Even RACGP values suggest that if you suddenly get rid of what appears to have been your best and most successful CEO ever, you should probably explain yourself, even just a little, to your members.
The silence and mystery surrounding the sudden exit of RACGP CEO Paul Wappett this week has, in one fell swoop, taken us back to the bad old days of the RACGP – the days when it was okay to do what you want at the top, wave off very weird goings-on with official puffery and talk of confidentiality, and have no regard at all for transparency or, more importantly, for actual member input or engagement.
Trust us, we’re the board.
When Mr Wappett landed at the RACGP just over two years ago, things were in bad shape all over the place.
Despite a pretty good president at the time, the previous CEO had proved not up to the task and after eight months had to be ejected, timing that was less than ideal given the situation with the college taking over training which would more than double its size and complexity.
The task of taking over training, given the government position, and the run-in, was mind-boggling.
The political situation was severe with the government ramming through objectives that seemed crazy on a timetable that was crazier and the logistics of hiring over 700 new employees mostly from various registered training organisations around the country in just a few months beyond doable.
The change management required within the existing organisation required without collapsing under the weight of the newcomers was unprecedented.
During the process we wrote the following:
“Dismantling every one of them [RTOs] and trying to put them back together again in the space of 9 or even 18 months is a business management transformation project that would be beyond the dream team of the world’s greatest business managers of all time.”
“Given the state of RACGP management experience and capability, no amount of consulting firm contracts and assistance is likely to result in any magical solution to what is, on paper so far at least, an impossible business problem.”
You could shrug at these statements and think, we were simply way off the mark.
But we weren’t.
It was a gargantuan task. Much smaller transformations in some of Australia’s best-run corporates have gone off the rails quite rapidly in recent times.
Unless the board is holding something really big back from everyone, Mr Wappett seems to have done an amazing job.
And not just on training.
He appears to have given the exam disasters serious thought and invested a lot of time and money into getting that vital process fixed moving forward (it’s probably not all there yet, but it’s a lot better).
Even if there were some dead bodies lying around that nobody is being told about, it’s so far, an amazing job, given what he was handed when he started.
What about the financials?
At one point the college seemed to be staring down a $10 million deficit in the changeover which was initially a shock to many. That said, in such a huge transformation project, on such tight timing and with some wild asks by DoHAC thrown in, it probably should not have been any shock at all.
But even this problem seemed to be well managed. It has been reduced to only $5.6 million in the last annual report, and – if you can believe that report – is under control following swift cost control actions taken by management (and the board) earlier this year.
It’s hard to look at any KPI that Mr Wappett might have been facing and see him leaving it worse than when he started.
Let’s quickly score a “before and after” on the seven key objectives outlined for the college in its 2022-25 operating plan:
| Objective | Goal |
Degree of difficulty (10) |
Current state (10) |
A year ago (10) |
What the annual report says | Wappett’s score (10) | Comment |
| Career attractiveness | More doctors see the specialisation as their first choice of medical career | 7 | 3 | 1 | 19% increase in register applications, 18% increase in application submissions | 6 | Has been in decline for five years, so stemming it to any extent is a good start |
| Optimal coverage | All communities in Australia have access to well trained competent GPs | 9 | 5 | 6 | Nothing. Report just pats college on the back for successful transition to managing training | 7 | Abandoning bulk billing has significantly disrupted the system and is reducing access in the short term. If you were scoring Wappett for the transition he’d get 10 |
| Whole person care | People regularly consult GP as an essential part of maintaining and improving their health and wellbeing | 8 | 7 | 8 | $5.7 billion for strengthening Medicare, $1.5 billion for Medicare indexation | 8 | Again, things are slipping, but the government has never been so on-side and lots of money and programs are being thrown at the problem now |
| Supportive regulatory settings | The value of GPs is reflected in policy settings and funding arrangements to support quality and sustainable patient services | 7 | 6 | 3 | See above | 9 | This stuff really falls on the president and others more than the CEO but he’s at the helm so he gets the mark |
| Connection and life-long learning | GPs choose to be members of the RACGP in order to be part of a supportive community of practice in which they can gain and share knowledge, resources and experience throughout their career | 8 | 7 | 3 | Significant CPD platform investment, new relationships with education providers, NT faculty established, significant research funded | 9 | Biggest turnaround in support for college by its members in history. NFP score gone from negative to positive |
| Great employer | People want to work at the RACGP because we do meaningful, challenging work and have an extraordinary culture and employee value proposition | 7 | 5 | 2 | Not a lot said other than they employ another 700 people and do a lot. No measurement of goal in terms of people wanting to work at the college | 6 | Some progress from what has been described in the past as a pretty toxic place to work. 50/50 now on independent review sites, still bad on senior management comms |
| Financial stewardship | We use members, public and other funds responsibly and sustainably | 9 | 7 | 6 | 2022-23 cost reduction, 2023-24 says focus will be on financial and cultural stabilisation | 7 | Maybe the biggest question mark and hint as to what is going on. Is it much worse and trending badly in terms of finance and people? |
On this scoring, which comes mainly from available reporting and documentation, and a little external assessment on my part, Mr Wappett scores an average of 7.4 with a pretty high degree of difficulty against most of his objectives.
Now according to the college, Mr Wappett has done nothing wrong from a legal perspective, so we should be able to assume it’s a mix of performance and, possibly, disagreement on strategy direction and execution. Thus far there has been no hint of the latter, so let’s look at performance.
To offload someone like the board has, with no red flags or forewarning of things being off-kilter, you’re going to need a CEO that is performing more like 1-3, not 7.4. And even then you should have been seeing it and flagging it in some way.
So what is happening here?
It’s very difficult to discern so far. No one is talking. It’s tightly locked down.
The only hints we have so far is that whatever Mr Wappett has been doing, it’s off-track quite a bit from where the board think they should be heading.
The board thinks the college is all about a major transformation remember.
So, the transformation is off track?
And that is Wappett’s fault?
Given the starting point, it’s hard to see how you could be blaming Wappett at this stage.
Other confusing factors might be what the government is doing and what the board thinks the government should be doing, but given GPs have the most supportive government they’ve had in decades, it’s hard to see this is an issue.
No matter what is going on the board has created for itself a massive problem with members by playing the silent card and specifically, by timing the exit, seemingly deliberately, so members had no chance to question what was going on at last week’s AGM.
It looks very deliberately controlling and secretive. It looks like the old RACGP.
It’s worse than that though.
Let’s just say the board has a really good reason for what they have done and Mr Wappett is genuinely screwing things up, or has screwed things up.
What role has the board had in such a situation?
Potentially, a lot. So being quiet looks in one sense like the board is covering its own backside.
If things are so bad that you’ve had to ditch your CEO, what aren’t you telling members, that really they should know? And how much of that implicates the board in the issues that have seen the departure of Mr Wappett?
The board’s bigger problem is that while they want to keep why they have done what they have done a big secret, everyone is going to speculate, like I am here.
It’s a vacuum into which conspiracy theories will likely flood. That’s very bad leadership and management on the part of the board.
But that isn’t all that surprising.
The board and its governance is entirely wrong for what the college has become, a giant and very complex training and governance organisation/company.
No one on the board has any decent experience in business, let alone the management of the complex business the college has now become by taking on training.
The board is not designed in any way to oversee the financial, logistical, people and strategic issues that running this organisation has evolved into.
Essentially, the board is made up of a group of GPs, some GP owners (who will claim business experience but won’t have anything like the experience they need to bring meaningful advice to this organisation) and a few GP academics, all with very limited experience in managing such a business.
That’s not to say that GPs shouldn’t be a big part of a board running a GP college. They should be. But there is only one person on the board who is not a GP. And that person’s CV isn’t anything out of the box in terms of finance and governance experience.
In the light of this problem, members could rightly be very worried about what has actually gone on here.
It shouldn’t just be a group of GPs and GP practice owners trying to work out the future of such an important organisation to the wellbeing of all Australians.
GPs should be there, and they should control it all, but there should be a sensible mix of expertise the GPs can defer too when required.
Without any explanation as to what has gone on here, it’s not just members who should be worried.
It’s the government, which just handed over $120 million per year to the college to run GP training across the country.
The CEO that seemed to execute the initial transition, against all odds, has been sent packing with zero explanation as to what is going on.
And there isn’t much else left in the way of business expertise to manage the government’s money, and the most important doctor training set-up in the country.
While the board attempts to keep everyone in the dark on what is going on here, people could be excused for thinking the board is running the place like it’s a fiefdom.
