Seven appointments between the public and private systems

Mandate

Restore theatre productivity and nursing stability after the pandemic, bring operations into insurer contracting and settle the future of the group's loss-making regional services.

Outcomes

• Raised utilisation of booked theatre time from 66 to 81 per cent and cut same-day cancellations from 5.8 to 2.7 per cent.
• Reduced agency nursing from 11.6 to 3.8 per cent of nursing hours, saving about A$19 million a year.
• Co-led a forty-one-day out-of-contract period with Wyralee Health Fund, ending in indexation of 3.4 to 3.6 per cent against an offer of 1.9 per cent.
• Moved Kelvarra Rockhampton from a A$3.9 million loss to a A$1.4 million surplus through a maternity partnership and public elective contract.
• Led the four-day isolation of all sixteen sites during the August 2024 cyber incident and rebuilt downtime procedures.

Decisions in context

I became COO in March 2021, as elective surgery recovered from pandemic restrictions and nurses were leaving private hospitals faster than we could replace them. The chief executive asked me for three things: get theatres and wards working reliably again, make operations a full participant in how we are paid, and decide what to do with regional services that were losing money and clinical confidence. Eight directors report to me, and about 6,300 of our 7,400 people work in my line. I attend every board meeting and both of the board committees most relevant to operations. The work has involved some unpopular decisions: reallocating surgeons' sessions, letting our largest insurer contract lapse for forty-one days and ending private births in Rockhampton. It has also involved the longest four days of my career, when we isolated every site after a supplier's account was misused. Revenue grew from A$910 million in 2020–21 to A$1.18 billion in 2025–26.

Reason for the move

Current role. Not seeking an executive move; considering one further non-executive seat with the Kelvarra board's consent.

Mandate

Improve flow through a hospital whose surgical growth had outrun its beds, and prepare the site for a cardiac expansion.

Outcomes

• Reduced average length of stay after joint replacement from 4.9 to 3.6 days with a nurse-led discharge pathway.
• Opened a second cardiac catheter laboratory and a ten-bed coronary care extension in 2019.
• Ran the hospital through 2020 pandemic restrictions, redeploying 140 theatre staff and returning elective activity to 96 per cent of plan by October 2020.
• Replaced the sterilising services department ahead of the board's preferred theatre expansion, removing the hospital's main surgical bottleneck.

Decisions in context

Kelvarra Brisbane North was the group's largest hospital and its most crowded. Surgical activity had grown faster than ward beds, patients waited in recovery for a bed upstairs, and the cardiac service was ready to expand. I ran it for almost four years with nine direct reports, including the director of nursing and the director of medical services. We introduced a nurse-led discharge pathway for joint replacement, opened a second catheter laboratory and argued successfully that sterilising services should be replaced before more theatres were built. Then the pandemic arrived. In 2020 non-urgent surgery was restricted, our capacity was offered to the public system, and 140 theatre staff were redeployed to intensive care, wards and vaccination work. By October 2020 elective activity was back to 96 per cent of plan. Those months taught me how a private hospital fits within the state's health system, and they prepared me for the group role I took in March 2021.

Reason for the move

Appointed group chief operating officer when the previous COO retired.

Mandate

Make a fast-growing network of acquired clinics work as one business, with consistent quality and report turnaround in regional towns.

Outcomes

• Built a central reporting hub that cut CT report turnaround in regional clinics from twenty-six hours to six.
• Standardised contrast-reaction and radiation-safety protocols across all 38 clinics.
• Closed four clinics that could not be staffed safely and consolidated their patients into neighbouring sites.
• Raised clinic earnings margin from 14 to 19 per cent while Medicare rebates for many imaging items stayed flat.

Decisions in context

Vellacourt was a private-equity-backed network assembled from acquired radiology practices, and when I joined in September 2011 it ran each clinic much as its previous owners had. I was hired as general manager of operations and became chief operating officer in 2014, with six direct reports and about 900 people in clinics and reporting. The business lived on Medicare rebates that had not kept pace with costs for many years, so efficiency was a condition of survival rather than an ambition. Our hardest problem was radiologist supply in regional towns, where scans could wait a day or more for a report. We built a central reporting hub in Brisbane, standardised safety protocols across 38 clinics and closed four that we could not staff safely. Working for a fund taught me to put an operating argument in numbers that an investor would test. When the fund sold the business in 2017, my role was absorbed into the buyer's structure, and I chose hospitals.

Reason for the move

After the fund sold the business to a larger imaging group in 2017, the operations role was absorbed; I chose to move into hospitals.

Mandate

Make eleven small hospitals safer and more consistent, and connect them to the base hospital's specialists.

Outcomes

• Standardised emergency-care protocols and escalation rules across all eleven sites.
• Linked nine sites to base-hospital specialists by video consultation by 2010.
• Reduced avoidable aeromedical transfers by about 19 per cent over three years.
• Converted two hospitals to multipurpose health services combining acute beds with residential aged care.

Decisions in context

This was the role that taught me how hospitals are run. Each of the eleven sites had between eight and forty beds, an emergency department covered by a rural generalist or a visiting doctor, and a director of nursing who often doubled as the facility manager. I reported to the district chief executive and spent much of each week on the road. The central question at every site was what it should not attempt and how quickly it could move a patient to somewhere that could. We wrote common emergency protocols and escalation rules, linked nine sites to the base hospital's specialists by video and reduced avoidable aeromedical transfers by about a fifth. Two hospitals became multipurpose health services, combining acute care with residential aged care for towns too small to support both separately. I completed my Master of Health Administration part-time during these years. By 2011 I wanted to see how private operators managed cost and quality before choosing where to spend the rest of my career.

Reason for the move

Wanted to learn how private operators manage cost and quality before deciding where to build the rest of my career.

Mandate

Modernise an imaging department whose films still travelled by bus from rural towns to be reported.

Outcomes

• Installed one of the region's first digital image archives in 2004, ending the transport of films for reporting.
• Introduced remote reporting of rural X-rays by base-hospital radiologists.
• Commissioned the base hospital's second CT scanner in 2003.
• Reduced the outpatient ultrasound wait from eleven weeks to four.

Decisions in context

I returned from London in early 2000 to manage the imaging department where I had begun my career. It had 46 staff and served a district the size of a small country, but X-ray films from rural towns still came to the base hospital by bus or courier before a radiologist could report them. Patients in those towns could wait days for a result. We commissioned a second CT scanner in 2003 and, in 2004, installed one of the region's first digital image archives, which allowed rural images to be reported remotely within hours. I learnt to manage radiologists as well as radiographers, to plan equipment replacement over ten years rather than one, and to bring a business case to a district executive that had many other priorities. Outpatient ultrasound waits fell from eleven weeks to four. In late 2005 the district asked me to take responsibility for its rural hospitals, a role I had not expected and accepted immediately.

Reason for the move

Asked by the district to take responsibility for its eleven rural hospitals.

Mandate

Lead general and emergency radiography shifts and help reduce waits for outpatient imaging.

Outcomes

• Led emergency radiography shifts in a department handling about 140,000 examinations a year.
• Helped redesign outpatient booking, reducing the plain-film wait from three weeks to five days.
• Trained eleven newly qualified radiographers in emergency and theatre imaging.

Decisions in context

Like many young Australian health professionals of my generation, I went to London on a two-year working visit. I joined a two-hospital trust in outer London as a senior radiographer, leading shift teams of six in a department that performed about 140,000 examinations a year. The scale was new to me, and so was the way the English system counted waiting. Lists were measured, published and managed with great care, sometimes more care than the patients on them. I worked with the department's managers to redesign outpatient booking so that most plain films were done within five days rather than three weeks, which taught me that much of a patient's wait lies in handoffs rather than in clinical capacity. I also trained eleven newly qualified radiographers. When Kinnabar offered me the management of its imaging department at the end of 1999, I came home.

Reason for the move

Returned to Australia to manage the imaging department where I had started.

Mandate

Provide general, emergency and theatre radiography, including a share of the after-hours on-call roster.

Outcomes

• Covered general, emergency, theatre and mobile radiography, including one in four after-hours on-call nights.
• Supervised student radiographers on clinical placement from 1996.
• Joined the base hospital's first CT team when the scanner was commissioned in 1995.

Decisions in context

I started work in January 1994, two months after graduating, as a radiographer at the base hospital of a large central Queensland district. The department had about thirty staff, and junior radiographers took their share of after-hours on call, which in a regional hospital means road trauma, farm accidents and theatre cases at any hour, often alone. Eight months into the job, a film processor failed in the early morning while a trauma patient waited, and a senior colleague talked me through the repair by telephone. That night taught me how much clinical care depends on systems nobody notices until they fail. I joined the hospital's first CT team in 1995 and began supervising students on placement in 1996. I left at the end of 1997 to work in London, wanting to see how a much larger system handled the same problems.

Reason for the move

Took a two-year senior radiographer post in London to broaden my experience.