EY CEO Outlook: Business, Purpose and Healthcare with Brian Walsh, CEO of Vhi

In this episode of the EY CEO Outlook Podcast, Brian Walsh, CEO of Vhi talks with host Richard Curran about leading Vhi, combining business with purpose, and the shift toward digital and community-based healthcare.

The career path that Brian Walsh has travelled is testament to the early influence of his parents and childhood.  His mother worked in healthcare and his father in business, and Brian developed deep interest in both fields. These twin passions then converged in 2014 when Brian took a leadership role in Vhi, and today he is “really proud now to be in a role and with a business that marries both healthcare and business”. 

Being drawn to “travelling the path less travelled’, Brian’s career has spanned international roles across finance, telecommunications, and food industries, with experience in Hungary, Germany, and the United States. He became CEO of Vhi in 2021, having previously served as CFO. Keenly aware of the unique position that Vhi holds in Irish society, Brian is determined to keep the company purpose and values-led at its core, and to help its members to love longer and stronger and healthier lives. 

They also discuss:

·       Brian’s Career Journey: His early life, influence of his parents and global experience that led him to combine business and healthcare.

·       Leading with Purpose: Brian talks about the organisation being extremely purpose led and values led. How these clear values help guide decisions and manage different stakeholder needs. 

·       Changing Healthcare: How Vhi is using technology and community care to improve healthcare.

·       Reinvesting in Membership: How the company reinvests all income to benefit members and improve services

·       Brian’s views on leadership and his advice for others in management. 

Transcript

Carol Murphy, Partner and Head of Markets, EY Ireland:

Welcome to the EY CEO Outlook podcast where our host Richard Curran chats to some of Ireland's leading CEOs about life and leadership. 

Hi, I'm Carol Murphy, Partner and Head of Markets at EY. In this episode, we welcome Brian Walsh of Vhi, the market leader for health insurance in Ireland. Brian talks about leading Vhi, combining business with purpose and the shift towards digital and community-based healthcare. Over to you, Richard.

Richard Curran:

Thanks, Carol. Well Brian Walsh, you have lived and worked in several different countries, from Hungary and Germany to Los Angeles in the United States. But it all started in Kilkenny City. What were your early years growing up like there?

Brian Walsh, CEO of Vhi:

Great fun, to be honest with you, Richard. Good morning to you. So I grew up in Kilkenny. Mum was a dentist. Dad worked in the fertilizer business, so we were quite close to farming and agriculture. And, you know, great education in the local CBS and went off to boarding school in Roscrea for a number of years. But a great childhood, really enjoyed it.

Richard Curran:

Did you have many ideas or clear ideas about what you wanted to do career-wise when you were growing up?

Brian Walsh, CEO of Vhi:

Yeah, it's extraordinary how, you know, the circle closes over life in so far as, you know, I grew up in a household with health care and with business and gave consideration to both directions. I decided to join PwC, become a Chartered Accountant, having studied in UCD, studied commerce. So my draw was very much to business, but I'm so happy and really, really proud now to be in a role and with a business that marries both health care and business. 

Richard Curran:

And if you reflect back on those years growing up and what you wanted to do and studying the BComm and then going into accountancy, what would you say influenced you the most in the direction in your life? Was it your parents? Was it where you were from? What were the things?

Brian Walsh, CEO of Vhi:

I would say my parents and perhaps in particular my dad. I have a huge admiration for both my parents in who they are and what they did. But my dad worked in business, you know, from a very, very young age. I used to do summer jobs, etc. And I really enjoyed the, I suppose, the cut and thrust of all that happens in agriculture and farming, the cut and thrust of business. I really, really enjoyed that. And that drew me to all that business offers, the opportunities, the challenges.

Richard Curran:

And it's interesting in your career, not only the different locations where you work, but the different types of businesses and sectors. So for example, you were with Avonmore?

Brian Walsh, CEO of Vhi:

Yeah, so immediately following qualification as a Chartered Accountant, I guess I still perhaps have a bit of a nomadic nature and a little bit of a desire to travel the path less travelled. So I worked with Avonmore, Glanbia in Hungary for a short period of time, then moved to Germany, worked with Citibank, worked with Deutsche Telekom, came back, actually worked with Eir, Eircom for about seven years, then worked in a private equity family office, buying, supporting, developing SME business across central Europe, and then subsequently moved with Ornua, actually over to California for two years and came back and joined VHI.

Richard Curran:

Lots of people go to California and don't come home. Brian, you enjoyed it out there, obviously. Was it an interesting spell in your work life?

Brian Walsh, CEO of Vhi:

It was. It was a business, a specialty foods distribution business, so not mainstream Ornua, who is, I guess, best known for the Kerrygold brand globally. They had a business that they were looking to develop, ultimately, actually, to exit. And just at the end of my time there, they did exit that business or partially exited. But again, that that cut and thrust, you know, negotiating around pricing, around the type of services that we delivered to huge global organisations like Kroger, which is one of the biggest supermarket retail organisations in the world. Tesco had a business actually in Southern California at the time. 

Richard Curran:

Did you enjoy LA?

Brian Walsh, CEO of Vhi:

I did. Yeah. I like, I like the warmth. I like the heat.

Richard Curran:

I've been there twice and I could never get my head around it as a city because it's so sprawling. The center is so relatively small and a bit of a non-event. I think there's a prison in the middle of the downtown along with five-star hotels. I could never get my head around the place. It was such a different kind of place.

Brian Walsh, CEO of Vhi:

Yeah. And maybe we were a little bit different. So we lived maybe about 70, 80 kilometers inland in what's known as the Inland Empire.  And therefore, we were quite a local community, you know, I’ve four daughters. They came and attended school for a year in the States. So we had a community principally through school and through my colleagues in work.  And therefore, we felt quite at home. I can imagine in, you know, more the urban sprawl of downtown L.A. It's very, very different. But we had some of the wonderful experiences of being able to, you know, head up the mountains in the morning, be back down in the beaches in, you know, south of L.A. in the afternoons. It was a great experience.

Richard Curran:

And the weather to go with it. 

Brian Walsh, CEO of Vhi:

And the weather to go with it but look, it was an adventure.

Richard Curran:

But you did come home. Did you think eventually, you know, this is time now to settle back in Ireland for good?

Brian Walsh, CEO of Vhi:

Well, that that occurred over, you know, a number of occasions actually during my life. So my wife and I lived in Germany for five years. Our first child was born there. And at that time, following five years, really kind of faced a choice that if I stayed and if my children, you know, attended school, etc., then more likely than not, you might continue to live there. You might stay. And whilst I'm maybe a little bit of a nomad, a little bit of an adventurer, I'm also a homebird. I love Ireland. I love living here. I think it's one of the most fantastic places to live. We have a wonderful climate. We have wonderful people. You know, we don't do extremes in terms of politics, mostly, thank goodness. 

Richard Curran:

Not yet, we haven’t lost it yet.

Brian Walsh, CEO of Vhi:

But there's a wonderful balance. And I think a very, very good lifestyle to be had. So again, it comes back to that sense of community, I feel a great sense of community, living in Ireland. And yeah, a love of Ireland, a patriotism for Ireland.

Richard Curran:

So when you came back, it was 2014, you joined VHI as CFO. And then more recently, as CEO, it's a very distinct organisation, because it's, it's not quite a state company or a semi state company. It's not a private company. You've got a minister technically, I think, as a shareholder, but you also have regulation from the central bank. It holds a very unique kind of position, doesn't it?

Brian Walsh, CEO of Vhi:

Well, I think first and foremost, I think as a brand, as an organisation, it holds a very distinct position in Irish society. And I would say even in the hearts of very, very many Irish people. It is a very, very distinct organisation also, in that we are a statutory body. We are a commercial semi state organisation. We operate in probably one of the most competitive areas of, you know, of business in Ireland. And, you know, we have many stakeholders, including the central bank, as the regulator of our insurance business, the health insurance authority, as the regulator of the health insurance business. And, you know, very, very many other interested parties as well.

Richard Curran:

Does that get a bit complex to manage those sort of different stakeholders?

Brian Walsh, CEO of Vhi:

I guess it can be if, if you maybe overthink it. I think as an organisation, we are extremely purpose led, and we are values led. And so long as we adhere to our purpose and hold true to it, and so long as we operate to our values, I truly believe that, you know, doing the right thing will work with most of our stakeholders. Now, you know, it nonetheless is and can be something of a burden to the organisation in terms of engaging with, with those stakeholders. But, you know, I like to try and, and draw convergence of interests, ultimately, for the, you know, delivery of longer and stronger and healthier lives for our members. And I think that most of our stakeholders are very aligned with that.

Richard Curran:

COVID was obviously a very interesting moment in relation to the health service, health insurance. At the time, because you didn't have anything like the same amount of claims going on and so forth, afterwards, you returned a lot of money to customers, I think it was a total of 450 million euro went back. And since then, it's sort of got back on more of a long term even keel after that initial period. But one of the things that strikes me, I suppose, about health insurance from a media point of view, there are all these newspaper articles talking about price increases. And it's not necessarily a VHI thing, it's your competitors, it's everyone. It sort of gives a sense that, that it's inexorably going to go up. And the reason for the price increases is because of the rising cost of healthcare itself, a growing population and an aging population. How do you sort of respond to, is that difficult at times? Because sometimes, do you feel you're, you know, you end up getting a lot of criticism about price increases?

Brian Walsh, CEO of Vhi:

Look, I think the circumstances are very real. They're experienced by our members, they're experienced by every member of our society, and indeed globally. So, you know, aging is real in the demographics across the world. Lifestyle, the environment, are having impacts on people's health and well-being. And there is significant innovation in the development of new therapies, new drugs, new manners of the delivery of healthcare. But at the same time, there's what we are doing as an organisation and what is happening globally. So, you know, the delivery of healthcare is changing. We must do things differently. If we look back, you know, over the years in Ireland, it has been a very hospital centric healthcare system. That cannot continue. Hospitals, acute hospitals are great at what they do, but they are very, very expensive. 

Richard Curran:

So, in other words, if we continue providing healthcare in the way we do with that emphasis on hospitals, it is just inevitably going to become more and more expensive. So, we have to rethink that. 

Brian Walsh, CEO of Vhi:

Well, it certainly will not be optimal for the health and for the well-being of people in Ireland and further afield. So, we have to move to more digital healthcare, leveraging and scaling healthcare. We have to deliver more healthcare in community settings where it is more convenient for people. They have a better experience and hopefully, it actually delivers better value. We have to move from being a more reactive deliverer of healthcare to being much more proactive. And what I mean by that is that we move into the preventative space that we support people in their continuing health, in their continuing well-being. 

Richard Curran:

Why do you think we haven't done that so well in the past? Is it just a cultural thing and it requires a change of mindset. It requires a different kind of planning, a different way of thinking about health?

Brian Walsh, CEO of Vhi:

Yeah, I do think that it requires a very very different mindset. We speak often about standing on burning platforms, but oftentimes we want to be the change, but oftentimes we have to feel the heat under our feet to be that change. Our organisation, Vhi, I think we are well on that road. We have, and I do think that COVID, in all its disruption, has been a great catalyst of that. So even before COVID, we were developing and investing in our health centres across Ireland. We were developing and implementing better healthcare in digital settings. And many of the things that we are doing in terms of the care and the support of our members is of a preventative nature. So we definitely have set off on that journey. We need to continue it, we need to do better, we need to do more. 

Richard Curran:

And again, COVID was interesting because it kind of forced people into experimenting or accepting or pursuing things like digital medicine, distance medicine, telemedicine, whatever way you want to put it. Because people might have felt, oh no, I want to see the doctor, I want the doctor to be physically there. Suddenly they kind of got over that.  Do you think we're running with the ball sufficiently now in terms of that change? Do you think that something, a switch has flicked in relation to people's minds about that and we can build on that?

Brian Walsh, CEO of Vhi:

I absolutely do. I mean, look, I think people, our members, are very keen on their wellbeing. There's a real focus on that. And there is an awful lot that can be delivered in healthcare and wellbeing that can be remote, that can be done digitally. But even in acute settings, we hear so much more now about the use of AI in terms of diagnostics and imaging, etc. So there is enormous innovation going on in the way that healthcare is delivered. There is enormous improvement in what can offset some of the continuing cost increases. And at the same time, albeit we must invest in preventative care and that can have a near-term additional cost that does pay dividends down the road in terms of lower cost, lower illness occurrence downstream and into the future. So we have to invest today for the future.

Richard Curran:

When you look around at other countries, Brian, who do you think does this well? Are there some examples of countries that do some of these things better than we do?

Brian Walsh, CEO of Vhi:

I recall a story recently of somebody who became ill at a wedding in Norway and the hospital crew arrived and they had immediate access to records of the person who was ill, understood their medical history and were able to support the person without actually requiring to put them in the ambulance and bring them to the hospital. So there are standout countries and amongst them are in the Nordics, Estonia, Norway, Denmark, where I would say they have invested in unified records and portability of records and that I think can have a huge input to more efficient care and indeed avoidable care, which is really, really important in delivering value and delivering better experience. 

Richard Curran:

The Netherlands on sort of prevention and a preventative approach, are they pretty strong on that?

Brian Walsh, CEO of Vhi:

The Netherlands are very, very strong in preventative care and I would say the Netherlands is quite similar also in the private health insurance space to Ireland in terms of that community rating, in terms of the implementation of a risk equalisation scheme. They're probably a little bit more advanced in that because within Ireland community rating is enormously important. It does mean that for the same plan, whether you are a more healthy or a less healthy person, that history doesn't matter, you pay the same price. But that is essentially supported by a risk equalisation scheme that supports better, the investment in better healthcare by funders like Vhi and the avoidance, if you like, of cherry picking within the market and seeking out more healthy to the exclusion of less healthy.

Richard Curran:

Because we have a dual system and we're far from unique in that, where we have a public system and we have a private system and we have health insurance, is there a danger that if the public system isn't run to the optimum that it can be, people will lose confidence in it. And even if they have health insurance now, when they retire, if they can't afford health insurance and you have perhaps a depleted public system, we're suddenly in a very difficult place then, aren't we?

Brian Walsh, CEO of Vhi:

Well, I think look at the end of the day, the public system and the private system must coexist and must complement one another. Sláintecare is government policy and has been for some years and its intent is absolutely correct to deliver a better healthcare system for all to invest in better preventative care. At the same time, there's hardly a healthcare system across the world that can meet all of the needs of all of the people all of the time. And it is for that reason that people make provision for themselves by buying private health insurance policies. So I think that will continue to exist. There will be continuing balancing in terms of how public healthcare is delivered and hopefully the continuous improvements in that regard, but also the service and the care that we offer as a healthcare partner to our members.

Richard Curran: 

As CEO of Vhi, what's it like, you have a commercial directive, you make money, you want to make money, you need to make profit, but that gets reinvested back into the business and back into ultimately the future as well.

Brian Walsh, CEO of Vhi:

Absolutely. It is one of the other unique aspects of VHI that every euro of premium income from our members is invested for our members. So yes, we require to make a profit, but we require to make a profit to reinvest in our healthcare, our services, the experience of our members, the value that we deliver.

Richard Curran: 

One of the things that health insurers are sometimes criticized for is having too many policies. It's too confusing, there are several hundred out there. Why are there so many?

Brian Walsh, CEO of Vhi:

There's always that tension between, I suppose, simplicity and the somewhat more complex needs of people in terms of their healthcare requirements. And we have a regulatory requirement to engage with our members and to ensure that the plan that they elect or select is appropriate, is suitable. I think it is very important to note we in Vhi over the last number of years have run a continuous review of our products. We have reduced our number of products. We have sought to simplify the overall construct of both our product portfolio and the benefits within our products. And we, Vhi, have approximately 48% market share by members in Ireland. We have less than 25% of the products on the market. So I think that that would demonstrate our care in making sure that our products are as accessible as they can be whilst acknowledging the needs of members are varied and not always simple.

Richard Curran: 

I'm talking to Brian Walsh, CEO of Vhi, and we're going to talk a little bit about the future and a few other things right after this.

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Richard Curran: 

When you look to the future, Brian, if you project, whether it's from a health insurance point of view or how health care is delivered in Ireland, think 10 or 15 years down the road, how do you think it will be different?

Brian Walsh, CEO of Vhi:

I think that the increasing population in Ireland, the increasing age of our population, alongside that, the increasing incidence of chronic disease will characterise ever increasing demand for health care. Expectations of people will also characterise that ever increasing demand. But at the same time, I foresee a huge amount of innovation and change. At Vhi, we have 1.7 million insurance customers of whom 1.2 million are private health insurance members. Our intent is to support those members with more preventative care, with more community care. I think that that has to be the direction that health care moves in. I also believe that more digital care is absolutely essential in terms of leveraging what is a scarce resource. Clinical professionals, doctors, nurses, physiotherapists, they are a scarce resource. But there is opportunity to leverage their skill, make their care more accessible even remotely, and complement what they are doing with the use of technology, with the use of AI. I think that is the space that health care must get to. That is what is different about tomorrow compared with today.

Richard Curran: 

Well, I have a few questions that I ask all of our guests on this podcast. You could call it the quickfire round and I will fire them across at you now, Brian. The first one, what CEO or leader do you most admire and why?

Brian Walsh, CEO of Vhi:

Back in my days in Eircom, Soula Evans was managing director of retail. Soula was a force of nature. She was a Greek woman who sadly is no longer with us. But she was the strongest advocate that I have ever worked with for a customer, the strongest advocate for a colleague.  Certainly, when I think and get up in the morning each day, I think if I could live some of those values, if I could be as Soula operated, I think that I would be proud of myself.

Richard Curran: 

If you had Soula in your corner at the time, you were in a good place basically.

Brian Walsh, CEO of Vhi:

Exactly. Yeah, she was a wonderful woman.

Richard Curran: 

What's your favorite book or film?

Brian Walsh, CEO of Vhi:

I've watched An Cailín Ciúin twice in recent times. I love the emotion of it. I love the simplicity of it. I love actually the closeness to nature of it. And yeah, the fact that it brings Ireland and the Irish language to a global audience, those all resonate enormously with me.

Richard Curran: 

It is a beautiful film. One of the things that strikes me about it is that a lot of films that are made today lack nuance or subtlety. They're much more sort of direct. It's a beautifully nuanced film.  So little says so much. 

Brian Walsh, CEO of Vhi:

It is. And look, it reflects so much of life, challenge, opportunity, happiness, sadness. I really enjoy it. I recommend it to any of your listeners.

Richard Curran: 

In business or in life, do you have a mantra, something you tell yourself that you find helpful?

Brian Walsh, CEO of Vhi:

Yeah, do what you believe is right. Do your best in doing it but also maintain a balance. Look after yourself. So I think if we abide by those three things, we will do right by others and we will also do right by ourselves and we must do both.

Richard Curran: 

When you're finished this job, what would you like people to say about what you achieved and how you achieved it?

Brian Walsh, CEO of Vhi:

I would want people to think, you know, Brian has made a positive difference. He has supported the resilience, the sustainability of VHI. And going back to our discussion in relation to the future of healthcare, that he has contributed with his colleagues to the creation of those solutions and the change in the way that we do things. And I'd like people to think that he did that in a honest, forthright, clear way that Brian was and is approachable. He listens. He takes on board people's views, but he is decisive.

Richard Curran: 

Your biggest regret or mistake, would you say, in life or career, if you reflect back? 

Brian Walsh, CEO of Vhi:

I don't know whether this is a reflection on my character, but I don't really kind of look back and say mistakes. I think we all make decisions in life and we make the best decisions that we can and do at the time. One always kind of thinks about, would I have taken such a job that I was offered? There are lots of T junctions in life where I might go left or I might go right. But no, I look back on my life and feel, again, going back to that mantra, I have made the best decision that I could at the time, seeking to do the right thing and hopefully looked after myself, my family and those close to me along the way.

Richard Curran: 

You don't think I should have spent a few more mornings at the beach when I was in LA?

Brian Walsh, CEO of Vhi:

No, again, the people I worked with were wonderful. It is extraordinary. I sat near the exit door to the office and it's such a different lifestyle. People will be heading home at 4pm and they'd pass me by and say, "Good night." And I'd say, "Good night”. It's 4pm. But these folks have been in the office since half past 5, 6 o'clock in the morning. It's extraordinary, but it's a great place.

Richard Curran: 

Any advice for someone, Brian, starting out in a leadership role?

Brian Walsh, CEO of Vhi:

I would say, do things with purpose. Do things where you want to make positive change and have a positive impact. And do things that you get fun from, because if there isn't some fun, and life is short enough, if we don't derive some joy, some fun from what we're doing, then I do think that we're probably not doing the right thing. And again, we're not probably doing right by the people around us as well, because that is part of leadership, setting a vision, inspiring and exciting people.

Richard Curran: 

Well, on that note, we leave it there. Brian Walsh, CEO of Vhi, it's been a pleasure talking to you this morning and the very best of luck with the role in the future. 

Brian Walsh, CEO of Vhi:

Thank you. You're very kind. Thank you, Richard. 

Richard Curran: 

Well, we hope you're enjoying this EY Podcast CEO Outlook series. Remember, you can catch previous interviews we've done with lots of other CEOs. Until next time, thanks for listening. Bye-bye.