2023 | Volume 24 | Issue 5

Presidents perspective


I hope this message finds you well. I wanted to provide you with an update on our recent efforts and initiatives at the College.

As you may be aware, I have been communicating regularly on the College's financial position, and I am pleased to say that we've taken significant steps to ensure our financial sustainability. Our comprehensive plan encompasses a range of initiatives, including a thorough review of our governance structure, fee structures, staffing levels, digital transformation investments, and expenditures affecting our cashflow requirements.

In addition, we've introduced a risk-based internal audit program that places a strong focus on identifying and addressing key risks within our organisation. This program informs our annual audit plan, with a particular emphasis on the financial sustainability risk, project governance, and financial controls, including procurement, for the upcoming 12 months.

While it's anticipated that we will record a deficit for this year due to the high-cost structure we had, I'm pleased to share that we are making progress towards achieving a positive operational cash flow position in the coming year. Furthermore, we've budgeted for a modest surplus in 2024. These achievements underscore our successful implementation of financial turnaround strategies and our collective commitment to stability.

In addition to our financial efforts, we are actively advancing the transformation of the College's governance structure. This transformation aims to reduce bureaucracy, streamline processes, enhance transparency, and decrease costs. The result will be a smaller, more agile, skills-based board that will significantly enhance our governance capabilities and financial oversight making us better equipped to address the challenges our College faces.

We have started discussions with the presidents of the surgical specialty societies to begin work to streamline our core business operations, improve the administrative burden, and increase engagement and collaboration.

In August, I had the privilege of leading a senior RACS delegation to Darwin. During this visit, we engaged with the Northern Territory (NT) Department of Health to discuss our progress on the RACS and NT Memorandum of Understanding (MoU). This partnership seeks to improve access to surgery across the NT, and our discussions covered a wide array of topics, including specialist international medical graduates (SIMGs), general practice training, outreach support, external validation of professional practice, accreditation, diversity and inclusivity in surgery, the NT General Surgery Training Hub, and support for research.

We also had the opportunity to meet with various healthcare stakeholders, including the executive leadership of the Royal Darwin Hospital (RDH). This visit included a tour of the RDH and the Menzies Institute, where we engaged in fruitful discussions with our Fellows, Trainees, and staff.

I'm also pleased to report that our recent Fellowship Exam in Adelaide ran exceptionally well. The efficiency of our examinations team and the dedication of our local coordinators were greatly appreciated. Notably, the SIMG pass rates were comparable to the surgical education and training (SET) pass rates in several specialties.

The overall success rate was outstanding, with 71 per cent of SET and SIMG candidates successfully passing the exams. It's worth noting that women candidates achieved a slightly higher pass rate at 73 per cent compared to 70 per cent for men.

I attended the Aotearoa New Zealand Annual Surgeons Meeting in late August and had the opportunity to meet with the Minister for Health, the Director of Health, and the CEO of MCNZ among others. We had discussions regarding the changes to the healthcare system in Aotearoa and will continue to advocate on behalf of our Aotearoa members.

In Aotearoa New Zealand, the healthcare system is facing unprecedented challenges, impacting care provision. With elections due, the next government must address workforce shortages and infrastructure issues urgently.

The RACS Aotearoa New Zealand National Committee (AoNZNC) sought major parties' views on crucial surgical profession concerns, including workforce, health equity, women's health, Te Aka Whai Ora (Māori Health Authority), and climate change.

We received responses from Labour, National and the ACT Party. For detailed questions and responses, view this link.

AoNZNC also continues to advocate for Accident Compensation Corporation (ACC) compensation for earners who require surgery for injuries incurred when they weren't earning.

In other advocacy efforts, government consultations have increased. The RACS AoNZ is preparing a submission on the MCNZ's draft statement about disclosure of harm following an adverse event, suggesting alignment with RACS courses and consideration of the ’four Rs‘ format.

Lastly, I'd like to address an issue that I've spoken about on several occasions—the importance of respect in our profession. It is deeply concerning to hear reports from the United Kingdom of women being sexually assaulted, even in operating theatres, and women trainees enduring abuse from senior male surgeons. It is heartening to see many organisations in the UK condemning such unacceptable behaviour. I want to emphasise that sexual violence or any form of misconduct has no place in any work environment, including our field of surgery.

I have had several meetings with the Royal College of Edinburgh and the Royal College of Surgeons in the United Kingdom and offered our assistance in light of our experience with the Building Respect, Improving Patient Safety initiative.

RACS is committed to addressing discrimination, bullying, and sexual harassment. Legislation in Australia at federal, state, and territory levels, including in Aotearoa New Zealand, defines specific unacceptable behaviours. It is the responsibility of every professional in the workplace to be aware of and adhere to relevant legislation. In Australia, recent amendments to the Anti-Discrimination and Human Rights Legislation (Respect at Work) Bill 2022 require employers to proactively address and mitigate sexual harassment, harassment based on gender, hostile work environments, and victimisation to the fullest extent possible.

For those seeking information and resources on these important matters, I encourage you to explore the resources available on the RACS website, which can be found here.

Congratulations to the successful candidates and sincere thanks to all the candidates who nominated. The results of the 2023 elections to RACS Council will be tabled at our Annual General Meeting in Christchurch on Thursday 9 May 2024 when the newly elected Councillors will take office.

I want to thank each of you for your dedication to our mission and your commitment to maintaining the highest standards of professionalism and respect within our profession. Together, we will continue to drive a positive change and uphold the principles of excellence and integrity that define RACS.

Associate Professor Kerin Fielding