2017 FULL YEAR RESULTS PRESENTATION

Transcription

1 2017 FULL YEAR RESULTS PRESENTATION

2 MEDICLINIC RESULTS DISCLAIMER This presentation contains certain forward-looking statements relating to the financial condition, the regulatory environment in which we operate, results of operations and businesses of Mediclinic and the Group, including certain plans and objectives of the Group. All statements other than statements of historical fact are, or may be deemed to be, forward-looking statements. Forward-looking statements are statements of future expectations that are based on management s current expectations and assumptions and involve known and unknown risks and uncertainties that could cause actual results, performance or events to differ materially from those expressed or implied in these statements. Forward-looking statements include, among other things, statements concerning the potential exposure of Mediclinic to market risks and statements expressing management s expectations, beliefs, estimates, forecasts, projections and assumptions, including as to future potential cost savings, synergies, earnings, cash flow, production and prospects. These forward-looking statements are identified by their use of terms and phrases such as anticipate, believe, could, estimate, expect, goals, intend, may, objectives, outlook, plan, probably, project, risks, seek, should, target, will and similar terms and phrases. 2

3 MEDICLINIC RESULTS AGENDA INTRODUCTION Page 4 FINANCIAL REVIEW Page 6 OPERATIONAL REVIEW Page 19 STRATEGY Page 24 QUESTIONS AND ANSWERS Page 30 APPENDIX Page 31

4 INTRODUCTION DANIE MEINTJES CEO MEDICLINIC INTERNATIONAL

5 MEDICLINIC RESULTS HIGHLIGHTS 2017 FULL YEAR GROUP RESULTS Revenue* EBITDA* Operating profit* CASH CONVERSION 31% 15% (incl. Al Noor FY16 pro forma revenue) 17% EBITDA* margin 18.2% 7% EPS* 19% 101% of underlying EBITDA FINAL DIVIDEND 4.70 pence per share *Underlying measures presented Switzerland: Southern Africa: Middle East: Steady revenue growth and underlying EBITDA margin expansion Good revenue growth and underlying EBITDA margin in line with expectations Stable performance in Dubai; Abu Dhabi impacted by revenue shortfall Spire (UK): Solid 2016 growth in adjusted revenue, EBITDA and EPS; Patient growth of 2.2% 5

6 FINANCIAL REVIEW JURGENS MYBURGH CFO MEDICLINIC INTERNATIONAL

7 CONSOLIDATED INCOME STATEMENT m FY17 FY16* % CHANGE Revenue** 2,749 2,100 31% EBITDA** % EBITDA** margin 18.2% 20.4% Depreciation & Amortisation** (138) (93) 48% Operating profit** % Net finance costs** (80) (57) 40% Income from associates % Underlying earnings** Underlying EPS** (19%) Dividend per share (pence) Translational impact of currency Good revenue growth in Hirslanden, Southern Africa and Dubai offset by Abu Dhabi EBITDA margin declined due to Middle East underperformance Spire contribution post amortisation Finance costs and number of shares increased by Spire/Al Noor acquisitions Dividend maintained Weighted avg number of shares (m) % *Including Al Noor s results consolidated from the effective date of the acquisition (15 Feb 2016) **Underlying measures presented Combined Al Noor and Mediclinic FY16 pro forma underlying revenue: 2,384m 7

8 m REVENUE ANALYSIS 2,749 1,321 Hirslanden (48% of Group) 2,100 1,123 18% Strong growth particularly in outpatient activity Up 3% in constant currency Southern Africa (28% of Group) FY16* FY17 20% 98% Good organic growth Up 7% in constant currency Middle East (24% of Group) Addition of Al Noor Revenue growth in Dubai offset by Abu Dhabi weakness Up 72% in constant currency UAE Southern Africa Hirslanden *Underlying and includes Al Noor s results consolidated from the effective date of the acquisition (15 Feb 2016) FY17 revenue* increased 31% to 2,749m 8

9 m REVENUE BRIDGE 284 Abu Dhabi Pro-forma adjustment MCME ,749 2,749 Good revenue growth in constant currency Driven by Switzerland and Southern Africa Middle East revenue shortfall: - Thiqa co-payments 2,100 - Doctor vacancies - Business and operational alignment - Increased competition FY16 Hirslanden constant currency Southern African constant currency Dubai contant currency Abu Dhabi constant currency Effect of reporting currency FY17 9

10 m UNDERLYING EBITDA ANALYSIS Hirslanden (53% of Group) Operating leverage Specific cost management measures Continued insurance mix change Up 5% in constant currency % Southern Africa (33% of Group) % Pharmacy inflation and ongoing investment in clinical personnel Ongoing change in patient mix Up 6% in constant currency Middle East (15% of Group) FY16 FY17 9% Addition of Al Noor Affected by revenue shortfall Down 5% in constant currency Corporate Cost Middle East Southern Africa Hirslanden FY17 underlying EBITDA increased 17% to 501m 10

11 PENCE PER SHARE UNDERLYING EPS BRIDGE FY16 Hirslanden contribution Southern Africa contribution MCME contribution Spire contribution Corporate costs Comparative result Finance charges Number of shares issued FY17 11

12 GROUP BALANCE SHEET SUMMARY m 31 Mar Mar 16 Assets 7,422 6,549 Non-current assets: Property, equipment and vehicles 3,703 3,199 Intangible assets 2,156 1,941 Other non-current assets Current assets 1, Borrowings down in constant currency Continued investment in buildings and equipment Strong working capital management Equity and liabilities 7,422 6,549 Shareholders funds 4,086 3,509 Non-controlling interests Interest-bearing debt 2,030 1,841 Other long-term liabilities Current liabilities

13 GROUP CASH FLOW SUMMARY m FY17 FY16 Net cash flow from operating activities Cash flow from investment activities (218) (1,549) Investment to maintain operations (109) (72) Investment to expand operations (140) (114) Strong cash flow generation across all platforms Expansion capex driven by Middle East platform Other 31 (1,363) Cash flow from financing activities (169) 1,242 Proceeds of shares issued Distributions to non-controlling interests (9) (7) Distributions to shareholders (62) (48) Share subscription (Feb 2016) Borrowings and other (98) 222 Net increase/(decrease) in cash and cash equivalents 7 13 Closing balance of cash and cash equivalents Net debt (1,669) (1,536) 13

14 GROUP CAPITAL EXPENDITURE TOTAL CAPITAL EXPENDITURE FY17 ( m) BUDGETED CAPITAL EXPENDITURE FY18 ( m)* 71m 29% 52m 20% 71m 25% 92m 33% 249m 281m FY18 capital expenditure growth driven by expansion in the Middle East platform Targeting economic rates of return 126m 51% Hirslanden Southern Africa Middle East 118m 42% *Constant currency basis: GBP/CHF: 1.29 GBP/ZAR: GBP/AED: 4.80 Ongoing investment across the Group in buildings and equipment 14

15 HIRSLANDEN FINANCIAL OVERVIEW CHF m FY17 FY16 % CHANGE Revenue* 1,704 1,647 3% EBITDA* % EBITDA* margin 20.0% 19.7% Depreciation & Amortisation (98) (92) 7% Operating profit* % Net finance costs* Δ (73) (79) (8%) Income tax expense (35) (31) 13% Effective tax rate 20.7% 20.1% Earnings* Δ % Modest revenue growth including tariff provision release Outpatient strategy yielding positive results EBITDA* margin supported by operating leverage and cost management Cash conversion 101% (FY16: 88%) Capex totalled CHF163m Borrowings decreased by CHF41m Movement in bed days sold (0.7%) 3.4% Movement in revenue per bed day 3.0% 1.9% Inpatients (000 s) % *Underlying measures presented Δ Includes inter company loan interest which is eliminated in the Group earnings reconciliation 15

16 MEDICLINIC SOUTHERN AFRICA FINANCIAL OVERVIEW ZAR m FY17 FY16 % CHANGE Revenue 14,367 13,450 7% EBITDA* 3,049 2,877 6% EBITDA* margin 21.2% 21.4% Depreciation & Amortisation (466) (414) 13% Operating profit* 2,583 2,463 5% Net finance costs (496) (270) 84% Income tax expense (582) (637) (9%) Effective tax rate 27.6% 28.8% Earnings* 1,239 1,305 (5%) Movement in bed days sold 0.8% 2.9% Movement in revenue per bed day 5.8% 6.3% Admissions (000 s) % Revenue growth in line with expectations Bed day growth impacted by weaker macro economic environment and increased competition EBITDA* margin impacted by pharmacy inflation, clinical positions and a continued change in patient mix Cash conversion 104% (2016: 109%) Capex totalled ZAR1,305m Borrowings increased by ZAR2,791m *Underlying measures presented 16

17 MEDICLINIC MIDDLE EAST FINANCIAL OVERVIEW AED m FY17 FY16** % CHANGE Revenue 3,109 1,802 72% EBITDA* (5%) EBITDA* margin 11.7% 21.3% Depreciation & Amortisation* (173) (54) 220% Operating profit* (42%) Net finance costs (31) (10) 210% Non-controlling interest 2 (3) Earnings* (49%) Revenue and EBITDA* affected by lower volumes in Abu Dhabi Integration benefits more than offset by increased costs and provisions; annualised synergies AED75m Cash conversion 120% (FY16: 99%**) Capex totalled AED245m Borrowings increased by AED510m Movement in bed days sold (6.2%) n/a Inpatients ( 000s)*** (4.8%) Outpatients ( 000s)*** 3,173 3,514 (9.7%) *Underlying measures presented **Including Al Noor s results consolidated from the effective date of the acquisition (15 Feb 2016) ***Comparative period pro forma Combined Al Noor and Mediclinic FY16 pro forma revenue: AED3,392m 17

18 MEDICLINIC INTERNATIONAL FY18 OUTLOOK HIRSLANDEN Modest revenue growth given already high occupancy rates, stable beds and Easter impact Lower underlying EBITDA margin due to tariff and regulatory environment, increasing costs and assuming no further net tariff provision benefits; partly offset by ongoing efficiency gains MEDICLINIC SOUTHERN AFRICA Revenue growth in line with inflation due to challenging macro-economic environment, greater competition, funder constraints and Easter impact Broadly stable underlying EBITDA margin despite cost inflation running above tariff increases MEDICLINIC MIDDLE EAST Dubai: Performance expected to remain stable despite the competitive landscape Abu Dhabi: Gradual improvement over the next couple of years MCME: Modest improvement in revenue for the full year MCME: Gradual improvement in underlying EBITDA margins over time, including the impact associated with the opening of new facilities MCME: 1H FY18 performance down versus 1H FY17 due to lower patient volumes and revenues in Abu Dhabi following the Thiqa co-payment introduction, asset sales and business and operational alignment initiatives 18

19 OPERATIONAL REVIEW DANIE MEINTJES CEO MEDICLINIC INTERNATIONAL

20 NUMBER OF BEDS BED OCCUPANCY RATE OPERATIONS HIRSLANDEN OPERATIONS OPERATIONAL OVERVIEW Competitive, mature healthcare market Further increase in productivity through continued cost focus High occupancy rates, particularly in second half of the year Ongoing investment including outpatient service development and Hirslanden 2020 Continued change in insurance mix HOSPITALS 16 BEDS 1,677 BED NUMBERS AND OCCUPANCY 1,800 1,600 1,487 1,567 1,655 CLINICS 4 1,677 1,677 EMPLOYEES 9,402 85% 80% Ongoing review of regulations at a Federal and Cantonal level including TARMED and outmigration 1,400 1,200 1, % 76.2% 76.3% 76.2% 73.3% FY13 FY14 FY15 FY16 FY17 75% 70% Operational beds Bed occupancy rate 20

21 NUMBER OF BEDS BED OCCUPANCY RATE OPERATIONS SOUTHERN AFRICA OPERATIONS OPERATIONAL OVERVIEW Continued growth in patient volumes despite ongoing macro challenges and increased competition Stagnant medical scheme membership HOSPITALS 52 EMPLOYEES 16,848 BEDS 8,095 DAY CLINICS 2 Ageing population and increase in chronic diseases; patient mix continues to shift from surgical to medical Health Market Inquiry and National Health Insurance review ongoing Ongoing day clinic roll out BED NUMBERS AND OCCUPANCY 9,000 7,436 7,614 7,885 8,017 8,095 8,000 7,000 6,000 5, % 4, % 71.5% 71.5% 3,000 2, % 1,000 0 FY13 FY14 FY15 FY16 FY17 78% 76% 74% 72% 70% 68% Operational beds Additional capacity Bed occupancy rate 21

22 OPERATIONS MIDDLE EAST OPERATIONS OPERATIONAL OVERVIEW Long term opportunities in UAE remain strong; supports expansion strategy HOSPITALS 6 CLINICS 31 Thiqa co-payments significantly impacted Abu Dhabi volumes in addition to business and operational alignment initiatives, increased competition, doctor vacancies and the sale of several non-core assets Focused on doctor recruitment and new insurance mix and tariff strategy Encouraging patient activity since opening the new Mediclinic City Hospital North Wing and Mediclinic Al Jowhara Hospital Mediclinic Parkview Hospital project progressing in Dubai BEDS 714 INPATIENT VOLUMES IN ABU DHABI EMPLOYEES 6,375 OUTPATIENT VOLUMES* ( 000) IN ABU DHABI 000s FY16 FY17 Movement Daman - Basic Plan % Daman - Enhanced % Daman - Thiqa % Others % Total 2,353 1,976-16% FY16 FY17 Movement Daman - Basic Plan 15,937 15,823-1% Daman - Enhanced 7,671 6,885-10% Daman - Thiqa 8,055 5,416-33% Others 8,184 6,940-15% Total 39,847 35,064-12% *Outpatient volumes by insurance mix show paid attendances, excluding follow up visits. Abu Dhabi outpatient attendance including follow up visits declined by 14%. 22

23 SPIRE HEALTHCARE GROUP PLC UNITED KINGDOM Mediclinic s 29.9% investment in Spire remained stable and gives the Group exposure to UK private healthcare market Full Year 2016 performance was in line with expectations, after adjusting for St Anthony s Strong growth in Self-pay and NHS business; increased market share in the PMI sector Investment continued at the new Spire Manchester and Spire Nottingham hospitals Management expects growth in all payor groups (including the PMI business) over the medium to long term as a result of an under funded NHS plus favourable healthcare demographics Spire is ideally positioned to be a leading player in the independent hospital sector given its scale, reach and quality of care 23

24 STRATEGY DANIE MEINTJES CEO MEDICLINIC INTERNATIONAL

25 MEDICLINIC INTERNATIONAL EVOLVING HEALTHCARE INDUSTRY GLOBAL DEMAND FOR HIGH- QUALITY HEALTHCARE SERVICES REMAINS ROBUST Underpinned by an ageing population, growing disease burden and new technology LOWER ECONOMIC GROWTH Increases the pressure on patients and funders GREATER COMPETITION Impacts patient choice and service offerings INCREASED FOCUS ON AFFORDABILITY OF DELIVERING HEALTHCARE Resulting in changing care delivery models and greater regulatory oversight Mediclinic focusses on high-quality care and optimal patient experience 25

26 PATIENTS FIRST PATIENT EXPERIENCE INDEX PRESS GANEY OVERALL MEAN SCORE MCSA n=34763 MCME n=1484 RECOMMEND THE HOSPITAL MCSA n=34494 MCME n= % 82.90% 81.90% 82.10% 69.80% 71.60% 23.60% 22% 4.30% 4.50% 2.20% 2% April - Sept 2016 October March 2017 Definitely yes Probably yes Probably no Definitely no 26

27 PATIENTS FIRST STAFF ENGAGEMENT INDEX PARTICIPATION RATE 2015 vs % 87% 81% 81% 78% 78% 76% 90% 57% 65% 65% 71% Gallup Overall Gallup Healthcare Hirslanden Middle East Southern Africa MCI Overall ENGAGEMENT INDEX Engaged Not Engaged Actively Disengaged 11% 11% 11% 11% 10% 9% 12% 9% 18% 16% 14% 13% 41% 41% 38% 38% 56% 52% 52% 58% 51% 51% 54% 51% 48% 48% 51% 51% 34% 39% 39% 30% 31% 33% 32% 36% Gallup Overall Gallup Healthcare Hirslanden Middle East Southern Africa MCI Overall 27

28 Rate per 1,000 Patient Days Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Readmissions / Admissions (%) Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Rate per 1,000 Patient Days Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Rate per 1,000 Catheter Days Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Rate per 1,000 Patient Days Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar PATIENTS FIRST CLINICAL QUALITY IMPROVEMENT Hirslanden 1.50 Hospital Associated Pressure Ulcer Rate Mediclinic Southern Africa HAI Rate CAUTI Rate Mediclinic Middle East HAI Rate 3.0% 2.5% 2.0% 1.5% 1.0% 0.5% 0.0% 30 Day Readmission Rate

29 MEDICLINIC INTERNATIONAL STRATEGY PUTTING PATIENTS FIRST IMPROVING EFFICIENCIES Superior clinical performance in a safe clinical environment Improved patient experience Integrated and coordinated care Improved operational effectiveness - Leverage combined international capacity through collaboration and shared resources - Pursue initiatives in operating platforms to improve operational efficiency Leveraged international group benefits - Use central resources to achieve Group wide procurement efficiencies CONTINUING TO GROW Increased capacity at existing infrastructure Acquisitive or organic growth in existing platforms Further international acquisitions 29 INVESTING IN EMPLOYEES Identifying, attract and retain leading specialists and talented healthcare professionals Improve employee engagement 29 Create long-term shareholder value 29

30 QUESTIONS AND ANSWERS James Arnold Head of Investor Relations MEDICLINIC INTERNATIONAL PLC 14 Curzon Street London W1J 5HN United Kingdom Tel: +44 (0)

31 APPENDIX

32 OPERATING PLATFORM FOREIGN EXCHANGE RATES Average rates FY17 FY16 % CHANGE GBP/CHF (12%) GBP/AED (13%) GBP/ZAR (11%) Closing rates FY17 FY16 % CHANGE GBP/CHF (9%) GBP/AED (13%) GBP/ZAR (21%) 32

33 GROUP DEBT STRUCTURE 31 MARCH 2017 MEDICLINIC SOUTHERN AFRICA Carrying value ZARm Carrying value 'm TERMS Senior term 4, M Jibar plus between 1.51% (ZAR 2,950m) and 1.69% (ZAR1,200m), repayable on 3 June 2019 Preference shares 3, Prime x 69% and 73%, Repayable Yr 3-5 Senior amortising M Jibar +1.06%, repayable October 2017 Subsidiaries 85 5 Prime interest rate, repayable between 1 and 12 years Capex facility M Jibar +1.51%, repayable on 3 June 2019 Total 8, Total interest expense HIRSLANDEN Carrying value CHFm Carrying value 'm TERMS Secured long term bank loans 1,472 1,178 CHF 1450m Swiss 3M Libor + 1.5%, CHF 100m Swiss Libor %, amortising July 2020 Swiss bonds CHF 145m at 6 year 1.625%, CHF90m at 10 year 2.0% Secured long term finance 2 - Total 1,708 1,367 Total interest expense MEDICLINIC MIDDLE EAST Carrying value AEDm Carrying value 'm TERMS Bank loans M Libor %, amortising June 2020 and May 2021 Total Total interest expense 33 7 MEDICLINIC INTERNATIONAL PLC Carrying value 'm Carrying value 'm TERMS Bridge loan - - Libor with a minimum base rate of 1% % Total - - Total interest expense 6 6 TOTAL GROUP DEBT ( 'm) 2,030 TOTAL GROUP INTEREST PAID ( 'm) 74 33

34 GROUP CAPITAL EXPENDITURE FY17 Actual capex ( m) Hirslanden Southern Africa Middle East Total To maintain operations To expand operations Total capital expenditure Hirslanden: Hirslanden 2020 and HQ relocation. Expansion includes acquisition of building in Bern MCSA: Maintaining 52 hospitals. Expansion increased beds by 78 during the year MCME: Mediclinic City Hospital North Wing and Parkview Hospitals FY18 Budgeted capex ( m)* Hirslanden Southern Africa Middle East Total To maintain operations To expand operations Total capital expenditure Hirslanden: Ongoing investment projects MCSA: Gradual expansion programme continues; excludes Klerksdorp investment awaiting CC approval MCME: Mediclinic Parkview Hospital and other expansion *Constant currency basis: GBP/CHF: 1.29, GBP/ZAR: 4.80, GBP/AED:

35 Movements CHF m Underlying EBITDA margin % HIRSLANDEN FIVE YEAR PERFORMANCE 1,800 1,600 1,400 1,200 FINANCIAL PERFORMANCE 21.5% 1,436 1, % 1,563 Revenue Underlying EBITDA EBITDA margin % 1,647 1,704 22% 21% CAGR FY13-FY17: 6.4% 1, % 19.7% 20.0% 20% % 4.4% 0 FY13 FY14 FY15 FY16 FY17 18% OPERATIONAL PERFORMANCE 9% 8.4% 7% 5.6% 5% 3.4% 2.1% 3.0% 3% 4.4% 1.2% 1% 2.5% 1.9% -0.7% -1% FY13 FY14 FY15 FY16 FY17 Bed Days Sold Revenue Per Bed Day PATIENT MIX 45% 39.6% 41.4% 44.8% 42.7% 43.5% 40% 34.0% 35% 33.0% 32.3% 31.9% 31.2% 30% 26.4% 25.6% 25.0% 24.6% 24.0% 25% 20% FY13 FY14 FY15 FY16 FY17 Basic Semiprivate Private 35

36 CAPITAL PROJECTS HIRSLANDEN CAPITAL PROJECTS DURING 2017 Hospital Project Completion Clinique Cecil Hybrid operating theatre 1H17 Clinique La Colline Doctor s consulting rooms 1H17 Klinik Stephanshorn Restructuring of radiology 1H17 Klinik Aarau Third cardiac catheterisation laboratory 1H17 Klinik Permanence Restructuring of sterilisation unit 2H17 Klinik St. Anna Modular operating theatres 2H17 Klinik Stephanshorn Modular operating theatres 2H17 Klinik Hirslanden Restructuring of emergency department 2H17 FUTURE PROJECTS Hospital Project Expected Completion Klinik St. Anna MRI 3 Tesla 1H18 Klinik Stephanshorn Restructuring of entrance 1H18 Klinik Birshof O-arm Surgical Imaging system 1H18 Klinik St. Anna O-arm Surgical Imaging system 1H18 Klinik Stephanshorn Operating roboter DaVinci 1H18 Klinik Im Park Outpatient surgery unit Bellaria 1H18 Klinik Hirslanden Capacity expansion; MRI, gastroenterology & stroke unit FY18 AndreasKlinik (Cham) Medical centre/physicians house FY18 Klinik Permanence Radiology institute Cosmos FY18 Klinik Birshof Medical centre/physicians house FY19 Clinique La Colline Sport medicine centre FY19 Klinik Stephanshorn (Schuppis) Medical centre FY19 Klinik Hirslanden (Seefeldstrasse) Medical centre FY19 36

37 Movements ZAR m Underlying EBITDA margin % MEDICLINIC SOUTHERN AFRICA FIVE YEAR PERFORMANCE 16,000 14,000 12,000 10,000 FINANCIAL PERFORMANCE 21.6% 21.5% 11,205 10,059 Revenue Underlying EBITDA EBITDA margin % 13,450 14,367 12, % 21.4% 21.2% 22% CAGR FY13-FY17: 9.3% 8,000 21% 6,000 4,000 2, , FY13 FY14 FY15 FY16 FY17 20% 9.0% 8% OPERATIONAL PERFORMANCE 6% 5.9% 5.8% 6.3% 5.8% 4% 4.6% 5.4% 3.5% 4.4% 2.9% 2% Bed Days Sold Revenue Per Bed Day 0.8% 0% FY13 FY14 FY15 FY16 FY17 37

38 CAPITAL PROJECTS SOUTHERN AFRICA CAPITAL PROJECTS DURING 2017 Hospital Completion Beds Growth into existing license Mediclinic Upington 1H17 26 Mediclinic Emfuleni 2H17 17 Mediclinic Worcester 2H17 20 Mediclinic Bloemfontein 2H17 4 Mediclinic Windhoek 2H17 11 Total licenced beds Year end ,095 FUTURE PROJECTS* Hospital Expected Completion Beds Existing licenses Mediclinic Bloemfontein 1H18 12 Mediclinic Thabazimbi 2H18 12 Mediclinic Newcastle 2H18 30 Mediclinic Midstream 1H19 11 Mediclinic Legae 2H19 23 Mediclinic Vergelegen 2H19 28 Mediclinic Cape Gate 1H20 13 Mediclinic Potchefstroom 1H20 70 Mediclinic Stellenbosch 1H20 70 Mediclinic Medforum 2H20 81 Day clinics Mediclinic Nelspruit Day Clinic 1H20 16 Mediclinic Bloemfontein Day Clinic 2H20 22 Mediclinic Cape Gate Day Clinic 2H20 16 Additional/new facilities Klerksdorp Awaiting CC approval 256 Life Path Health Completing DD then requires CC approval 308 *Subject to DOH Approval 38

39 Cases as a proportion of total admissions MEDICLINIC SOUTHERN AFRICA CLINICAL TRENDS AGE DISTRIBUTION DIFFERENCES 2006/ / % 1.5% 10.0% Changes (2006/ /17) 2006/ /17 1.0% 8.0% 0.5% 6.0% 0.0% 4.0% -0.5% 2.0% -1.0% 0.0% < Age Category -1.5% 39

40 Proportion of Cases with a Chronic Disease Code MEDICLINIC SOUTHERN AFRICA CLINICAL TRENDS CHRONIC DISEASE CODED 35.0% 32.6% 30.0% 29.6% 29.7% 29.9% 30.6% 30.8% 25.0% 24.2% 20.0% 19.0% 15.0% 14.4% 15.9% 16.8% 16.2% 14.8% 15.5% 17.1% 11.1% 10.0% 6.4% 5.0% 0.0% 2000/ / / / / / / / / / / / / / / / /17 Note: Pre 2011/12 data not comparable with subsequent years Financial Year 40

41 Proportion of Hospital Admissions (Medical vs. Surgical) MEDICLINIC SOUTHERN AFRICA CLINICAL TRENDS PROPORTION OF MEDICAL AND SURGICAL ADMISSIONS 100% 90% 80% 70% Surgical Medical 60.1% 59.3% 58.3% 59.1% 57.4% 56.5% 56.4% 55.9% 56.0% 55.4% 55.6% 55.2% 54.8% 54.6% 54.3% 53.4% 52.8% 60% 50% 40% 30% 20% 39.9% 40.7% 41.7% 40.9% 42.6% 43.5% 43.6% 44.1% 44.0% 44.6% 44.4% 44.8% 45.2% 45.4% 45.7% 46.6% 47.2% 10% 0% 2000/ / / / / / / / / / / / / / / / /17 Financial Year 41

42 Proportion of Hospital Admissions (Day Cases vs. Inpatients) MEDICLINIC SOUTHERN AFRICA CLINICAL TRENDS 100% PROPORTION OF DAY CASES AND INPATIENT ADMISSIONS 90% 80% 31.1% 32.1% 30.9% 30.0% 29.1% 29.0% 29.2% 28.8% 28.4% 28.3% 28.2% 27.5% 26.9% 26.3% 25.8% 25.0% 24.5% 70% 60% 50% 40% 30% 68.9% 67.9% 69.1% 70.0% 70.9% 71.0% 70.8% 71.2% 71.6% 71.7% 71.8% 72.5% 73.1% 73.7% 74.2% 75.0% 75.5% 20% 10% Daycase Inpatient 0% 2000/ / / / / / / / / / / / / / / / /17 Financial Year 42

43 CAPITAL PROJECTS DUBAI MEDICLINIC CITY HOSPITAL NORTH WING Completed in September 2016 ARTIST S IMPRESSION CURRENT PROGRESS State of the art Comprehensive Cancer Centre built in collaboration with Hirslanden Construction and commissioning completed within budget at AED255m 61 net additional beds created at City Hospital 27 in North Wing 34 in main hospital (12 commissioned during FY18) Strong initial patient volumes MEDICLINIC PARKVIEW HOSPITAL Acquired land on the Umm Suqeim Road Al Barsha in March 2015 Commenced building in 2016; Projected completion in Q4 FY19 Creating 188 new beds (phased commissioning period) General hospital including cardiology, ER, Maternity and NICU Budgeted capex: AED680m (c.75% of total spent over FY18 & FY19) 43

44 CAPITAL PROJECTS ABU DHABI MEDICLINIC AIRPORT ROAD HOSPITAL Campus expansion Comprehensive Cancer Centre Completion expected Q4 FY19 MEDICLINIC AL JOWHARA HOSPITAL 51 bed hospital (43 beds opened FY17) General hospital with a focus on maternity EXPANDING MEDICAL NETWORKS Al Yaher Clinic: Opened in Q2 FY17 Ghayathi Clinic: Opened in Q3 FY17 Aspetar Clinic: Opened in Q3 FY17 Khalifa City A Clinic: Recently opened in Q1 FY18 Opened Q3 FY17 Well located to serve Thiqa patients MEDICLINIC AL NOOR HOSPITAL (KHALIFA STREET) Currently reviewing all expansion and upgrade plans for the hospital Finalise plans during 1H FY18 44