Graham Reid: Hi, I'm Graham Reid, partner head of client and markets at EY in Ireland. This week Mairéad McCaul, managing director of pharmaceutical giant MSD Ireland, is in the studio. As a former nurse, she chats about how her background has shaped her leadership approach, the strength of the pharma industry in Ireland and how personalised medicine will impact all of our futures. It's a great listen. Hope you enjoy.
Richard Curran: Thanks, Graham. Mairéad, you're very welcome to the podcast. You have been MD of MSD and head of the country team since 2020. You've had a fascinating career journey along the way, from nursing to pharma sales to management, and all the way to running a business that has been in Ireland for 50 years and has a huge presence here with 3000 employees. You're very welcome. I want to go back to the very start, actually, of all of that. It all started for you on the family farm in County Monaghan, rural County Monaghan.
Mairéad McCaul: Yes. Hello, Richard. It's great to be here today. Yeah, so I'm originally from County Monaghan. I come from a small rural community. It's probably one of the smallest villages in County Monaghan, a place called Rockcorry, which is quite close to the Cavan border. I'm one of a very large family and yeah, my father was a farmer back then.
Richard Curran: A lot of good memories? Or memories of a bit of hard graft on the farm when you were growing up?
Mairéad McCaul: Well, I'd say if you asked any member of my family, the last thing that they would say that I did was hard graft on the farm! I wasn't an enthusiastic farmer but I suppose it was a very simple, simple life. You know, there was a great sense of community, a great sense of family. And really, I suppose the community was centered around GAA and the church.
Richard Curran: And one of the things, you know, from talking to business people whose background maybe was in farming, one of the things about farming is you've got to be able to respond to things going wrong, and you've got to be a bit of a, a bit of a master of all trades. Was that the case growing up with your brothers and sisters and so forth, you would have had to have, you know, helped out in different ways?
Mairéad McCaul: Yeah, I suppose in many respects it is, it is like business. You know, no day is exactly the same. And you have to be able to respond very, very quickly, whether it be to, to an emergency or whatever happens on, on the farm, you know, so you have to be resilient and you have to be focused on what needs to be done. And you have to expect the unexpected in many ways.
Richard Curran: And an interesting connection with the whole FDI multinational and, you know, pharmaceutical and medical realm, as well as the food realm. Abbott, your dad worked in Abbott in Cootehill at the same time as well.
Mairéad McCaul: He did. He did. So I'm one of a large family. We are farmers or my dad was a farmer, and I suppose by way of supplementing his income for that very large family, he was very fortunate to get a job with Abbott when they set up in Cootehill many, many years ago. And I suppose that's something that stays with me. You know, I saw first-hand the impact of foreign direct investment and in particular, you know, a health care company and the impact that that had on a local community as well, both from an economic point of view, you know, from a social point of view et cetera.
Richard Curran: And that's something you're in a position now to be very aware of because, you know, MSD has so many sites around the country.
Mairéad McCaul: Yeah. So in total we have five manufacturing sites around the country. Then we have our head office, which is in Leopardstown here in Dublin where we have our commercial business. So the human health commercial business and an animal health commercial business as well. And then we have another facility in Blackrock, which is very much focused around traceability and digitization from an animal health perspective. So we have over 3000 colleagues around the different sites. The majority of those obviously are working within manufacturing. And when I talk about manufacturing, we manufacture medicines and vaccines that are exported around the world and benefit patients around the world.
Richard Curran: And I want to talk to you a bit about that shortly. But just even going back to childhood, did you have any sense when you were growing up that you might end up in the kind of career and in the kind of role you're in now? What did you want to be when you were a kid? What did you want to be 'when I grow up', basically?
Mairéad McCaul: Oh, gosh. Um, probably many different things, many different times. Um, probably teaching that was that was considered, you know, a steady and sort of nice job to have. But there were, I suppose, considerations around potentially studying law, for example. I didn't really have any huge, huge idea. And I certainly never thought that my decision to go into nursing, way back in the early 1990s would have led to this position today.
Richard Curran: So you studied nursing and you started working. At one stage were you working in Dublin in the Coombe?
Mairéad McCaul: I was, yeah. So I did my general nursing, my nurse training up in Northern Ireland. And then in 1995 I started midwifery training in the Coombe. And that was a really great experience because I suppose working within the Coombe, it gave me a great insight into, into society at large in Ireland but it also gave me an insight into some of the inequities and health inequities that exist within Ireland as well.
Richard Curran: Did you enjoy nursing?
Mairéad McCaul: I did. I really got a lot out of it. I always remember the very first day that I started my nurse training. The head lecturer or tutor at the time said, you know, when you meet somebody and you're caring for them, you're in a privileged position and you should always treat them as if they were your mother or your father or your brother or sister or your child. So that's something I think, that I have always carried with me, and it's something that I've carried into this role as well because for me, you know, patients are not just a homogenous group. They are individuals with, you know, individual impact and connection and family ties as well.
Richard Curran: So that time nursing, for you, has informed how you think about the job you do now and the impact that it can have.
Mairéad McCaul: Exactly. Yes, it certainly has.
Richard Curran: You decided to get out of nursing and it was, it was the sales reps that sort of made you think about a new role or a new career.
Mairéad McCaul: Yeah, I remember when I was working both in general hospitals and also then in the Coombe, I used to see medical sales reps coming in and I thought, well, I think I could do that job. So it was something that I started to look at as a potential.
Richard Curran: They're always very sharply dressed, the medical sales people going into hospitals and that, aren't they? They're always looking, very smart.
Mairéad McCaul: Well, I suppose that's all part of your personal branding. You want to look professional and going into, going into hospitals, meeting with, with really important health care professionals so I think it's a respect thing.
Richard Curran: Yeah. You made the switch then. And did you enjoy it? Were you good at sales? Did you find that you were good at that?
Mairéad McCaul: Yeah, I, so I started out my sales career and it wasn't actually in pharmaceuticals. It was actually selling equipment. So I worked for a company called Bayer Diagnostics. They had a manufacturing site actually out in Swords that subsequently became Siemens Diagnostics. So I sold, actually, equipment for testing at the bedside. So point of care equipment, as we called it, but also laboratory equipment. So things like chemistry analysers, blood analysers, histology, various different analysers. And I think when, when you look at it, when it comes down to the nub of it really, it is thinking of who will benefit at the end of this. What are you selling? And it's really reinforcing the benefits of that. But ultimately the benefits to the patient at the end of the day.
Richard Curran: Did you get a bit of a buzz out of making your first sale? Do you remember the first day or the first week and you say, yeah, I've got that over the line. They're taking that?
Mairéad McCaul: Of course. It was, particularly in that diagnostics industry, it was a lot of the sales were as a result of tender responses. So European tender based selling. So you know, if you won a contract you had a contract for anywhere between 5 and 7 years. So that was an absolute high. But if you lost it, there were absolute lows as well. But I really enjoyed it. I have to say. Definitely got a buzz out of that. And particularly with the interactions with different people.
Richard Curran: So you joined MSD, it would have been around 2007? How did you make the switch then from sales into management and all the way through MSD then?
Mairéad McCaul: So I joined MSD in January 2007. So it'll be 17 years this coming January in a couple of months. I joined prior to us launching a product for the treatment of type 2 diabetes. I had particular expertise and experience within that area from a clinical point of view when I worked as both a nurse and a midwife. So it was probably quite a natural transition for me to bring my understanding of the broader health care system and of diabetes into, into MSD. So I joined at a reasonably junior level in MSD, and over the years I was very fortunate to have managers and a leadership team in MSD that saw something in me that I might not necessarily have seen in myself and really encouraged me to continue to progress. So I moved from my very first role into sales management within the first year. I really enjoyed the sales management role because I loved the commercial side but I loved working with the team and with people as well and with health care professionals. And then I was asked to take on a marketing role. And then from that I moved into commercial operations and the complexities around our supply chain. And then I moved into various different leadership team roles.
Richard Curran: And along the way, having started your career in nursing and then you move into medical equipment sales and then you're working your way up through MSD, it's an extraordinary achievement. I mean, you can't, you can't do that unless not only do you have the skills and the ability, but you must have a lot of drive. Are you a very driven person? Would you say you were an ambitious person?
Mairéad McCaul: Yeah, I probably never really thought about that too much until sort of the last couple of years when I have been asked that question on a number of occasions. And yeah, there is, there certainly is an ambition. I always want to see what's next. And I always want to stretch myself. I'm ambitious for myself, but I'm also ambitious for my team and the impact that we can have as well.
Richard Curran: And where do you think that comes from, that kind of motivational thing?
Mairéad McCaul: Uh, I suppose.
Richard Curran: Was it in the family? Was it there when you were growing up, do you think?
Mairéad McCaul: Yeah. Well, as I mentioned previously, I'm one of a large family, so there's always a good bit of healthy competition in a, in a large family from Monaghan in particular! Exactly, exactly. But there probably is some intrinsic motivation and I think I've, you know, my own parents would have always been really encouraging of all of us. And, you know, we never doubted that we could do anything that anybody else could do.
Richard Curran: MSD and, not only that, MSD itself has a long track record in Ireland. The business has been here 50 years in total and huge investment over that time as well. Do you think sometimes that the role and scale of the pharmaceutical and the medical industry in Ireland is maybe even underestimated by people who aren't working directly in the sector, what the country has achieved?
Mairéad McCaul: Yeah, and I think, I think that's really key. Those of us working in the sector or those communities where, you know, there is a presence of a large pharmaceutical company in a particular local area or region, you know, they have an appreciation. But I think probably as a country, we don't have that great appreciation of what we've achieved collectively. And when I talk about what we've achieved collectively, that's really down to a strong collaboration between government, between academia, between industry and various other support agencies as well. And it's something that we should be really, really proud of as a country. The products that are manufactured here - medicines and vaccines are having phenomenal impact around the world, in Ireland, but also around the world and that's something that I think we should pause and reflect and celebrate in many ways.
Richard Curran: One of the things about foreign direct investment that people will talk about is that sense of, you know, is it going to be here for the long term? And it applies particularly with the likes of maybe the technology industry. People might feel, oh, will these businesses all still be here? But when you look at your own industry, the capital investment that has gone into Ireland, I mean, you guys have put, is it a billion dollars into one of the one of the facilities here. Um, there is that sense that after spending and investing all of that money, that we're not suddenly going to lose that sort of investment presence in the future. Do we have to work hard at retaining that and not be complacent about it?
Mairéad McCaul: I think it is important that, you know, as a country that we do continue to work hard at retaining and, and continuing to attract that investment. We have built up some huge knowledge capital, I guess, in terms of the industry here. And as mentioned previously, the, you know, that collaboration between industry, academia and government has been really, really strong, but it's something that we need to continue. We need to continue to look at what's next within the industry, and how do we make sure that Ireland is at the forefront when it comes to those investment decisions, whether at various different, whether it be US multinationals or other large multinational companies.
Richard Curran: Well, Mairéad, we've talked a bit about your own background and your own career story and MSD here. We'll talk a bit more about the future of the sector and what might lie ahead after this.
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Richard Curran: Mairéad, we were just talking about the investment that's gone into the industry in Ireland and retaining it. Do you have to compete within MSD for investment to continue to come to Ireland, and is that a difficult case that has to be made around, this is the best place for the group headquarters to spend and invest their money?
Mairéad McCaul: Yeah. And I think it goes back to very much the benefits that we have seen in Ireland from the sector and the benefits that the industry has, has brought here in terms of jobs and the impact in local communities around the country. That hasn't gone unnoticed across Europe, across the world. We have some very strong manufacturing hubs and facilities around the globe as well. And I think, you know, we have done it very well in Ireland in terms of making sure that we have the right pipeline of graduates and the right skills and capabilities available to serve our industry. But it isn't something that can be taken for granted either. You know, we need to continue to invest in making sure that we are focused on getting as many Stem graduates through et cetera.
Richard Curran: Are we doing enough on that, do you think? You're saying it has improved, and what we have done has put us in good stead up to this? Do you think we need to do more? Are we doing enough?
Mairéad McCaul: Yeah, I think the industry and when you look at some of the courses available at college and university level, they are adapting to the needs of the sector. So both the pharmaceutical and the tech sector as well. So we do have the highest number of Stem graduates within the OECD. We have a really, really talented pipeline of colleagues and graduates coming through here so I think we are in a good place, but we need to continually look to see what's next. So what's next in terms of the capabilities required, for example, around personalized medicine, what's next from a manufacturing and digitization perspective as well?
Richard Curran: The idea of personalized medicine that seems to be a big growth area for the future. How would you describe personalized medicine and what that might look like in the future?
Mairéad McCaul: So I think and my basic understanding, and I suppose translation of it is if, if you, Richard, come in and you present with a particular condition that we, that in the future and, and in some instances currently we could do some tests to understand how your body might react to a particular medicine, and there could be a particular treatment approach that would be created specifically for you. So if you think about that, that's revolutionary in many respects. And it means that in terms of the investment, for example, in a therapeutic approach or a medicine, you're sure that it's going to be the best one available. And it's, you know, we're looking then maybe at very much a bespoke approach rather than, you know, going back to that broader approach.
Richard Curran: Rather than a uniform mass product, it's able to be tailored. And we mentioned about the role that Ireland plays within the global supply chain in the industry, which is very significant now. But this is something that you've brought up before. You feel that in many cases, medicines that are actually being manufactured in Ireland aren't becoming available to the Irish public quickly enough, if at all, in some cases.
Mairéad McCaul: Yeah. And that continues to be a challenge. It's something that, as an industry, we continue to work with key government stakeholders, with the Department of Health.
Richard Curran: What's going wrong?
Mairéad McCaul: So I suppose just firstly, to give you an example, if you were a patient in Germany, you would receive a medicine, an approved medicine when it's approved by the European Medicines Agency, two years on average before you would receive it as a patient in Ireland. So there are a number of different challenges, I think, within the system. I think it's something that both industry and the health service and the broader government approach, it's going to require a collaborative approach to make sure that not only is Ireland in the top quartile when it comes to manufacturing of pharmaceuticals. We should really have an ambition as a country to be in that top quartile when it comes to the availability of medicines for patients.
Richard Curran: Is this about money and what the manufacturers can charge, and what the state is willing to pay for certain medicines, or is it simply about not processing the regulatory aspects of it quickly enough?
Mairéad McCaul: Yeah, it is complex. So there are a number of different elements to that. Ireland is, the average, the price of medicine here is the average of 14 other European countries. So we're not the cheapest but we're not the most expensive. We are the average of a number of different European countries. The other challenge is really around the process and maybe some of the resourcing that's available. And when I talk about resourcing, it's around that human resourcing that's available within the system to process some very, very sophisticated drugs and products. If you look at the journey that has happened over the last number of years, you know, we've moved very much from, like, tablet or what we would call small molecule medicines into, you know, much more bespoke and more sophisticated treatments and vaccines for various different conditions. So there are a number of different things that need to be addressed around the process. And the Minister for Health did announce earlier this year a review of that process. And hopefully we will see some, we will see some results and patients ultimately will see the results in terms of speed and access to medicines and vaccines.
Richard Curran: As a woman CEO in an industry at such a senior level in the industry that you're in, I would have thought that's quite unusual. I wouldn't have the image of, you know, necessarily medicine, pharmaceutical manufacturer, health care, all of that whole world. I would have thought at senior levels, it's quite male dominated, is it?
Mairéad McCaul: Well, if I look at MSD alone, we have five manufacturing sites around Ireland. And if you look at three out of those five sites now are headed up by really talented female colleagues. It's an area that we have put significant emphasis on as a company, making sure that everyone feels that they can fulfil their career. It doesn't matter about your background, it doesn't matter about your gender. And really the approach is around embracing diversity because without reflecting, I suppose, the patients that we serve in many respects and a lot of decision making is taken by women when it comes to healthcare within families and within homes. So we as a company need to reflect that as well.
Richard Curran: Do you think maybe some companies could do better? Others?
Mairéad McCaul: I can only talk about MSD.
Richard Curran: That's very diplomatic, there Mairéad! And about your own leadership style and your approach to how you manage, how would you characterize it?
Mairéad McCaul: I like to think of myself as a pragmatic leader and a responsive leader and a leader that is really focused on, and this is something I mentioned to my teams regularly, on people and on patients, and they are the two critical things. And it's something that's not just personal to me, but it very much is a theme from an MSD point of view. We focus on patients and we focus on our people really, really critical to us.
Richard Curran: Do you find it easy or difficult to switch off from work when you're, when the day's work is done?
Mairéad McCaul: It depends on what's happening during the day, or maybe more importantly, what's due to happen the following day or the following week. But I do, you know, I live up in the north east, up in County Louth, out in the countryside. So I have a particular spot on the M1. When I get to that point, I'm going home and I'm switching off.
Richard Curran: Do you do that as a kind of a deliberate mechanism? "Here's, here's that particular lamppost or that particular tree. I'm off now. I'm switched off now."
Mairéad McCaul: I try to, I try to. And it's actually a beautiful view of the Cooley Mountains and Dundalk Bay that's my particular trigger point that where I switch off. I like to get outdoors as much as possible. I like walking. Very enthusiastic walker and an occasional runner and an occasional cyclist and a reluctant gym goer.
Richard Curran: And all of that helps to switch off. There are a few questions, Mairéad, that I ask all of our guests on this podcast, and you could call it the quickfire round. I'll throw them at you now. The first one, what CEO or entrepreneur do you most admire and why?
Mairéad McCaul: Well, I was considering this question because we had, I knew that it was going to come up, and I thought about it more in terms of what leader I admire. And I think many people can show up as leaders because they have it in their title or in their job description. But what I think is more impressive is the leader that is maybe unexpected. So when I think of some of the leadership qualities that I admire; resilience, integrity, transparency and bravery, I think particularly of the late Vicky Phelan, and I think she's somebody that I would look to and she incorporates and embodies a lot of the qualities that I admire.
Richard Curran: And the extraordinary bravery that she did show as well. Your favourite book or film?
Mairéad McCaul: Um, favourite book is a book, now I can't remember the name of the author straight off, but it's a book called When Breath Becomes Air, and that's a book about a really, really talented neurosurgeon who actually was facing or faced a terminal diagnosis. And it's a really interesting, I suppose, interplay between science and literature in many respects. And it really brings to the forefront, I suppose, the human condition when you're faced with mortality.
Richard Curran: Yeah. Sounds interesting. Another one, do you have a mantra in business, something that guides you?
Mairéad McCaul: Yeah, I think the mantra that I would have is very much what has made either me or my business be successful in the past is not going to make me successful in the future. So it's very much always challenging the status quo and challenging the way that I and my team think about things.
Richard Curran: When you're finished this job, what would you like people to say about what you achieved and how you did that?
Mairéad McCaul: I suppose it goes back to that whole, those two key areas for me, patience and people. I would like for the people that I have worked with to say that I made a difference for people and for patients, ultimately.
Richard Curran: Biggest mistake or regret?
Mairéad McCaul: I haven't got any yet.
Richard Curran: No mistakes or no regrets?
Mairéad McCaul: Oh, I'm sure there are lots of mistakes, but no regrets. Everything's been a learning.
Richard Curran: Any advice you'd have for another business leader or leader in any capacity who might be starting out?
Mairéad McCaul: I think my advice to other leaders or to colleagues or whoever is always be yourself, be your authentic self and put your energy into, um, you know, your day job rather than trying to be somebody else. So that would be my piece of advice.
Richard Curran: Well, Mairéad McCaul, MD of MSD and Country Leader, thank you so much for joining us. It's been a fascinating conversation with you and a fascinating career journey as well. And we hope you're enjoying this EY podcast CEO Outlook series. Remember, you can catch previous interviews we've done with CEOs and we'll have lots more to come. Until the next time, thanks for listening. Bye for now.
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