Continuing our recognition of divisions, Karen Burge reports on the two finalists of the governance category in this year's Divisions Achievement Awards.

IT'S said that good corporate governance is like building a skeleton, but the challenge lies in putting the flesh on the bones.

Whether it's a multinational company or a division of general practice, sound governance is the key to a well functioning business. The recent 'Review of the Role of Divisions of General Practice', commissioned by the federal government, stressed that divisions would be subject to rolling audits and higher governance standards.

So now, more than ever, good governance is becoming a higher priority for divisions that have not already set the wheels of change in motion.

The Divisions Achievement Awards 2003, in November, will recognise the hard work of a division that has been dedicated to improving its governance. The winner will have shown that governance is a priority that has led to improvements in the division.

Two urban divisions - Brisbane South and Central Sydney - have been named finalists in the governance category, and punters say it will be a tough decision for the judges.

The Brisbane South division made a strong commitment to good governance in 2000 which led to some major changes, including creating a sharper strategic focus, encouraging amore active board, conducting annual governance reviews and ongoing training. It has consistently achieved or exceeded its targets in all business plans prepared since1999.

CEO David Gardner says the division is pleased to be a finalist and hopes other divisions can benefit from their approach.He says governance can't be handled in a light-hearted way, if divisions are to achieve all they can. "It's something that we are very proud of." We take the divisions movement and our role within it very seriously and if, in reaching the finals, we can help other divisions improve their lot in life, then that's a good thing. We're all in this together."

Brisbane South has made governance a big focus over a number of years and when the division sought a new CEO in1998, the decision was made to find someone who was a professional manager rather than a health bureaucrat. This was followed by an in-depth review in 2000 of the internal systems that were in place, and what structure could ensure the best outcome for the division, GPs and populations they served.

A number of steps were then taken to improve governance and roll out the recommendations from their review."Over time, we've really worked hard at having appropriate governance to ensure we achieved all we could," Mr Gardner says."We have limited resources and what we really need to do is be the best organisation we can and make the best use of those resources."

The Central Sydney division has also made a leap in terms of governance in the past few years, setting up a system of 'advanced governance'. It is a process designed to improve the quality of governance and fulfil the division's mission to improve healthcare in the community by supporting, educating and advising local GPs and their staff members.

Directors and staff have been proactive in compliance, legal liability, strategic planning and financial management, to name just a few areas, and the division has formed a policy for the ongoing training of directors."We've actually come a long way in a very short time," says CEO Dr Michael Moore."We were one of the first 10 divisions established and, in order to expedite things, the division decided to make the Central Sydney Area Health Service the corporate entity, rather than setting up as an association or a not-for-profit company.

"That model provided many advantages at the time but eventually, Dr Moore says, it became problematic and "the division started to lose credibility with local GPs". In 2000, the division's management committee chose to break away from the area health service and establish a not-for-profit company, as many other divisions were doing.

"In the past three years, the division has had to start from scratch. When you build a house from a greenfield site it's fairly straightforward, but when you have to demolish the house that was there before and build on top of it, that can be fairly complicated and that's really what the division had to do," Dr Moore says."I've only been here for the past 18 months so a lot of the hard work was done before I started, but, basically, they've taken what was good from the old structure and maintained it, and built the governance from the ground up.

"We've now got in place a governance structure that is as good as anywhere else and probably better, in that we've streamlined things and made them very simple and straight forward."In developing good governance,Central Sydney drew on the experiences of other divisions to work out the right path."We are very much focused on the fact that we exist to improve the health of our community and that is a mantra we repeat at every board meeting.It's the first item on theagenda," Dr Moore says.

We run things absolutely democratically and are continuously examining our processes to make sure that were present the aspirations and ideas of our GPs." As for the competition, Dr Moore says Brisbane South is a very good division."Brisbane killed us in the AFL; they could get us in the governance category, too". MO

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