GUBERNA Directors Sparkle - Hadewig De Corte

Modern hospital governance requires a particular approach and specific knowledge of corporate governance. This is because there is an additional ‘power’ at the boardroom table: the Medical Committee. The Board has to deal with fascinating concepts such as ‘co-governance’ and ‘co-management’. GUBERNA alumna Hadewig De Corte, who was CEO of a hospital from 2018-2022, looks back for us at the strategic exchange of ideas and policy development, including during the pandemic.

Watch the interview first and then read on?

At the Clinic Saint-Jean in Brussels (the successor of the Augustine Hospital Sisters, first established eight centuries ago), 2000 employees and 300 highly-trained doctors give their very best for the clinic and for the more than 500 patients who stay there every day. Economist Hadewig De Corte spent four years as CEO of the Clinic, after 15 years at BNP Paribas Fortis and 5 years with Wolters Kluwer. A mother of a new stepfamily with 5 children, De Corte is also a GUBERNA Certified Director.

In each of her previous professional positions, De Corte has always been driven by the desire to help create a positive impact for a better world. And in the hospital sector – a socially-relevant sector par excellence – she was able to put her heart and soul into achieving that goal.

“A clinic is an incredibly complex organisation, in terms of content, processes, governance and the regulatory framework it operates within. And every single process is ‘vitally important’. You feel that you bear the ultimate responsibility for people there.

As an organisation, a hospital is a complex interplay of many different people and stakeholders; hospital funding in particular is in urgent need of modernisation. This means that our entire quality health system is under real pressure, a fact which quickly became clear to me as I faced some of my biggest challenges at Saint-Jean.

Funding is now mainly based on medical procedures, rather than on outcome. Not only that, nearly everything (how many people are doing what, for whom and when) is strictly defined in the regulations. In order to be sustainable and to be able to continue to offer quality care, you need to better (re)distribute the resources you have and to give yourself room to respond flexibly in response to new events. Let’s take COVID as an example. With just a few of the right incentives, you can create synergies, further optimise the use of new technologies and break free from the myriad rigid rules that get in the way of the flexibility you need.

My training at GUBERNA gave me additional business tools and methods that enable me to make a positive contribution to the further professionalisation of the hospital sector – a sector where I have been lucky enough to get to do my dream job over the past few years.

The Governing Body – the new name for the ‘Board of Directors’ – is the ideal place to advance in one’s career. These are what I see as the key tasks of the Governing Body:

1. To act as the guardians of a mission that should be as clear as possible;
2. To set the strategy, based on a proposal by management;
3. To appoint the right leadership;
4. To monitor the implementation of the strategy and carry out the required and appropriate ‘checks and balances’ by means of inspections;
5. To support the CEO and the executive team, particularly at key moments.

For example, I saw how the COVID-19 pandemic led to a health crisis, but also presented us with momentum and extra leverage. Thanks to the strategy which we had already mapped out, we were able to make it through the eye of the storm and knew where we were headed after the pandemic. As soon as the worst was over, and in parallel to the ongoing crisis, we continued with our strategic projects, such as the renovation of the outpatient clinic and delivering new ICT infrastructure. Not only did the crisis confirm that we were on the right track, but it also showed us that having a good strategic plan was a strong foundation in difficult circumstances.

The Medical Committee has a number of binding powers, established by law, on matters about which the Governing Body may not and cannot decide unilaterally (such as the recruitment of doctors, the contributions paid by doctors to the hospital, and more general financial matters). This is a good example of what we call ‘co-governance’ with the Governing Body. You always have to find a balance between the Governing Body and the Medical Committee. So this actually also means that the legislator has added an extra body to the ‘governance tripod’ which is traditionally made up of the General Assembly, Governing Body and Executive Committee.

Within the healthcare sector, doctors, who often have an independent status, are a crucial target group, so there is a need for closer direct cooperation between doctors and management in addition to engaging with the Medical Committee. That’s what I would call ‘co-management’. Doctors should also be involved at every level of the institution in the day-to-day running of the hospital (e.g. monitoring the functioning of a new outpatient clinic, a new IT system, or the optimisation of processes in the operating theatre). Clear rules are needed to ensure everyone knows their role. That can sometimes cause quite a bit of tension…

In my role as director too, I always try to get the best out of people. Taking the organisational values as my guide, I seek to help the organisation focus on the right priorities. For a director, it’s useful to be able to take a multidisciplinary and systemic approach that enables everyone to excel. As Vice President at the Royal Theatre of La Monnaie, I bring experience in finance, operations and transformations to the table, while the other directors complete the spectrum with their own expertise. As a director, you don’t have an operational role, but you are there to question and advise. You deal with each proposal with both an open mind and the necessary critical mindset. My academically-based training at both GUBERNA and Vlerick has provided me with a number of techniques to function well in this role. I also think it is important for the good of the organisation that we keep each other on our toes within the governing collegial body.

Exactly. The GUBERNA Alumni association is a useful network for me, as it provides an opportunity to constantly exchange reflections, experiences and insights with others.