In the highly anticipated Part 2 of "Mastering Leadership Agility: Lessons from a CEO and Board Director in Hospital, Health and Aged Care" your host, Jocelyn Santosa, Partner at Watermark Search International, is joined once again by the remarkable CEO, Chair, and Board Director in the healthcare, hospital, and aged care sectors, Toby Hall.
This episode dives deep into different aspects of leadership in these critical fields. Together, they tackle essential questions such as:
Public vs. Private: Are there differences in working in these settings, and what key insights should individuals be aware of when operating in these unique environments?
The Transition Challenge: How difficult is it to transition from public to private, or vice versa? Discover the complexities of this shift and the skills required to succeed.
Boardroom Dynamics: Unravel the mysteries of boardroom leadership. Learn how to ensure that your leadership team is well-versed in key governance issues.
The Art of Board Membership: What qualities make an exceptional board member? Toby Hall shares invaluable insights on what it takes to excel in this role.
Board Selection: Explore due diligence strategies to employ before committing to a board position, ensuring it's the right fit for you.
Continuous Self-Reflection: Discover the importance of self-reflection when choosing board roles, ensuring you make choices aligned with your values and goals.
Listen to gain their insights and advice for current and future leaders.
You can also find the podcast on several different apps, Spotify, Apple Podcasts, Breaker, Castbox, Google Podcasts, Overcast, Pocket Casts, and RadioPublic. Click here to listen & subscribe on your favourite app or read the transcript below.
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Part 2 - Mastering Leadership Agility: Lessons from a CEO and Board Director in Hospital, Health and Aged Care
Agile Leadership Lessons, Episode 7, transcript:
Jocelyn Santosa, Partner at Watermark Search International:
Welcome to the Watermark Search International Agile Leadership Lessons Podcast. My name is Jocelyn Santosa and I will be your host today. I'm a Partner in our health, human services and life sciences practice. If this is your first time welcome. The Watermark team is made up of dedicated Partners who have a long expertise in Board, Executive and Interim Executive appointments. Our podcast invites highly regarded leaders in and we ask them questions in each episode to share their knowledge and expertise of agile leadership, spanning public, private and not for profit settings. We ask them how they navigate different leadership challenges and their key lessons. Today's podcast is part two of my interview with Toby Hall. If you have not heard part one, I would encourage you to go back and listen to that. Let me tell you a little bit about Toby. Toby’s most recent executive role was as the Chief Executive Officer for St. Vincent's Australia, Australia's second largest health provider delivering public and private hospital services, aged care and research activities. Prior to this, Toby was the Chief Executive Officer of Mission Australia, a national Christian charity with a vision to end homelessness by providing safe and affordable housing, support disadvantaged children and families, empower troubled young people and assist those with a disability and mental illness. Toby has also been the chair of Sterihealth, the board member for Working Links and a board member for Goodstart Early Learning. These days, Toby is the Chair for For Purpose Aged Care, the Chair for Sana Health, and a board member and advisory board member for Fujitsu Australia and New Zealand and UNICEF. Toby is also a husband, father and grandfather. Let's continue the conversation now.
Toby, you mentioned some of these examples from places like St. Vincent's where you were leading public and private hospitals. I'm just curious as to; Are there differences working in those two settings can lead as transfer between public and private, and what are the key things we should be aware of?
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
My focus on running organisations and this is getting into kind of very technical, how you lead, is that you have to understand who your customer is. And everything is driven by your customer. So we've talked very clearly about care and culture for a period of time. But let's talk about focus, because the person that counts in the private hospital sector is the customer, the person that counts in the public hospital sector is the customer. And operationally the outcomes are achieved in terms of care for people and delivery of care and treatment, in both environments are almost exactly the same way. And you kind of turn around say well that's good from a very end customer point of view, but actually the customer for private hospital, and this will sound very counterintuitive to a lot of people, is not directly the patient. The customer in private hospital is actually the clinician because the private hospital network is providing a place where clinicians can operate and provide care to their patient. And the hospital's job is to help, largely provide a nursing environment and a safe environment for them to do that in. But the relationship largely is actually between the clinician and the patient. And that patient is that clinician’s customer, but the clinician is the hospital's customer. Whereas in the public sector, the patient is actually your customer. And understanding the difference between those is absolutely vital, because you need to know who you're working with, who you're working with closely, who your customer is, who your customer isn't. And I revert back also to who is actually paying you for the work you're doing. And when you understand who is paying you and who your customer is, you need to focus on what are the outcomes they're looking for. And this goes right back to when I talked earlier about understanding customer outcomes and delivering great customer outcomes. You do need to understand really clearly, who's paying you for what you do, and what are they expecting? And what are the customer outcomes you're expecting. And I structure businesses around that. And the fact is the skill set of an executive in the private hospital system and what they need to do to deliver is very different from the skill set in the public sector. And if you if you want my honest opinion, it is way harder to run the public sector, where the patients are your customers, than it is running a private hospital where you're really just dealing with a group of clinicians. And the reason why is that you've got far more customers in a public system, far more stakeholders in the system, you've got a payer, who is the government, who is very interested in what you're doing, and you've got a patient who's getting an outcome who is very interested in what you're doing. And you need to understand those different skill sets. And they don't necessarily marry easily. I don't know many people who successfully transition from the public sector across to the private sector or the other way around. And the reason is, it's actually quite a different operating model, it's quite a different structure. And that's not to say it's not possible, it is possible. But this comes back almost to the strengths kind of discussion before, which is, when you know your strengths and you apply it to a particular sector and how you operate works in a sector, the likelihood is that if you're more driven towards the kind of public sector model, in your strength base fits with that, you'll be successful in that environment. If you take that same strength base and say let’s just put it into a private environment, it doesn't necessarily work. Almost always, I had people from the private sector work in our private sector business. I had one exec who I think was a really brilliant executive who transitioned across between public and private, I think successfully. I think not so many people can do that. And so I tend to focus on let's get the right people for the private hospital spaces, get the right people for the public hospital space. And I'd extend that across different industries. So when I was running Mission Australia, we were in aged care, which is funded by the government, we ran employment services, which is really a fairly commercial, government tender process, and we ran homelessness, which was paid for by donors. And so those three different businesses have very different engagement with different groups of people and needed different leadership skills, different thinking skills to deliver them successfully. And I would try and find the people who have the skill sets and the focus for each of the business areas to be able to deliver.
Jocelyn Santosa, Partner at Watermark Search International:
That's a terrific answer Toby. I think the things that you talked about; figure out who's paying for the work, identifying the different complexity, customers stakeholder base, and the different levels of engagement, understanding of the regulatory. Having done search assignments in both public and private and having worked in the private healthcare space, they are both very different. And then you also overlay that with talking about Mission Australia, which is donors, and that's got different sets of challenges there all together. One of the things we also talk about is diversity of experience. Because you've worked across public, private and not for profit you've articulated the differences very well, but you're saying it is very challenging for people to be successful across one, two or three, if they haven't operated in those environments before, is that right?
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
It's often quite hard for people to do that transition. And I think, you obviously work in search and your firm is an expert in search. One of the things which is interesting and quite intriguing is, you figure well, it's got to be easy to find CEOs for these kinds of great organisations. But when you actually go and do a search quite often, you realise that finding the right skill set is very hard in some of the organisations. And in fact, in some ways, the nonprofit sector particularly has got so many stakeholder groups engaged, that you have to have people who've got quite unique character sets to be able to operate in that environment. And in fact, I've had a lot of people come out of the corporate sector, into the nonprofit sector work with me. Initially, it's almost a shell shock for them, because you have suddenly gone from kind of fairly simple, you've got shareholders and you've got customers. The shareholders, you kind of don't really hear from that much unless they're unhappy, in which case, you might see some dramatic change. But generally speaking, you don't hear from them much, therefore you have got customers. You go into the non profit sector, you've got government with an interest in what you're doing, you've got donors interested in what you're doing, and let's face it, you're getting money off people for free to do something that you're delivering an outcome for them, you've got to be pretty good at influencing to get money to help deliver an outcome, you've got the people you're working with, plus you've got often quite strong advocate groups working alongside those people. And suddenly you go from an environment where you have not that many stakeholders to a whole range of interested parties in what you do, and finding the leadership skill set that can manage that complexity is not necessarily easy. And in fact, I was talking to a board yesterday, and they were asking about this and to be honest, it is way easier doing the private sector stuff I do than any of the nonprofits that I did. Because we don't have that complexity of stakeholders. So the skill set to be able to move across I think has to be predominantly about people relationship, and also the intellect to understand the business. Most people can go into a new business and learn a new business, and learn a new structure and a new way of doing things. And personally, I always start with two things when I look at a new business. Firstly, I spend a lot of time with people on the front line because I find that they usually understand the business better than anyone else. They know what's working, and they know what's not. And then I also spend a lot of time looking at the history of the organisation, predominantly because of that discussion we had earlier around culture and what's normalised. Because you need to understand how an organisation's got to where it's at. And I think you need to do that before you even contemplate any changes within your organisation. And then I actually look at the cash flow. Where does the money come from? Where does it flow? And generally speaking, those things are transferable across sectors. What is the thing which is hardest to transfer is the complexities of stakeholder management and relationship management. And that's where I think it's not easy to necessarily just transfer one person to a different organisation, which has got a way, way more complex environment around it. And arguably, you could even say the same for government where people work in government, and a lot of people I think, are not as respectful of our government colleagues as they should be, because they work in a really complex environment where we are the stakeholders, they got politician bosses who are the stakeholders, and everyone is interested in what they're doing. And often they're working in a very, very complex environment with lots of different voices coming into it and that takes a specialist skill set. And they're really, really good at that. Whether they can easily transition into a different sector, some can, some can't. And that comes down to the adaptability of the individual, I think.
Jocelyn Santosa, Partner at Watermark Search International:
Yeah, I think that's absolutely right. And I echo your comments about the complexity of working in government. They've also got to be concerned about what happens if something hits the press tomorrow, what does that look like? Does it pass the pub test? And then there's a whole lot of very interested stakeholders. And one of the questions that people always ask, in getting in government is, am I going to be able to get things done? Is it so bureaucratic? What about the pace of it? But you really need to have the influencing skills because you may not have direct accountability or you can't move things along just with force.
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
Yeah. Yeah.
Jocelyn Santosa, Partner at Watermark Search International:
Toby, the next thing I just want to ask is about your experience on a board. How do you get comfort that your leadership team is across the key governance issues?
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
I think governance on a board is something you're always questioning. And you have to continually look at the leadership team to say are they understanding what we need from a governance point of view? Are they understanding what can be quite complex regulatory requirements? Are they understanding what are the changing dynamics within the sector? Are they close to what's happening within the organisation culturally? There's a lot of things you need to look at, from a board. Interesting, that's the first thing I look for, in terms of the leadership team is really do they have a passion and a love for what the organisation is about? And it doesn't matter whether it's a private sector business, or public sector businesses, if they've got that passion and drive, and then a kind of desire to want to be excellent at what they do, they tend to be really good at delivering the kind of work across the board that is needed. Now some of that, executive teams want to do. I can tell you in the aged care sector, the compliance regime in aged care is just phenomenal. I always pity the poor executive teams that have to respond to what is a huge bureaucratic processes in terms of compliance. Because they came into aged care to care for people not to tick a lot of compliance boxes, and some of those compliance boxes are really good and are about caring for people, but some of them, I think, are quite bureaucratic processes that can be painful to manage. But you've got to have people that care enough about the outcome to be able to say, if that's part of what I've got to do to care, then I'll get that work done. I think around the board, you're always assessing. One of the great board chairs I had said to me one day, it's like basically, we're giving you the keys to the Holden, and it's your job to drive it. And we're going to let you drive it until we say one day, maybe it's time for someone else to drive the car. And that's actually a really encouraging thing. And really good boards do empower their CEOs and their teams to get on and drive things, push them through. What he didn't say is that he'd be sitting in the backseat the whole time watching. And that’s what boards are there to do. They are there to watch, check things are going in the right direction, hopefully after really encouraging improvements to turn around and say, hey you're speeding, you need to slow down, keep to the rules. You're going too fast and not taking everyone along with you. Maybe some of the time you kind of veer into the wrong side of the road, or you take a wrong turn and boards are there to help kind of correct that and move people in the right direction. And when they do that in the right way and it's encouraging and building up the organisation for the right reasons, it's a great environment to be in. I think boards predominantly need to be supportive of their teams and help them get better at what they're doing. And if a board isn't making the organisation better than there is just the wrong people on the board.
Jocelyn Santosa, Partner at Watermark Search International:
But a lot of people aspire to be on a board. As I meet executives, they might tell me about their aspirations eventually to be on a board. One of the first questions I always ask them is, why do you want to be on a board? Do you have a view on that in terms of what makes a good board member?
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
The desire to be on a board I think is, and this comes back to the skill set, is understanding what you're strong at. Being able to add value in a board environment means that some of the time you are going to speak a lot less than you would do in an executive environment. In fact, the best board members I think I've had hardly speak at all. They know when to make a contribution and know when they can add value because they understand themselves and know what they're strong at. They don't try and pretend they are good at things they are not good at. But when they do know an area, they can zone in on it really quickly and be phenomenally helpful. I remember one board member I had at Mission Australia was like this. He could zone in on a problem better than almost anyone I've met in my career and get right to the root cause of a problem and do it in a way which was kind of encouraging, saying, hey have we thought about this issue, because I think this is where the problem is. And that's where great board members can work well. I think boards in good times are easy environments to be in. I sit on the board of UNICEF Australia and it's great. We've got a brilliant management team, great board leader, Ann Sherry who is the Chair, is just outstanding to work with. And it's a really nice environment, and things are going brilliantly so it's a great space to be. But when I joined it probably wasn't quite there because the leadership team had taken over from a different group of people. And so they had to go through a transition. And through that period, the board encouraged the leadership team to make the changes that needed to be made, to bring in new skills, to kind of develop the organisation, to push them to a new level and also I think set some new aspirations that the team I think might not have done if they'd been on their own and left to their own devices. To really say that we believe that you as a team can do way more than you even think you can. And we actually set out pretty much to double the turnover for the organisation. And even as a board member, sometimes you sit there and think is that a bit crazy. But actually, they managed to do that in a period of about four years. And that came because they had a board which let the exec team get on with what they were good at. But also push them to say, hey we can do better in these areas so let's focus on that, let's get the right people in. And the leadership group did that and has got a very cohesive relationship with the team. And when you get that environment working in a board, it's really empowering. I think what isn't empowering is when boards attack their executives, don't back them, don't support them. I had this discussion with a board member last week and said, look when your board member is there and your executive is there and they're in the role, you support them. And I use an example of Qantas. Qantas is a great organisation but it doesn't take any rocket science to see Qantas has got some great press but it's also had some kind of pretty rough press over the years. I don't remember once, through all that time, hearing a single negative comment or anything other than full support for Alan Joyce as the CEO from Qantas and their board. And that is what a great board does, it sticks by its people through thick and thin. But there may be a day where they turn around say, well it's time for that person to go. But whilst that person is the CEO, the board sticks with them, helps them be as successful as they can be, supports and encourages them, pushes them and drives them, and creates a great environment. And where there's things which are not right, it's always done behind the scenes, it's always done quietly, it's always done responsibly. And I think good boards are calm, rational, collegiate environments, but environments not afraid to question and not afraid to push people to get them to go to the next level, to get them to be more than they expected they could be. And that's what I kind of look for in a board environment. And if you can get on that kind of board, it's great fun. If you get onto boards that aren't like that, to be honest I've had a couple, you kind of think, why did I even bother to get involved in this. So you’ve got to find the right place. And personally, I will only work and serve on boards in areas that I'm really passionate about, that I love the field that we're working in, and with boards with people that I like. Because I want to sit around and work with people who've got the same kind of mindset and thinking. It doesn't mean there shouldn't be diversity in the thinking but in terms of the passion for the area, and the passion for being excellent. I want to be around people like that. And if an opportunity forms to serve on a board where that’s not present, I just say no thanks.
Jocelyn Santosa, Partner at Watermark Search International:
You talked about some boards where you questioned why you were on that board. Did you only discover that once you joined the board? Or do you have any comment about maybe the due diligence you did before you took on that board appointment?
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
Yeah and I've had a couple of boards where I didn't serve for a long period of time. And I kind of hope that I would have done the due diligence and talk to people about what was happening around the board, what the kind of focus of the board was, how the people were. And I think when you get into the board environment and find out that maybe there's a cultural or integrity kind of weakness that you hadn't picked up before, you do have to look at it. And I think once you've come onto a board in that environment you then have to, as a board member, be very clear in confronting the issues you're concerned about with the board. And it's a question of saying to them, look, and this goes back to what I said about the dealing with change. It's actually just honestly saying, hey this is my perception of what I've seen, I'm not sure that it's a good thing and I want to understand what is your perception of it. And if we kind of don't have something working are we prepared to go through a change? I had an example of this, where there was something with the board which I was uncomfortable with, I didn't think it was particularly ethical. And so I sat down said to people, we need to go through change on this, we need to accept that it's not the right way to go and if we can't then it's probably not the right environment for me. In that particular case, some of the other board members didn't want to change and I said, well that's fine but this is not the right place for me because I can't be an environment where I don't accept or agree with the issue, particularly when it is this core integrity platform. And I think in those environments, then you have to turn away and say, well look it's just not the right space for me. And equally I have been on probably five boards who I have served on for 10 years and served out the whole time and just really enjoyed it and had a great experience and great learning. And I think also, I'd say to people, when you approach boards, particularly first boards, it's a huge learning opportunity for people. I think it's a good space for executives to go because you suddenly see all the things you do wrong when you're an executive when you get onto a board. And it's kind of quite, it's actually quite grounding initially. I think you kind of go, oh my goodness, I do that and that does not come across well. So it helps you kind of round out yourself as a personal leader as well, I think.
Jocelyn Santosa, Partner at Watermark Search International:
Yes. Toby, I think one of the things is it sounds like it's a great opportunity for continued self-reflection and honesty. And we keep maturing, don't we?
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
Anyone who's not learning shouldn't be on a board and shouldn't be in a senior executive position. And anyone who's not questioning themselves about how to get better, how to learn more, how to do new things, I think that's a really challenging environment. I always look for people who will push and challenge themselves to grow, to learn more and to develop more. I want to be around people like that and it doesn't matter whether you're 20 years old, or 90 years old. You’ve got to kind of question and grow and develop. And if you lose that drive to want to change and grow, then it's a pretty bad place to be, in my view. You’ve got to be always wanting to learn, always wanting to grow. And there's always new areas to learn and develop. And I spent a meeting three weeks ago with a group, mostly in their late 60s, learning about AI. And nearly all of these people, very successful business people, very successful investors, it would be really easy for them to turn around and go, yeah I could not make the effort to do that thing. But they are all actually sitting down and learning about a whole range of new stuff in AI technology. And that's the kind of thing you’ve got to see in leadership teams and boards, is people who want to learn and want to grow and who want to go to the next phase.
Jocelyn Santosa, Partner at Watermark Search International:
So just on that learning, and this might be my final question. What are you learning at the moment? How are you investing in yourself? Are there things that you're reading? Are there topics that you're interested in? Can you give us some insight into what Toby is learning about?
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
Yep. At the moment, I am spending a lot of time thinking about artificial intelligence, which actually to be honest is not artificial at all. It's just algorithms on computers. But understanding the importance of that, and how particularly computer aided decision making will become a formal part of the world that we have to engage and grow in, I think is really important. I'm doing that because I've seen a lot of organisations are slow to invest in the right technology. But the people who have invested in the right technology often get criticised upfront for spending a huge amount of money on this technology and then you wake up five years later, and they've got this marked gap between their organisation and others in the sector because they've invested in technology. And so a lot of time on technology. Rather boringly also looking at cyber risk. I chair an audit and risk committee and one of the boards I'm on and understanding the space, understanding the risk there, I think is important. And I am doing quite a bit of work on looking at risk as a field, because it's important to understand how that plays out for organisations and also the organisation and the team looking at the problems which potentially could come up. And I've had two organisations who've been through basically cyber games where they've been attacked by a cyber break in, to understand how do they respond, what is the way that they can deal with that. And so learning in that space is really important. I also, at the moment, probably as a learning, I've seen really quite acutely the focus of people on understanding how to sell and continually sell. I've been quite intrigued. Particularly in a couple of the companies that I am coming to work with and encouraging the teams to have really good data systems and management around their sales process and understanding their sales process has been key. And I've probably seen that more acutely because I'm working with different organisations, some are very successful in that field, and some who are less successful. And actually, the interface between the AI and sales process now is so acute that you do need to understand their sales pipelines so I've done quite a lot of work on that with teams at the moment and recently to learn and understand that better. Particularly in the world where social media plays a massive impact on sales, it which didn't used to in the past. So understanding how that flow works from a huge amount of information being poured into social network systems, which eventually flows down into a relatively small number of sales. Understanding the detail in that process. A tweak of 1 or 2% can make the difference between a huge profit and loss. And so I have spent a lot of time understanding sales flow and sales channels recently as well. And actually have read some really brilliant books on that. Some by very mainstream academic authors but some by influencers who, it's very easy to dismiss influencers and all these people who are just kind of people playing on TikTok. But actually these are people who've created great sales channels, great sales networks, and it's different from what we're used to. But that's why you need to learn. You need to work out where does different work? Why does it work? How do we engage with it and get it to work for us as well?
Jocelyn Santosa, Partner at Watermark Search International:
Yeah that's terrific Toby. I could talk to you for many more hours. I am just very grateful for your time and for your wisdom and for your experience. I agree that one of the themes of great leaders is that continuous learning mindset, that growth mindset. We really encourage that and I see that in the best leaders that I meet. They're always looking to improve themselves and to learn more about the way that our world works. Toby, thank you so much for your time.
Toby Hall, Chair, Director and Former CEO in Hospital, Health and Aged Care:
That’s great Jocelyn, I had a good time. I hope it went well for you as well.
Jocelyn Santosa, Partner at Watermark Search International:
Absolutely. Thank you to you listeners for spending this time with me. And thank you to Toby. I'd like to let you know that our two most recent thought leadership pieces are available on the Watermark Search website, which is at watermarksearch.com.au. There you'll find our 2023 Interim Executive Survey and our 2023 Board Diversity Index. I hope you'll subscribe to our podcast and join us next time. Thank you for listening.