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NETWORK HEALTHCARE HOLDINGS LIMITED - AUDITED GROUP RESULTS FOR THE YEAR ENDED

Release Date: 18/11/2003 07:30
Code(s): NTC
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NETWORK HEALTHCARE HOLDINGS LIMITED - AUDITED GROUP RESULTS FOR THE YEAR ENDED 30 SEPTEMBER 2003 NETWORK HEALTHCARE HOLDINGS LIMITED The Integrated Healthcare Network Registration number 1996/008242/06 Incorporated in the Republic of South Africa JSE share code: NTC ISIN code: ZAE000011953 ("Netcare" or "the Company") Growing with people AUDITED GROUP RESULTS FOR THE YEAR ENDED 30 SEPTEMBER 2003 * Revenue up 24,9% (Organic 17,9%) * EBIT up 30,0% * Headline earnings per share up 25,1% * Capital distribution up 30,4% * Market share growth across all divisions * Netpartner completes Integrated Healthcare strategy * Netcare International establishes UK platform * Netcare receives highest quality rating INTRODUCTION The year under review has been characterised by three key factors: 1. GROWTH As a result of the Group"s focused integrated healthcare strategy, Netcare has experienced significant organic growth in all of the primary healthcare businesses. The commitment of management, as well as the dedication and professionalism of medical professionals and staff has once again yielded significant returns for all stakeholders. 2. DEVELOPMENT Platforms have been established in three pivotal areas of Netcare"s defined strategy to ensure sustainable growth for the Group: * Completion of the healthcare value and supply chain through the development and formation of Netpartner Investments Limited ("Netpartner"); * Initiation of the Public Private Partnership with the Free State Health Department; and * Progression of the International Expansion plans with two potential major contracts to provide quality care to patients under the National Health Service ("NHS") in the United Kingdom. 3. LEADERSHIP STRATEGIES During the year Netcare made key enhancements to its stated value disciplines; * Operational excellence - Specific management interventions have resulted in improved margins in the majority of the Group"s businesses. * Customer intimacy - Together with the overwhelming support for Netpartner, an additional 95 specialists have relocated to Netcare facilities, and a further 104 general practitioners and dentists have contracted with Medicross for management and administration services. * Best and safest product - Independent research by TWIG S.A. has found that Netcare achieved the highest quality ratings in its peer group. In addition, comprehensive patient satisfaction questionnaires completed by over 1 million patients across the operational units have reflected ratings in excess of 90%. These three leadership strategies, together with fanatical attention to detail and the Group"s commitment to investing purposefully in businesses which directly or indirectly support the core hospital business, will ensure that Netcare succeeds in its objective of generating sustainable shareholder wealth. Significantly, the year has not been without its challenges. The dynamic nature of the healthcare industry as well as growing pressure on the Public Sector Health Services has resulted in additional requirements being placed on the Group in terms of its Corporate and Social commitments. Encouragingly though, it is in the face of these challenges that the Group has adapted and evolved to yield satisfying results. FINANCIAL OVERVIEW OPERATING RESULTS Netcare"s Revenue for the year increased by 24,9% to R6012,6 million (2002: R4812,3 million), with the Group"s interests in diagnostics and imaging administration and management services, including its 50% interest in the Ampath Trust ("Ampath") (collectively referred to as "Netcare Diagnostics") being proportionately consolidated for the first time. Organic growth in Revenue amounted to 17,9%. EBITDA margins increased to 20,1% (2002: 19,6%), while EBIT margins have increased to 16,9% (2002: 16,3%). Headline earnings per share ("HEPS") increased by 25,1% to 45,9 cents per share (2002: 36,7 cents per share). Since 1997, the 6-year compound annual growth in HEPS has amounted to 36,2%. The results have led to a return on ordinary shareholders" equity ("ROE") of 25,0% which, after adjustments for past goodwill write-offs, amounts to a more modest 19,3%. SEGMENTAL REPORTING REVENUE (RM) EBITDA (RM)
2003 2002 % 2003 2002 % Hospitals 4 625,1 3 992,6 15,8 1 070,9 869,5 23,2 Other businesses 1 387,5 1 114,7 24,5 139,5 127,5 9,4 Medicross 569,3 489,6 16,3 63,9 52,8 21,0 Netcare Diagnostics 324,5 295,0 10,0 67,7 54,1 25,1 Traumanet 219,3 163,0 34,5 (32,2) 8,0 NA International 59,1 31,6 87,0 6,2 (1,5) NA Other 215,3 135,5 58,9 33,9 14,1 140,4 Total 6 012,6 5 107,3 17,7 1 210,4 997,0 21,4 EBIT (RM) 2003 2002 % Hospitals 923,7 741,6 24,6 Other businesses 94,2 86,2 9,3 Medicross 42,1 30,8 36,7 Netcare Diagnostics 58,8 44,7 31,5 Traumanet (33,0) 5,1 NA International 4,8 (1,6) NA Other 21,5 7,2 198,6 Total 1 017,9 827,8 23,0 The Group has several business units with the South African hospital division being its core business. An analysis of Revenue, EBITDA and EBIT for certain of the Group"s larger business units is set out below. The comparative figures have been adjusted on a pro-forma basis to take account of Netcare Diagnostics. These investments are now accounted for as joint ventures and are proportionately consolidated, whereas in the prior year they were largely accounted for as associates. This change has no effect on earnings. Whilst the core hospital business, which represents 76,9% and 88,5% of Group Revenues and EBITDA respectively, reported solid results for the period under review, the reported loss at Traumanet was extremely disappointing. BORROWINGS AND FINANCING COSTS Financing costs increased to R157,6 million (2002: R104,7 million) due primarily to the cash resources being cost effectively applied in reducing creditor financing and the Netcare Diagnostics inclusion. Material cash flows during the period included: investment in the Group"s capital expenditure programme amounting to R425,1million (2002: R366,1million), share repurchase of R79,8 million, capital distributions of R183,1million (2002: R137,4million), and the net cash inflow of R106million on the Netpartner transaction. Notwithstanding, interest cover remains at a satisfactory 6,5 times (2002: 7,5 times). The current declining interest rate climate, with rates having been significantly reduced during the past six months, bodes well for reduced finance charges in 2004. These factors, as well as the proportionate consolidation of Netcare Diagnostics, have contributed to net interest-bearing debt increasing to R899,4 million (2002: R752,1 million) and net debt:equity ratio reducing to 28,7% (2002: 34,3%). CREDIT RATING During the year Netcare achieved a credit rating upgrade by Global Credit Ratings to A1 for its short-term debt and A (previously A-) in respect of its long-term debt. ACCOUNTING POLICIES The financial statements are prepared in accordance with and comply with South African Statements of Generally Accepted Accounting Practice. The principal accounting policies as set out in the 2002 annual report have been consistently applied, except for the change in policy as detailed below. During the year the Group applied AC133 relating to the Recognition and Measurement of financial instruments. The Group has elected to account for the changes in fair value of financial instruments regarded as "available for sale" through changes in equity and not through the income statement. The adoption of AC133 has resulted in an increase in opening reserves of R46,1 million, and a positive impact on equity in the current year to the extent of R118,6 million. AUDIT REPORT The joint auditors, Grant Thornton and Fisher Hoffman PKF (Jhb) Inc. have issued their opinion on the Group"s financial statements for the year ended 30September 2003. A copy of their unqualified report is available for inspection at the Company"s registered office. JSE SECURITIES EXCHANGE REQUIREMENTS The final announcement has been prepared in accordance with the listing requirements of the JSE Securities Exchange South Africa. SIGNIFICANT CORPORATE TRANSACTIONS During the year the Group implemented a specific repurchase of 52,7 million Netcare shares for an effective consideration of R79,8 million. Shareholders are referred to the circular and announcement dated 12 December 2002 and 27 January 2003 respectively for further INFORMATION ON THIS REPURCHASE. At the end of the financial year a transaction between the Group and Netpartner was implemented in terms of which the Group sold a 20% stake in Medicross and issued 100 million Netcare shares for a total consideration of R324 million to Netpartner, while Netcare invested R218 million in Netpartner in consideration for a 48,4% stake. OPERATIONAL REVIEW The Netcare Group and its associated divisions demonstrated significant organic growth for the period under review. Despite pressure on margins due to improved staff benefits; lower inflation and the impact of a strengthening Rand on the hospital division, profitability improved across the Group with the exception of Traumanet. The Group"s strong performance was largely underpinned by good growth in market share and effective buying strategies introduced at the end of 2002. Patient care quality continues at satisfactory levels and remains a high priority as a differentiator going forward. CORE HOSPITAL NETWORK NETCARE HOSPITAL DIVISION * The hospital division has shown increased market share and recorded strong organic growth in Revenue of 15,4%. Inflation and case mix accounted for approximately 11,2%. The out of pocket Revenue continues to increase reflecting the growing need by patients for first world quality healthcare on demand. * The key activity indicators of patient days, admissions and maternity cases increased by 3,5%; 8,6% and 7,4% respectively. * EBITDA margins increased significantly from 21,8% in 2002 to 23,2% in 2003, reflecting the implementation of alternative reimbursement methods, the performance highlighted above and further operational efficiency gains. * The hospital infrastructure was bolstered by the realignment and improved utilisation of more than 150 beds, all forming part of the national capital expenditure programme incurred in upgrading and expanding certain of the Group"s full service acute care hospitals. As these became effective at various stages during the year, the benefits are likely to be realised more fully in 2004. SUPPLY CHAIN TRAUMANET Traumanet (the owner of the Netcare 911 brand) offers fully integrated, world- class pre-hospital emergency medical assistance, evacuation by road or air and telephonic medical advisory services in South Africa and the rim countries. The number of insured principal members grew 64% year-on-year, rising from 5,2 million to over 8,5 million by September 2003 and the number of emergency cases attended increased by 50% over last year to a record of 133 848 (1 case every 4 minutes). Increased brand awareness (082 911) as well as the with lack of resources and budgetary constraints in the state sector resulted in indigent, non paying patient transfers increasing by 79% during the year. This reflects 24% of total response calls and translates into a loss of more than R39million. The Board however considers this to be a humane and important responsibility and will continue this practice. To date, while no agreement has been reached to recover these losses from the Provinces, Netcare has deemed it prudent to write the above amounts off as irrecoverable. Despite the higher workload, overall service levels remained high. The first emergency ambulance was on scene within twelve minutes in at least 90% of the time-critical (Priority 1, red code) cases across metropolitan regions. TWIG SA market research, conducted monthly among our user base, revealed positive service satisfaction indices and overall experience ratings in excess of 92%. The disappointing performance was substantially due to increased services to indigents, administration issues and exponential growth in market share which outstripped infrastructure and controls. The division is receiving the necessary attention with a new management team in place. NETCARE INTERNATIONAL The NHS has committed to increase its healthcare spend to GBP87 billion over the next five years, which includes outsourcing of certain services. With three successful waiting lists having been completed and the fourth currently underway, Netcare International is developing a sustainable working relationship with the NHS. Netcare is also the preferred bidder on two Independent sector Treatment Centre contracts with the NHS. These contracts each span over five years with guaranteed patient volumes and a combined contract value of approximately GBP113,8 million. Importantly, this expansion represents a valuable human retention strategy for Netcare by allowing staff to work on a rotation basis in the UK and return to employ their skills and expertise into their respective hospitals. NETPARTNER Netcare"s strategy has always been to develop an integrated healthcare delivery model and to be the lowest cost provider of quality healthcare. Netpartner is key to achieving this end with the overall intention of ensuring that private healthcare will be more sustainable, affordable and accessible, while offering the new SA a new healthcare solution. The most encouraging aspect of Netpartner has been the support of healthcare professionals for its primary objective to bring "BETTER CARE TO MORE PEOPLE", and will certainly; * provide a meaningful foundation to increase the number of insured lives; * offer a comprehensive solution for those Public Sector employees who are currently uninsured; and most importantly, * be a positive advance in retaining quality healthcare professionals in the country. The private placement of Netpartner shares was over-subscribed with more than 4000 General Practitioners and Specialists and 2 200 Dentists, Pharmacists, Optometrists and other shareholders investing (32% representing individuals from previously disadvantaged communities). Netpartner is well capitalised and favourably positioned to roll out its business development strategy with approximately R600 million in assets (includes R100 million in cash resources). As at the date of this announcement the ruling share price was trading at a 40% premium to the offer price. ADMINISTRATION, LOGISTICAL AND SUPPORT SERVICES Netcare has invested in and developed a core competency in providing administrative, logistical and support services to a range of healthcare providers. MEDICROSS Medicross has successfully increased its management and administration services to more than 92 general practitioner and dental practices (2002: 60) across South Africa. The financial turnaround of Medicross since its acquisition by Netcare in 2001 has continued during the reporting period. The organisation has outperformed expectations by posting a 21,0% increase in EBITDA to R63,9 million (2002: R52,8 million) and a 16,3% increase in Revenue to R569,3 million (2002: R489,6 million). Patient visits grew by 16,3% to 2,8 million for the period, with dispensed prescriptions rising by 11,9%. The use of generics has increased from 32% to 39% over the period. In addition, the number of capitated lives managed by the organisation grew during the year to over 40 000 across nine medical aid schemes. These figures are indicative of the growth and operational efficiencies experienced across the organisation. NETCARE DIAGNOSTICS Netcare"s increased involvement during the year with the management and administration of diagnostic and imaging practices as well as Ampath, has resulted in EBITDA increasing to R67,7 million (Pro forma 2002: R54,1 million) with EBITDA margins at 20,9% (Pro forma 2002: 18,3%). The professional practices served by Ampath have gained further market share, with the number of requisitions growing by more than 3,7% year-on-year. Ampath remains the only pathology management group in South Africa with a truly national footprint. JOINT INVESTMENTS WITH COMMUNITY HOSPITAL GROUP ("CHG") (BEE Partner) The Group"s strategy towards the empowerment of previously disadvantaged communities has proven successful with the performance of Community Hospital Group ("CHG") meeting all expectations. CHG generates Revenue on an aggregated basis in excess of R250 million per annum with an EBIT margin of 16,0%. The prospects for this Group are encouraging given the opportunities within healthcare in SA and given Netcare and Community"s commitment towards working with Government on a national scale in providing meaningful healthcare assistance and solutions. OTHER SUPPLY SIDE BUSINESSES NATIONAL RENAL CARE ("NRC") NRC remains the leading Total Renal Disease Management Company in the private renal dialysis market in South Africa, focusing on cost effective quality renal care and outcome management, benchmarked against international standards. Six additional dialysis units were opened during the year bringing the total number of NRC units in southern Africa to 38. Revenue and EBIT grew by 19,2% and 19,6% respectively versus the prior year. CLINICAL PARTNERS Clinical Partners healthcare managed care model continues to deliver excellent results, as evidenced by the Netcare Medical Scheme. The scheme"s reserves exceed 30% with contribution increases for 2004 the lowest in the industry at less than 8%, despite paying participating specialists above the recommended tariff. The expertise developed by Clinical Partners, together with the Medicross capitated product, will be utilised by Netpartner to develop and manage new products. SAA-NETCARE TRAVEL CLINICS There are now eleven retail SAA-Netcare Travel Clinics on a national basis. Revenue was up 44,3% which includes a growth strategy around large scale site tenders for occupational health. CORPORATE CITIZENSHIP The Group provides support to disadvantaged communities for humanitarian and social endeavours. In the past year more than R60 million was applied in this regard. Walter Sisulu Cardiac Institute for Africa ("WSCIA") Following on the relocation of Dr Kinsley and his team to Sunninghill hospital in January 2003 the WSCIA has been established as a cardiology centre of excellence specialising in paediatric cardiac medicine. The WSCIA was officially opened by former president Nelson Mandela with a Section 21 company (Not for profit) established to raise an apply funds to, inter alia, reduce mortality associated with congenital heart disease for all the children across Africa. GROWING WITH PEOPLE The Netcare Group increased its spend on training to more than R84,0 million by expanding training and development at all levels in the organisation to improve service levels; encourage personal growth; meet SETA objectives and position the Group favourably for expansion. As an additional spend and focus was motivated by the SETA programme, which grants did not all materialise, an unexpected under recovery of approximately R8,6 million resulted. The Goldcare programme continues to be a successful staff initiative in maintaining high quality care with new modules continuously being introduced. In addition, Netcare was once again voted one of the top 40 companies to work for in South Africa, a commendation the Group is extremely proud of. PROSPECTS With the solvency of Medical Aid Schemes being better than ever and single digit provider medical inflation anticipated to be the lowest in a decade, the private healthcare sector is well positioned to benefit from increasing numbers of insured lives. Several new legislative changes will be implemented with single exit pricing on ethicals due to be finalised by May 2004. The inefficient fee for service model is gradually being replaced with alternative reimbursive models which Netcare has pioneered with great success through its capitated products in Medicross and the integrated model via Clinical Partners. In partnership with Netpartner healthcare professionals, the Group can now offer a full range of healthcare services to almost 80% of the insured population on a national basis. This favourable positioning will see the development of numerous preferred provider products in the future with the ultimate objective of making private healthcare more affordable to more people of South Africa. Netcare remains confident that as with other healthcare reforms introduced over the past seven years, it will adapt its model and continue to provide acceptable shareholder returns without compromising on its delivery of exceptional service to its patients and customers. Accordingly, in the absence of any unforeseen circumstances, the Group believes that its business model is balanced and sound to continue to generate satisfactory increases in earnings in the year ahead and meaningful returns for all stakeholders. CHANGES IN DIRECTORATE Mrs SV Zilwa and Mr P Warrener resigned as non-executive and executive directors with effect from 17 January and 23 September 2003, respectively. CAPITAL DISTRIBUTIONS In accordance with the authority given to the directors by way of an ordinary resolution passed on 24 January 2004, the Board of directors has declared a final capital distribution out of share premium of 9,0 cents per ordinary share, payable to shareholders recorded in the register of the Company as at Friday, 6 February 2004. Taken together with the interim distribution of 6,0 cents per share, the total distribution paid and to be paid in respect of the 2003 financial year amounts to 15,0 cents (2002: 11,5 cents) per ordinary share, an increase of 30,4% over the prior period. In compliance with the requirements of STRATE the following dates are applicable: 2004 Last date to trade "CUM" the capital distribution ("LDT") Friday, 30 January Trading commences "EX" the capital distribution Monday, 2 February Record date Friday, 6 February Date of payment Monday, 9 February Share certificates may not be dematerialised or rematerialised between Monday, 2 February 2004 and Friday, 6 February 2004, both dates inclusive. By order of the Board Michael I Sacks Dr Jack Shevel Sandton Chairman Chief Executive Officer 17 November 2003 GROUP BALANCE SHEET Audited Audited 2003 2002
(Rm) (Rm) Assets Non-current assets Property, plant and equipment 2 704,0 2 413,0 Intangible assets 169,6 89,8 Investments and loans 488,6 181,6 Deferred taxation 41,5 41,5 Other financial assets 426,7 183,1 Total non-current assets 3 830,4 2 909,0 Current assets Inventories 376,5 233,6 Accounts receivable 1 159,9 854,0 Total current assets 1 536,4 1 087,6 Total assets 5 366,8 3 996,6 Equity and liabilities Ordinary shareholders" equity 3 061,6 2 187,7 Minority interest 71,8 7,7 Total shareholders" equity 3 133,4 2 195,4 Net interest-bearing debt 899,4 752,1 Non-current liabilities Deferred taxation 268,1 128,6 Current liabilities Accounts payable 871,1 749,7 Vendors for acquisition - 13,3 Current taxation 194,8 157,5 Total current liabilities 1 065,9 920,5 Total equity and liabilities 5 366,8 3 996,6 Net equity per share (cents) 200,0 150,6 GROUP INCOME STATEMENT Audited Audited 2003 2002 % (Rm) (Rm) change
Revenue 6 012,6 4 812,3 24,9 Operating profit before depreciation and amortisation (EBITDA) 1 210,4 942,9 28,4 Depreciation and amortisation 192,5) (159,8) Operating profit (EBIT) 1 017,9 783,1 30,0 Net finance charges (157,6) (104,7) Profit before taxation 860,3 678,4 Taxation (202,5) (170,6) Profit after taxation 657,8 507,8 29,5 Attributable earnings of associates 0,4 20,5 Profit after taxation including associates 658,2 528,3 Minority interest (1,1) (2,3) Earnings attributable to ordinary shareholders 657,1 526,0 24,9 EARNINGS RECONCILIATION Audited Audited 2003 2002 %
(Rm) (Rm) change Attributable earnings 657,1 526,0 Goodwill amortised 6,9 3,9 Profit on sale of investment (8,8) - Headline earnings 655,2 529,9 23,6 Earnings per share (cents) Headline - basic 45,9 36,7 25,1 - fully diluted 43,8 34,8 25,9 Attributable - basic 46,0 36,4 26,4 - fully diluted 43,9 34,5 27,2 Cash equivalent earnings per share (cents) 58,7 49,6 18,3 STATEMENT OF CHANGES IN SHAREHOLDERS" EQUITY Audited Audited 2003 2002 (Rm) (Rm)
Ordinary shareholders" equity at beginning of year 2 187,7 1 580,2 Adjustment to opening balance on adoption of AC 133 46,1 - Restated balance 2 233,8 1 580,2 Earnings attributable to ordinary shareholders 657,1 526,0 Fair value surplus on available for sale investments net of tax 118,6 - Currency translation reserves (7,9) - Issue of shares 315,5 218,9 Share buyback (79,8) - Capital distributions (183,1) (137,4) Other 7,4 - Balance at end of year 3 061,6 2 187,7 ABRIDGED GROUP CASH FLOW STATEMENT Audited Audited 2003 2002 (Rm) (Rm) Cash generated from operations 1 189,0 941,2 Working capital movements (310,2) (116,9) Cash generated from operating activities 878,8 824,3 Net finance charges (157,6) (104,7) Taxation paid (153,6) (130,5) Cash inflow from operating activities 567,6 589,1 Capital distributions paid (183,1) (137,4) Net cash retained 384,5 451,7 Other investing and financing activities (455,4) (525,6) Capital expenditure (425,1) (366,1) Net investment in businesses (255,8) (167,6) Share buyback by subsidiary (79,8) - Net equity movements 305,3 8,1 (70,9) (73,9) Net debt assumed on consolidation of businesses (76,4) (1,0) Movement in net interest-bearing debt (147,3) (74,9) Net interest-bearing debt At beginning of year (752,1) (677,2) At end of year (899,4) (752,1) KEY FINANCIAL INFORMATION Audited Audited 2003 2002 Ordinary shares (millions) In issue 1 530,7 1 452,9 Weighted average number of shares 1 428,8 1 444,8 Fully diluted weighted average number of shares 1 496,5 1 523,9 Distributions Capital distributions (cents per share) Interim 6,0 4,5 Final 9,0 7,0 Other salient features EBITDA margin (%) 20,1 19,6 EBIT margin (%) 16,9 16,3 Interest cover (times) 6,5 7,5 Effective taxation rate (%) 23,6 25,0 Operating profit return on net assets (%) 29,2 30,4 Return on ordinary shareholders" equity (%)25,0 28,1 Debt:equity ratio (%) 28,7 34,3 Capital expenditure for the year (Rm) 425,1 366,1 Capital commitments (Rm) 185,4 206,4 This is a summarised commentary and results announcement. A full annual report will be published on the Internet and a hard copy will be mailed to shareholders on or about 12 December 2003. The annual general meeting will be held on 23 January 2004 and notice thereof will be given in the annual report. The results can be viewed on the website www.netcareinvestor.co.za Registered office - 76 Maude Street, Sandton 2196 (Private Bag X34, Benmore 2010). Transfer secretaries - Ultra Registrars (Pty) Limited, 11 Diagonal Street, Johannesburg 2001 (PO Box 4844, Johannesburg 2000). Sponsor - Merrill Lynch South Africa (Pty)Limited. Executive directors: MI Sacks (Chairman), Dr J Shevel (Chief Executive Officer), Dr RH Friedland (Chief Operating Officer), SR Favish (Chief Financial Officer), Dr RH Bush, IM Davis, Dr I Kadish, PJ Lindeque, Dr C Rossolimos, N Weltman. Non-executive directors: Dr APH Jammine, JM Kahn, HR Levin, Dr JA van Rooyen. Company secretary: J Wolpert Date: 18/11/2003 07:30:22 AM Supplied by www.sharenet.co.za Produced by the JSE SENS Department

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