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Tuesday, September 02, 2008

Does e- Health (and NEHTA) Need Commercial Skills?

The Australian Financial Review published an interesting view while reporting on the arrival of the new CEO for NEHTA.

E-health body adds to commercial talent

Tuesday, 02 September 2008

The Australian Financial Review

Ben Woodhead

National e-Health Transition Authority chairman David Gonski has solidified the organisation's tilt towards a more commercial operating model by appointing a chief executive from the financial services sector.

It is the first major mark Mr Gonski, a director of Coca-Cola Amatil, ,Westfield Group, Singapore Airlines and ASX Ltd, has made on the country's peak e-health authority since taking over as chairman in July.

It brings to a close interim NEHTA chief executive Andrew Howard's stint at the authority, which started in April when founding chief executive Ian Reinecke quit after almost three years in the job.

Mr Howard will continue at NEHTA until September 29, when he will hand over to Peter Fleming, who is now general manager technology, business integration at National Australia Bank.

Mr Gonski, who steered the decision on a new boss with the board, yesterday welcomed Mr Fleming' s appointment to the role.

He said the banking executive brought a wealth of knowledge running large information technology operations from his stint at NAB.

Mr Fleming also had a strong background of working with key stakeholders in the health sector, thanks to a previous position as chief information officer at listed medical services provider Mayne Group.

More here:


The suggestion contained here is that NEHTA needs to be more commercially driven and focussed.

Can I say I disagree with that assessment utterly. What NEHTA needs is a cultural transformation to become a responsive service provider of e-Health Infrastructure to the total health sector and to become fully engaged with the issues and needs of that sector.

If it is really these motivations towards commerciality that have driven the new CEO appointment I must say I am more than a little concerned. What is required is for NEHTA to be reigned in and to be made to ‘stick to its knitting’ of delivery of necessary e-Health infrastructure in a professional way that understands and responds to the culture of the sector.

My understanding is that Peter Fleming was the CIO at Mayne Health from 2002 until 2005 or so.

This from the 2002 Annual Mayne Group Report.

“Peter Fleming.

BBM, GradDipComp

Chief Information Officer

Peter joined Mayne in 2002. He is responsible for information technology initiatives across the group, including the evaluation of emerging technologies to support Mayne’s businesses internationally.

Previously Chief Information Officer at Vodafone Australia and Colonial, Peter has also held senior IT roles with Coles Myer. Age 45”

Interestingly this was a deeply traumatic period for Mayne.

The details can be browsed here:


Essentially Mayne so badly mismanaged its hospital portfolio, and the doctors that worked there, that the hospitals were spun off the Mayne Group into Affinity Health (under new management)

This from the Financial Review in 2003.

“The sale is also likely to be conditional on approval from the Foreign Investment Review Board and the agreement of several state governments on whose behalf Mayne operates hospitals in Western Australia, NSW and Queensland.” Mayne Sells 53 Hospitals For $800m Australian Financial Review October 21, 2003.

The divestment was finalised in December, 2003.

I am sure having been an executive in such a period of turmoil, which eventually was the demise of the Mayne Group as an entity, (a demise triggered initially by a previous CEO not recognising the need to be pragmatic managers of health professionals) Peter has learned just how powerful such professionals can be if not dealt with appropriately.

I hope the lesson is well learnt and he can have much more luck the second time around with the sector. The sector sure needs it!

It is not commercial skills that will make him successful I believe – it is sectoral and cultural understanding of those he is to both lead (NEHTA) and support (the health system).

The best of luck with it Peter!



Teki said...

The commercial background of Fleming seems in parallel with the selection of Christine Bennett as Chair of the National Health and Hospitals Reform Commission.
There was a nice little trade magazine called Hospital&Healthcare, published by the Jaffa group. It has since been transformed into Hospital&Agedcare. In July '03, it published an article by Katherine McGrath, then CEO of Hunter Area Health Service, in which she said she expected Hunter to have an EHR within 5 years. McGrath moved on to be a Deputy Director in NSW Health, and then to Medibank Private's Group Manager Corporate and Medical Affairs. Gary Cohen of IBA used to write on EHR in the same magazine.
Five years later, both people are still significant players in the health care industry, but the dream of a national EHR is just as far away. I can't imagine either IBA or Medibank Private are too far away from Ministerial offices in Canberra. The commercial interests in health care rely on transaction fees for profit. Efficient IT cuts down on transaction costs. Hence percentages and perverse incentives are in play. There will be a lot of talk about EHR, but until the governments hear coherent and fully costed arguments from the public agencies, free of contamination from hidden commercial entanglements, it will remain talk.

Teki said...

More coming in through the revolving door - BHP exec gets top job at CSIRO.
How long before the new CEO has a close look at Australian e-Health Research Centre?

Anonymous said...

The commercial interests in health care rely on transaction fees for profit. Efficient IT cuts down on transaction costs.

Not all of the commercial interests in health care rely on transaction fees - some of them rely on subscription fees from their installed sites. Oddly enough, they've been focussing their energies on areas other than integration. (Things like better workflows on the clinical desktop and better information for practitioners.)

Teki said...

Megan Clark, the incoming CEO of CSIRO, was on the board of VPAC. VPAC, with a staff of about 50, specialises in data integration. They have a couple of health projects, including a cancer patient database. CSIRO has health data integration products, too. Seems like some scope for a new CEO to indulge in rationalisation and/or outsourcing.
If anyone goes to Information Technology in Aged Care, Melbourne, Australia, 4 September, please drop a line.

Anonymous said...

Hi Teki - I was at the ITAC conference. Happy to 'talk'. Drop a line where to?

Teki said...

Re ITAC conference - a few lines right here, perhaps?

Anonymous said...

NEHTA is definately more commercial and delivery focussed.