. What-in what could be very difficult and damaging circumstances. But the patient's interests are what is most protected here. And there's a fabulous website, go to it, have a look at it, and I commend you to it. It's a great piece of law.

I think I'll stop there, Jo, because there's an immense amount of stuff there. And I urge everyone to take a look, ask questions and use the resources. And while you're doing all that, have a bit of fun as well, and enjoy being on your board, and in delivering great service to your community. Thanks, Jo, thanks.

Jo Flynn - host: Thanks very much, Bill, we gave you lots of material to cover there and thank you for doing that.

There are some questions about the need for insurance which I'll come back to later on. I've just publicly put a simple reply in there, but we can talk about that a bit more, so encouraging people to post some questions and look at those that are already there as we go.  

We're now moving to the last presentation of our series this afternoon which is about organisational culture and leadership and we're very pleased to have with us Robyn Batten, who's the chair of Western Health, done a lot of work in these areas. So welcome, Robyn, over to you.

Organisational culture, leadership principles and practical tips – Robyn Batten, Chair, Western Health

Robyn Batten: Thanks very much, Jo and as Brigid and Bill have both said that we as directors have direct responsibility to build a culture of integrity and today I'm going to talk a bit about how do we do this as directors but also how do we know that we have a culture of integrity within our organisations

I've been asked to use Western Health examples, so forgive me if it sounds a bit I'd like I'm just promoting Western Health but I think there's some real examples are helpful and I do absolutely recognise that each organisations culture is somewhat different and that each board and organisation needs to build their culture that is right for them.  

So just going onto why is culture so important in the next slide.

[Slide 40]

You know as Peter Druker famously said, culture eats strategy for breakfast, and I actually believe that that's true. So it talks about the fact that a powerful, empowering culture is a much surer route to success than an effective organisational strategy and this isn't to say that we shouldn't have strategic plans, annual business plans, strategies, outcomes, targets all the things that we have in place.  But I think it is saying that an engaged and empowering culture is actually more important. And from my CEO experience, I have I would say that this is true. It's interesting for us to reflect, isn't it as directors about how long we spend talking about strategic plans and business plans and how much time we do spend actually talking about the culture of the organisation.

I think one of the important enablers of a good culture, you need some sort of a framework and different organisations use different frameworks to describe and to engage staff in about the organisational culture.

At Western Health we use what's called our Best Care Framework and it's a quality and safety framework and we link our strategies our cultural work, all things to this Best Care Framework. And it certainly supports a culture of quality and safety, so just to give you a flavour of that, there are four tenets of this framework. One is that we partner with patients and their families. The second is we care for our people, staff and volunteers that we deliver services at the future so we're innovative and that we're better together, we partner with others to do it. And it was interesting when looking at the materials around organisational culture that the department has that available to you and that the elements of this best care framework pick up many of the themes in those materials particularly around caring for our people, innovation, looking to future improvements while holding people accountable and most importantly, working together across all levels of the organisation.

The next one to talk about — “what is culture?”. I think in some instances it might be difficult to find the balance between holding people accountable and blame. It's quite a, it's a very nuanced thing, isn't it? Because people have to take responsibility. But do they feel that they're just being blamed and that's not appropriate.

But we do have to have accountability because it's central to ongoing quality improvement and safer care. And we'll go I'll go back to that later. But we also have to absolutely make sure that our staff are safe and our staff safety, I would say in all our health services is increasingly at the forefront. We're confronting, I think, levels of occupational violence and aggression, which are and should be very worrying for us all. And a very important part of the culture is taking initiatives and demonstrating to staff that we see their safety is of the highest importance. I think we were all emerged in this one's immersed in this, I should say in during COVID. And how are we going to keep our staff safe while providing care to thousands of people with COVID.

I just like to use an example of the our Sunshine Emergency Department where we see about 290 people per day and we were seeing quite unacceptable levels of violence, often through mental health and drug and alcohol abuse. And we worked with the staff and our clinical research people to develop frameworks that were became evidence based really around predicting risk and it helped staff assess all, each patient to identify those who perhaps could be at greater risk of being violent and the staff were charting this and then they would then they had a whole range of actions that they could take to try and prevent actual incidents of violence.  

I think this will be quite an innovative approach and it's certainly won one of the VHA awards, or the VHA award for Workplace Health and Safety, and one of the other things that's happened recently is that we actually hosted a national conference. So Western Health, how this conference on occupational violence and there were many strategies celebrated and talked about there by our staff and that had great interest.

The other thing that I want to emphasise on this slide is training and development.

[Slide 45]

It's so integral to not just to the development of our culture but to the development of who we are and as an organisation. And I think it's particularly important for us to know what's going on in our organisations around leadership development and absolutely commit to having a pipeline of people who will come into leadership roles, who understand and are imbued in the culture of the organisation. And over the past 12 months, we've had approximately 400 people complete leadership training and have designed accredited courses for which the staff can gain credits for their postgraduate studies in the leadership area. And also delivering in-house, because I think one of the challenges for our staff these days around training and development is actually the cost. So we need to do what we can practically to support them to attain qualifications in leadership. But of course in a whole lot of other areas as well.

But to return from the to the tone from the top, and Bill actually mentioned this, that every time that we interact with someone in the organisation, whether it be going up in the lifts or in the cafe, we're giving very clear messages to people about respect and about how we see ourselves working in partnership with them. And people are seeing us and they do hear what we say, and not only what we say, but how we say it. One of the things that we did recently as part of our indoor evaluation of the board and every three years as an independent evaluation, external evaluation and we include the executive in this too, particularly around the questions of respect and trust and how the executive and board work together. And they both completed the questionnaire but also were interviewed because we as directors, need to know we might think we're great and we might think we're all working together and behaving and respectful ways, but it's very important to us to actually give the executive an opportunity to say clearly to us to whether this is how we're perceived in the organisation.

Of course, there are some more quantitative indicators as well about the organisational culture and I think the People Matter Survey is quite important in this regard. We do get a sense of engagement and we also need to, of course, to act on what comes out of those surveys. There's no point in keeping surveying staff unless they can see that we've heard what they've had to say and that we've acted on those things. We also, I think it's important, that's quite it's quite a lag time involved with the people matter surveys and you might want some more recent and current information about the culture and pulse surveys can be quite a good way to do that too. Especially if you have concerns about the culture in a particular area of the organisation, pulse survey can be done in that area and then you can see what the issues are that are being raised and act on those as well.

Another strategy to in relation to the tone from the top, I think, is mentoring programs. Having in place mentoring programs from the four people who are going to be future leaders in our organisation. And certainly our executive and senior leadership group are involved in mentoring opportunities where staff who are seen as future leaders are given an opportunity to be mentored by one of those one, of those people.

Just to turn to performance targets, and there's this is in the literature as well. “Are the performance targets measuring or supporting the culture we want?”. Obviously we need to have measures and in large organisations. We've got twelve hundred staff, we need to have hierarchical structures.  But we really need to understand the implications for people who are providing the clinical care of these some structures and, for example, sometimes our targets can get in the way. Such as the four-hour emergency department— four-hour stay emergency department. We found that some of the clinicians were raising the question about having to meet these targets to have people move to beds from the emergency department rather than having the clinical need as the highest priority. And so it's a good example. It was really important for the board to say we understand we can't meet these targets and the clinical prioritisation must be absolutely what's needed not meeting those targets. And then we'll have to explain to the Minister why that's the case.  

I think I might give and I'm running out of time to we'll just skip over the next one and we go to blame and accountability, and Bill has mentioned the open disclosure. But research does tell us that what really families want from us is to take responsibility and be accountable to remedy the situation, ameliorate the impact, and avoid making those states mistakes again in the future and encouraging that reporting culture. And again, we can see this in the people atter survey because staff are asked about t whether they feel safe to speak up and whether they believe that management will act if they do raise matters.

We go on to “how do we have visibility and a good culture?”. Probably now that COVID is less to the forefront, hopefully boards are taking the opportunity to go on organised walk-arounds, very important to do it in just one or two people actually sit with patients to hear what they've got to say, hear what the staff have got to say directly. I think this is absolutely invaluable. I'm mean when Bronwyn and I were given a complete serve by a couple of the patients and it was, it was really important and important for us to hear an experience that directly as well.

The other important thing is to hear from people in our organisation, at the board level, not only through the CEO. You certainly experience when you have the people who have been writing reports for the board, you do get much more of a feeling of what's going on in the organisation than if all matters are coming via the CEO.

And of course, we should be linking all our reward and recognition programs to having a good culture in the organisation as well. And maybe feel the vibe. But we're generally not known by most of the staff and certainly not quite patients and I find it quite interesting just to go and have quietly have a coffee in the cafe, and see how people are interacting; the staff are interacting together, and also with patients or and their families who are who are often in our cafes as well. So just getting the feel for it.

So I would like to say that culture certainly does eat strategy for breakfast and through our organisational culture, we affirm the importance of the lives and wellbeing of every patient in our health service every day and their families and staff.  

And if we have a good culture, we respect their humanity, the nature of our shared humanity, of the patients and those who provide care for them. And we know with a certainty of evidence and experience that the quality of our care our patients receives depends on the staff delivering the care and the organisational culture in the workplace. Because at the end of the day, the patient experiences our cultures via minute-by-minute care that our staff are providing. Thank you.

Jo Flynn - host: Thanks Robyn. We now come to the Q&A section of our afternoons presentation and we've got about 15 minutes for Q&A.

Thank you to those who've already posted questions and to those who've indicated your priorities in relation to those questions. So I'm going to take a couple of questions.

Questions and answers

First of all, for Brigid Monagle of Victorian public Sector Commissioner Brigid, a couple of questions there. One is about whether putting up on your Twitter post that the opinions expressed personal is sufficient to protect you or may in fact reverberate on the reputation of your organisation; and the other one’s a question which I think many people are thinking about at the moment which is in relation to the Voice and how is the background to the approach of that for that being different to the approach that was taken in relation to the marriage equality plebiscite

Brigid Monagle: Yes, absolutely too great questions. I'll start with the first one. First So it's an area that requires judgment, and so in that area, I would absolutely recommend that you if you've got any concerns, if you feel that making a public statement in any way could damage the reputation of your entity, just get advice on it. You can call me. You can call your chair. You can call people in the department. Because a part of it depends on sometimes on cultural context that you might not be aware of. So I'd encourage you to do that.

There are sort of three broad factors that we recommend you consider when making a public— public political statement. One is your level of seniority. So a more junior or relatively newer board member, someone who's not the chair of the board might have more freedom to express their private views. It might not necessarily impact on the entity as much. One is the sort of strength of the view you're providing. So if it's quite, if it has sort of violent tones, or the way if it's sort or if you’re really forceful and militaristic about it, that could potentially damage more. And the other is a relationship to the particular topic area and the area you work on. So you know if you’re commenting on health policy potentially that could potentially more have more damage on your entity than if you were talking about forestry issues, for instance. So they’re sort of the three guiding principles we recommend you have a think about, but it’s just something always to have in the back of your mind that you are representing a public entity and will this potentially impact on it, seek advice.

On the second question around the referendum and the guidance, some really important points I want to, I want to make on that. One is with with the guidance, there is nothing at all that would stop people from supporting their Aboriginal workforce. So you know, as we saw during the vote on marriage equality, you know, it's put have Aboriginal flags, talk to your Aboriginal staff, see what they want to support. So absolutely express that. So that's the first thing I want to say is that please don't feel that you can't have Aboriginal flags, or Aboriginal were Aboriginal motifs in your workplace. That's absolutely not the case.

In terms of it being, they're both political issues. They're absolutely both political issues and they're both political issues that governments— that Government, big “G” have positions on; and in those cases, they would both support. But there's a difference between the Government and the public sector.

And so the Government and public entities and people who represent public entities on board. So the Government has the position and the government absolutely is within its rights to direct public servants to work in support of that. So if the government was to say tothe First Peoples’ state relations in DPC, we want you to do work that supports the Voice. Absolutely. That's totally within its rights and what a responsive public sector should do. But it is not, what it's not is and what it's not appropriate is for public sector leaders, particularly more senior ones, to take a position as an entity. Because it is a political issue and the advice we have, legal advice, is actually this is the most changing. The Constitution is the most political issue you can have, even more so than election. So we have to be more cautious than ever because it's such a profound change to our constitution and our constituting documents.

And then the other thing just to remember in this case too is, what I keep saying is when you're talking in your organisation— a lot of people will support “yes”, but a lot, there's a numbers of Aboriginal staff in organisations too who don't support. And so while the tendency might be to want to go out with a position of support and it's intended that is to support our Aboriginal staff, there are Aboriginal staff who don't support, and Aboriginal staff who are saying to us and also saying to their other employers they don't want anything mentioned in the workplace because it's not, it doesn't make them feel safe. So that's something to be cautious about as well. So it's a complicated issue, but it's one that we have landed on the guidance and we're more than happy to talk through any nuances with people who have questions as well; any Aboriginal staff that need extra support as well. So sorry, that was sort of long winded, Jo, sorry.

Jo Flynn - host: Thanks very much, Brigid. Thanks, Brigid. It's a complicated issue and I there are health services and for instance, I know I think this is right, Robyn; that Western health has got a statement up on its website which doesn't really recommend a position but explores the issues and the importance of self determination for Aboriginal people. So it doesn't direct how people might vote and for those of you who are thinking about that, I think it's a really good model which I've certainly had cause to refer to in another organisation.

And I'll come to Robyn a bit later, but I just wanted to take a couple of questions for Bill first. So Bill, we have a question here which is always a question in these webinars, which is about insurance for directors  and whether individual directors should be feel sufficiently protected by the VMIA insurance covering their entity or required to take any other steps?  And I also wanted to perhaps if you deal with that one first and then I'll come back to with you with to the next question 

Bill Brown: Thanks, Jo. I think the answer is pretty simple. You will be covered, but if you have any doubts then please seek assurance from within your organisation. There will be VMIA insurance with typically described as D&O insurance that will be there. But again just make sure that it is there, that you and you're satisfied that it's there. But I can assure you that it should be and therefore you should be okay. 

As to taking out further insurance, that's a personal choice. My view is that you should direct your attention to making sure your organisation complies and that's far better use of your time than getting a second insurance. So I know that's very practical and personal, but you will have very minor insurance there.

Jo Flynn - host: Thanks, Bill. The next question that I'd like you to go to is the question, there's a question here about governance and the board accountability and the role of the department. So it's a question about sometimes it's a little unclear to boards about the role of the department, the role of the board, particularly where there might be different priorities, how do you manage that and how— how do you do you minute that?  

So I'm gonna ask Bill to comment on that question and then I'm going to ask  Robyn to comment  on that question. So if we can go to Bill now and then straight to Robyn.

Bill Brown: Thanks,  Jo. My lawyer— a typical  lawyer’s response will be—your obligation  is to your organisation, that's the beginning of your obligation  and sometimes can  be the end of your obligation when you get to another side of a debate.

However, the department is a major stakeholder as the minister is a major stakeholder. So it's your duty to listen as well to the views of a major stakeholder. You don't have to always agree but you always, should always have an open mind and be honest in your reaction and ultimately have a well-reasoned, well-documented, in the minutes, if necessary, and in communication—written communication— with the department why you've taken a position, a particular position, or particular stance.

You have the obligation to use your best judgment that is acting in good faith with due diligence and also with the appropriate care. And this good faith, I keep reminding, keep referring to it again, but it's about making good, well-informed, well-reasoned decisions, and it may be that on some things you might disagree with the department, but make sure your reasons are good.

Robyn Batten: Yes, even when acting in good faith, sometimes it can be, it can feel like the a decision that the department wants you to make is not a decision you might make on a board.  It's not a government board and we have to keep in mind that we are on government boards. We certainly have our legal responsibilities as Bill has set out. But the minister, or in fact the Secretary, of the department can also direct the board to take certain measures. Of course, that's not the path you would go down initially.

However, there might be circumstances whereas a director, if you didn't feel you could make a particular decision, you spoke with the Secretary of the department and sought perhaps direction from them as a, as a last, a last, last resort.

Just to go back to the Voice for one second, because Jo mentioned it before and our statement. The statement that we have on our website is a statement that was recommended to us by our Aboriginal health unit. And I think this is this does go to the core of culture, doesn't it? If we're saying we want to listen to our First Nations people, then to do that in terms of how our health service is responding to the issue nor to the referendum is also important. So I think that was a good parallel process. We asked them what they would like us to say and the statement they were we have up is what they came back to us with and the board endorsed that.

Jo Flynn - host: Thanks  Robyn. I've got a few more questions, Robyn to direct to you arising out of things that you said.

So can you say a little bit more about how Western health measures culture and what do you think that the best ways of kind of determining whether you think your cultures ok or not?

And then also could you say a bit more about you manage occupational violence and aggression in Western Health. And how, again, what do you think the most important ways and most successful ways of trying to respond to that are?

Robyn Batten: Thanks, Jo. I've mentioned some of the measures. I mean, I do think the People Matter survey is very important, but also there are a lot of our indicators as well. “What, what's your turnover?”, “what's the vacancy level?”, you know, I think some of those things are quite important. And because and it's easier for us to compare perhaps in the we do get health service data, don't we are from across the state and in the health, monitor, isn't it, I think it's called and we can see our vacancy rates etcetera. And we'll actually look at those and things like we got a whole lot more vacancies than other health services. And if so, what does that tell us about whether people want to come to our health service.

Now, I'm not saying that that's a single factor. These things are of course complex But I do think that a whole lot of the HR metrics which we have in-depth discussions at the board about every six months are very important, as I things like exit interviews, as are things like asking people if they're coming to us about why you coming to Western health. And in fact in some of the walkarounds that's the sort of thing that I that I asked people, I say “how long are you doing here?” and what made, if they haven't been there that long, “what made you come here and how was it when you arrived?”. So it's some of those both more quantitative and engagement as is appropriate with staff as well.

The occupational violence is such a mixed issue for us all. I know in the ambulance service you, you've probably vast experience in the in this, Jo. But we have moved to try to be more predictive than reactive in this area. And there, there is research around situations that will be volatile and for staff to be on alert for that and put measures in place to protect themselves before the violence actually erupts.

For example, we have all the men, well we have all the prisons in our region, and sometimes prisoners are brought from the prison when they're released and taken to the emergency department, they're not happy. But when we know that's happening, we can make sure that there are the safeguards around the staff. There is security staff are there, that security staff is trained primarily to de-escalate, not escalate. All those sorts of measures, so prevention really is so important. However, if incidents obviously do happen and then the organisation needs to absolutely wrap itself around those staff members who are hurt not just with our legal obligations, but one of the things that we've done is employ the psychologist in-house for the staff around some of the trauma that they experience in the workplace and that's being found to be very positive and very well supported by the staff. So all the measures to support staff as well, when these things do happen, are absolutely crucial.  

Jo Flynn - host: Thanks, Robyn. I'm going to go to Bill now and ask Bill to comment because there's a couple of questions in here about the questions about how some of these things apply in smaller entities. And sometimes it's harder to survey staff if you've got smaller cohorts of staff because you're questions about anonymity, which are important, particularly in any sense where the staff may not feel that it's a safe environment, may not be fully trusting. So Bill, in your experience, what are your best gauges for culture?

And then there's a question in the chat about whether, when board members talk with patients or with staff, should that be always in the presence of management, or how should that be managed?

So your thoughts on both of those?

Bill Brown: Thanks, Jo. I'll have to take my legal hat off here, I think to answer both of those.

From a practical point of view, particularly in relation to gauging culture in smaller organisations. I think that if you don't live in the area where there smaller organisation is, then it you might find it a bit more difficult if you don't attend the premises or your have in person board meeting. So if you if you're from outside the general area geographically, then I'd encourage you to take the time to actually get to the get to your hospital service and to get amongst the staff one way or another.

And I think you'll then, along with your fellow directors who might live more locally as well, don't do it one at night with sunglasses on. But do it openly and transparently and inform your fellow board members, and particularly your chair, that that’s what you’d like to do because it is much easier, I think. Although there are layers in the country, don't think we don't think it's all simple in the country. There are layers, dimensions to things that aren't always obvious. And the way to get around that without surveys which do in smaller organisations feel less anonymous than in larger ones. So it's a matter of getting out and talking and listening and responding and making sure that you're you are amongst it. And be open, and if I'm out and about, I do try to take my tie off, for instance, that's not a great signal for a good conversation. But the way you go about that is important. And to do it regularly, not every meeting, but regularly to be seen and be heard.

One of the key issues is to listen. You won't, you won't have all the answers, but you have to listen, and listen hard, and listen intently, and don't dismiss. Take, the information away and talk about it with your, with your directors, your CEO, your chair, whoever. It's important that you don't hold on to the information. And the important thing is to communicate it and together as a board. You'll, make better outcomes.

As for surveys, they're important, not just one offs, but also over time have consistency in surveys. If you choose to do one yourself off your own bat, look for trends, look for themes in the different ways people answer. It's not just a single survey is of some value, but I think multiple surveys over time show trends and themes that will surface.

When out and about and talking with staff, one tactic I use is let the management over showing you around walk often off into another room and another space and then linger, linger behind the group and have a chat one-on-one with the people who are left there. And again take your tie off, and think about and ask about what “what's really going on, the big wigs have gone; now you can tell me”.  You’re not trying to deceive anyone, but just be open. Be friendly, be cordial and be concerned about really wanting to hear what people have got to say. I've heard some great stories after people have moved on and you just linger behind and have a chat. It's as much about as having a chat as anything else, so that's it. That's a tactic I've used because I think there is real value in not always being with management when you're out and about talking to staff and I don't get the time to sit in a cafe. I love coffee, but I'd like to sit more in a cafe and listen and observe and watch. I think that's a great idea as well. But don't be afraid to let people know who you are. Some will know who you are and stay away. But observing, listening, watching, they're all great ways in which you can learn about your organisation.

Thanks, Jo.

Jo Flynn - host: Thanks very much, Bill. Thanks, Bill and thank you to all our panelists.

We're coming to the end of our session. I just want to close off a couple of things and then answer a question in relation to ongoing training.

So firstly, somebody asked about “Ryan's Law”. We don't have the equivalent of “Ryan's Law” in Victoria, but there is a new framework being developed which I think has a legislative basis for parents who are concerned about the wellbeing of their children that the state government announced recently, children who are inpatients.

In relation to the comment that Bill made, I think the issue about how you engage with your staff and the patients. I support what Bill is saying and just to add— it is a matter of judgement, so it's not appropriate for you to go into your health service ostensibly anonymously and gather anonymous feedback in any disguise. It does need to be open. The management of the organisation needs to know that you're there and just as we don't want to be surprised by anything that comes to us from our executive team, they don't want to be surprised by staff from us. We do need to be open and transparent, but it's not, you're not going in the sense of “I'm here to check up on the management team, tell me the dirt”. You’re here, because you say to the people you're talking to, “it's really important for we as the board to get a feel for how people are feeling. How's our organisation living up to what we promise, and, getting, to get a sense of how people are managing on the ground, be they staff will be they patients.”

It's very fortunate for us that we have people who are willing to come and engage in these webinars and I'd like to thank our three panelists tonight. It was terrific to hear directly from the Victorian Public Sector Commissioner Brigid Monagle. It was great to have two very experienced chairs in Robyn Batten and Bill Brown— one from the rural sector and one from a large metropolitan health service— but both of them, with much broader experience than that, talk to us.

I appreciate that we haven't been able to answer all of your questions, but it's great to see the questions and really encourage you. Those of you who are new directors particularly, to speak to other people on your board, speak to your chair, as Brigid encouraged you. And recognize that by being on the board of a public hospital or public health service, you're part of a network of really terrific people who are here acting to try and serve their communities, serve the wider community of Victoria and provide the best healthcare that we can, and the best experience we can for—our—for those working with us in our organisations.

So, it's a role with great responsibility, but great opportunity and satisfaction and it's terrific that there are people in the state too who are willing to do that. And I think most people are.

You will have sometimes when you get anxious and there are things that seem not to be going as well as you would want, there are also great satisfactions to be had and the satisfaction of knowing we're doing something that's really important and doing it as well as we can.

This was the second of our series of webinars this year, the first one on the structure of the health system in Victoria, the role of the Department and clinical governance, and the role of Safer Care, Victoria. To those of you who might have missed that— webinar will be published shortly.

This one tonight, the link will be available to all those who have registered and will subsequently appear on the website in the department website.

And the third webinar in this year series. The final one is on the 20th of September, and that webinar will focus on the accountability for health service boards on funding of healthcare in Victoria and on risk management. So, I encourage you all to keep that evening free again. It'll be a four to five-thirty event.

Now in terms of ongoing opportunities, as I said, talk to people, talk to those on your boards and your chair about what works. There are resources available and there's a slide of those here.

[Slide 49]

The VMIA provides lots of resources. There are broader training opportunities for people who want to develop their skills as board directors. There is some funding available some of those things, although I think each of us has a responsibility also to be thinking about the wise use of the resources the financial resources of our entities that we're on the board of and so that's a balance. But the most important thing is to be curious, to have questions, and to seek the answers to those questions.

So, thank you all again for your participation. Thank you to our speakers. Thanks to the team in the DH Governance unit who do all the work to make these sessions work. And I look forward to seeing many of you at the next one next month.

Thank you.

[End of transcript]