High flyers

In our series of interviews with CPAs, we meet Andrew Whittingham, acting CFO of The Royal Children’s Hospital Melbourne, who plays his part in caring for some of the sickest kids in the country.

What has kept you in the health sector?

You come into the hospital and every day there’s the opportunity to help. Public health is about trying to get the most out of what you are given, to treat as many as possible, while also giving hope and opportunity to those more complex areas. Although finance is traditionally back-of-house in a hospital, it is fundamental to making sure the place keeps going in the long run. Kids come here from all over, whether for our transplant program or other specialties. It’s the only place in Australia offering paediatric heart transplantation.

What is the hospital’s biggest challenge?

It’s the ever-increasing demand and patient numbers while trying to manage available resources and the cost pressures of innovations and new technologies.

Meaning as technology advances, it gets more expensive to deliver better care?

It does and that’s what we face, on a dayto-day basis, whether to use an innovation in drugs or technology. You have to work to balance the care your patients require, which can often be incredibly complicated and resources-intensive, and manage that within the hospital’s overall resources. Sustainable health care is the big issue and you embed that in everything you do.

It must give your decision-making an ethical dimension outside many CFOs’ roles...

You can never take the fully commercial decision – and nor should you. When you’re the leading children’s hospital in Australia, if not the entire Asia-Pacific, you attract the most complex patients. Sometimes there’s no other location for them.

Who are “complex patients”?

The hospital treats some of the sickest kids in Australia, from those who need cardiac surgery to children with major clinical conditions, such as cancer, and complex developmental issues. That incurs a lot of expenses but you deliver the care because it’s our role in society to look after the sickest kids when they arrive here, even if there isn’t a perfect funding model to achieve that. You’re trying to get the most out of every dollar to both provide health care and become more efficient in delivering it – getting more capacity into the system. But you’re always coming back to the challenge of advances in health care versus the volume of kids waiting to be treated. There’s a finite pot of money.

How do you face those decisions each day? What questions do you ask?

I work with a great team of clinicians who make their decisions based on the clinical evidence.

rout in There There area lot of kids who are under of kids who are under routine protocols but with the more extreme cases, you do rest with the advice of the senior eminent clinicians. We have challenging conversations about what we can do and how much we can invest in. You ask: does the clinical research back up where you’re going? Sometimes, clinicians come back with international research that shows it will lead to lower complications so those techniques are supported. Or surgeons or nurses suggest a new technique that saves bed days and that can contribute to the cost of new equipment.

What’s your most exciting achievement at The Royal Children’s Hospital Melbourne?

Being part of implementing the Electronic Medical Record. Launched in 2016, the EMR replaces paper- based medical records. Clinicians can access a child’s medical history and pathology test status and make immediate clinical decisions. The EMR assists with prescribing medication, as it prompts warnings on dose and potential complications. Having pathology test information available also minimises duplicate ordering of tests. I was just one cog in a much bigger project team but it is one of the most signififificant electronic medical record implementations in Australia and was talked about worldwide.

Is there something you’ve learnt about leadership that would have surprised you when you were more junior?

No-one can ever underestimate people skills and listening to other views. You can have strategy and know where you need to get to but the communication, the selling of the message, implementing it and grabbing everybody on board to achieve it, they’re the key things that are missed a lot of the time.

What’s been your biggest career break?

I think becoming acting chief fififinancial offiffifficer at The Royal Children’s Hospital Melbourne. It’s the type of role you aspire to from the day you leave university qualififified as an accountant. And every day you come in here, you’re supporting great clinicians and other health professionals. Every day you’re giving something back.