My contribution to a board
What I can offer a board is operating judgement from the parts of health care that directors rarely see: a theatre suite at seven in the morning, a rural hospital with one doctor on call, a ward running on paper during a cyber incident. I have spent thirty-three years learning where clinical risk and financial risk meet. In most health organisations they meet in the same places, the roster, the waiting list, the supplier contract and the handover between services, and a board that understands those places asks better questions.
I would bring three specific capabilities. The first is clinical governance seen from the operating side. I have reported to a quality and clinical governance committee for nine years, through serious incidents, credentialing problems, accreditation findings and a maternity service transition. I know what a good incident report contains and what a sanitised one leaves out. I would be ready to chair a quality and safety committee after a year as a member, once I understood the organisation's clinical leaders, its incident history and its culture of reporting.
The second is funding literacy across public and private care. I have negotiated with insurers, contracted with state health services for public patients and worked within Medicare-funded imaging. Many care organisations now depend on several funders whose rules interact, and directors need someone who can see where those rules will push the operation.
The third is the habit of disagreeing on the record. I have recommended letting our largest insurer contract lapse, reallocating sessions held by senior surgeons and ending a regional maternity service opposed by one of our own directors. In each case I put the argument, the opposing view and the cost in a paper before the meeting. A non-executive director has less information than an executive and must rely more on asking. I would ask in the same way: in writing where it matters, with the alternative stated fairly.
Judgement in practice
01Asking for an external review of our own serious incident
In 2022 a patient died two days after a routine procedure at one of our day-surgery centres, after being discharged the same evening. Our internal review identified gaps in discharge criteria and in after-hours follow-up calls. The centre's clinical leaders felt the review was sufficient. I recommended to the quality and clinical governance committee that we commission an external review by clinicians with no connection to Kelvarra, disclose its findings in full to the family under the open disclosure framework, and apply its recommendations at every centre. The committee agreed. The external review found a third issue our own review had missed, concerning how anaesthetic notes reached the recovery nurse. On a board I would ask management the same question I asked myself: is this review independent enough that the family would accept it?
02Funding the sterilising department before the theatres
In 2018, as general manager of Kelvarra Brisbane North, I brought the board a capital request that ran against its own preference. The board wanted two additional theatres, at A$22 million, to meet surgical demand. My analysis showed that our sterilising services department, built for fourteen theatres and now serving eighteen, was already the constraint: instrument sets were arriving late and some lists started behind time for that reason alone. I recommended replacing the department first, at A$14 million, and deferring the theatres by two years. Two directors argued that sterilising capacity could be outsourced in the meantime. The board approved my sequence after visiting the department. Start-time delays attributed to instruments fell by four-fifths. As a director I would look for the unglamorous constraint behind every expansion request.
03Leaving the money to others when Kinnabar sat across the table
When Kelvarra negotiated the Rockhampton maternity partnership in 2022, the counterparty was Kinnabar District Health Service, where I had worked for seventeen years and where several former colleagues were still executives. I told our chief executive and the chair of the board before negotiations began, and I asked that the financial terms be negotiated by the chief executive without me. I continued to lead the clinical and workforce design, where my knowledge of both organisations was useful, and the board minuted the arrangement. The agreement was approved on terms our chief financial officer considered sound. A director's conflicts are rarely financial in the narrow sense; more often they are loyalties. I would expect any board I join to hear about mine before they become relevant.
My first year on a board
Before my first meeting I would ask for a short list of documents rather than a long induction pack: the last two years of board and committee minutes, the risk register, the most recent accreditation or regulatory assessment, the serious incident log with outcomes, and the funding agreements that account for most of the revenue. I would read them looking for the issue that recurs without being resolved.
During the first two meetings I would mostly listen and ask for context, and I would request two site visits, one at a service the executive is proud of and one it is worried about. In a care organisation the worried-about service usually teaches a new director more.
By the sixth month I would want to have met the chief executive, the senior clinical leader and the company secretary individually, and the external auditor once without management present. I would join the quality and safety committee as an ordinary member and resist any suggestion that I chair it in my first year.
At the anniversary of my appointment I would ask the chair for frank feedback, including whether my operating background had led me to stray into management's territory. It is the most common failing of executives who become directors, and I would rather be told than drift into it.
Conflicts and their management
Kelvarra Health is my employer and comes first. That rules out several kinds of board entirely. I would not join any private or not-for-profit hospital operator, any day-surgery business, any private health insurer, or any supplier of theatre equipment, prostheses, clinical software or hospital services to Kelvarra. I would not join the board of a state public health service in a region where Kelvarra contracts with that service for public patients, because I would sit on both sides of the same agreement.
Two personal relationships need disclosure too. My husband is a general practitioner in Brisbane who refers patients to many hospitals, including ours. And I retain friendships with former colleagues across central Queensland's public health services. Neither would prevent most appointments, but any board considering me should know about both.
If a conflict arose after appointment, for instance because the organisation began buying services from Kelvarra, I would declare it at the next meeting, leave the room for the relevant item and, if the relationship looked likely to continue, offer to stand down. I would also seek the Kelvarra board's consent before accepting any seat, and tell them if anything changed.
My independence statement
I am a full-time executive of Kelvarra Health and one of its senior managers. Kelvarra has no shareholders and pays me no equity, but it competes with other private hospitals, contracts with insurers and state health services, and buys from many suppliers. I would only consider a board where none of those relationships exists in any material form, and I would set out every relationship I or my family have with the organisation before any appointment was discussed. Whether I am independent for a particular board is for that board to decide on what I disclose; I will make sure it has everything it needs to decide.
Committee contribution
Chair and member readiness| Capacity | Committees |
|---|
| Ready to chair | A quality and safety (clinical governance) committee, after a year as a member |
|---|
| Ready to join | Quality and safety committee · Audit and risk committee · People and culture committee |
|---|
Board and committee exposure
Presented to the Board or a committee
Kelvarra Health Limited
Board of directors: operating performance, insurer contracts, regional service changes and capital projects
March 2021–present
Presents the operating report at every board meeting and leads board papers on insurer negotiations and service changes; not a director and holds no vote.
Reported to a committee
Kelvarra Health Limited
Quality and clinical governance committee: serious incidents, credentialing, accreditation findings and clinical indicators
May 2017–present
Reported as a hospital general manager from 2017 and as COO since 2021, including the external review of a day-surgery death and the Rockhampton maternity transition.
Reported to a committee
Kelvarra Health Limited
Audit and risk committee: business continuity, the August 2024 cyber incident and operating risks
March 2021–present
Reports twice a year on continuity and operating risk; led the committee's post-incident review of the 2024 isolation.
Served as a director
Tarrabool Community Transport Limited
Board of a not-for-profit community transport and home-support provider
July 2019–present
Non-executive director of a A$38 million not-for-profit organisation funded by Commonwealth home-support programmes and state transport subsidies.
Member of a committee
Tarrabool Community Transport Limited
Finance, audit and risk committee
July 2020–present
Member of the committee that reviews the accounts, the risk register, vehicle safety and the external audit.
Capacity and preferences
- Time available
- 25 days per year
- Current directorships
- 1
- Sectors
- Residential and home-based aged care · Disability and community care services · Primary and community health organisations · Medical technology and pathology outside imaging
- Company type
- A not-for-profit or ASX-listed health or care provider with revenue between about A$200 million and A$1.5 billion, with no contract, competitive overlap or supply relationship with Kelvarra Health
- Company stage
- An organisation working through regulatory reform, a change of funding model or rapid growth that has stretched its clinical governance
The seat I am pursuing
I am looking for one non-executive seat at a health or care organisation outside private hospitals. The sectors I know best and could help most are aged care and home care, disability and community services, and primary or community health. Each depends on a workforce that is hard to recruit, on several funders whose rules interact, and on clinical governance that must work across many small sites. Those are the problems I have spent my career on, from rural multipurpose health services to sixteen private sites.
I would expect to join the quality and safety committee and, after a year, chair it if the board wished. I would also be useful on an audit and risk committee, particularly on continuity and cyber resilience. I am not looking for a seat to complete a skills matrix, and I would not take a third board role while I remain an executive. Twenty-five days a year, agreed with Kelvarra's board, is what I can give properly, including preparation and site visits.
Governance learning and readiness
IICA Independent Directors’ Databank: Not yet registered
India's IICA databank exists for candidates to the boards of Indian companies, and registration there has no bearing on an Australian appointment. Because every seat I am considering is in Australia, I have not registered and the status shown simply records that it does not apply. In Australia, directors' duties come from the Corporations Act and, for registered charities, the ACNC Governance Standards; listed companies report against the ASX Corporate Governance Council's Principles and Recommendations.
- A company directors' course completed through the Marwood Directors' Institute in 2022
- Six years as a non-executive director and finance, audit and risk committee member at Tarrabool Community Transport
- Attendance at every Kelvarra board meeting since 2021 and at its quality and audit committees as a presenting executive
- Structured briefings from Kelvarra's company secretary on directors' duties under the Corporations Act and the ACNC Governance Standards