Mental Health Training

#3 How he leads from behind – Pat Grier, ex CEO, Ramsay Healthcare (s01ep03)

Sep 15, 2021

Pat Grier is the ex CEO of Ramsay Health Care. Pat talks about how he established a vision for Ramsay Healthcare to be recognised as the best hospital operators in Australia, and how he developed the term leading from behind. Pat reflects on his proudest achievements in his career and the lessons that he learnt from the many obstacles that he encountered.
"Certain people have faith in you and help you along the way. Those are the people who have actually made a difference."
- Pat Grier


  • Pat talks about how he established a vision for Ramsay Healthcare to be recognised as the best hospital operator in Australia
  • how the term “leading from behind” develped
  • Pat’s proudest achievements in his career
  • Lessons learnt from the many obstacles that he encountered.


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Transcript from the interview

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Graeme Cowan, Pat Grier

Graeme Cowan  00:02

Hi everyone, this is Graeme Cowan, and welcome to the caring CEO podcast. We create this podcast because we believe that every leader is number one priority is to build a more caring and resilient team who enjoys growing together. It is my job to interview CEOs and other senior leaders who value building both a culture of care and a culture of high performance. I’m very keen to understand how they do this. And I’m sure there’d be lots of insights and tips for anyone who wants to build a high performing team. I’m really delighted that Pat Grier the former CEO of Ramsay Healthcare is one of the first interviewees on the caring CEO podcast, you’ll hear how Pat arrived in Australia with just five suitcases his wife and three boys and $2,000 in the bank to how he grew from that start to be the CEO of Ramsay Healthcare. During the period that he was with Ramsay the number of hospitals went from just over 10 to up to over 100. And he really believes that that happened through a philosophy of leading from behind and explains what that is he didn’t see himself as being rah rah CEO, but just really striving to understand the 80% good in all employees and all direct reports and focusing on that to help a person to go outside their comfort zone and grow as an individual. He was also very successful at changing private hospital policy with the government and describes how he went about doing that. He was very proud of his time at Ramsay Healthcare in building this incredible culture and then being able to hand it over to his then Chief Operating Officer, Chris Rex, who took it again to another level. Finally, he really believes in the benefit advantages of obstacles, because he was able to really reflect and identify that obstacles led to him being more creative to his team being more creative and to the organization being more innovative as well. And finally, he does talk about his one regret. And this is a salient message, I think, for anyone who’s aspires to senior leadership, and he outlines what he would do differently. Some great words of wisdom and gems from Pat, and I really hope you enjoy this discussion. I’m delighted today to welcome Pat Grier. Pat is the former CEO and poor director of rent and healthcare perpetual and Ramsay’s in 1987. It had 12 hospitals and an annual turnover of 300 million and was in financial difficulties. When he left in 2017, it had 100 hospitals, 3 billion turnover 35,000 staff and approximately 300 million in annual profit, and even though rarely had stellar financial growth, they also had half the injury rate of comparable health care organizations. Since stepping down from Ramsay, Pat has served as a non-executive director on number of boards. It’s very, very fitting that Pat is one of our first interviewees, because I learned a lot about the value of having a culture of care from Pat and chain. I first worked with Pat in 1987, where I hoped to recruit Chris Rex as his chief operating officer, Chris lead, became the CEO when Pat stepped down. Pat is certainly a leader who has embraced a culture of care and a culture of growth. Welcome, Pat. It’s really great to have you on the show.

Pat Grier  03:49

Thank you, Graeme. I’m looking forward to this interview. Because as you say, we’ve been back, we go back many years. And it’s quite nice looking back on how things started and what came together. And you’ve mentioned Chris Rex, that was a great point. Thank you very much. And that is through Jeff Morgan, and you and so on. But secondly, you are instrumental in helping me sell the Ramsay Way to our staff, particularly our general staff as opposed to the executive so we go back a long way, Graeme, so I look forward to this interview.

Graeme Cowan  04:21

Yes, thanks, Pat. We do know each other pretty well. And I know you’ve had an unconventional background, certainly someone who is in Australia now and it’s been very successful. Your childhood was in Zimbabwe or was formally known as Rhodesia. What was it like growing up there?

Pat Grier  04:41

Well, I’ve got to say by my memories of Rhodesia, because when we left it was still it was Rhodesia becoming Zimbabwe are in general turns happy. I got to say it was a great country to be growing up in. These days. You don’t mention this but because colonial Africa a preserve trust. This country, unlike South Africa, to a large extent, we got on very well with the blacks, the whites, and we mingled very well. And it was a very prosperous country. And I look back to my childhood, in general terms, and I can go into some of the negatives of it, which actually made a difference to the way I developed myself. But in general terms, it was a happy time, I’ve got to say Rhodesia was a great country to be brought up in.

Graeme Cowan  05:25

And also recall that you had, you know, a challenging family environment. Do you want to just explain a bit more about that?

Pat Grier  05:32

Yes, I don’t harp on it. But I do know that my upbringing, especially if I didn’t make it has made a big difference to how I developed and how I have developed over the years. Some people have eighth ocean and just say, Well, I just had a great childhood, great family. And thank you very much. And, and I’ve moved on. But in my case, it had a couple of fundamental emphasis on me. One of it was I was really an only child, wake up marriage, I remember the marriage breaking up, it was all sad and all the dramatic, and my mother was left on her own single mum. And I did have the draconian grandmother’s there for a while. But my sister was nine years older than me. And my brother was 11. And I left soon after the breakup.I grew up as a single in a single family. My mother was very distraught about the breakup and never got over it had to work really hard. And so my thoughts of those days of those days is that it was a lonely time, particularly doctor work early came back exhausted. The second thing is not having brothers and sisters, etc. I do remember not in the loneliness, but also, we just didn’t have any money. And a lot of people can say that everybody said it. Not even a lot of it. But I do remember the beginning of the month, getting meats and mince and Oh, fantastic. I knew that it was payday, because we got a whole lot of things. By the end of the month, it was basically just the basics, the basics, rice and things. And so those two things, not having any Venus, quite a lonely person at home. And don’t ever remember my mother saying she loved me, I was actually quite good at sports, she never once came to my sport and sound. So this is not so much was me. But more, it made a big difference to me later on. And I turned to my friendships, my my friends, I stayed with other people a lot in those days. And it was the friendships that actually made me feel good about life in those days. And that’s why I think I have grown up and wanted people around me and enjoyed people and made a big thing of my life, working with people, motivating people. And that word people comes the whole time to my mind. And I think that was because of my loneliness at the time, the lack of love, and so and so I got to actually go well, it’s funny enough, turn around and say it wasn’t the greatest. As far as family, anything’s concerned. But it helped make me for the rest of my life.

Graeme Cowan  08:06

Great insight and point there. You got married, you had three children. And then you made a decision. Can you just explain about what led you to leave Rhodesia and what it was like arriving in Sydney Airport, with your wife, three kids and five suitcases?

Pat Grier  08:27

Well, I can tell you it was pretty daunting. Take a step back after school and so on, I realized that I had to create my own future. And that I liked the idea of business, I really did. And I liked the idea of being a leader and so on. But I had to make myself a better person. So I did a whole lot of courses, etc, etc. I also was concerned about the future of Rhodesia at the time. And I thought, well, if I am one day going to lead this country, I better take some courses and so on. So having got married and don’t have children. And so I also spent a lot of time doing every course that I could find. But nevertheless, I didn’t really want to leave. And when it looked like we were going to get independence. And so and I think this is fantastic, great country now we’re going to have money pouring in. And the firm I work for said oh, this guy’s got a better future. So let’s see, we can offer him a good job to stay and all the things. Well, I got to say my wife Delene had a she’s had a lot of influence on me on various directions I’ve taken and she saw Mic Harvey come in and took one look at him and said, Well, this guy, boy, let’s get out that you can’t trust him. And so a few things happened. We’ve gone through a war terrorist war, we call it terrorist equal to freedom war, and people would have died around this. My wife was actually getting prepared to go out one night, and she heard on the radio that her cousin had been killed in the war on his farm, and that’s it. We’ve got to get out of here and even Magog came in. She took one look came and said, We’re going I said, Well, hey, we just about to go were about to grow we better, Well anyway, she was right, we left. But you know what we left with five suitcases and those days you couldn’t take money out where you find out but couldn’t take money out we left the house in the bank lost all that. And we came to Australia was no job. CV I gotta say was a bit expanded a good way of putting it. I went to my boss when I was leaving. So here’s my CV, but it’s pretty standard. This is this year are you? I can do it. I can do it. I wish I could. No job CV. And I still remember arriving with three children, one in nappies, sitting under the Harbour Bridge, the lawn, under the Harbour Bridge in Sydney. Only we only knew one person in Sydney and two people in the whole of Australia. And then my wife was saying, isn’t this fantastic? We’re gonna make it here. One or $2,000? You got to be joking. That’s how we started it was it was scary. It was scary. No job $2,000.03 children, one in nappies. But a very, very supportive wife and saying, Come on, we’re going to make it in Australia. How did you get your first job? How are ya? It’s an interesting one, we got to say we did. We went to a dinner with a friend of ours, we only had one friend here. And I met up with a guy called Bill Potter. And he listened to our story. And I think he was quite taken very, what I done, and so on, and so on. And so he said, I don’t have a job for you. But I think you’d be best to go and do an analysis. I wanted those job analysis type thing. And guess what, from that, he gave me a job. And it was very, it was quite quick, actually. But the hard part about it is that, you know, I had promised that I would deliver all sorts of things to get the first job. And I really didn’t have all the equipment to do it. But I believed in myself, but it was tough. So there you’ve got a job that you was really way above your ability at that stage or your experience, not ability experience. And it was very tough. But I knew if I lost my first job, very, very, very tough. So, boy, you had a term. And then we had to find places to live. And we decided my wife who I decided we’re not going to go off into places that are tough areas to live. So we overextended ourselves there at providing security for our kids, we bought clothing that they had to wear to the school that looked like going from a business bag. And she couldn’t work because he was one of those fissures in Naveen. So this work I got, I got to say it was a scenario was that my immediate boss didn’t want me, I was put in there because Bill Potter believed in me. And I’ve got to say if there’s one person that I’ve got to thank it’s Bill Potter, in so many ways of giving up his job, but he also taught me all about building a business, building a culture, and building something around people. So that was my first job. And it was bloody tough because it was way out of my ability at that time. But I knew that I had to be successful. Also, you know, I would never find my way back. So it was a tough time.

Graeme Cowan  13:22

So what were the main things you learned from Bill Potter? What did you take to your later career from then?

Pat Grier  13:29

Okay, well, he was a charismatic leader. And he also saw how important this was bringing people together to energize people. And so as the National Sales Manager, I just taught how to do that sort of thing through him. And one of the things that he did was run very good conferences, management conferences, and people were brought together and they were made to work together and sound that hadn’t happened before. And he ran award systems up to this and said, Well, this is what charismatic leadership is all about. So he taught me how to develop a culture all about people. And it fitted my way as well, because that, as I said earlier, I learned that if I’m going to be successful, I have to have successful people around me. But I’ll tell you those tough times. And I remember my first conference where I had to speak, and I had never spoken to 100 or more in a conference and are now maybe they helped me with my speech sometime I made this week. And my legs were absolutely shaking, in fact, the podium was shaking and it was one of the worst things that ever happened to me. And he came to me after Pat you haven’t done that before, have you? No, actually, but I’ve got to learn to do that very quickly because if you want to be a leader, you’ve got to be able to publicly speak and I went to courses and I even had went to a hypnotist that taught me how to sleep better and get over this fear of speaking. So that was one of the sort of things that he taught me very early on as far as managing people and managing conferences and producing something energizing people.

Graeme Cowan  15:16

Were there any other significant roles you had before joining Ramsay after that position?

Pat Grier  15:22

Well, I guess ups and downs I went to Wick and Co. And that taught me more about marketing. I went to Revlon and that taught me about must not have a company that has management by fear. Revlon was started by Revson a very dynamic person started from nothing selling lipsticks, and so on, and then built up this empire around the world, and he died and was taken over by accountants, okay, provisionally. And overnight, it changed from being very much a product, and people organization to a financial organization, bottom line. And everything was all about sticking figures, and so on, and so on. So that taught me We must know, when I get to that stage where I can run a company. And so we must not have management by fear. And the bottom line is not everything. It’s how you get there. It’s the product, it’s the people, and all the systems and so on. And then finally, if you do all that, right, the bottom line follows. So I think that’s what I learned between the early days when I arrived, is the Johnson and so and that management by fair does not get it gets regarded as a short term. But in the end, it implodes on itself and that’s why I left Revlon.

Graeme Cowan  16:38

And how did you hear about the Ramsay position? And what led you to decide to pursue it?

Pat Grier  16:45

Well, I was fortunate, I met Jeff Morgan, who you know, very well worked for him quite early on. And he was, I’ve always thought, wow, isn’t fantastic, certain people have faith in you, and help you along the way. And you look back and laugh is those are the people that have actually made a difference. And he did for me, gave me faith in myself, when times were tough. I get some ups and downs. And he’s talented, well, I’m going to get through this, etc. But he had faith in me. And a couple of times, he put me on to jobs, and sometimes I didn’t even look at them. So but then an American company was coming into Australia, hospital, Corporation hospital, correct for Corporation of America and in Hospital Corporation, Australia. And he said, you know, Pat, you got two things going for you. One is you’re into marketing and so on. But you also people person, and have you thought of healthcare, and I said, What, what, what? And he said, No, no, no, I know, you’re concerned that you’re not a doctor, and so on. But that’s why I think you do well. And so the private sector was about to open up. And he got me into healthcare. And then from there, I got into HCA. And once again, I learned a lot there about management, leadership, and all that sort of thing. But I also learned about running hospitals, which is amazing, because I didn’t know from a general surgeon to an orthopedic or urologist or whatever. And in fact, the first was when I ran my wife, who is a nurse Delene, she gave me a list of all the different specialty so that when I saw some within the corridor, other bones today, I could say, well, how’s the urinary tract? The reason I fell on my feet in healthcare was because it was a combination of management, systems, processes, and people motivating people and what they wanted in the private sector, which hadn’t happened at that stage, was marketing people people, not necessarily doctors and clinicians and so on. But people had bought in a vision to whatever they did. So I was given a hospital. And that was also a pretty tough time as well.

Graeme Cowan  18:58

Yeah and how did you transition from HCA to Ramsay?

Pat Grier  19:02

Well, first of all, going back to HCA, I was given a very tough hospital, which was in a very down and out area at that time, Wentworthville, there was actually shootings and things anything work. And the boss said to me, Bob Sheridan, if you can make this switch you can make anything work. And I’ve always had a saying, create your own future, or businesses, create your own future. Don’t make excuses for what you’ve got, as the reason why it’s a failure, find the formula for success, there will be a way out of it, throw somewhere in it. And that was a very good example of how you can create your own future. This was in an area that had about 10-15% health insurance. And as I said, at that time, they were actually beating up in the streets. Wentworthville was not the place to be running a private hospital. And I said, Well, what can we do to make this a success? And we had three urologist said, you will be able to you spend a lot of money on neurology, we can actually get behind. Yeah. So what do you mean? They said, well, there’s a thing called a lithotripter. And I didn’t even have to spell that. But they said this actually blas kidneys from outside, etc, etc, when going to. And if you put that in, we can actually make this a center where people will come at it well, it’s no one marketing to where there’s no health insurance. But let’s make ourselves a destiny, a destiny, a destination. So we put in a lithotripter, thanks to the CEO of accounting Bob Sheridan the back me, we put in a lithotripter two and a half million, 3 million research people in and all that studying, and we call ourselves and we built a whole new wing, and we call ourselves a center of excellence in urology. Now, really, we were the longest or the furthest away for ever getting into research that maybe we’ll get patients have filled in a form. Anyway, it has many perceptions of reality, and purpose hospitals are what we call a centre of excellence in urology, we produce brochures and such we might and suddenly, and by the way, the public sector said, We don’t spend money on this, this is terrible. Well, it’s a waste of my time. So we were the first Hospital in Australia to do lithotripsy in neurology. With that came, other doctors say this place might not be too bad. And we became a destiny, not just something floundering in winter as well, we changed our name to Charles winter, because we were hitting over the mountain Zoo to a big vision ahead. And we got other doctors coming in wanting to work there. And guess what, about two years later, we won the Private Hospital Association’s Award for Best Hospital under 100 bid. And that important thing there, Graeme is creating your own future. And yeah, we have to do that. And that was, and that philosophy is what I’ve carried through whatever I’ve done.

Graeme Cowan  21:58

How did you then transition to Ramsay? How did that come about?

Pat Grier  22:02

Okay, so basically, check off Steve Lacey was running Ramsay as if it was not going well. And he realized he needed some good management around him. And I had a bit of a name by that stage. He got hold of me and said, This remedy is going is going fantastic. It’s going to go even better. Well, he was a great salesman, because when i arrived I’m moving from one to the other, and I actually thought it was time to maybe in set stage, I was moving around too much. But every time I moved, what I thought was for an upward sometimes it was before they got hold of me and got rid of me or I kept ahead of it and it was never quite as bad as that. But nevertheless, and I went to Ramsay’s, but I didn’t realize how bad Ramsay’s was. I joke about it, but the results took about six weeks to come out. So you have quite alot of time to look around for another job if they didn’t like what you were doing. Anyway, I got there and Steve Lacey left soon after he left a bit of a hole and sort of fell into our operations manager with another person well, and I fell into the management role. And then I realized how tough things were that I didn’t realize, and so on. So we had to then start to rebuild Ramsays. And I’ve always said, it’s a tough time that makes you so here we’ve got our hospital, that group that learning, we had about 10 or 12 hospitals, I think at the time mainly all psych not all that well run, they’re not making much money. Paul Ramsay and Michael Siddle floated the company several years before, they got 50 cents, the share price got down to six cents. And basically, I think it was the banks around and said, we’ve got to sort this out once you’re going to go under. And that was about where I took over. And they brought in a consulting firm called Gresham’s, you might know them very good. And Paul was basically his credit card was tore torn up, and Michael and Paul were told to get out of management. And I was brought in. And I was quite lucky to be at the right place at the right time where everybody was behind me and my team in succeeding and the basics of Ramsay is big with what we did have, we didn’t have any money with a float, we were moving floats around all over the place, trying to survive as far as money was concerned. But the one thing we didn’t have Graeme much was interesting was generally very good people were psychiatric, mainly, I think eight or nine of our hospitals. And they had very good people, but nothing much else. Even the facilities, most of them weren’t all that good do so on so we were starting from ground zero to turn the company around. And we didn’t have much, but we did have some very good people. So that is why we had no incentive but to start to say, Well, what are we going to do? We’d like good people. Let’s turn this around based upon building a culture.

Graeme Cowan  24:49

And how did you decide on your priorities? You know, you found out that it wasn’t in great shape. How did you work out what your priorities were, Pat?

Pat Grier  24:58

I remember, once again learning from Bill Potter, we got a conference together very early on. And in that conference with some key doctors, you’re the executive, the board. The board wasn’t a formulated board. It was Paul and myself and a few others. And and financial advisors. And so I’m in this conference, say, how do we get out here? Where are we going, where’s our vision. And we started on the Friday, and it was all about building this new business and so on. Now, the interesting thing is, we obviously did well, we’re going to have to raise money here, we’re going to have to do this quality is not at all either all these different things at the same, then last session was right, let’s have a vision for the company, we will now have the different things we have to fix up. And always remember, they really went away came back and we finished up and you know, the vision we came up with, which was amazing. And this is quite a lesson. And so the vision was one day And don’t forget, we must be the children again, one day, Ramsay Healthcare will be recognized and was recognized not as recognized as the best hospital operators in Australia. Here’s a group of hospitals struggling, most probably they’re gonna go under the banks did all three. But that was our vision to really not be one day recognized as the best hospital operators in Australia. And that actually set the whole scene, from then onwards, actives and so on, it raised us from thinking all it survived to how do we do that? And that’s a long term vision. And that was our first thing. And then later on, we started to say, Okay, how do we energize our people into a cohesive team not, giving up and so on. And so, so that was the idea started on how do we build a culture, we didn’t really have a lot of money, we couldn’t just suddenly spend a lot of money on fixing up and all that. And that’s when we started to talk more and more about building and formalizing that’s important, you know, everybody for our they have a good culture, and then suddenly, it all falls apart because there isn’t any substance. So we formalized it at another conference, believe it or not, this time was Ayers Rock and we came up with the idea of calling it the Ramsay Way. I was very fortunate that the owner of the company was Paul Ramsay, he was a fantastic guy to work for, but very much the spiritual leader that you could actually get behind and say, trust him trust his name, and all those things. So we call it the Ramsay Way in which was embedded everything into what and we came up with a whole what is Ramsay Way and so on. And then later on, there’s a whole process that started to say, well, let’s have some principles on how do we develop the Ramsay Way content. And I’ve always said it’s no one just having a plaque up on the wall if nobody believes in it. So we started with principles, they started to take off as Ramsay Way we came up with a so people caring for people. And then we got people like fantastic people like Graeme Cowan, to help us sell the Ramsay Way. Because we didn’t want it to be just from the top down. We wanted the bottom up better from the undo that whole program on what do you want out around? What do you believe in there and all that sort of thing?

Graeme Cowan  28:10

I must say that was just that was an amazing experience. You know, as you mentioned, the leadership team, the CEOs, directors, and nursing finance people, they came up with a first draft. And then I think I went to about 15 different focus groups that hospitals. And you know, we’d ask people what they thought the Ramsay Way was and then show what had been reviewed by management that was tweaked and tweaked and tweaked and tweaked. But it was one of the things that I always remember was how many anecdotes people mentioned about Paul Ramsay, and no matter didn’t matter whether they were, you know, a gardener or receptionist or the CEO, they just really talked to him as being incredibly warm, incredibly present. And I can see why you would mention him as like a spiritual leader because he was there’s real reverence in his interaction with people.

Pat Grier  29:03

And so it was interesting because he and Michael Siddle had run a company for 20 odd years. And it was just about going under. But he never lost that glow of being a very special person. And by getting in good management around him, it meant that his legacy was going to be made. So yeah, I was fortunate having because it allowed me to do the same sort of leadership style as Paul Ramsay, but I’ve managed to put it into actual practice as a management process and so on. So that was great working with him. What was the main things you learned from him? Well, I guess it was his ability to make everybody who spoke to special, even though he didn’t know the names, how are you? Oh, that’s great to see her Yeah. Then you say well, I think that was it and also louvois adversity and say, well, let’s do our very best and if we Can’t do anything more than if you’ve got, let’s bloody make the best out of it. And they will couple of times when that happened when. And also because, for me, it was great because he completely trusted me in what I was doing, even though I was a soft type of leader that come to my leadership style is now but because that’s what you asked me to do that but you know, he could have been hey things are bloody terrible. What are you bloody doing? Well, I don’t think it’s good, I’ll find something never ever like that. He would be probably going to fix this. I remember being at a conference once. And Chris Rex and I put together the future didn’t look good. We have a, b and c. And a was we’re going to lose about 5 million b was, we’re going to lose 50 and, and c was more like 30 or something and we put the scenarios together because we were going to lose major contract was dva, and all that sort of thing. And Chris Rex is very good at this sort of thing. He put together the scenarios with different names, and Mariah Heat , which was what were the worst and Merlin was the best, because that was just absolutely bullshit we will never see and thoughts. We have bought around. And he said, Oh, come on, there’s got to be a better what do you think is the likely of the a b and said, well, more than likely to be but it could be c, but definitely not Merlin you’ve to be joking. Anyway, he said, Come up, then he pushed us. And then he said, Okay, if you believe that, if you think we can get through at least be? Well, that’s what it is. Okay, kept his hands up, let’s go and have a drink. And there was an accident we did. And I think we got through it all, and so on. But that’s the sort of relationship that you need, with what you hope to get what you do. I don’t know you later, whatever it is. So it was great. It was a pleasure working with him.

Graeme Cowan  31:47

And you obviously formed a very good partnership with Paul, what do you think he learned from you?

Pat Grier  31:54

Well, I think he handed over the whole running of the place to me. And I think he learned to trust people. And he didn’t have to be a minutiae. He could, if he believed in you, he trusted you. And so I think he two things he, knew that he did not have management hands-on ability, he didn’t know anything about processes and systems and quality improvement, and all those different things that are brought in. And so he learned that, hey, you need two things, you can have a vision you have behind people and so on. But you’ve also got to have the ability to do it. And that’s what I brought to him. And then of course, my style was very similar my style was, I’m not a Genghis Khan and lead the way and we’re for our caer and follow me I build good people around me, I build good systems. And then I energize them so that they go out and do it. So I learned from him that when I was really doing that sort of thing. But I think he gave me a lot of trust that I would not let him down.

Graeme Cowan  32:59

Excellent. And how did you go about building a strong team? Pat, your direct reports. How did you go about putting that strong team together?

Pat Grier  33:09

Okay, so that is very important, if you my type of leadership. And as I said earlier on. Feeling that if I’m going to be successful, I’ve got to have good people around me, I’m not going to be a Genghis Khan, I’ve got to find ways of energizing people. And so it’s I always say things don’t just happen, they are made to happen, there has to be a process. And first of all, you yourself has to have a belief as to where the organization’s going, you can’t relinquish the responsibility of being the leader. So you’ve got to have a vision, you’ve got to have an idea of what can happen. And by the way, it’s a formula for business, I call it the formula, find the formula and so on. Now, that sometimes happens with the people or it happens within you or whatever. But you’ve got to leave that part of it, you know, so that people can latch on to what you believe in, and so on. So, strategy and all that comes into it. But secondly, from my point of view, it’s then very important to build people around you. And that becomes more and more important these days where business complexity is getting more and more specialization. But then the big thing is to have a whole lot of processes that make it happen that, for instance, a few principles that I’ve worked on, build a weave organization and this comes back to the Ramsay principles as well. Build a weak organization. I always talk about we, we, we, because it’s all about energizing people. If people do a lot of work and the new take away what they’ve done, you de energize this, and so quite often two and two equals five if you energize them, but if you de energize a two and two equals one, it comes back very quickly. So you got to think of how you talk to people how you energize them, and make them feel good. And I remember once saying to a manager look useful talk about I, I, I the whole time, hasn’t anybody around, you actually help you? Oh, yeah, but it was me in a done everything. Now, every time we talk about ‘I’, you are diminishing what they have done. Talk about we, we, we in the end, that guy had to go, he didn’t fire him, he just realized he was out of kilter. So, a we organization is very important, promoting people and awarding them, I’ll give you a good example. And you got to put your ego in your pocket. And praise people when sometimes it’s your idea, but you’ve turned around. Another example is, we went up to a hospital that was doing badly a woman is working there. And I believed in her, and I knew that she could do it, but she had lost faith in herself. And so, so we went to her. And I knew that I was saying, Well, have you thought about this way? Oh, that’s great. And you find a way to say, Oh, that’s been always turned around with them. and in the end, we had a plan and and came away and on purpose. I never once said, Now, do you know what you’re doing? Now you see, well, usually, and then I’ll keep intouch then, when it did start the catch, Well done, well done. Fantastic. Never ever once mentioned to her, that I had anything to do with it, because it was her and guess what she built on and built on. And suddenly she became one of our great success, also how you energize people to make them feel good, I call that two and two equals five, when you have an organization, things are happening on their own, you’re not making them happen, then you are halfway there to making this very special organization and then starts to multiply. And that’s when I coined the phrase leading from behind, you’re still leading, but it’s the way you do it to make people feel they’re energized. It’s their idea. And boy, it’s amazing how they come up with so many things that they didn’t even realize they could have. But there’s a system there’s a process, and it just doesn’t happen.

Graeme Cowan  36:51

And what does that process? What does that system how do you because it’s not just you a leader of a larger organization growing all the time, you couldn’t influence everyone, there was lots of CEOs or hospitals, etc, etc. What would processes you put in place to make sure that that philosophy that we philosophy expanded across the greater organization?

Pat Grier  37:11

Well, I don’t know how well Zoom’s will do in the long term, phone calls, and so on, and so on. I do believe to motivate people, you’ve got to have a fair amount of one on one relationship with group relationships. So as I said, conferences at Ramsay’s was very important for us to bring them all together, and so on, break up and sign up, people say, Oh, we all do, but it’s how you run those conferences where people feel belonging, and identity and be a part of it. And then you also build up rituals. For instance, Funny enough, Ramsay, we both have a ritual of American Pie, Don McLean. And at some stage in the night, we all had to go on the floor and sing Don McLean. And so as small things like that build up, a camaraderie amongst each other. And it’s not centered around you that’s important, is centered about them doing things and showing you put them into teamwork. And so you’re actually looking for how can we get people to work together? And by the way, they very much part also of building the future? In other words, what is our strategy? What are the, and it’s going to be flexible, because things change, but what is our formula for success? How do we get there, etc. and people start to go along with this. So you start from the top, because it always comes from the top. And then slowly, you make sure that everybody follows that same special energy, energy that is produced by people being a weak person, and so on, and you play well done to them. And then the people below, you do the same thing. And it’s amazing how it can happen. Now, what can also happen that, if you are saying, well, it’s more the product, the outcomes, and the systems and so on. And finally, the bottom line is what measures us, I always used to say, well, we have to have a good bottom line to be able to get the money to be able to do all the things we want to do and so on. But I always get back to the last I never made that the first thing. What I do see an organization’s it’s quite early on, the financials become more and more important, and the teamwork and the ability to make things happen individually goes. And Sunday. And by the way was Ramsay’s I used to say we are decentralized organizations, and decentralized even in each organization, in each department and so on. And you talk about decentralized, what happens is it becomes centralized and quickly becomes worthwhile from your family’s money being the driver of everything, the bottom line, and all that sort of disappears, and it’s a real pity. I’ve seen that happen very often. So you really got to work at it the whole time. But it’s amazing. The results multiply comes through multiplying two and two equals five.

Graeme Cowan  39:11

And it was extraordinary. You didn’t manage to balance financial performance and having this culture of care. Well, the Ramsay Way help you, you know, match those two dynamics, because I mentioned at times, there’d be some tension between those two things.

Pat Grier  40:07

Pretty much. And whether we like it or not you taking people’s money on the promise you’re going to get a return and so on. But I didn’t, there’s a lot of people who are CEOs look at the bottom line, look at the share price every day, I made a point of when you’re looking at every now and again, every week, two weeks, sometimes, and so on, because it’s what it is that time, I emphasize very much on the product, and making things happen and so on. But of course, the final measurement was always making a return on investment, and so on. So that didn’t come into it. But it came into it as part of a total rather than the main reason you were there, I really work hard, not making people feel the reason they come to work is to make money for the corporation, the reason that comes because of the product we’ve got. And in the case of the hospitals, when I walked around the wards, and so on, and so on, I never talked about making money, it was all about how things going, how’s the quality, how’s the patient satisfaction, or laxatives. And, by the way I introduced quite early on, when I left HCA thing called moments of truth, I was always looking for ways of building teamwork. And I don’t know if you know moments of truth, but it was all about, you have a screen of judgments made by people buying your product. And each one is important as the other. And if one of those string of judgments is a negative, it often has a huge negative results on everything. So one bad result of a person’s visit to a hospital would have a huge negative on all the good, the good things that people were doing, will emphasize and anybody who let the side down was really sort of shown up as letting the side down. And that was teamwork built amongst themselves. So you always got to look for techniques like that, that make a difference.

Graeme Cowan  42:05

Were there other books as well Pat or other people that you saw in action that inspired you to try new things.

Pat Grier  42:14

But I go back in the 80s, this chap called Iacocca, who was a pretty hard nosed guy, but I liked what he did because he turned businesses around. And I like the challenge that the thought you go into a place and it’s not going well. And you say, Well, first of all, what’s the problem? What’s the formula? Is it how do we change it, and then get the people in the systems and so on. And he did that a few times. So I like the Iacoco book, there was another book called From Good to Great. Can’t remember Who made it? Jim Collins, and I loved that because it was a bit like the Ramsay story. Yeah, we were good. But how do you take it to the next level. And I use that, at one of our conferences, somebody came and spoke on the book and all that sort of thing. So it gave me inspiration to the people. So those sort of books, I enjoyed theme jobs, enjoy the book, because of these creativity because he’s visionary. But he also admitted, a lot of mistakes. Same thing. At the end of his life, his biggest mistake was thinking that money is everything. materialism is everything, and a lot of soft part of life. He underestimated how important that was. In other words, a car a $3,000 car is just as important as a $30,000 or $100,000. Later on South Park like that story as well. In other words, how much do you really need in life. And so to me, if I had to look back at happiness, success, the most success is not whether Ramsays made money and everything. It was the people that that I helped become something special in their life. So those sort of story. But you know, you asked me , anybody in particular sit down at their dinner table. And so well, Bill Gates would be one, Steve Jobs would be another virgin guy, I think he’d be very interesting to look outside the square. John Lennon for me would be quite an interesting person. because he’d be very lateral. And he admitted to a lot of mistakes he made. But that would be different to me, rather than just listening to Steve Jobs in charge, but those were the sort of books that I used to read a lot of.

Graeme Cowan  42:45

Jim Collins And if there was a young person who just worked in a team and then was promoted to manager, so their first real management position, what would be your advice to them to grow? How would you encourage them or guide them to grow themselves and grow, grow their team?

Pat Grier  44:45

I think I would always give him advice to the younger people. Big advice would be, do what you enjoy doing. Don’t set a target of I’m going to be this I’m going to be that and then have to learn a whole lot of things that you don’t like do To me, for instance, I have never been a heavy accountant. And even though we’re one day, maybe running an accounting firm, I know that I’ve looked back and say, was that what I really want to do to start off, do what you like doing, because that will produce the energy you need to be a success. Then the second thing is, create your own future, work out what you have to do, to be able to be a success. Now, by the way, the word success can vary. In my case, it was because I were wanting to be a success. I never wanted to be having mints once a week, once a month sort of thing. And so I wanted to be a success in business, I learned that I wanted to be business in business or not other things, and like marketing, and that related to people. And then I went and did a whole lot of things to, to mint, what I wanted to do sell the same thing I’d say, do you want to do what you really like doing? And then arm yourself with everything you can get hold of, to be able to do that and be happy to doing what you’re doing? So those things? And if, if there was somebody in my organization that sit down and say, Well, where do you want to go? What are you? Are you happy with you doing? It would be better? Okay, now, what would you have to do to get better, and not push yourself into areas that you don’t want to do? I’d rather do them because you enjoy doing it, that’s when you will be a success.

Graeme Cowan  46:26

And it’s really interesting how Ramsay’s evolved, as you said, when you join them now very much psychiatric hospitals, they had a heavy bias there. But they evolved not just in Australia, but also overseas. How did you make it safe for people to try new things to take risks?

Pat Grier  46:45

Yes, okay. I think you’ve got to build up a feeling of you can say what you want to say without being beaten up. One of the things I learned in one of the organization was management by fair, is terrible. And yet, there’s a lot of organizations that deliver management by fear, I would rather hear suggestion from somebody who genuinely believes that this of all she believes it’s a great suggestion. And so it’s rubbish, then never hold it inside and never say it. And so first thing is you, when you manage people, and so on, you must not be management by fair, you’ve got to encourage people to say what they think and learn from what they say, because that’s the only way they’re going to learn. But if you have management, I fear these people in this particular lesson, they never, never really. And I’ve also went to another theory of 80/20 principle in everybody, there’s 80% goodness, if you find it, they might only think themselves at 40 50% or 70, you can find that 80%. And the way to find is not to look at the 20% that are negative and people, but look at their positives, and those positives grow. And the negatives Get lost. And you can always find other people to do the stuff that you can’t or they can’t do. In other words, you will find somebody who’s very good at the 20% that they are no good at them prosper and do well, was what they’re good at. A good example that I remember when I came and joined whatever organizations and he said, This management beat you up. And I say I said you know what, I call it the mirror story, I stood in the front of my mirror, saving about a year or so ago. And I was so pleased with myself, I just come into the organization and I can’t wait to get to work a year later, or two years, or whatever it was, I looked in the mirror and I said what happened to that guy. So unsure of himself, I’m not what I am, what happened? what had happened was management was management by fair, was concentrating on the negatives in him, and they weren’t seeing his positives and all he was seeing his negatives. And so that’s not good. So the 80/20 rule, you can always find goodness. And wherever you find the goodness, it’ll multiply, we found the badness, it’ll multiply. So there’s all these techniques that you’ve got to learn. It just doesn’t happen. But they work and the greatest thing is to see people flourishing that maybe wouldn’t flourish if it hadn’t worked for you.

Graeme Cowan  49:10

Yeah. What do you think of your career Pat and, you know, the various roles, various companies you work for? What is one thing you feel really proud about something that, you know, you might not tell other people, but it was just really, really meaningful to you?

Pat Grier  49:26

Hey, that’s a hard one. Because I was very fortunate. And I think I made my thing but nevertheless, to fall into Ramsay a bad time. And so and, and I worked with Paul Ramsay, which was fantastic. And, you know, I was given a huge opportunity where I think, and things were going really badly at some of those times. And I was just given a lot of opportunity to actually show my work. But I think if I look back to it better and say Ramsay’s and various other things, it was the tough times. That made me and made Ramsay’s available. So if you face a crisis, grab the crisis and get hold of the leadership in a crisis because that’s how you will be remembered how you manage in a crisis is how you’re going to be remembered. So never say never let a crisis go to waste. And you will always be remembered how you handle the crisis. So I guess looking back at Ramsay’s, they were terrible. By the way, there were times when we were going under. And I talked about creating the future, I got very involved in an I suppose, I had to look back at this with more likely than 1 in 1000 jumps out, there’s because I enjoyed the creating the future. And so I got very involved in the politics, the private hospitals were very on their knees. And I managed to convince first of all words to put in legislation that all health insurance had to cover psych because if they had dropped psych Ramsays was going under, that was a big plus. The second thing was, I then convinced them to uncheck Russell Schneider convinced him that the private hospitals as a sector are going under. And the way to solve that is to put some sort of floor under the private sector to prop them up, and even more than 90 of that state, but in the UK came around to seeing it. And we convinced him to bring in the 30% rebate. And basically how we convinced him was, look, if the private sector goes, you’re gonna have to look after the whole of the healthcare system, which is bloody expensive. And it’ll go like the NHS, which is as much as everybody likes to say, in the UK, it’s great, it’s not. On the other hand, you build out a partnership with the private sector, it will cost you X amount of in rebates, but give a floor to it so that people can afford to have their health insurance, and then build out what we call a balanced healthcare systems between public and private. And I guess, I will say this fibrillation, that partnership between public and private now, and oh, ad has cost the government a 30% rebate, but people are paying for their own health care. The other 70% and more, has actually produced one of the best health care systems in Australia. And there was a time when we were hitting like most of the other countries where there’s no private or really little energy all public, we now have a fantastic healthcare system because of that balanced healthcare system. And I had quite a lot to do with it. And a lot of people with it. So I guess my look, and I have a bit of pride It is me and my team, as well as the private hospitals. And Russel Schneider the private health insurance really created a very special health care system in Australia.

Graeme Cowan  52:50

You had very stressful roles, you mentioned that at times, it was be touching, go have a look at your own health during that period.

Pat Grier  52:58

I haven’t been very good on that, to tell you the truth. And I go to a gym because I feel I have to. And then I come away thinking Oh, that was great, because I’m now picking up and having a shower again, on my way. So I’ve never been very good at it. And I’ll tell you another thing I haven’t been very good at is balancing my homecare with my work, work always first and so on, and I take my hat off to my wife, and to my three boys, that they still love me. Well, I think they still say it. And my wife had to put up with some bringing up the family on their own and so on. So if I had to give advice to be balanced your home life with your business life, and you become a better person for that as well. I take my hat off to Chris Rex, for instance, he very good, very good operator, and then became CEO and so, even he in the end agreed that he lost control of that balance. But he was really good at saying sorry, got to get to spend more time at home etc etc. So I didn’t bet as well. And I’ve got to say if I had to give advice to parents that because I was very fortunate, my wife still with me, he’s had a hell of a lot of influence and coming here and what jobs to get, and we got to live in better areas because we will go back to Rhodesia, and all that sort of thing. And I’m just amazed that you still with me by the by the way, Graeme three weeks time 50 years of marriage.

Graeme Cowan  54:23

Well congratulations.

Pat Grier  54:26

But the amount of people that say to my wife, we never thought you would last that long.

Graeme Cowan  54:34

Well one of my usual questions at the end is to ask, you know what advice you’d give your 18 year old self and in your case it probably would be when you were sitting on the lawn overlooking the Harbour Bridge and the Opera House but you’ve already gone through it now. So if you had your time again and I’m paraphrasing here you would have more balance you would ensure that the your home life got greater priority.

Pat Grier  55:00

Yeah I think that the two things I’ve learned one is I would have done that more. And I’m just very fortunate that I still got a son, my son is I love you dad. And I’m just so fortunate when you see so many people, when they get to my stage in life, they look around and they turn to their family. And they say, well, you weren’t there and there’s a few songs like this, you weren’t there when we want to do why, or why should we give you love now, so I’ve been very fortunate that way, if I have to be said, What I really learned is in life, it’s the tough times that make you and if you say sitting on that lawn, job is huge city and you know, we came from Little stalls be Rhodesia to this, and the daunting future and so on, in your look back, it was the challenge of that those tough times that actually make you. So the outcome, don’t let the tough times and the crisis get you down. It’s the turn it around to being a positive. And those are the things those are times that make you But yeah, my balance, I would do that better. And advice we all going to have to have. And by the way, if you don’t have tough times, that means you’re more likely to much in a comfort zone, and you will never really meet your full potential.

Graeme Cowan  56:15

Thanks very much. It’s been a pleasure talking with you, and just hearing about your journey arriving in Australia, like many migrants, and really making a huge impact in Australia. And I think we should be very proud of that. So thank you very much for joining the caring CEO podcast. I think there’s lots of lessons and insights for managers and leaders out there to take away. So real pleasure talking to you, Pat.

Pat Grier  56:42

Thank you. I just want to say one more thing. I’ve been very lucky to be in Australia, space in my life in Australia now. And being an Australian so great country, and we all should recognize that. Graeme, thank you for the interview I really enjoyed it.

Graeme Cowan  56:58

Thanks for joining us today. I hope you’ve learned something new and heard some practical tips you can try with your team. If you enjoyed this interview today. Please rate us on iTunes, Spotify or your favorite podcast platform. When you rate us It helps other people to find us. We also welcome any comments. If you are interested in seeing details about our scalable weekend Mental Health Training Programs, please visit us at fat to Our goal for these programs is to make them accessible, practical and ongoing. If you’ve been impressed by a CEO that you would like us to interview please email details to support at please subscribe by clicking the button below. We really would love to have you as part of the care movement. Thanks for joining us.

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