I WAS dismayed when I got the email about the recent decision by the Royal Australian College of General Practitioners (RACGP), Australia’s largest medical college, to appoint former Victorian Police Commissioner Christine Nixon as the Chair of its Council.
Her appointment has already made Wikipedia:
“In October 2019 Nixon was selected as the chair of the [RACGP] board. This was the first time in the college’s 61-year history that a non-GP was chosen for the role. She had been on the RACGP council since 2017. RACGP president Harry Nespolon praised her prior large organisations skills and said of the appointment: ‘Ideally we would have a GP chairing the RACGP as a member-based organisation, but at the moment, Christine is the right person’.”
This appointment comes on the heels of the resignation of long-standing CEO of the RACGP, Dr Zena Burgess, only a few weeks earlier.
The appointment of Ms Nixon was extraordinary – and, in my opinion, unacceptable – for a number of reasons.
Ms Nixon was a senior police officer who has extended her career by becoming a professional board director; she sits, or has sat, on many important boards, many with public profile – including Foster’s Group, the Alannah and Madeline Foundation, Onside Victoria, Operation Newstart Victoria and the Phoenix Club. She has also been appointed as Deputy Chancellor of Monash University.
In spite of these notable achievements, she is not trained in medicine.
Personally, I know many doctors who are Fellows of the Australian Institute of Company Directors (AICD); therefore the RACGP cannot infer that there are not enough doctors with the appropriate executive experience. Nowadays, it is not uncommon to come across doctors with law degrees and significant business and governance experience.
Chair versus CEO and role of boards
In modern businesses and organisations, boards (sometimes called councils or similar words) have many important functions, including:
- appointing and overseeing a CEO and sometimes senior managers;
- managing risk;
- setting and monitoring strategy and policy;
- approving budgets and ensuring good financial management; and
- driving good performance for the benefit of members and shareholders.
For more details, the AICD spells out the role of boards very well.
It is not the role of a board to manage operational matters; that role falls to the CEO and the staff. Operational issues tend to be more generic. That’s why CEOs can often move between different industries. It is also the reason why organisations can successfully recruit CEOs from outside their sectors.
It is also true that boards sometimes include CEOs or their CEOs attend board meetings; this is essential for the board to remain properly informed about the organisation’s affairs.
Furthermore, boards can also benefit from a diversity of views and experience. This is why more boards are co-opting directors from outside their industries and setting diversity targets.
But the Chair of the Board and the board at large need to have a strong understanding of the organisation’s mission, function and operations. It is for this reason that Chairs need to have a deep understanding of the organisation or at least the industry or profession in question.
And few would dispute that the RACGP retains the following important functions:
- training and examining GP registrars;
- setting and maintaining standards; and
- managing continuing professional education of GPs.
Acquiring the knowledge and experience about those three areas of expertise takes many years. It is hard to imagine how one can achieve this without having at least worked as a GP; many may argue being a Fellow of the college would be the most rudimentary prerequisite.
At a stretch, an experienced director of another medical college may have knowledge and skills that could work.
Medicine is a complex profession. General practice is the broadest of the specialties, with the biggest of the college memberships.
To think that someone without medical training and medical work experience can somehow not only understand the specialty but then go far beyond that to understand the College and then go far beyond that again to lead policy and strategy is simply something I cannot accept.
From a strategic point, this fails because:
- it devalues members and Fellows, stating that they are not good enough to be Chair;
- it sets a very unfortunate precedent that now cannot be deleted from history;
- the Council itself has no faith in its GP directors to do the job; and
- it is a sign of board weakness that a co-opted director has to be made Chair.
If such an appointment was made by a government, private corporation or university, there would be outrage.
The fact that it has been done by Australia’s largest medical college causes outrage and sadness.
Dr Aniello Iannuzzi is a GP, a Visiting Medical Officer at Coonabarabran District Hospital, and a Clinical Associate Professor at the University of Sydney and University of New England. He is Chair of the Australian Doctors Federation.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.