Special report: leadership chaos strikes the RACP

Medical politics

16 Apr 2024

You don’t have to step far inside the RACP’s historic headquarters in Sydney to understand how the college sees itself.

From the richly padded carpet, to the wood panelled walls, to the bespoke cabinetry filled with rare books (the oldest published in 1489), the building radiates its elite status. It all says ‘we are venerable, respectable and dignified’ and might add that answering questions is for others occupying less rarified real estate.

But behind the sandstone facade is an organisation in turmoil. The college is embarking on an unprecedented spend on curriculum and technology upgrades while attempting to overhaul its decision-making structure. This is all without its CEO and president, who have both resigned this month, dropping bombs as they did so.

And in the background lies a mammoth accreditation review by the Australian Medical Council (AMC) that insiders say is far from a guaranteed success.

Given the college’s recent history, members will have some reason to be concerned.

Still visible in the rearview mirror are memories of the college’s 2018 divisional written exam meltdown, when computer glitches resulted in 1200 trainees having to resit their exams. A review pointed to issues with governance as key drivers of the fiasco.

Resigned: Dr Jackie Small and Lee Whitney

A year later, the RACP received official warning from the Australian Charities and Not-for-profits Commission that it could lose its charitable status, amid claims of — yet again — poor governance and inappropriate use of charitable funds.

Infighting amongst those at the top has been pervasive, typified by an extraordinary general meeting held in 2020 for a vote on whether to sack then- incoming president Professor John Wilson, along with his successor Dr Jacqueline Small and Professor Paul Komesaroff from the college board. Notably, each had been elected promising to reform the RACP and improve transparency for members.

In any event, the trio survived the vote, while those who called the EGM remained anonymous to protect them from “victimisation”, in the college’s words.

So perhaps there should be less surprise over the events of this month, which began with a brief notice on the college website announcing the departure of its CEO, Lee Whitney.

Resignations over ‘governance’

Few details were offered other than that Mr Whitney had resigned “after forming the view that the agenda of the RACP would be best addressed by a CEO with a specific focus on governance reform”.

How Mr Whitney had come to that conclusion only six months into the job was left unsaid. Nor were there any specifics about what he thought was wrong with the college’s governance and what was needed to fix it.

Adding to the sense of alarm over the departure of the former Chartered Accountants Australia and New Zealand executive was the announcement’s timing. That same day, the college unveiled a massive investment in IT and training infrastructure, with major projects underway including a renewed advanced training curriculum to meet AMC requirements, and new training and member management platforms.

Concerningly, the college could not say just how much it would be spending on these upgrades, beyond the fact that it would mean posting deficits until at least 2028, openly declaring it had not “projected an all-up cost”.

Governance was also identified as the trigger for Dr Small’s resignation a few days later, although again details were lacking.

What were her concerns? Were they structural – related to the planned reforms – or was she alluding to the failed EGM, or more infighting and bullying in the leadership? What, if any, was the connection with Mr Whitney’s resignation? Or with the multimillion dollar projects being announced at the same time?

And how would college governance be improved by the combined loss of its most senior employee and most senior elected member at such a pivotal moment in its history? Dr Small did not say.

“In my view, significant governance improvements requiring constitutional changes are required,” was all she wrote in her message to members. The paediatrician did not respond when contacted by the limbic.

Dr Small’s reticence and the timing of her resignation, just a month out from the RACP’s 2024 congress, as well as the college’s recent history of infighting, may point to an interpersonal issue rather than a purely constitutional one. That is according to those who know her, although it is pure speculation.

RACP restructure in the works

But there were some other clues that she was unhappy with the RACP’s performance in her president’s message of 4 April, which included a number of admissions of failure on behalf of the college.

“We know that our current delivery of services is not meeting your expectations and must improve,” she said as she announced the multimillion dollar upgrade of the RACP’s technological infrastructure.

“In education, we operate using a range of outdated technology systems and manual processes to deliver our current training programs.”

“Some of our current systems cannot support the new Basic and Advanced Training curricula that we are implementing to meet AMC accreditation requirements, and they need replacing.”

Read here for details about the investment, announced simultaneously with Mr Whitney’s resignation, which is expected to see the college post major deficits for at least the next four years.

Conversely, Dr Small said she was proud of her work to establish a “Board Council Governance Advisory Committee” tasked with considering a “board nominations committee and other strategies to improve college governance”.

Under her leadership, the board had begun planning to “streamline” governance of the college’s various committees and internal institutions, releasing an overview of three proposals in a communique earlier this year (link here).

“Our education governance structure poses a risk to our compliance with AMC/MCNZ and our overall performance in the current regulatory landscape where standardisation is strongly recommended,” it said in the overview.

“Varied and unclear reporting lines, and risk and issue escalation pathways impede proper oversight by the board on education matters, contribute to lack of accountability on decisions, and delay the decision-making process impacting trainees and members.”

Professor Jennifer Martin

New board chair Professor Jennifer Martin

“Our structure has ineffective communication and engagement processes in place with key stakeholders, such as Divisions, Faculties, Chapters and Specialty Societies.”

There was also a concern raised about the current structure posing a risk to “sustainability”, given the recurrent problem of prolonged vacancies for committee positions and increasing resource constraints.

The proposed changes are bureaucratic, but essentially amount to more centralised and standardised decision making by an empowered college education committee, moving away from the myriad of peak bodies currently operating under the RACP board. Stakeholder consultation on the proposal closed on 5 April, a day after Mr Whitney’s resignation announcement.

Its future is now in the hands of the reconstituted board, led by newly minted chair Professor Jennifer Martin, a general physician and clinical pharmacologist in Newcastle. She officially becomes president at the college’s AGM next month, where she will be joined by former PwC managing director Steffen Faurby, who has been announced as interim CEO.

The pair will have a job on their hands. With annual subscriptions rising above $2100 this year and with rival CPD homes now offering membership at a fraction of that price, the risk of fellows turning their backs on the college has never been higher.

It might just be time to open the doors of that grand old building in Sydney and let in some sunlight.

RACP statement on the appointments:
Dr Jacqueline Small has resigned as RACP President effective 12 April 2024. The President-elect, Professor Jennifer Martin, has been confirmed as Chair of the Board and will assume the College Presidency at the Annual General Meeting on 17 May 2024.

The RACP Board thanks Dr Small for her outstanding contributions to the College, its members, and its advocacy for a more equitable and sustainable healthcare system.

During her time as President, Dr Small has overseen significant RACP projects for greater visibility for women leaders and gender equity in health, a strong advocacy focus for child health, and for regional and remote workforce improvements. The Board Council Governance Advisory Committee Dr Small helped establish will assist the transformation work of the Board and the broader College.

RACP President-elect, Professor Jennifer Martin is a general physician, clinical pharmacologist and the Chair of Clinical Pharmacology in the School of Medicine and Public Health at the University of Newcastle. Professor Martin is also a member of the Corporate Governance Committee of the Australian Institute of Company Directors, a member of its NSW Council and the University of Newcastle Council.

The RACP has briefed the AMC and MCNZ about the transition and will continue to liaise with them as usual.

The Board has reiterated its ongoing commitment to improvements in training and education, governance, and member experience. We continue to work actively on these improvements. The RACP has a detailed set of operating plans and transformation priorities for 2024 which the leadership team will continue to implement.

Interim Chief Executive Officer appointed

We are also pleased to announce the appointment of Mr Steffen Faurby to the position of Interim Chief Executive Officer of The RACP and welcome him to the College.

Mr Faurby has held Chief Executive Officer and Board level roles in large state government education and transport sector organisations. He has Managing Director consultancy experience and has held prior international senior executive level positions in the global maritime industry.

Mr Faurby will join the College on 15 April 2024 and will formally take over the role of Interim Chief Executive Officer from 22 April onwards.

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