2023 | Volume 24 | Issue 6

Presidents perspective

Dear colleagues

It has been a challenging year but one that is ending on a positive note.

Despite the challenges, I am pleased to say that we are on a positive trajectory compared to where we were earlier in the year. I would like to commend the great effort by our staff, Council and the Recovery Committee who worked so hard to help restore the financial health of RACS. We are diligently working towards achieving a break-even position by December 2024.

I also want to thank you—our Fellows, Trainees and Specialist International Medical Graduates for your patience and understanding as we navigated the difficult times we faced as a College.

In the last six months, we have implemented a financial sustainability plan, including a review of governance structure, fees, staffing levels, digital transformation investment, and expenditures impacting cash flow requirements.

We also initiated a risk-based internal audit program focusing on key risks included in the annual audit plan. This plan centres on the financial sustainability risk, encompassing project governance and financial controls, including procurement for the next 12 months.

We want to assure you of our commitment to transparency and accountability in fund allocation. The sustainability and success of the College remain paramount. Our 2024 annual budget reflects months of sustained efforts and initiatives—aimed not only at attaining a surplus but also at strengthening the institution's foundation for the long term.

While we anticipate a deficit this year due to the early high-cost structure, progress toward achieving an operational positive cash flow position in the new year is evident. We have also budgeted for a modest surplus in 2024, showcasing successful implementation of financial turnaround strategies and shared commitment to stability.

Looking ahead, we are refining our governance structure to better serve the bi-national nature of the College. The proposed separation of Council and Board structures—with a focus on skill-based responsibilities—is underway, and updates will be communicated to Fellows on completion.

More recently, we announced the appointment of Stephanie Clota as our new chief executive officer effective from January 29, 2024. Stephanie brings a wealth of experience to the Royal Australasian College of Surgeons (RACS), most recently serving as the CEO of GPEx, South Australia's leading primary care specialist training and workforce planning organisation. During her tenure at GPEx, she spearheaded the successful delivery of the Australian General Practice Training program in South Australia and oversaw its transition to a college-led model in 2023. Please join me in welcoming Stephanie to our team. We look forward to her many contributions and the positive impact she will make to our College, Fellows, Trainees, Specialist International Medical Graduates, staff and the communities we serve.

In Aotearoa New Zealand, a new government was sworn in on 27 November, and the National/ACT/NZ First coalition has been quick to show its intention to take the country in a new direction. We developed a briefing paper, highlighting the main issues and detailing how the College can help provide workable solutions. Some of the recommendations we made in our paper include our willingness to train more surgeons if the government funds more training posts and the importance of supporting Māori and women surgeons as an important element in improving diversity and health equity. Read our briefing paper to find out more.

In Queensland, our Trauma Committee held a successful symposium with Jamieson Trauma Institute. The event was part of RACS Trauma Week and aimed to tackle an increase in e-scooter injuries and deaths since the devices gained popularity in recent years. E-scooter injuries are growing and constitute five per cent of trauma admissions in Australia and this proportion is increasing, putting pressure on emergency departments and operating theatres.

Our Surgical Workforce Census, which is conducted every two years to guide workforce planning and advocacy, is out now. The census collects valuable data on work patterns, wellbeing, and future work intentions for Fellows. We had a great response rate of 24 per cent and there are some interesting findings on various topics such as work hours, public and private employment, regional and rural practice, pro bono work, wellbeing and surgeons’ future work intentions. I encourage you to read the full report.

We also released the RACS Activities Report, which provides interesting insights on our surgical workforce.

As the year draws to a close, I take this opportunity to wish you a happy and safe holiday season. I am sure that like me you are looking forward to a wonderful new year.

Associate Professor Kerin Fielding