The only editorial change in the submission made here is to move the acknowledgements from its position at the front of the original document to the end.]
Submission to the Commission of Inquiry on Hormone Receptor Testing
by
Canadian Public Relation Society –Newfoundland and Labrador (CPRS-NL)
May 15, 2008
I. Introduction
In July 2007, the Government of Newfoundland and Labrador appointed the Honourable Margaret A. Cameron to head a Commission of Inquiry on Hormone Receptor Testing.
The Commission’s terms of reference include:
- an inquiry into problems with estrogen and progesterone hormone receptor tests conducted between 1997 and 2005 in the Newfoundland and Labrador health care system;
- what happened to cause or contribute to the problems, when the problems came to light and whether they could have been detected earlier;
- whether protocols were in place during the relevant time frame and what steps, if any, were taken by responsible authorities upon becoming aware of the problems;
- a review of both policy and legal issues and the duties, if any, of the responsible authorities to patients, other parties within the health care system, and the public respecting differences in test results on re-testing;
- examination of whether the estrogen and progesterone hormone receptor testing systems and processes and quality assurance systems currently in place are reflective of "best practices";
- examination into the response of authorities when the problems were discovered, including the communications with affected patients and others. Further, the Commission is to study present practices related to estrogen and progesterone receptor testing.
As well, the Commission has heard from experts who presented papers on the topic of public disclosure. However, the Commission has not yet heard from public relations staff employed at the Eastern Health Corporation or within the Provincial Government, not has it heard from experts in public relations (PR).
CPRS-NL believes that PR experts with expertise in issues management, risk communications and PR best practices could add to the Commission’s understanding of this profession. For this reason, the Canadian Public Relations Society of Newfoundland and Labrador (CPRS-NL) has decided to submit this brief to the Commission of Inquiry on Hormone Receptor Testing.
CPRS-NL hopes that this paper will inform the Commission about the profession of public relations and promote a better understanding of how best practices in PR can help authorities to respond more effectively in the future when faced with issues around disclosure of adverse health events.
In fairness to our colleagues at the Eastern Health Corporation and within the provincial government, CPRS-NL wishes to state that it does not intend to pass judgment on the actions or inactions of public relations practitioners involved in the hormone receptor testing controversy. Our purpose is to inform, not judge.
CPRS-NL encourages people to wait until all the evidence has been presented to the Inquiry and the Commissioner’s Report is made public before drawing conclusions.
In this submission, we will provide for the Commission a definition of public relations and description of what PR practitioners do at various levels within the organizational structure. We will discuss best PR practices and the importance of including PR in decision-making at the most senior levels of the organization.
This submission will highlight key elements of effective risk and crisis communications. Further, we will briefly discuss how strategic public relations can assist management in its efforts to communicate effectively with different audiences.
Also included in this submission is information about the Canadian Public Relations Society (CPRS), which is the national professional organization for public relations practitioners, its ethical guidelines and accreditation process.
Finally, we will discuss gaps and challenges in the development of public relations best practices in Newfoundland and Labrador and some of what CPRS-NL plans as next steps to address the gaps and challenges.
II. Professional Public Relations and Best PR Practices
Definition of Public Relations
The evolution of public relations has seen numerous attempts to define the concept and practice of public relations. The Canadian Public Relations Society defines public relations as "the management function which evaluates public attitudes, identifies the policies and procedures of an individual or organization with the public interest, and plans and executes a program of action to earn public understanding and acceptance.”
Some common elements in many definitions suggest that public relations:
(a) conducts a planned and sustained program as part of an organization’s management;
(b) deals with the relationships between an organization and its publics;
(c) monitors awareness, opinions, attitudes and behaviour inside and outside an organization;
(d) analyzes the impact of policies, procedures, and actions on publics;
(e) adjusts those policies, procedures and actions found to be in conflict with the public interest and organizational survival;
(f) counsels management on the establishment of new policies, procedures and actions that are mutually beneficial to the organization and its publics;
(g) establishes and maintains two-way communication between the organization and its publics;
(h) produces specific changes in awareness, opinions, attitudes and behaviours inside and outside the organization; and,
(i) results in new and/or maintained relationships between an organization and its publics.
It is important to understand that the practice of PR in an organization can range from a tactical role where practitioners are engaged primarily in activities like media monitoring, media relations and events planning to a more strategic counseling role. Some of the points listed above clearly illustrate a role for senior public relations people in the policy making process.
Progressing from a tactician to strategist takes years of experience, training and sound judgment. Not every practitioner makes it to this level and such a progression is even more difficult in the absence of certain necessary conditions, like training and mentoring.
Public relations is no stranger to criticism and practitioners strongly object to the use of pejorative descriptions, such as ‘spin doctoring’ to describe the valuable work that we do for our organizations and clients. This description, and similar characterizations, has appeared in several articles written recently by local journalists and in comments made about the ER/PR matter. CPRS-NL wishes to state that public relations activity that attempts to deceive the public or manipulate the truth for the benefit of the client is not condoned in any way by CPRS or CPRS-NL.
Strategic Communications Planning
Some of the criticism has come from what may be an unclear understanding of strategic public relations. Strategic public relations planning, also referred to as strategic communications planning, refers to a process of using research to identify problems and opportunities, establishing goals and objectives, defining key messages for specific audiences, determining actions for achieving the goals and objectives and establishing methods of evaluating effect and impact. In principle, they are not unlike other strategic planning processes used to identify and achieve desired goals and objectives. For example, financial advisors help people develop strategic financial plans to meet economic goals. Strategic communications plans are common industry practice for achieving measurable communications objectives, such as increasing awareness or informing target audiences.
There are many templates available for strategic communications plans, but the value of these plans for management is in the content, not the organization of the document. Therefore, it is important that the development of strategic communications plans be overseen by qualified, experienced public relations practitioners with the skills and training necessary to prepare strategic plans. A key purpose of strategic communications should be to make communications more effective, not to make the organization look good in the media. CPRS-NL wishes to inform the Commission that strategic communications is an important management tool that helps remove some of the guess work in communications.
The intent in developing a strategic communications plan should be to achieve desired public relations and communications goals. Plans should be evaluated on the basis of how well they worked in achieving the goals. At the most senior level, public relations is uniquely positioned to act as a ‘corporate conscience’ -- advising management when policy decisions are at odds with both the public’s and the organization’s interest and how to adjust the policy to address the situation. To coin a phrase, “Good PR cannot make a bad policy good, but bad PR can make a good policy bad.” PR has a responsibility at the management table to identify when policy decisions can affect the reputation, integrity and credibility of the organization. Bad decisions can have negative financial, legal and operational impacts, but if the organization’s integrity and credibility are at risk, the result can be catastrophic.
III. Risk Communications for Health Care
The Nature of Risk Communications
First, it is important to say that there is no template for risk communications. There are principles and best practices that practitioners turn to in risk communications that increase the probability of handling an emergency successfully and effectively, but generally speaking, emergencies are unique and require unique responses. Decisions are made immediately under duress and often without complete information, so there is always a chance that the wrong decisions will get made. The important thing is to correct any problem as quickly as possible.
Below are nine key elements of successful risk communications for consideration in the development of a policy on public disclosure of adverse health events.
Key Elements of Successful Risk and Crisis Communications
(i) The primary goal of the risk communicator should be protection and promotion of public health.
The public should be given sufficient information and knowledge to place the risk in proper perspective. The risk communicator should try to foster autonomous decision-making by the public as a means to the primary goal of health protection. In the age of the Internet, it is reasonably safe to say that people can access information about adverse health events and effects with the touch of a button. However, information obtained through the Internet is not always from a reliable source. Public relations can guide patients towards sanctioned websites that contain information relevant to the patient’s need.
(ii) A single authoritative source of information is essential.
One thing that is absolutely critical in an emergency is the need for a single authoritative source for information during the crisis. Having more than one source of information increases the risk of the wrong information going to the public and this could make matters worse. Emergencies are by their very nature dynamic situations and things change constantly, so it is vital to control communications in a crisis. Accurate, honest and timely information is essential in risk communications.
Often in an emergency, communicators cannot afford to spend time correcting misinformation reported in the media because it takes them away from the important job of acquiring facts and getting them out to the public. For this reason, it is important to take the time to explain things once in as much detail as possible using the right spokespersons. However, misinformation should be corrected when it is revealed.
(iii) The longer it takes to establish control and demonstrate effective management in an emergency, the more likely it is that the situation will become a crisis.
In risk communications, trust and credibility are your most precious assets. An emergency becomes a crisis when it is not managed effectively and the public loses confidence in the organization’s ability to manage the situation. A crisis does not necessarily involve a risk to life, but it can be anything that poses a serious threat to an individual or organization’s reputation, credibility and integrity.
(iv) Disclose information as early as possible.
Some experts in the field of risk communications have suggested that responsible authorities have only 24 to 48 hours to respond publicly when a serious problem first becomes known. In some cases it is even more immediate. When spokespersons tell reporters ‘no comment’, the immediate reaction is that they must be trying to hide something. If this happens, it can create very serious problems because they have created bad will with the reporters and lost the trust of the public. Standby statements are common practice in the field because it identifies for the media the authoritative source of information, even when the answers to any questions could be months away.
When the authoritative source of information chooses to avoid the media, or is perceived to be avoiding the media, the media seek information from other sources that have legitimate perspectives on the issue. This is a reality of the news business. The perspectives of stakeholders should, in fact, be part of the reporting, but so must the information and perspectives of those in the authoritative agency or agencies.
(v) Communicate even when there is nothing to communicate.
Problems become known much more quickly than answers. If you wait until you have all or some answers before you say anything publicly, the situation could turn much worse. Reporters may decide the progress report is not newsworthy, but they appreciate being kept informed because they know they will be contacted when there is something significant to report.
(vi) A significant challenge in risk communications is selecting a spokesperson, deciding what information to release and how?
There are three criteria that must be met to be a spokesperson. First, the person must have the information necessary to answer reporters’ questions. Second, he or she must have the authority to speak to the media. Third, he or she must be accessible to the media.
Selecting and presenting to the media an appropriate spokesperson is difficult at times in a hospital setting. In some matters, doctors are the appropriate spokespersons, but they are not always easily accessible to the media.
Doctors may also feel reluctant to discuss sensitive matters in the media when they believe it is best addressed directly with patients. Additionally, without significant media training, many individuals are reluctant to answer a barrage of media questions which will certainly be about sensitive matters.
(vii) Accept and involve the public as a partner
People have a right to participate in decisions that affect their lives, their health, their property and the things they value. Involving the community early will produce an informed public that can be part of creating a solution to whatever crisis exists. Listening to their specific concerns and responding accordingly is important. Communications is a two-way street.
(viii) Make the media your partner.
You have to meet the needs of the media. What is also important to know in a crisis situation is that the media can be your best friend or your worst enemy. To ensure it is not the latter, it is best to make the media your partner in risk communications. Despite some of what has been
written in local papers about PR practitioners and their relations with the media, the reality is that both public relations practitioners and the media have common objectives in an emergency situation. The public are always better served when the media and public relations work together to inform.
(ix) Coordinate and collaborate with other credible sources
Building trust can be easier when other credible and authoritative sources of information lend their support to your efforts. Building bridges with other authoritative organizations will assist you in your communications.
IV. The Canadian Public Relations Society (CPRS)
Who We Are
The Canadian Public Relations Society (CPRS) is an organization of men and women who practice public relations in Canada and abroad. Members work to maintain the highest standards and to share a uniquely Canadian experience in public relations, while working with our North American and international partners to promote recognition of the practice as a profession world-wide.
Membership in CPRS is restricted to public relations practitioners, whereas the International Association of Business Communicators extends its memberships to a broader group of communications professionals.
CPRS was founded 60 years ago in 1948 from two original groups - the first in Montreal and the second in Toronto. In 1953, these became associated as the Canadian Public Relations Society, and, in 1957, the organization was incorporated as a national society.
Today, CPRS is a federation of 16 Member Societies based in major cities or organized province-wide., CPRS works to advance the professional stature of public relations and regulates its practice for the benefit and protection of the public interest. Ethical standards are established through the CPRS Declaration of Principles, the Code of Professional Standards, the organization’s by-laws and regulations, as well as through its statements regarding confidentiality, privacy and conflict of interest. Members are required annually to affirm their
commitment to the standards of practice established in the Code of Professional Standards. Both the Code and the Declaration of Principles are attached as appendices to this submission.
Global Alliance
The Global Alliance is a framework for collaboration with a mission to enhance the public relations profession and its practitioners throughout the world. The Alliance was formally established in Chicago, Illinois, USA, on 25 October, 2000, after a Public Relations World Congress sponsored by the Public Relations Society of America and the International Public Relations Association.
More than 20 national and international associations were actively involved in the founding of this historic framework. CPRS is a proud partner in the Global Alliance.
The mandate of the alliance is to:
- Unify the profession
- Assist in building and growing public relations associations
- Develop and propose universal standards for the profession
- Be an advocate on behalf of the profession
- Serve the needs of the individual members of GA member organizations
- Offer reciprocal benefits to our collective membership
What We Do
The Canadian Public Relations Society, as a distinct Canadian association, seeks:
- to group all public relations practitioners in Canada and to foster their professional interests
- in cooperation with its regional Member Societies and with like-minded organizations in other countries, to advance the professional stature of public relations
- to regulate its practice for the benefit and protection of the public interest
- to serve the public interest by upholding a standard of proficiency and code of ethics, and
- by providing ongoing professional development to its members and public relations practitioners across Canada.
Accreditation in Public Relations
CPRS offers a globally recognized accreditation program in public relations (APR). This professional designation is a cornerstone of the society’s recognition of professionalism and competence and all members are encouraged to seek the designation when they are eligible.
CPRS Accreditation (APR) is a respected measure of professional experience in the field of public relations. This program recognizes the dedication, energy, perseverance and competence of successful public relations professionals.
To pursue the accreditation process, a member must satisfy the following eligibility requirements:
- Member in good standing of the Canadian Public Relations Society.
- Employed full-time in a public relations position for at least five years; and
- Spends at least half of your professional time involved in specific public relations activities.
The goals of CPRS National Council on Accreditation are to assure professional competence; establish standards for professional practice; increase recognition for the profession within business organizations and the community, and influence the future direction of the profession.
Below are suggested reasons for practitioners to pursue accreditation in public relations:
- Accreditation establishes professional credentials and enhances the professional image
- Accreditation improves skills and knowledge and prepares you for greater on-the-job-responsibilities
- Accreditation reflects achievement and builds self-esteem
- Accreditation improves earnings potential and improves career opportunities and advancement
- Accreditation offers greater professional recognition from peers
V. Next Steps in Development of PR Best Practices
Membership in a Professional Association and Accreditation
As noted above, membership in a professional public relations society can greatly benefit practitioners and the organizations they represent. CPRS has a national committee formed to examine ways of encouraging more practitioners across the country to apply for accreditation.
CPRS-NL hopes that the work of the Cameron Commission will be useful in highlighting the value of belonging to a professional organization and that it will encourage many senior public relations practitioners in the province to join and become involved in CPRS and the local member society.
Professional Development through Public Relations Societies
Each year, CPRS holds its national conference and annual general meeting in a location sponsored by a local member society. This is an opportunity for practitioners from across the country to learn about current best practices and explore recent trends and issues affecting the PR practice today. The CPRS national conference is open to members and non-members and employers are encouraged to support the attendance at this event of their public relations staff.
The national CPRS Board of Directors supports numerous professional development sessions throughout the year. Some of these opportunities are web-based, while other initiatives include workshops and courses at locations across Canada. CPRS-NL has been actively seeking more web-based seminars given the cost associated with travel outside the province to attend professional development events.
CPRS has also been supportive of local societies’ efforts to organize professional development. A few years ago, CPRS and CPRS-NL held a one day mini conference where experts from across the country came to speak on a broad range of current topics in public relations.
CPRS-NL has formed a committee to assess PR training needs in the province and to formulate an action plan for improving access to professional development for local PR practitioners.
Post-Secondary Education in PR
There is no degree granting PR program available in this province at present. The nearest available Bachelor of Public Relations (BPR) program is at Mount St. Vincent in Halifax. The absence of such a program is a major obstacle to developing and improving best PR practices among local practitioners. Many PR practitioners entering the field come from journalism or marketing backgrounds and many possess degrees in various social sciences. However, there are a growing number of BPR graduates in the province, which is encouraging.
CompuCollege, a private school, is the only institution in this province offering a Diploma in Public Relations.
In Newfoundland and Labrador, a small number of private companies offer training in some aspects of PR, such as the three courses available through the College of the North Atlantic (CNA) – the Fundamentals of Public Relations, Message Driven Media Relations and Strategic Communications Planning.
Efforts are underway to expand the number of courses available through CNA in areas where there are gaps.
What this means is that local practitioners interested in developing their skills and broadening their knowledge must frequently look outside the province for training opportunities. Because this is often cost prohibitive for many practitioners, CPRS-NL has been moving more towards web-based and distance education programs.
VI. Conclusion
Although public relations practitioners have received some criticism in relation to the handling of the ER/PR issue, the answer is not to exclude PR from decision making, but rather to include PR at the most senior levels. Contrary to what some might expect, the answer is not less PR, but more.
All organizations are facing much more complex public relations and communications issues these days and they require expert assistance in dealing with these challenges in an effective manner. This means that organizations with intensive public responsibilities are well served when they have senior accredited public relations practitioners heading departments, which are also staffed with personnel who are capable in media relations, risk communications, community
relations, internal communications, and other specialty areas.
APPENDIX A
CPRS DECLARATION OF PRINCIPLES
The National Society, in setting forth its Declaration of Principles and Ethics of Professional Conduct, strives to:
- affirm that the obligations of a public trust are inherent in the practice of public relations;
- promote and maintain high standards of professional practice and conduct among the membership, so as to ensure that public relations shall be esteemed as an honourable profession;
- safeguard good taste and truthfulness in all material prepared for public dissemination and in all aspects of the public relations practitioner's operations;
- ensure that membership represents surety of ethical conduct, skill, knowledge and competence in the practice of public relations;
- foster increased attention to public relations as a course of study in universities,colleges, institutes and other similar educational organizations in order to further the proficiency, knowledge and training of anyone engaged in or interested in entering public relations;
- adhere to the Global Protocol on Ethics in Public Relations of the Global Alliance for Public Relations and Communications; and
- subscribe to the principles of Canada's Charter of Rights and Freedoms
Code of Professional Standards
Members of the Canadian Public Relations Society are pledged to maintain the spirit and ideals of the following stated principles of conduct, and to consider these essential to the practice of public relations.
- A member shall practice public relations according to the highest professional standards. Members shall conduct their professional lives in a manner that does not conflict with the public interest and the dignity of the individual, with respect for the rights of the public as contained in the Constitution of Canada and the Charter of Rights and Freedoms.
- A member shall deal fairly and honestly with the communications media and the public. Members shall neither propose nor act to improperly influence the communications media, government bodies or the legislative process. Improper influence may include conferring gifts, privileges or benefits to influence decisions.
- A member shall practice the highest standards of honesty, accuracy,integrity and truth, and shall not knowingly disseminate false or misleading information. Members shall not make extravagant claims or unfair comparisons, nor assume credit for ideas and words not their own. Members shall not engage in professional or personal conduct that will bring discredit to themselves, the Society or the practice of public relations.
- A member shall deal fairly with past or present employers / clients, fellow practitioners and members of other professions. Members shall not intentionally damage another practitioner's practice or professional reputation. Members shall understand, respect and abide by the ethical codes of other professions with whose members they may work from time to time.
- Members shall be prepared to disclose the names of their employers or clients for whom public communications are made and refrain from associating themselves with anyone who would not respect such policy.Members shall be prepared to disclose publicly the names of their employers or clients on whose behalf public communications is made. Members shall not associate themselves with anyone claiming to represent one interest, or professing to be independent or unbiased, but who actually serves another or an undisclosed interest.
- A member shall protect the confidences of present, former and prospective employers / clients. Members shall not use or disclose confidential information obtained from past or present employers / clients without the expressed permission of the employers /clients or an order of a court of law.
- A member shall not represent conflicting or competing interests without the expressed consent of those concerned, given after a full disclosure of the facts. Members shall not permit personal or other professional interests to conflict with those of an employer / client without fully disclosing such interests to everyone involved.
- A member shall not guarantee specified results beyond the member's capacity to achieve.
- Members shall personally accept no fees, commissions, gifts or any other considerations for professional services from anyone except employers or clients for whom the services were specifically performed.
Acknowledgements
I would like to thank the Honourable Justice Margaret A. Cameron and Co-counsels Bernard Coffey, Q.C. and Sandra Chaytor, Q.C. for providing CPRS-NL the opportunity to submit a formal brief to the Commission of Inquiry on Hormone Receptor Testing.
On behalf of our members, I would like to extend our support and best wishes to breast cancer patients and their families.
The difference between relations with the public and professional public relations (PR) is
not well understood outside the profession itself as evidenced by comments in the media, comments of witnesses at the Commission hearings to date, and particularly questions asked of panelists at the April 23 Symposium. CPRS-NL appreciates this opportunity to inform the Commission and the public generally about our profession.
I would like to thank the Executive and members of CPRS-NL for their assistance in
preparing this submission. I also want to thank Karen Dalton APR, Executive Director of
CPRS for her helping us find the expertise in other CPRS Societies to assist with the
content of this paper. In particular, I want to extend a special word of thanks to Sarah K.
Jones APR, Partner, Kennedy Jones & Sweeney Inc, Toronto, and a past-President of
CPRS, for her contribution to this submission and for taking the time from her busy life to help colleagues in a fellow public relations society.
Sean Kelly B.A., B.Ed. APR
President
CPRS-NL