HCI International Medical Centre case study

Though it was under new management, HCI was at that time suffering from voluble and cynical media attention fuelled by adverse political and public opinion. The campaign conceived by MEA contained a full spectrum of PR elements from crisis management and positive news generation in local, national and international media to a focused business-to-business campaign targeting specifically the medical/healthcare sector, and political lobbying.

This report focuses purely on the turnaround in political and public opinion achieved with huge success between September 2000 and February 2002.

Campaign Objectives and Target Audiences

One key objective has informed all PR activity since October 2000 – to facilitate HCI in winning contracts with NHS Trusts and Boards targeting waiting lists.

It would be impossible to underestimate the magnitude of the opportunity presented to private healthcare providers by NHS contracts. The significance of HCI’s location in Scotland is highlighted by two key turning points in the political landscape worthy of note.

First was the Concordat introduced by Health Secretary Alan Milburn and signed in October 2000, which opened the door to private contractors by encouraging NHS Trusts to turn to the private sector to help combat waiting lists.

The second pivotal moment was the Scottish Executive’s decision not to follow the Westminster lead, by refusing to sanction at Executive level the use of the private sector to tackle waiting lists.

During the four years to September 2000, MEA had to win the backing of journalists and editors – not only in Scotland but throughout the UK – by providing a wealth of news and feature story material covering human-interest, new medical techniques, breakthrough clinical research and sensitive political changes.

This positive relationship between HCI and the media was crucial to bringing about the sea change in public and political opinion so vital to HCI’s future success:

ï public support would ultimately underpin all political and media backing, and further improve revenue streams from one of the fastest-growing markets for private healthcare providers, the self-pay market

ï political support would open the way for closer co-operation between HCI and the Health Service.

The target audiences of MEA’s PR campaign, therefore, have been the Scottish political establishment, NHS decision-makers throughout the UK and the public, both as supporters of close co-operation between HCI and the NHS, and also as consumers of HCI’s world-class medical services.

Method

Generating Positive Media Interest

MEA has maintained a constant stream of positive news stories in both Scottish and national media, from specialist trade magazines and journals, to national daily and Sunday newspapers and television and radio news.

This providing of HCI with a prominent and positive public and media profile has been essential in positioning the hospital at the forefront of public and political opinion and at the centre of the debate on NHS/private sector relations in Scotland.

To that end, and to keep HCI in the public eye, a period of positive news generation was undertaken between September 2000 and February 2002 with outstanding success. Some of the resultant media news and feature stories included:

ï Male cosmetic surgery – the phenomenal growth in men using cosmetic surgery to enhance their career prospects. Features in a large number of daily and national papers focused on a case study from Glasgow who had been to HCI for a rhinoplasty (a nose job).

ï Raymond Harris – an Irish heart patient who had to be dramatically paralysed for three weeks using a ground-breaking anaesthetic procedure while cardiac and plastic surgeons both repaired his heart and rebuilt his sternum using a flap of muscle from his lower abdomen. The operations were ultimately highly successful and generated media coverage in every Scottish and London-based national newspaper.

ï Liridona Halilaj – the nine-year-old Kosovar girl discovered in treacherous mountains near capital city Pristina by the British army was flown by emergency transport to HCI for an operation to fix a potentially fatal hole in her heart. The BBC covered the entire journey from Kosovo and the British national and regional press took Liridona to their hearts, covering her stay at HCI for over a month.

ï Cosmetic dentistry – charting the amazing rise in cosmetic dentistry, a number of Scottish dailies carried features on truck-driver Rhona Russell, whose smile was fixed by HCI’s dental department.

ï Rahma Reriballah – a tragic case of a two-year-old toddler from Algeria born with her spine so twisted that she would overbalance as she tried to walk. No surgeon could be found, either in Algeria or elsewhere in Europe, who felt that they could operate on such a young and extreme case, but an HCI delegate saw an Algerian newspaper campaign and within three weeks, Rahma was at HCI for groundbreaking surgery by a team from England and the US.

Changing Public Opinion

It was acknowledged by both MEA and HCI that only a dramatic change in public opinion towards the NHS using private sector capacity to impact on waiting times could herald the change of heart required at a political level to bring this about.

This became the focus of the PR campaign from July 2001, beginning with a high-profile announcement through the national media of clinical audit results which confirmed HCI’s position in the highest echelon of global excellence for cardiac and paediatric cardiac surgery.

Neither media, public nor political opinion could now escape the fact that Scotland had a world-class centre of clinical excellence sitting on its doorstep and, with edicts from Westminster that the NHS was duty-bound to utilise private sector hospitals to help reduce waiting times wherever possible, MEA ensured that HCI was positioned as the natural choice for Scottish NHS Boards suffering waiting list difficulties.

Changing Political Opinion

With a supportive media behind it and growing public backing, the only ideological hurdle preventing Scottish NHS Boards using HCI to tackle their waiting lists was the political climate.

Between August 2001 and January 2002, therefore, the PR campaign focused on three key areas:

ï continuing to demonstrate HCI’s commitment to and capability in taking some of the strain away from NHS Trusts and Boards suffering from the effects of waiting lists

ï maintaining the public/media debate about co-operation between the health service and the private sector

ï positioning HCI as the answer to the problem of waiting lists in Scotland.

Through maintaining key channels of communication with the media, MEA was well placed to some extent to manipulate media opinion in the debate on HCI, and has certainly been able to provide the hospital with relevant and often crucial intelligence, effectively making it possible to remain on the front foot in the debate.

HCI’s UK-wide reputation as a major solution to waiting list problems was sealed when it won two substantial contracts from English NHS Trusts in September and December 2001.

When MEA managed and directed the release of these stories to the media, it ensured that briefings and statements carried the message that capacity at HCI is limited, meaning that if it was booked out by English NHS Trusts, Scotland could miss out.

As a result, Scottish politicians – many of whom had been openly scathing about HCI in the past – turned the focus of their attention to the Executive’s decision not to utilise the spare capacity at HCI.

ï “There are 540 beds available at HCI in Clydebank and thousands of extra operations could be carried out there each year if the political will existed.” (David McLetchie MSP, Conservative Party leader, Daily Express, 7.12.02)

ï “Presumably the HCI has spare capacity to take Scottish patients, but we are not sure that the Scottish Executive is into the same scheme as we are.” (Department of Health spokesman, Scotland on Sunday, 9.12.01)

The public debate on Scotland’s use of the private sector to combat growing waiting list problems became a high-profile media issue during the second half of 2001. MEA’s intensive news management during this period ensured HCI remained at the centre of the media’s NHS debate, and positioned HCI as the facility that Scottish NHS Boards should naturally turn to for assistance.

Results

The hugely successful PR campaign implemented by MEA for HCI between 1996 and 2002 has brought about a comprehensive turnaround in political and public opinion, and the most crucial period of change occurred between September 2000 and February 2002.

Key results include:

ï invoking massive public support of HCI as a prominent asset in Scotland’s and the UK’s healthcare industry

ï turning political opinion in favour of HCI, opening the way to the facility being used by the NHS to tackle waiting lists

ï highlighting HCI’s worldwide reputation within its home market as a centre of clinical excellence

ï improving communication between HCI and the UK media, and positioning it as a positive resource for news and feature material.

Analysis of media coverage and political debate during the period reveals a very strong correlation between the intensity of media coverage and political debate on this issue.

As the media coverage of NHS/private sector co-operation – and in particular NHS/HCI co-operation – increased, so political statements on the issue grew, culminating in HCI’s regular mention in political debate in the Scottish Parliament during December 2001.