Strategy consulting: NHI Public Affairs strategy to maximise Influence for Mediclinic Southern Africa and the private hospital sector at large – an example of a high-level engagement programme

This programme was recognised with 2012 Category Winner PRISM Awards in both the Public Affairs and Healthcare categories

Healthcare provision is a South African national priority. The health Minister embarked on a new National Healthcare Insurance (NHI) development process, initially a one-sided politicised approach, calling for an inclusive process where stakeholder opinion could contribute relevant international expertise, correcting misperceptions about the private hospital industry and debunking some myths to add value.

Stone developed a comprehensive integrated Mediclinic public affairs NHI strategy to contribute solutions in a positive approach. The three-tiered strategy (engagement, lobbying and research provision) has facilitated significant process influence and improved understanding of the NHI issues at hand.

Client company profile

Mediclinic Southern Africa (MCSA) is a top-three South African private hospital group, part of publically listed Mediclinic International, the sixth largest private hospital group in the world. Mediclinic Southern Africa has 7 200 beds in 52 multi-disciplinary hospitals in South Africa and Namibia.

Specific problem or opportunity addressed by the programme

Stone is Mediclinic’s partner in developing and implementing an integrated public affairs communication strategy to enable an inclusive regulatory process and to communicate the correct private hospital perspective on NHI. The objective was to influence the NHI process towards inclusivity and transparency, while cultivating a correct public, industry, public sector and media understanding about the issues impacting on the debate and processes towards redefining healthcare provision in South Africa.

Initially the private hospital sector was ignored in the debate and rather positioned as the problem, diverting attention from problems in the South African healthcare space. Overall, the real issues, commercial realities and value of the private sector were ignored to meet political objectives in a one-sided approach. During the initial announcement and publication process of the NHI promulgation process and papers, Mediclinic and other hospital groups came under fire as being expensive, exploitative and not providing value to South Africans. Mediclinic led the way in influencing a more inclusive process with Mediclinic as the facilitating voice of reason in a contributory role, where Mediclinic applied its significant international expertise to find solutions for a truly South African NHI. The process still continues.

The situation called for quality, decisive public affairs engagement on many levels and strong communication across various integrated channels. The strategy focused on gaining positive contributory influence, counteracting misperceptions and debunking myths, while educating the media and opinion leaders on the dynamics at play. The approach was not in any way disruptive, but rather a positive engagement – Mediclinic being the voice of reason and contributing to the process for workable NHI solutions, appropriate for South Africa.

Research

Stone conducted comprehensive research in Southern Africa and internationally to understand all the relevant commercial, public and healthcare issues at hand from a national healthcare and private hospital perception, as well as opinion perspective. The research included integrated target audience mapping using the bespoke Stone Pebble Ring Thinking© methodology and scanning of prevailing opinion and perceptions from all relevant stakeholders.

Mediclinic’s Health Policy Unit (HPU), a dedicated research and policy unit/department, conducted and shared significant comparative NHI research internationally and in South Africa. This formed the basis of an informed opinion and approach to the public affairs strategy, not only informing communication, but indeed the content shared with Government and other stakeholders to significantly influence and contribute to the debate at hand.

Key research objectives

• Build a comprehensive view of all stakeholders, their influence and their opinions on all the issues at play to develop appropriate initiatives that will resonate, while achieving impactful results and not only coverage.
• Understand the perceptions and views of the integrated target audience base (opinion and content influencers, business topic growth segments and internal audiences) and how to integrate the strategy to meet stakeholder needs and change opinion.
• Understand perceptions and myths about price, approach, costs and dynamics at play in the industry.
• Understand the true impact and influences that will play a role in developing a workable South African NHI.
• Build a case of evidence to support the communication objectives of the strategy.
• Understand and build a case to change perception about the issues at play and the role Mediclinic and the private hospital sector can play in the process.

Research result

• A clear understanding of the dynamics at play.
• A sound understanding of the influences on developing a workable and relevant NHI.
• A target audience map with their perceptions, priorities and their trigger points and the actions required to enable impact and influence.
• A solid understanding of engagement channels and choices to ensure quality engagement and interaction to enable a sound understanding of the true facts at hand and to gain the required influence.
• Participative scope to develop a sound implementation plan, schedule and tactics with the correct level of engagement from Ministerial level right through to Joe Public.

Programme objectives and establishment of measurable criteria for success

The campaign aimed to develop and implement a comprehensive integrated public affairs engagement strategy that positioned Mediclinic as a leader in the industry and as the driving force in seeking and negotiating workable solutions for a South African NHI.

The following business outcomes were paramount

• Position Mediclinic as the voice of reason.
• Gain influence and representation in an inclusive and consultative process.
• Safeguard the commercial position of Mediclinic and the private hospital sector.
• Explore and promote PPP and PPI opportunities, as a workable model in NHI.
• Explore and promote other potential Mediclinic contributions to the NHI process.
• Provide and leverage the contribution of quality, international research by Mediclinic.
• Address shareholder, supplier and customer concerns through strategic and well positioned communication to the integrated audience map stakeholders.
• Support and facilitate the potential business growth opportunity for Mediclinic in an NHI context in line with the MCSA business goals.
• Align with and promote HASA, the HPU and the industry position.
• Position Mediclinic as a facilitator to influence policy formulation.

Determining target audiences

Based on the extensive research, a comprehensive list of stakeholders formed part of an integrated target audience map, including Government decision makers at all relevant levels, regulatory opinion leaders, the industry, the regulatory and legislative communities, media across all channels, as well as other relevant public audiences.

Formulating target audience message

To position, leverage and share the NHI communication and research content, Stone followed the following approach:

• Messages were aligned with other private sector initiatives and national healthcare.
• Messages had a supportive slant as the voice of reason, incorporating commercial realities.
• Content was leveraged based on solid local and international research.
• Messages were directed to support long-term MCSA plans in an NHI context.

All communication supported Mediclinic’s desired NHI outcomes and positioning

Communication channels and opportunities used

• Comprehensive public sector Government one-on-one meetings and engagements at all appropriate levels with a representative match in seniority of stakeholders (CEO to Minister, public affairs directors, policy leadership, commercial leadership, etc.).
• Mediclinic has the only participative private hospital sector representative member on the NHI development body reporting to the Minister.
• Hosted own industry forums and information sessions for stakeholders to inform and educate them on the dynamics at play, as well as the private healthcare position on these issues.
• Engagement with relevant and related academic and business opinion leaders.
• Placement of supportive and endorsing editorial by respected leading public voices, like Dr Mamphela Ramphela.
• Significant media relations with a high implementation frequency including:
  1. Opinion-leading articles to position the facts, debunk myths and drive a sensible reasonable approach.
  2. Positioning of the Mediclinic opinion and position in own and other trade publications.
  3. Editorial placement and interviews with leading journalists across the business, public policy and healthcare beats – a strong relationship engagement model was followed with significant interaction with and support of leading writers on the topic.
  4. Distribution of quality research to inform and educate stakeholders on the true position and issues at hand.
  5. Milestone media forums – engagement opportunity with leading editors to educate them on all the issues and dynamics at hand, rather than just announce a specific position or approach.
  6. Maintenance of regular online communication with media on opinion and issues.
  7. Provision of fact sheets on the prevailing myths regarding the private hospital sector.
  8. Development of a bespoke micro website specifically for media engagement on the NHI, coupled with real-time webcast streaming from media forums in Johannesburg.
  9. Significant digital positioning and online PR on the position of Mediclinic, including the use of own and related websites, social media, bespoke micro sites and direct digital communication to appropriate stakeholders.

Execution

The Mediclinic and Stone teams formed a very strong partnership and the consulting resource worked hand in glove with the client to ensure that the project remained on track, on strategy, on message and within budget. We strictly followed implementation matrices for each intervention that kept track of time, interventions, outcomes and validation of these as the process unfolded. Regular status meetings and inclusive strategy update sessions remained characteristic of the approach and management of the process.

Extensive executive engagement and media training preceded roll out and on-going monitoring ensured that spokespeople and public engagement executives remained abreast of developments and changes in debate dynamics. Apart from interview skills and content training, a live Q&A set was used to constantly update all Mediclinic spokespeople on NHI to ensure a uniform company point of view, public opinion and position at all times.

Milestone measurement allowed adjustment of certain interventions due to the fluidity and significance of this national debate. During regular status meetings and/or status calls these were evaluated and adjustments agreed, as and when required.

Through high-frequency, quality engagement, Mediclinic established itself as a source of quality leadership opinion. This was both appreciated and regarded in a very positive light by the media across the country and in various disciplines of journalism.

Key executive positioning relating to the debate also proved successful to the extent where the CEO, public affairs, policy and industry affairs executives gained in stature and opinion influence on topics related to the NHI debate.

New dynamics and unfolding realities in the debate often required reaction. However, the key message set on NHI was solid and reaction was positioned in a consistent fashion, keeping message integration and continuity in mind at all times.

Mediclinic’s influence in this debate has grown significantly and is regarded as a valued private sector contributor to a future NHI.

Evaluation

The stakeholder engagement strategy proved highly successful and positioned Mediclinic, not only as the leader in the industry, but also as playing a decisive role in seeking and negotiating workable solutions for both the industry and the legislator, as well as the public at large.