Boards with Purpose

Care Governance for Directors: Balancing Risk, Quality and Accountability in Today's Environment (with Virginia Bourke, Mercy Health Australia and Martin Laverty, Aruma)

Boards with Purpose

Show Notes

In this episode of Boards with Purpose, Phil speaks with Martin Laverty, CEO of Aruma, and Virginia Bourke, Chair of Mercy Health, about the evolving landscape of care governance across aged care, disability, healthcare and early childhood sectors. Together, they explore how governance has matured in response to rising community expectations, regulatory reform and the lasting impact of Royal Commissions. The conversation highlights the shift from compliance-focused oversight to a more holistic, person-centred approach—where quality care is defined not just by safety, but by dignity, choice and lived experience. Martin and Virginia unpack the growing expectations on directors, including the need for care governance literacy, stronger engagement with frontline services, and the ability to balance financial sustainability with high-quality care outcomes. They also discuss the challenges of measuring impact, building the right organisational culture, and navigating increasing complexity in a highly regulated environment. With practical insights on board practice, information flows and the importance of constructive challenge, this episode offers a timely perspective on what it takes to govern well in the care economy today. Key takeaways from this episode:

Care governance is still maturing - hospitals lead, aged care is progressing, while disability and childcare are still developing—especially in defining outcomes. Quality care now means person-centred care - beyond safety, it includes dignity, choice, and quality of life (including the "dignity of risk"). Director accountability has significantly increased - regulation, scrutiny, and legal exposure mean directors must be more proactive, informed, and engaged. Care governance must equal financial governance - boards need the same rigour for care outcomes as they apply to financial performance. All directors must be care governance literate - not just clinical experts—every director must understand enough to ask the right questions. Measuring outcomes is the biggest challenge - the sector is still moving from activity metrics to meaningful measures of impact and wellbeing. Culture is central to care quality - poor culture drives failures; strong governance frameworks must actively monitor and shape culture. Boards must balance compliance and improvement - heavy regulation must be managed alongside innovation, adaptability, and continuous improvement. Assurance relies on the right information and questioning - boards must focus on insights, outliers, and action—not just volume of reporting. Strong relationships and real-world insight matter - trust between board and executives, plus direct exposure (e.g. site visits), are critical to effective governance. Learn more about Mercy Health Australia: https://www.mercyhealth.com.au/ Learn more about Aruma: https://www.aruma.com.au/ Find key resources for those in the NFP space in the AICD Not-for-Profit Resource Centre.

More from Boards with Purpose

Oct 2, 2026

For many not-for-profit organisations, the founder is at the heart of the organisation's purpose, culture and growth. But as an organisation matures, the relationship between founder, CEO and board can change significantly. What happens when the governance structures need to evolve, new capabilities are required, and the founder needs to start thinking about what happens when they are no longer there? In this episode of Boards with Purpose, Phil Butler speaks with Hannah Andrevski (CEO & Founder, Roundabout Canberra) and David Pointon (CEO & Co-Founder, The Men's Table) about their experiences building founder-led not-for-profit organisations and navigating the transition from grassroots beginnings to more mature governance. They explore the changing role of the board, balancing passion with good governance, building the right skills and capabilities, succession planning, and the challenge of letting go. At the heart of the conversation is a question many founders and boards will face: how do you build an organisation that can continue to deliver on its purpose long after the founder has stepped away? Key takeaways from this episode: The board's role needs to evolve as the organisation grows. Founder-led organisations often begin with boards that are highly operational, but over time the focus needs to shift towards strategic governance, oversight and direction. Founders need to grow with the organisation — and recognise where they need complementary capabilities. As organisations become more complex, founders may need to develop new skills while also bringing people onto the board and into the organisation who can complement their strengths, particularly in areas such as risk and governance. Board composition should become increasingly deliberate. As the organisation matures, skills matrices and a more considered approach to recruiting directors can help ensure the board has the capabilities it needs for its next stage of growth. Succession planning needs to start before the founder is ready to leave. Building an organisation that can operate without its founder requires planning, developing internal capability and deliberately reducing the organisation's reliance on one individual. A founder's legacy is ultimately about building something that can outlive them. Both guests reflect on the importance — and emotional challenge — of letting go, while ensuring the organisation remains true to its purpose and has the structures, leadership and capability to continue into the future. Key resources: AICD NFP Resource Centre

Sep 7, 2026

Mergers are becoming an increasingly important consideration for not-for-profit organisations facing financial pressure, changing funding environments and the need to grow their impact. But as Elizabeth Wighton and Victoria Adams explain, merging for the sake of scale – or as a last-minute rescue strategy – can create more problems than it solves. Boards need to understand why they are merging, ensure their organisation is merger-ready and undertake rigorous financial, legal and strategic due diligence before committing. In this episode of Boards with Purpose, Phil Butler explores the governance challenges of NFP mergers, from navigating tax and regulatory requirements to managing culture, leadership and future board structures. Elizabeth and Victoria also discuss the importance of measuring impact, establishing a clear business case and maintaining commercial rigour while staying true to purpose. As federated organisations increasingly consider coming together, the conversation highlights what boards should consider before taking the next step. Key takeaways from this episode: Don't merge simply because you can: A merger needs a clear strategic rationale, whether that is diversifying revenue, expanding geographically, improving systems or creating efficiencies. Scale alone isn't a sufficient reason to merge. Get your own house in order first: Organisations need to be merger-ready, with their financial, legal and governance information in order. Boards should understand their own risks and liabilities before assessing those of a potential partner. Culture and governance can make or break a merger: Bringing together different organisational cultures, boards and management teams can be challenging. Future governance arrangements, leadership roles and potential points of disagreement need to be addressed early. Purpose and commercial rigour need to work together: Successful NFP mergers need to balance financial sustainability with the organisation's purpose and desired impact. Measuring what matters can help boards determine whether the merger is actually improving outcomes for clients, members and communities. Measure success against the business case – early and often: Boards should establish what they expect the merger to achieve and track progress against those objectives. If anticipated synergies or efficiencies aren't materialising, directors need to understand why and take action. Helpful resources: https://www.aicd.com.au/tools-and-resources/nfp-resource-centre.html

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