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Africa Outlook

Life Healthcare
South Africa


Breathing Life into SA Healthcare and beyond

Life Healthcare is opening up access to quality, life changing healthcare services across the whole of South Africa and parts of Europe. Group CEO Shrey Viranna reveals how

Writer: Tom Wadlow

Project Manager: Callam Waller

Quality healthcare delivery, quality patient experience and efficient operations built on strong partnerships – these are the hallmarks of the Life Healthcare Group, a market-leading, diversified and international healthcare provider.  Operating with a core purpose of making life better and improving the lives of others, the Group’s mission is to improve lives through the delivery of high quality care and cost-effective services for patients.

These services are underpinned by a set of core values. They include a passion for people, quality to the power of ‘e’ (ethics, excellence, empowerment, empathy and energy), performance pride, personal care and lifetime partnerships.

The Life Healthcare Group believes that caring for patients stretches beyond simply healing and recovery. It also involves building empathetic relationships with the people who use its hospitals, facilities, services and products.

An ever-present business

These values and beliefs have shaped the organisation’s identity as it has evolved over more than three decades. As a result, the Life Healthcare Group is well-positioned to contribute to the advancement of South Africa’s wider healthcare industry as well as that of western Europe and Poland.

The Group operates 65 hospitals and healthcare facilities throughout South Africa and Botswana, a presence that is complemented by a portfolio of mental health, acute rehabilitation, renal dialysis, oncology and employee health solutions.

This comprehensive footprint was established with origins stretching back to 1983 when, what is today known as the Life Healthcare Group, was founded as the hospitals division of African Oxygen Limited (Afrox).

The Group’s CEO, Dr Shrey Viranna, talks through some of the key milestones in the Life Healthcare Group’s history.

“In 1997, for the first time, Life Healthcare expanded operations outside South Africa by acquiring the Gaborone Hospital in Botswana,” he says. “A year later we began our diversification into complementary health services with the acquisition of Afrox Occupational Health Care, followed by the opening of Life Healthcare’s first rehabilitation, mental health and renal dialysis units in the major centres around South Africa.”

The Group’s growth continued with the acquisition of Presmed’s 38 hospitals and healthcare facilities through a merger and reverse listing on the Johannesburg Stock Exchange in 1999. This was followed by the purchase of the Amahosp Group and the acquisition of a 55 percent share in Life Esidimeni. 

In 2005, the Group delisted, and was sold to a private consortium led by Brimstone and Mvelaphanda, which saw the name change from Afrox Healthcare to the Life Healthcare Group. After listing on the JSE in 2010, the Group’s diversification continued with the acquisition of Careways, an established health and wellness business.

“Over the past 35 years, Life Healthcare has built a strong brand anchored in the delivery of quality healthcare and patient experience, efficient operations, strong partnerships and making a meaningful contribution to society and the communities we serve,” adds Dr Viranna.

Diversification drive

The Life Healthcare Group further strengthened its expertise through acquisitions and ventures into new markets and territories, tapping into the likes of India, the United Kingdom (UK) and Poland. This diversification began with the acquisition of a stake in major Indian hospital group Max Healthcare in 2013. However, this shareholding has since been sold as an element of the strategic evolution in emerging markets from delivering acute hospital care to providing integrated healthcare.

Subsequent to the Group’s venture into India, it also acquired Poland’s Scanmed S.A., a private healthcare provider which operates in 40 locations across 23 cities, as well as UK-based Alliance Medical Group (AMG), a leading independent provider of diagnostic imaging services, with operations in 10 European countries.

The acquisition of AMG has proven to be a vital component in the Life Healthcare Group’s international strategy and has a “strong, highly complementary management team with a wealth of healthcare experience, which is helping support our international growth strategy,”
Dr Viranna says. The Group’s expansion did not end there. “Over the past year, we have continued to grow AMG through the acquisitions of Albaro Clinic, IMED and Centro Alfa in Italy, as well as Radiopharma and Piramal Imaging S.A. in other parts of Europe,” Dr Viranna continues. “We also started rolling out an outpatient diagnostic clinic model in Ireland.”

Dr Viranna’s vision for the Life Healthcare Group is to increase the revenue sourced from international markets to 50 percent in the medium term, an ambition which will also deliver benefits closer to home. This consistent acquisition of knowledge will, crucially, help to better provide for the needs of the South African market.

“This is our first substantial foray into the diagnostics market which, due to aging demographics and increasing demand, shows good potential for growth both internationally and in South Africa,” comments the Group CEO.

Making life better

Dr Viranna joined the Life Healthcare Group approximately 12 months ago. “When the door opened to serve as Life Healthcare’s Group CEO, I felt that this was the logical next step on my journey,” he says. “Life Healthcare’s purpose is ‘making life better’ and our mission is ‘to improve the lives of others through the delivery of high-quality cost-effective care’ – both of which are a perfect fit with the purpose of my own life.”

Dr Viranna’s career has always been rooted in healthcare, which includes a 12-year term at McKinsey & Co where he gained extensive international exposure working in East and Southern Africa, India and the UK. His altruistic nature stems from his family upbringing, in particular the influence of his mother.

“She devoted her entire life to providing healthcare services to rural communities in KwaZulu-Natal,” he says. “I believe that is part of the reason why I have always had this deep sense of an obligation to improve society. What really excites me are the opportunities that the future of healthcare holds and, further, how we can positively impact the lives of more people and help deliver on new healthcare models to benefit the people of South Africa.”

Today, Dr Viranna leads an organisation that is uniquely placed to do just this. Not only does the Life Healthcare Group provide the full spectrum of healthcare, it also operates with a single-minded focus on patients. “Patient centricity and compassion lie at the heart of everything we do,” Dr Viranna explains, “and this is emphasised through our dedication to patient wellbeing, clinical excellence, quality service, respect and a spirit of giving to those entrusted to our care.”

In support of this commitment to delivering quality care, the Life Healthcare Group is the first hospital group in South Africa to have obtained ISO 9001 and ISO 14001 certifications, bringing the organisation in line with international standards. Further evidence of commitment to the patient experience and quality service delivery can be found in the real-time publishing of feedback scores on the Group’s website. Other internal performance reports are also publicly available, adding another layer of transparency.

Sound environmental management is also a competitive strength identified by Dr Viranna. “Sustainability is an integral part of how we do business,” he explains. “We therefore identified and implemented four projects in support of the environment. Highlights for the year include the reduction of water usage due to two borehole projects being completed in the Western Cape, installation of solar photovoltaic panels at two of our operations, lighting technology changes and the replacement of evaporative cooling systems. We are all working together for a better, more sustainable world.”

Five-point plan

It is clear that Dr Viranna leads a strong organisation grounded by efficient, patient-centric care and industry-leading outcomes. The Life Healthcare Group is committed to building on this legacy and Dr Viranna identified five key focus areas that will maximise the Group’s potential.

“The first area is achieving operational excellence through adapting the operating model,” he explains. “Next is driving best-in-class initiatives across the Group through a data-driven and analytical approach. Thirdly, we want to accelerate growth by repositioning our existing assets in line with future growth, expansion of the complementary business range and a global focus on diagnostic growth. The fourth area looks at driving existing quality outcomes, expanding quality initiatives and benchmarking against world-class standards. Finally, we are evolving our operating model by adopting a group-wide integration approach, driving efficiencies, standardisation and synergies.”

The Life Healthcare Group is embarking on a series of initiatives to deliver on these objectives which, once fulfilled, will see the Company leading the way as an industry standard bearer, both at home and abroad.

A formidable footprint

The physical presence of the Life Healthcare Group extends across a network of hospitals and acute facilities throughout seven South African provinces, as well as in Botswana. Most of these sites are based in major urban settlements and range from high technology, multi-disciplinary hospitals to community hospitals, same-day surgical centres and niche facilities.

The acute business is complemented by nine mental health and seven acute rehabilitation facilities, as well as other services including renal dialysis, oncology and employee health solutions (employer-based occupational health and employee wellness), which currently serves 579,000 individuals.

Internationally, the Life Healthcare Group owns Poland’s Scanmed S.A. and UK-based AMG, which has operations in Italy and Ireland and additional activities in Spain, the Netherlands, Germany, Finland, Bulgaria, Austria, France, Norway and Poland.

Investing in excellence

Several recent investments are helping realise the Group’s goals, best showcased by its research in and adoption of relevant technology.

These innovations are transforming the way in which health services are delivered. Globally, the medical technology market, in other words technology used in the diagnosis, monitoring, or treatment of diseases and medical conditions, was worth $405 billion in 2017, a figure estimated to rise to $594.5 billion by 2024.

Stereotactic radiosurgery and robotic-assisted surgery are just two examples of the Life Healthcare Group’s most recent investments in this type of innovation. “We have invested in Novalis Tx™ Radiosurgery systems in three of our oncology units,” reveals Dr Viranna. “This technology is one of the most advanced cancer treatment options available and ‘shapes’ the radiation beam to treat the patient’s tumour precisely to deliver the most effective dose of radiation while safeguarding the surrounding healthy tissue.”

In the robotics arena, Life Kingsbury Hospital in Cape Town installed the latest version of the Da Vinci surgical robotic system, a solution which enables surgeons to perform precision surgery that minimises post-operative pain and reduces hospital stay and recovery times, making it the first hospital in Africa to use this technology.

Supplying skills

The Group’s investment in excellence also extends to its most important asset – people. Dr Viranna is acutely aware of the critical nature of South Africa’s shortage in medical skills, highlighting it as one of the greatest challenges facing both the Company and the wider industry.

According to World Health Organization (WHO) statistics for 2016, South Africa employed 0.8 physicians and approximately 5.2 nurses per 1,000 citizens, an alarmingly low figure when compared with countries such as Australia, which has around four doctors and 12 nurses per 1,000 citizens.

For the Life Healthcare Group, finding, training and retaining medical talent is essential to its continued success and growth. The Life College of Learning, operating in seven learning centres around the country, has been in operation for 20 years and was established to contribute to South Africa’s pool of skills, especially in the fields of nursing and health science. Last year saw 1,100 students graduate, which reflects the professionalism of the College’s clinical educators, nursing staff and hospital management, as well as the quality of students selected.

The College is accredited as a Nursing Education Institution with the South African Nursing Council, the Council on Higher Education and the Department of Higher Education and Training, and is affiliated with the Nelson Mandela University. The centre offers a broad range of courses that cover basic and post-basic courses in nursing, diplomas in midwifery, operating department assistance and health sciences, as well as a variety of short learning courses to develop specialised nursing skills.

Funding is another vital component in ensuring the country’s medical skills gap is reduced. In light of this, the Life Healthcare Group established the Nursing Education Trust, a body which awards bursaries to student nurses and, similarly, the Life Sub-Specialist Training Fund supports doctors who wish to further their studies. Furthermore, the Group provides bursaries for medical students through a partnership with the Colleges of Medicine of South Africa.

The Life Healthcare Group’s doctors are independent healthcare practitioners, and not employees of its hospitals. However, the Group’s doctor partnership model guides how the Company attracts and retains medical talent to build a sustainable doctor succession pipeline. “Relationship building with doctors begins while they are students and registrars at university, and we apply the same principles to attracting doctors as we do to recruiting our own employees by testing for technical skills, cultural fit and values,” explains Dr Viranna. “Once we agree to partner with doctors and provide an opportunity to establish their private practice within our facilities, we build a mutually beneficial, long-term partnership with them by creating an environment in which they enjoy practicing.”

Pharmacy is another subsector supported by the Life Healthcare Group through skills development. Through its pharmacist internship programme, the Company provides opportunities for fourth-year pharmacy students to attain valuable experience, thereby addressing the national and global shortage of pharmacy resources.

Remaining relevant

By supporting and remaining actively involved in the educational forefront of medical innovation, the Life Healthcare Group is able to stay abreast of key local and global trends and react to new developments. The Group’s capacity to research, monitor and anticipate these advances has been developed over time, feeding back into its strategic responses to these trends.

Dr Viranna points to a number of current trends which are changing the face of the healthcare industry. “People are living longer,” he says. “Many are living with chronic conditions, and populations are becoming increasingly unhealthy due to sedentary lifestyles, high personal stress levels, and poor dietary habits. This is placing a greater disease burden on healthcare systems. At Life Healthcare, we are seeing increasingly complex cases, both in terms of diagnoses and treatment, and our patients require quality care, not only in acute facilities, but across the entire continuum of care.”

Dr Viranna’s observations are supported by research into South Africa’s population. According to Statistics South Africa’s 2018 mid-year population estimates, the proportion of people aged 60 and over is increasing – 8.5 percent of South Africans fall into this category, up from 8.1 percent in 2017. Some 24 percent of this demographic live in Gauteng alone, while the country’s overall population has risen 1.55 percent to 57.73 million.

In terms of the impact on healthcare delivery, these shifting demographics are creating inevitable cost pressures. “Most global healthcare systems are looking at ways to reduce costs and improve disease prevention in society,” Dr Viranna explains. “We pride ourselves on our operational efficiency – we work hard to ensure we remain an effective and productive healthcare provider, without ever compromising on our commitment to provide quality patient care. We are already strengthening our offering across the continuum of care to empower patients to take ownership of their health, to support prevention as well as cure in response to both trends.”

Responding to patient demand

The Life Healthcare Group continues to respond to the ever-evolving expectations of patients, who are demanding similarly modern and personalised experiences to those that they are accustomed to in the retail and banking space. Digitalisation of healthcare is thus another trend being closely monitored by Dr Viranna and his team. People are also demanding convenience.

“In Europe, for example, home-based care is gaining traction, while personalised care, walk-in services and virtual queuing are also becoming popular,” Dr Viranna observes. “Evaluation and measurement of patient experience has fast become international best practice and assists in ensuring patient-centred care remains a priority for Life Healthcare.”

Dr Viranna also highlights how increased levels of connectivity have led to consumers becoming more knowledgeable and eager to compare quality between healthcare providers. With medical service delivery becoming more transparent, it is more important than ever to be unrelenting in the pursuit of quality service delivery.

Several research reports by recognised industry bodies like the World Health Organization point towards the positive impact technology will have on consumer experience and access to treatment. The 2018 Philips Future Healthcare Index, for example, found that technology and digital innovation, artificial intelligence, and connected care will be important enablers of healthcare access despite the impact of rising costs on affordability.

“One area already benefitting from technological advancements at Life Healthcare, which we will continue to grow, is diagnostic imaging,” says Dr Viranna. “Making use of smarter technology like this means healthcare providers can enhance the patient experience by lowering the risk of diagnostic errors while speeding up the provision of better, more affordable treatment.”

Social responsibility

While investing in cutting-edge technology enables the Life Healthcare Group to better serve patients at its facilities, the Company also recognises the importance of having a positive impact on the wider society outside of its hospitals and medical centres. The Group plays to its strengths and focuses on health and education in its community activities, complementing the work it already does to help build a healthier South African population.

According to Dr Viranna, social investment is a moral responsibility and an essential aspect of good corporate citizenship. To illustrate this, the Group CEO explains Life Healthcare’s 12-year partnership with the South African National Council for the Blind (SANCB). “During our partnership, to strengthen the SANCB’s vehicle fleet, which visits hospitals in rural areas, we have donated three mobile units fitted with the latest ophthalmic.”

Over the past 12 years, the partnership has screened more than 56,000 patients, performed 15,000 cataract surgical procedures, dispensed more than 13,000 pairs of prescription glasses, referred 9,000 other cases for medical treatment, detected almost 1,700 cases of glaucoma, and sponsored 66 cataract surgery tours, delivering between 40 and 60 procedures per tour.

The Life Healthcare Group donated a further R12 million to the SANCB Optima College, a nationally-recognised centre of excellence which upskills visually impaired adults to assist them in finding job placements. The Optima College was established in 1985 in Pretoria, and remains one of few education institutions catering exclusively to blind and partially sighted persons. Among the courses offered are computer literacy, contact centre training and braille literacy, while daily life skills are also nurtured through specialised classes designed to enable independent living.

Contributing to NHI

One issue private organisations and governments are working hard to address is the challenge of inequality in the delivery of healthcare services. A key part of South Africa’s National Development Plan 2030 (NDP) involves the implementation of the National Health Insurance (NHI) scheme, which proposes universal healthcare for all citizens and long-term residents of South Africa, regardless of their employment status or their ability to make a direct monetary contribution to the fund.

For Dr Viranna, working with public authorities in this way is a matter of duty. “Life Healthcare is acutely aware of the inequality in healthcare delivery in South Africa,” he says. “We have embraced the government’s NHI proposition which promulgates access to universal healthcare for all South Africans. Given the complex health challenges facing our country, we strongly believe South African healthcare providers have a moral obligation to work with the government to find solutions for the issues facing our country. We are committed to making our contribution towards achieving the important health objectives enshrined in our country’s NDP.”

The Life Healthcare Group recognises the scale of the task ahead to reduce the healthcare gap. World Bank research demonstrates that in 2015, more than a third of South Africa’s poorest citizens lived at least 20 kilometres from a hospital, 27 percentage points higher than the wealthiest segment of the population. The NHI is designed to address this disparity, and the Company is determined to contribute towards the implementation of this policy.

“We believe that the NHI will increase access to quality healthcare for all South Africans and, additionally, align South Africa with many international healthcare systems,” Dr Viranna explains. “We have gained valuable experience through our international operations, where government-led healthcare systems are the norm.”

The Life Healthcare Group has taken the time to understand the challenges facing healthcare in South Africa. Concerning implementation thereof, the Group has taken a long-term view of investing in the opportunities the NHI will inevitably present. “Essentially,” Dr Viranna adds, “we focus on how best Life Healthcare can support the government’s vision of achieving universal healthcare in South Africa and, therefore, we have aligned our business imperatives accordingly.”

Advancing access

Looking ahead, in addition to assisting with the implementation of NHI, Dr Viranna is looking to futureproof the business by delivering on his five key objectives in the short term.

He reiterates his desire to further diversify the Life Healthcare Group into a full-spectrum healthcare services provider, both at home and across the wider region: “We will continue to expand more aggressively into complementary services and businesses to achieve our aspiration of transitioning from a predominantly hospital business to an internationally diversified healthcare provider, offering a compelling range of services.”

In terms of the Life Healthcare Group’s domestic market, the focus will be on growing new services and launching products that cater to segments not currently served. For Dr Viranna, this all circles back to contributing to the betterment of South African healthcare delivery.

Indeed, the Life Healthcare Group recognises the importance of continually innovating and challenging assumptions to remain future-fit and deliver on its aspiration of improving the accessibility and affordability of quality healthcare.

“From a clinical perspective, we will have realigned our business model and moved closer to achieving our objective of becoming a clinically-led organisation,” says Dr Viranna. “This will be reflected in enhanced quality scores and patient outcomes.”