Mr Steve Rubic
When this interview took place, Mr Steve Rubic was the CEO of St Vincent’s and Mater Health Service Sydney. Having moved onto the position of CEO I-Med Radiology from 2012 until 2019, Steve was recently placed by Ccentric as the National CEO of Healthscope.
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Wayne Bruce (WB): Where you see the health care industry heading over the next five years?
Steve Rubic (SR): The health care industry will have gone through some major reforms in that period, both in the public sector and the private sector. I think in terms of public sector we’ll see much more accountability around the investment that community or communities and governments are making into the public sector specifically in New South Wales where we reside. There is sufficient money going into the health system, but I think it’s probably not being spent efficiently. There’ll be new structures in place there’ll be new accountabilities in place, and we’ll see a vast improvement seen in metrics in respect to health outcomes. I’m very confident of that but it will take five years to get there, in respect to private health I genuinely believe it will expand. I think there’s an opportunity in government for there to be some enhancement of competition policy, in terms of health and production of health services. I think the private sector is well positioned to be a participant in that. That could be both not for profit, charitable, or simply public listed private health providers. I think there’ll be an expansion in their service offerings. I think the other advancement we’re feeling here at St Vincent’s in modern health is around the technology issue and I think we’re on the cusp of vast improvements in terms of the use of technology. For us it’s around diagnostic services, in operating theatres, in Robotic Surgical Systems, and more specifically now, hands needed and more specifically pharmaceuticals. We are seeing great investments in innovation around pharmaceuticals and I expect that will deliver some fantastic improvements in pharmacological treatment of patients with certain illnesses. I have asked to think about one other area of improvement in the next five years. It would definitely be around the growth in research activities, both nationally and on a state basis. There is a lot of capital being invested in building research capabilities on most major health campuses in New South Wales and I understand in Queensland and Victoria. I think that would deliver quite significant translational research benefits for healthcare providers not just seeing test tubes on scientists desks and research papers being written but I think there would be seems quite practical improvements that arise out of research activities and an example might be one that’s relevant here. A fully artificial heart is within the next five years, so this growing need for transplants of transplanted hearts could diminish if these artificial hearts turn out to be effective. We think they might be. And of course, the other one is the cancer vaccines. Tens and hundreds of millions of dollars being spent on cancer vaccines in these research entities. I think you hope for our kids anyone that they’ll deliver some benefits in the next five years.
WB: You might have touched on this, but what industry trends have you noticed emerging in the last one or two years?
SR: There’s no question that there are some positive and some negative trends, I guess we’ll start with that with the with the negatives. I think the way that our expenditure or expenditures have risen so much in the last two years not so much in wages but I’m thinking medical surgical supplies, pharmaceutical supplies, the cost of medical equipment, the cost of information technology, it has been exhausting and I think for us to continue to cope with that there’s going to have to be some more rationalisation to deliver efficiencies in those areas, to hospital and health providers and I think that’s a major trend that will continue. In terms of positive trends we’re seeing a great deal of interest from Government and universities, in wanting to deliver solutions for the working shortages in nursing specifically but also in medicine and so there are a lot of university partnerships evolving between major health providers and universities to increase and to sponsor particularly nursing training programs at all some medical training programs.
WB: What do you see as being the major issues that are currently affecting your organisation, St. Vincent’s and Matar Health Sydney?
SR: For us, we need to continue to grow to remain competitive in the health industry. Growing both in the public services and private services, aged care and as previously mentioned we are growing in our research endeavours, so if we think about those four service lines it’s important for us to be cognizant of having to invest in all those areas and we are actually doing that as we speak. We are less impacted by the nursing shortages as mentioned, our issues are around being more efficient as a health provider, both in a group sense, but also in a national group sense, and I think potentially there is room for industry efficiencies particularly in Catholic Healthcare.
WB: Do you think because you’ve got a fairly unique mix of public and private research, and emerging into aged care, do you think that gives an organization like yours a competitive advantage in the marketplace whether that’s private public or whatever it might be?
SR: Oh most definitely, I mean our interactions with government, and with our interactions with health insurance funders, our interaction with investors of capital. They see us having characteristics of all those types of providers in health, and they certainly see it as advantage. We use it strategically, we leverage off it when it is convenient and appropriate to do so, and it’s given us some big wins. At the moment we are trying to pilot with New South Wales Health, a new management model for one of their rural hospitals where we’ll put a small private hospital onsite and potentially we’ll manage both the public and the private, and that’s unique to us because of our experience now and characteristics, I think the community see it as a significant positive attribute, and while all our stakeholders think that is important we’ll continue to use them.
WB: Talking about stakeholders, the mission and values are very important to St Vincent’s and Matar Health. How does that manifest itself in the strategy, but also the operations of the service?
SR: We don’t do everything well at St Vincent’s and Martar, but what we do well is culture. We do values well, and most of our staff are very clear on what our mission and vision is, and I think in this current environment of challenges in healthcare that serves us very well. It is good to hold managers and staff accountable for the values of the organisation, we manage people by the values, if they don’t perform consistently with the values, we take it a different path with them. So, we do hold people accountable, that’s important it’s good to know the history, tradition, the foundations of these hospitals and this healthcare system we have, and to continuously tell the story, and we do that very well. And as you know, St Vincent’s Public recently turned 150. St Vincent’s Private has turned 100 this year, the Matar turned 100 years a couple years back, St Josephs turned 125 years, and that tells you something about the mission and the values of these organisations. It is probably the single largest distinguishing feature, between us and our public hospital cousins, and our private hospital cousins, who were not so mission focused as we are, and again I mean all our stakeholders, particularly the community and our patients and their doctors see that as an important feature of what we do.
WB: Do you see that there might be further consolidation that occurs within the Not-For-Profit healthcare sector?
SR: I think it’s a must, I think there must be further consolidation in the Not-For-Profit sector, even just to remain competitive, in terms of some of the pressures I mentioned earlier unless we get more efficient, particularly around the so-called back of office operations, payroll, finance, I.T. It’s expensive to run them in isolation, it’s hard to keep up on the investment required in those areas and I think that will force particularly the smaller Not-For-Profits that will find it hard to get access to capital, will have to come together. If it’s not in the next five years it’s certainly not needed after that.
WB: What do you think are the key issues facing St Vincent’s and Matar Health, in terms of attracting and retaining senior level talent senior level executives?
SR: That’s an interesting question, we like every other provider have a large part of our workforce being nurses at an average age of close to 50, and that’s a different generation, they view the world differently. The youngsters that are coming through, these Generation X’s and Generation Y’s, want and desire, very different very different things from their employer. So, we’re having to actually try and refocus some of our human resources policies, and practices and flexibilities that are built into our enterprise agreements, and I think that’s a challenge for us. Health is a very logistic focused, based on logarithms, that say start here and go to three hundred for a particular process, and it’s not easy to build those flexibilities into wards, and operating theatres, and kitchens, and that’s a major challenge for us. We need to rebuild that platform of how we engage employees, and I think that’s a huge challenge for us.
WB: Going back to an earlier question, do you think that again having that unique cluster of public-private research. Do you think that gives you an advantage in being able to attract key people?
SR: In terms of attracting talent, we don’t have a shortage in attracting people, the challenge is keeping them engaged and keeping them challenged once they join us. We tend to be for those reasons that you mentioned, we tend to be a magnet. So, we have people knocking on the door wanting to come at both leadership levels, senior clinician levels, and even at non-clinical levels. In part because of mission values, in part because they see us as dynamic and that’s true. But once you get them they have to be challenged and I think about many of the under 30 year old’s I meet with and what they say to us is, unless you challenge me, I can’t hang around for too long. And they want that, it’s an interesting dynamic.
WB: So, how as an organization do you try and provide that challenge?
SR: We invest a significant amount in leadership and development training, and we run various modules of that on our own. We have a number of university joint ventures, in terms of ongoing training, even including nursing, ongoing postgraduate degrees. We sponsor more than ordinary organizations, for people wanting to have ongoing education, we do that well. We do a lot of events and activities that don’t relate to education but engage staff around functions and the usual social connections that you build with staff that, but we go out of our way to really invite staff to be part of that and many take it up, many but not all, we do Christmas spectacularly well, not because we’re Catholic, but also because we think it’s important to engage staff, so there’s always something on, we are never short of interacting with staff.
WB: And lastly Steve, what do you think are the key competencies that today’s senior health care executive needs?
SR: There’s no question, they have to have strategic capacity, if they can’t think strategically in the senior leadership levels, they are probably in the wrong position. We have many terrific people, particularly middle management levels, and they do a fantastic job. We’ve tried some of them at more senior leadership levels, some have done well, some have failed. The clear distinguishing feature isn’t how hard they work, they all work very hard, it’s their capacity to think high-level in terms of strategy, development, future, and building capacity. Particularly organisational capacity in the organisation and if you’ve got great organisational capacity you’ll achieve a lot.
WB: Thank you very much for your time today.