Read the Conversation

EF: What was Mediclinic's role during the pandemic in South Africa and the region?

RM: We have operations in Switzerland, South Africa, Namibia and the Middle East. The main thrust of the pandemic was in South Africa and we played a considerable role treating over sixty thousand Covid-19 inpatients in this country alone. To focus on Covid-19, we ceased elective surgeries in line with government guidelines and stopped other non-essential activities. We put things together very quickly, tested our staff and got the PPE supply chain moving, never running out of equipment or supplies, and never turning patients away. We have since gone through three successive waves, the third being the worst. None of this would be possible without our incredible staff. Their protection has remained a priority and now most of our staff has been vaccinated. We didn't have as many Covid-19 inpatients in our other countries. Our main contribution to the UAE healthcare industry was to become heavily involved in testing; we did thousands and thousands of PCR tests, something that is now tapering down. We also did mass testing and screening in Switzerland. In South Africa, we didn't do testing because we don't run labs. Our third contribution was to do vaccinations, not a profitable activity but the point was to help get people vaccinated so we put up vaccination centres in all four countries, starting with Switzerland, the UAE, followed by South Africa and finally Namibia. It has been wonderful to be part of the full healthcare journey, first treating, testing, and finally vaccinating the population. We will continue to focus on vaccination; there is still a lot of work to be done in this area with booster shots.

Stats by mid-November

Cared for 78 000 Covid-19 patients requiring hospitalisation across four countries

As a Group administered around 1.2 million vaccines

Operating 45 vaccination centres across our three divisions, the majority of which are in South Africa

EF: How did you go about adapting hospitals in South Africa to treat Covid inpatients? It cannot have been easy to prepare so many hospitals for the task simultaneously. 

RM: It was no easy task, mainly because we needed to create urgency without panic. When the pandemic started, people were in denial, they didn't know how to prepare, found it hard to cope and they had to understand we knew what we were doing and would support them. We had to act fast while avoiding panic in more than 50 South African hospitals. Once the urgency was created, the planning process began with the division of hospitals. The hospitals are community facilities spread all over the country; communities rely on these hospitals not only for Covid-19 treatment, but for other emergency care, so there was no thought of them just being Covid hospitals. Splitting each hospital in two with parallel processes – one for Covid-19 patients and one for non-Covid patients – was challenging, but we managed it through careful planning and execution following strict timelines. Soon, we were very efficient and proficient despite initial challenges, and I am hugely proud of the teams that seamlessly managed this.

EF: Did you have to adapt your management style? What were the lessons learnt from this process? 

RM: Historically, Mediclinic has been very conservative and not very innovative. I took over my role in 2018 and was in the process of implementing new strategies and innovating when the pandemic hit us. When the first lockdown was announced, we were given three days grace to equip 700 employees from our corporate offices near Cape Town to work from home. We managed it even though we had to organize a lot in record time. Without that deadline, we would have possibly taken nine months to implement a new way of working, as part of a change management process is planned through sub-committees, registered projects, and a lot of debate, but we did it all in three days, showing what can be done when we are pushed. It was the complete opposite of what Mediclinic had been doing to date and it was very encouraging to know we could make big decisions quickly and act fast. All the management teams learned the lessons very quickly. I believe  this dynamic working method will continue, making us flexible and more efficient. The other lesson we learnt was the importance of communication. Communications must be short, crisp, clear and to the point, and repeated a hundred times over. That was how we communicated during the pandemic and how we continue to communicate. From Covid, we have learnt the importance of alignment and communication to massive effect. 

The new digital world has made meeting people so much easier; I can easily invite four or five hundred people to one meeting, something impossible in the past; it is a powerful way to get my message across to a broad audience. We have the tools and use them positively.  

EF: Do you think we will go back to the pre-pandemic ways or has the working style changed forever? 

RM: As a result of the pandemic, the world has had a shock in terms of business approach. A lot of the change occurred virtually –huge emphasis on virtual. In October, I travelled internationally for the first time since April 2020. I have been running the entire business virtually and haven't seen my teams in other countries face-to-face in 18 months. We are all aware that the change from purely face-to-face to exclusively virtual was a bit too drastic; the ideal is somewhere between, more virtual than not. Still, physical interaction is important and must not be overlooked. The circumstances have brought forward old debates on virtual health and telemedicine, which we all knew but have not acted on. Suddenly, virtual health and the interplay between virtual healthcare and physical care are taking the front row -a significant change. Some healthcare trends have been accelerated by the pandemic, such as health migration of care, from intensive care to lower care and the difference between being hospitalized to having day case clinics and treating outpatients. Hospitals are becoming very different places from what they used to be, with all the technological advances accelerating the process of diagnosing and treating patients. A company like ours cannot go back to being conservative and relying on old manual processes. We must move forward quickly and with agility, using new technology and creating new business models. Our leadership strategy is to reposition the entire business across the continuum of care –hospitals, surgeries and primary care- integrating all parts for the seamless flow of patients in all care settings. We aim to coordinate it all, offering new value propositions. The other part of the strategy was to adopt large scale digitalization, virtual care, digital health and robotic process automation and offer analytical availability of artificial intelligence. The strategy was all in place before Covid, so when the pandemic arrived, we went forward with our plan only becoming aware of its importance after it was done: yet another lesson learned through Covid. Today versus one year ago, my team is a totally different team, same people but a different mindset. 

EF: How did you manage to ensure the security of supply at a time resources were scarce worldwide?

RM: At the onset of Covid-19, securing masks and other protective gear, as well as medication and other supplies, became critical. The entire supply chain was under strain and very restricted. We engaged with all our contacts, even in other industries, and managed to start importing the things we needed. We ended up with a surplus of certain items, proof that our suppliers supported us. It also helped that we buy centrally for all our four countries, and then distribute. 

EF: When you mentioned continuum of care strategy, does it refer only to South Africa and Namibia, or the entire group? 

RM: We have one strategy, one concept for the group, but each local region's implementation differs. In Switzerland, we partner with Migros -Switzerland's biggest wholesaler, involved in many service lines and different businesses. They decided to enter healthcare and established MedBase. They are establishing primary care and consultation clinics all over the country offering radiology and lab services; Mediclinic runs the radiology and lab services in their clinics and they run the consultations. We create value through this partnership; we go to the insurance companies and create supplementary insurance products for primary care and sometimes primary and secondary healthcare combined. Partnerships are an excellent way of furthering our brand and for patients to get different value propositions. We are trying to cover the patients’ entire healthcare journey, from diagnosis to rehabilitation. We aim to partner with our clients to offer comprehensive services and not the isolated hospital health service, adapting locally to the countries' context. Healthcare is very fragmented in South Africa, largely fragmented in UAE, and less so in Switzerland, and we want to create a comprehensive service that we can coordinate for the patient's benefit. It's working progress at the moment, challenges are being overcome, but we will get there following our strategic direction.

EF: What would be your message to business leaders that aren't in the healthcare space and could be interested in getting involved? 

RM: For investors, numbers are the most critical factor. Numbers do the talking and convincing, and the numbers will restore investors' confidence. When our numbers come out in November, they will hopefully convey a clear message. Secondly, there is an insatiable demand for the healthcare services we render, healthcare is a slow-moving industry and there are massive opportunities to fulfil, for example, the need for new technologies and innovative thinking. Healthcare is a less cyclical and a less vulnerable sector and has recovered very quickly post-Covid.  The need for healthcare will always be there and companies that are forward-thinking and can reposition themselves are the ones that will be attractive to patients and clients. 

EF: To what extent do you think the pandemic has shifted the skill set needed for employees in the future, and what would be the new soft skills required? 

RM: People need to feel safe in order to do their work and there is a lack of healthcare workers; there is a shortage of nurses all over South Africa, and we cannot afford to lose the ones we have. All healthcare workers have had a tough time during Covid. Psychological support and safety are essential and we have to keep creating programmes for their support. We need to keep our healthcare workers healthy from a physical and mental perspective by creating a safe space for them to work. They must know that the company is sustainable and cares for them. Our company purpose – to enhance the quality of life – is beyond money and a purpose they are proud to work for. It energizes our workers. 

EF: When you look back to this period in your professional career, what would you like your tenure to be remembered for, considering you managed through a pandemic?

RM: I am not too focused on my legacy, but I would like to be remembered for repositioning a big business successfully for the future of healthcare. I studied medicine, I am an anesthesiologist, I have seen the changes coming and am trying to get the company to a place to take advantage of the emerging opportunities. I am also quite proud of managing Covid successfully. But the big challenge was to get this company positioned. We are well on the way to that, but we still have more to do.

October 2021
South Africa