Annual Financial Report

RNS Number : 4462C

Mediclinic International plc

18 June 2021

 

Mediclinic International plc
(Incorporated in England and Wales)
Company Number: 08338604
LSE Share Code: MDC

JSE Share Code: MEI
NSX Share Code: MEP
ISIN: GB00B8HX8Z88
LEI: 2138002S5BSBIZTD5I60
("Mediclinic", or the "Company", or the "Group")

18 June 2021

POSTING OF ANNUAL REPORT AND FINANCIAL STATEMENTS,
NOTICE OF ANNUAL GENERAL MEETING AND PROXY FORM

Mediclinic announces that its Annual Report and Financial Statements in respect of the financial year ended 31 March 2021 ("2021 Annual Report") and notice of the Company's 2021 annual general meeting ("AGM") (the "Notice") are being published today on the Company's website.

The 2021 Annual Report, together with the Group's 2021 Clinical Services and Sustainable Development Reports, are being made available on the Group's annual reporting website at: annualreport.mediclinic.com ; the Notice at: investor.mediclinic.com/shareholder-centre/shareholder-meetings .

In accordance with Listing Rule 9.6.1, the 2021 Annual Report and the Notice are also being submitted to the National Storage Mechanism and will shortly be available for inspection there at:

https://data.fca.org.uk/#/nsm/nationalstoragemechanism . 

Shareholders who elected to receive shareholder information electronically are being notified that these documents are available on the Company's website and hard copies of the documents are being posted today to shareholders who elected to receive shareholder information in hard copy.

In accordance with DTR 6.3.5 of the FCA's Disclosure Guidance and Transparency Rules, additional information is set out in the appendix to this announcement. The information in the appendix is extracted from the 2021 Annual Report and should be read in conjunction with the Company's preliminary results announcement issued on 26 May 2021 (RNS number 8045Z). Together, these constitute the information required by DTR 6.3.5 to be communicated in full unedited text through a Regulatory Information Service. This material is not a substitute for reading the full 2021 Annual Report.

Arrangements for the AGM and Shareholder Event

The AGM will be held on Tuesday, 27 July 2021 at 15:00 BST at Rosewood London Hotel, 252 High Holborn, London, WC1V 7EN, United Kingdom ("UK"). Due to continued uncertainty regarding the UK Government's restrictions on large indoor public events and travel, as well as the higher potential COVID-19 transmission risk of indoor events, the AGM will be scaled back.

It is expected to be purely functional, principally putting the resolutions to shareholders and calling the poll. Shareholders and corporate representatives are strongly encouraged not to attend in person and not to appoint any proxy other than the chair of the AGM to attend.

However, to ensure that all shareholders have the opportunity to engage with the Board before submitting their proxy votes, there will be a live online shareholder engagement event on Monday, 19 July 2021 at 14:00 (BST). Further information can be found in the notice of AGM.

Mediclinic will continue to closely monitor the latest COVID-19 legislation and guidance issued by the UK Government. The Company will notify shareholders as soon as reasonably practicable of any proposed changes to the arrangements for the AGM through an announcement to the London Stock Exchange ("LSE") and JSE and on investor.mediclinic.com/events/event-details/2021-agm.

In compliance with JSE requirements, for shareholders on the South African Branch Register: (i) the record date for the purpose of determining which shareholders are entitled to participate in and vote at the AGM is Friday, 23 July 2021; and (ii) the last day to trade in the Company's shares in order to be recorded as a shareholder by the voting record date is therefore Tuesday, 20 July 2021.

About Mediclinic International plc

Mediclinic is a diversified international private healthcare services group, established in South Africa in 1983, with divisions in Switzerland, Southern Africa (South Africa and Namibia) and the United Arab Emirates ("UAE").

The Group's core purpose is to enhance the quality of life.

Its vision is to be the partner of choice that people trust for all their healthcare needs.

Mediclinic is focused on providing specialist-orientated, multi-disciplinary services across the continuum of care in such a way that the Group will be regarded as the most respected and trusted provider of healthcare services by patients, medical practitioners, funders and regulators of healthcare in each of its markets.

At 31 March 2021, Mediclinic comprised 74 hospitals, five subacute hospitals, two mental health facilities, 18 day case clinics and 18 outpatient clinics. Hirslanden operated 17 hospitals and four day case clinics  in Switzerland with more than 1 900 inpatient beds; Mediclinic Southern Africa operations included 50 hospitals (three of which in Namibia), five sub-acute hospitals, two mental health facilities and 12 day case clinics (four of which operated by Intercare) across South Africa, and around 8 600 inpatient beds; and Mediclinic Middle East operated seven hospitals, two day case clinics and 18 outpatient clinics with more than 900 inpatient beds in the UAE. In addition, under management contracts, Mediclinic Middle East operates one hospital in Abu Dhabi and will open a 200-bed hospital in the Kingdom of Saudi Arabia in mid-2022.

The Company's primary listing is on the LSE in the UK, with secondary listings on the JSE in South Africa and the Namibian Stock Exchange in Namibia.

Mediclinic also holds a 29.9% interest in Spire Healthcare Group plc, a leading private healthcare group based in the United Kingdom and listed on the LSE.

For further information, please contact:

Company Secretary, Link Company Matters Limited

Caroline Emmet

[phone]

Investor Relations, Mediclinic International plc

James Arnold, Head of Investor Relations

[e-mail]

[phone]

Media queries

FTI Consulting

Ben Atwell/Ciara Martin - United Kingdom

[phone]

Sherryn Schooling - South Africa

[phone]

Registered address: 6^th Floor, 65 Gresham Street, London, EC2V 7NQ, United Kingdom

Website: www.mediclinic.com

Corporate broker (United Kingdom): Morgan Stanley & Co International plc and UBS Investment Bank

JSE sponsor (South Africa): Rand Merchant Bank (A division of FirstRand Bank Limited)

NSX sponsor (Namibia): Simonis Storm Securities (Pty) Ltd

 

APPENDIX

A. PRINCIPAL RISKS AND UNCERTAINTIES

The Group's principal risks and uncertainties are detailed below, as extracted from pages 98-104 of the 2021 Annual Report. For further information, please refer to the 2021 Annual Report. 

1. PANDEMICS AND INFECTIOUS DISEASES
Type of risk: External risk/Threat	Owner Group Chief Clinical Officer	RISK APPETITE Low	RISK RATING Critical
Principal Risk A pandemic occurs when an infectious disease rapidly infects many people and spreads to multiple countries and continents. These risks refer to the Group's ability to respond effectively to the potential adverse clinical, operational and business effects caused by a pandemic or infectious disease.	Key stakeholders · Clients  · Employees · Governments and authorities · Investors · Medical practitioners · Professional societies Considered in viability assessment Yes, modelled adverse impact on volumes caused by COVID-19 pandemic.	Key mitigation · Hospital and business incident response planning · Central coordination of task teams and clinical governance · Monitoring · Financial scenario planning · Communication strategy	TREND FY21: Stable FY20: Increase The risk relating to the COVID-19 pandemic remains at an elevated level. Link to strategy Goal 1 Goal 2 Goal 3

2. Disruptive innovation and digitalisation
Type of risk: Strategic	OWNER Group Chief Innovation Officer	RISK APPETITE Moderate to significant	RISK RATING Critical
Principal Risk Disruptive innovation and digitalisation risks incorporate the disintermediation and erosion of the Mediclinic business model due to the impact of technological development. It refers to the extent and speed at which new technologies (and combinations thereof) change and transform industries, and to what extent an organisation can exploit these opportunities by being responsive and innovative, while managing associated risks.	Key stakeholders · Clients · Employees · Industry partners  · Investors · Medical practitioners Considered in viability assessment No.	Key mitigation · Dedicated Innovation function which includes digital transformation · Strategic planning processes · Proactive monitoring · Continuum of care strategy	TREND FY21: Increase FY20: Increase The increased risk relates to increased demand from clients and stakeholders for adoption of virtual solutions and innovation. Link to strategy Goal 1 Goal 3

3. Economic and business environment
Type of risk: External risk/Threat	OWNER Group CFO	RISK APPETITE Moderate to significant	RISK RATING High
Principal Risk These risks relate to the downturn in the general economic and business environments impacting the affordability of healthcare for funders and self-paying patients. The business environment risks include the effect of market dynamics on tariffs and fees.	Key stakeholders · Clients  · Governments and authorities · Healthcare insurers · Investors Considered in viability assessment Yes, modelled volume reduction and downturn in the macroeconomic and business environment.	Key mitigation · Monitor developments and trends in the economic and business environments and early warning indicators · Proactive monitoring and negotiation by the Group's Funder Relations functions · Focus on quality and continuum of care to reinforce the Group's market position	TREND FY21: Stable FY20: Increase The global economic environment and outlook remain uncertain. Link to strategy Goal 1 Goal 2 Goal 6

4. Regulatory and compliance
Type of risk: External risk/Threat	OWNER Group Chief Governance Officer and divisional CEOs	RISK APPETITE Low	RISK RATING High
Principal Risk These risks relate to adverse changes in legislation and regulations impacting on the Group, or where failure to comply with legislation and regulations may result in losses, fines, penalties or damage to reputation. The Group is also exposed to an increasing compliance monitoring cost. The risks include healthcare reform by regulators aimed at reducing the cost of healthcare, broadening the access to quality healthcare and increasing quality standards monitoring by regulators. The Group monitors the emerging risks from climate change in line with regulatory changes and disclosure requirements. The actions the Group is taking to mitigate the impact of climate change, and minimise its impact on the environment, are described on page 58.	Key stakeholders · Governments and authorities · Industry partners · Investors · Medical practitioners Considered in viability assessment Yes, modelled reductions in tariffs and volumes.	Key mitigation · Proactive engagement with stakeholders · Health policy units created to conduct research and provide strategic input into reform processes · Active industry participation across all divisions · Company Secretarial, Legal and Compliance functions support operational management, monitor regulatory developments, and, where necessary, obtain expert legal advice for the effective implementation of compliance initiatives · Compliance risks identified and assessed as part of compliance management processes · Group's Sustainable Development Strategy addresses environmental risks (refer to page 55)	TREND FY21: Stable FY20: Increase The risk remains stable for the period under review. It relates to the continued healthcare reform and the introduction of new legislation or regulations. Link to strategy Goal 1 Goal 2 Goal 5 Goal 6

5. Information systems security and cyberattacks
Type of risk: External risk/Threat	OWNER Group Chief Information Officer	RISK APPETITE Low	RISK RATING High
Principal Risk Information systems security and cyberattack risks relate to the unauthorised access to information systems through external or internal attack or unauthorised breaches resulting in the unavailability of systems, failure of data integrity and loss of confidential data.	Key stakeholders · Clients  · Employees and potential applicants · Governments and authorities · Investors Considered in viability assessment No.	Key mitigation · Comprehensive information systems identity access management, change and physical access controls · Regular security reviews · Disaster recovery planning · Group information security and data privacy policies · Group ICT Security Committee	TREND FY21: Stable FY20: Increase The risk relates to the continued external threat from cyberattacks and breaches, which has remained at similar levels to the prior reporting period. Link to strategy Goal 1 Goal 3 Goal 4

6. Competition
Type of risk: External risk/Threat	OWNER Group CEO and divisional CEOs	RISK APPETITE Moderate	RISK RATING Medium
Principal Risk This risk relates to the uncertainty created by existing and/or emerging competitors with alternative business models. The risk includes the outmigration of care (partly driven by further technological developments) and the development of alternative care models.	Key stakeholders · Clients  · Employees · Healthcare insurers · Industry partners · Investors · Medical practitioners Considered in viability assessment Yes, modelled reductions in volumes as well as tariffs.	Key mitigation · Proactive monitoring · Strategic planning processes · Quality and value of care processes	TREND FY21: Decrease FY20: Increase Providers in the healthcare market remain competitive with a slightly improved risk exposure for the Group. Link to strategy Goal 1 Goal 2 Goal 3 Goal 6

7. Workforce risks
Type of risk Internal preventable risk	OWNER Group Chief Strategy and Human Resources Officer and divisional CEOs	RISK APPETITE Low	RISK RATING Medium
Principal Risk There is a shortage of skilled labour, particularly of qualified and experienced nursing employees in Southern Africa. The availability and support of admitting medical practitioners, whether independent or employed, are critical to the Group's services. The risk includes the potential negative effect of COVID-19 on frontline healthcare workers, who are working under immense and unprecedented pressure for extended periods and putting their physical, mental and social wellbeing at risk	Key stakeholders · Employees and potential applicants · Investors · Medical practitioners Considered in viability assessment Yes, modelled shortage of qualified and experienced healthcare employees.	Key mitigation · Systems to monitor satisfaction, movement and profiles of medical practitioners · Details on the relationship and engagement with medical practitioners provided in the 2021 Sustainable Development Report · Employment, recruitment and retention strategies explained in the 2021 Sustainable Development Report · Extensive training and skills development programme and international recruitment programme explained in the 2021Sustainable Development Report · The wellbeing of all employees is actively monitored and managed through well-established support structures. Refer to the 'The people who set Mediclinic apart' case study on page 18 and the 2021 Sustainable Development Report for more information	TREND FY21: Stable FY20: Stable Vacancies and turnover ratios in respect of skilled resources and medical practitioners are expected to remain at similar levels to the prior reporting period. Link to strategy Goal 2

8. Business Projects
Type of risk Strategic	OWNER Group CEO, divisional CEOs and Group Chief Information Officer	RISK APPETITE Moderate	RISK RATING Medium
Principal Risk The Group is adapting to the evolving operational and regulatory environment and healthcare market. These risks refer to issues or occurrences that could interfere with successful completion of projects, including timelines, cost and quality.	Key stakeholders · Clients  · Medical practitioners · Industry partners · Investors · Suppliers · Employees Considered in viability assessment Yes, modelled failure to deliver sustainable cost savings.	Key mitigation · Effective project governance practices, methodologies and reporting · Experienced project management teams · Proactive monitoring and oversight	TREND FY21: Stable FY20: Decrease These risks remain stable for the year under review. Link to strategy Goal 1 Goal 2 Goal 3 Goal 6

9. Patient safety and clinical quality
Type of risk Internal preventable risk	OWNER Group Chief Clinical Officer	RISK APPETITE Low	RISK RATING Medium
Principal Risk These risks relate to all clinical risks associated with the provision of clinical care resulting in undesirable clinical outcomes Clinical risks are managed daily at all facilities. High-priority clinical risk areas include patient safety culture, adverse obstetric outcomes, medication errors, surgical and procedural adverse events and multidrug-resistant organisms. Such risks may also result in damage to Mediclinic's reputation and impact on brand equity1.	Key stakeholders · Clients  · Employees and potential applicants · Healthcare insurers · Industry partners · Medical practitioners Considered in viability assessment Yes, modelled reductions in volumes as well as tariffs.	Key mitigation · Refer to the 2021Clinical Services Report for a detailed analysis of the strategies to manage and monitor clinical risks · A Group-wide clinical risk register implemented per division · Accreditation processes · Clinical governance processes · Monitoring of clinical performance indicators · Focus on quality management processes · Stakeholder engagement and disclosure strategies · Clinical audits	TREND FY21: Stable FY20: Stable Clinical processes across all divisions remained a key focus area for the Group. Risk exposure remained at a comparable level to the prior reporting period. Link to strategy Goal 1 Goal 2
	Note  1. Brand equity refers to the commercial value derived from the consumer perception of the Group's brand names rather than the services provided under those brand names.

10. Availability and cost of capital
Type of risk External risk/threat	OWNER Group CFO	RISK APPETITE Moderate	RISK RATING Medium
Principal Risk The Group requires capital to finance strategic expansion opportunities and/or refinance or restructure existing debt - the cost, terms and availability of which depend on prevailing market conditions.	Key stakeholders · Investors · Banks Considered in viability assessment Yes, modelled increased cost of capital as well as working capital deterioration.	Key mitigation · Long-term planning of capital requirements and cash-flow forecasting · Scrutiny of cash-generating capacity within the Group · Proactive and long-term agreements with banks and other funders relating to funding facilities · Systems to monitor compliance with requirements of debt covenants · Refer to note 17 of the Group annual financial statements for further details on capital risk management and the Group's borrowings	TREND FY21: Stable FY20: Increase Interest rates are expected to remain at comparable levels during 2021. Long-term financing arrangements are in place. The Group's leverage across the divisions is at levels where the refinancing at current market conditions should be possible. Link to strategy Goal 1 Goal 3 Goal 6

11. Financial and credit risk
Type of risk External risk/threat	OWNER Group CFO	RISK APPETITE Low	RISK RATING Medium
Principal Risk Credit risks relate to possible loss due to a funder's inability to pay the outstanding balance owing; default by banks and/or other deposit-taking institutions; or the inability to recover outstanding amounts due from patients. Credit risk with respect to trade receivables consists mainly of medical schemes and insurance companies, which are required to maintain minimum reserve levels. In Switzerland and the UAE, a large part of trade receivables is owed by cantonal or government-funded programmes, which support healthcare providers with early release of payments due during COVID-19 business disruptions.	Key stakeholders · Healthcare insurers · Investors Considered in viability assessment Yes, modelled working capital deterioration.	Key mitigation · Preservation of a sound internal financial control environment · Effective operational risk management processes · Effective monitoring and oversight of operations · Regulated minimum solvency requirements for funders · Monitoring of approved funders · Group Treasury Policy	TREND FY21: Stable FY20: Increase The credit risks did not change significantly and remained stable. Link to strategy n/a

12. quality of service AND OPERATIONAL STABILITY
Type of risk Internal preventable risk	OWNER Group Chief Clinical Officer and divisional Chief Operating Officers	RISK APPETITE Low	RISK RATING Medium
Principal Risk Operational risks refer to diverse types of operational events with a potential for financial loss, operational interruptions or reputational damage. These risks refer to the quality of service and the stability of the operations, including: · incidents of poor service or where operational management fails to respond effectively to complaints; · operational interruptions, which refer to any disruption of the facility and may include the threat of disrupted electricity or water supply; and · fire and allied perils causing damage or business interruption.	Key stakeholders · Clients  · Employees · Investors · Medical practitioners Considered in viability assessment Not specifically. However, volume reductions have been modelled.	Key mitigation · Patient satisfaction surveys (both internal and external) · Complaints monitoring · Training programmes and supervision of service levels · Emergency backup electricity generation · Emergency and disaster planning · Extensive fire-fighting and detection systems, including comprehensive maintenance processes · Comprehensive insurance cover for financial impact of potential disasters	TREND FY21:  Stable FY20: Increase These risks did not change significantly and remain stable. Link to strategy Goal 2 Goal 5

13.Businessinvestments and acquisitions
Type of risk Strategic	OWNER Group CFO	RISK APPETITE Moderate	RISK RATING Medium
Principal Risk These risks relate to increased financial exposure due to major strategic business investments and acquisitions. They include the sensitivity of the assumptions made when capital is allocated and the effective implementation of major investment decisions.	Key stakeholders · Governments and authorities · Industry partners  · Investors Considered in viability assessment No.	Key mitigation · Strategic planning processes · Due diligence processes · Investment mandates · Board oversight · Post-acquisition management processes	TREND FY21: Stable FY20: Decrease The investment and governance processes remained unchanged for the period under review. Link to strategy Goal 1 Goal 3 Goal 6

Key:

Increase:	Risk exposure has increased due to change in business environment; increased investments; increased dependency of operations on information technology; information sensitivity; and associated cost.
Decrease:	Proactive and continuous monitoring; favourable results of negotiations; effective treasury; and risk management processes have resulted in lowering of risk exposure.
Stable:	Risk exposure has remained largely unchanged as the operating and regulatory environments have remained stable, and enhanced risk mitigation measures have kept the risk at the same level.

B. STATEMENT OF DIRECTORS' RESPONSIBILITIES

The Statement of Directors' Responsibilities In Respect of the Financial Statements below is extracted from page 182 of the 2021 Annual Report. This statement relates solely to the 2021 Annual Report and is not connected to the information presented in this announcement or the preliminary results announcement released on 26 May 2021.

The directors are responsible for preparing the annual report and the financial statements in accordance with applicable legislation and regulations.

The Act requires the directors to prepare financial statements for each financial year. Under the Act, the directors have prepared the Group annual financial statements and the Company annual financial statements in accordance with IFRS as adopted by the EU. Under the Act, the directors must not approve the financial statements unless they are satisfied that these give a true and fair view of the state of affairs of the Group and Company and of the profit or loss of the Group and Company for the reporting period. In preparing the financial statements, the directors are required to:

●	select suitable accounting policies and then apply them consistently;
●	state whether applicable IFRS as adopted by the EU have been followed for the Group annual financial statements and for the Company annual financial statements, subject to any material departures disclosed and explained in the financial statements;
●	make judgements and accounting estimates that are reasonable and prudent; and
●	prepare the financial statements on the going concern basis unless it is inappropriate to presume that the Group and Company will continue in business.

The directors are also responsible for safeguarding the assets of the Group and Company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The directors are responsible for keeping adequate accounting records that are sufficient to show and explain the Group and Company's transactions and disclose with reasonable accuracy at any time the financial position of the Group and Company and enable them to ensure that the financial statements and the Remuneration Committee Report comply with the Act and the Group financial statements with Article 4 of the IAS Regulation.

The directors are responsible for the maintenance and integrity of the Company's website.

Legislation in the UK governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

DIRECTORS' CONFIRMATIONS

The directors consider that this Annual Report, and accounts, taken as a whole, is fair, balanced and understandable and provides the information necessary for shareholders to assess the Group and Company's position and performance, business model and strategy.

Each of the directors, whose names and functions are listed from page 107 of this Annual Report, confirm that, to the best of their knowledge:

●	the Company annual financial statements, which have been prepared in accordance with IFRS as adopted by the EU, give a true and fair view of the assets, liabilities, financial position and profit or loss of the Company;
●	the Group annual financial statements, which have been prepared in accordance with IFRS as adopted by the EU, give a true and fair view of the assets, liabilities, financial position and profit or loss of the Group; and
●	the Directors' Report includes a fair review of the development and performance of the business and the position of the Group and Company, together with a description of the principal risks and uncertainties that these entities face.

In the case of each director in office at the date the Directors' Report is approved:

●	so far as the director is aware, there is no relevant audit information of which the Group and Company's auditors are unaware; and;
●	they have taken all the steps that they ought to have taken as a director in order to make themselves aware of any relevant audit information and to establish that the Group and Company's auditors are aware of that information.

CA van der Merwe Group Chief Executive Officer 25 May 2021

PJ Myburgh Group Chief Financial Officer 25 May 2021

C. RELATED PARTY TRANSACTIONS

The following description of related party transactions involving the Company and is subsidiaries during the financial year ended 31 March 2021 is extracted from page 274 of the 2021 Annual Report.

35.  RELATED PARTY TRANSACTIONS

Remgro Ltd owns, through various subsidiaries (Remgro Healthcare [Pty] Ltd, Remgro Health Ltd and Remgro Jersey GBP Ltd), 44.56% (2020: 44.56%) of the Company's issued share capital.

The following transactions were carried out with related parties:

		2021 £'m	2020 £'m
i)	Transactions with shareholders
	Remgro Management Services Ltd (subsidiary of Remgro Ltd)
	Managerial and administration fees	0.3	0.4
ii)	Key management compensation1
	Key management includes the directors (executive and non-executive) and members of the Group Executive Committee
	Salaries and other short-term benefits
	Short-term benefits	8	5
iii)	Transactions with associates and joint ventures
	Zentrallabor Zürich
	Fees earned	-	(1)
	Purchases	11	8
	Wits University Donald Gordon Medical Centre (Pty) Ltd
	Fees paid	2	2
	Agency fees received	(1)	(2)
	Spire Healthcare Group plc
	Non-executive director fee2	-	-
iv)	Loans to related parties
	Wits University Donald Gordon Medical Centre (Pty) Ltd	2	2
	Bourn Hall LLC	2	2
	Zentrallabor Zürich ZLZ3	-	-
v)	Other receivables & payables due from/(to) related parties
	Wits University Donald Gordon Medical Centre (Pty) Ltd	2	2
	Zentrallabor Zürich ZLZ	(1)	(1)

Notes

^1.  Details of directors' remuneration are contained in the Remuneration Committee Report on pages 164-181.

^2.  Amount is less than £0.1m.

^3.  Amount is less than £0.5m.

Terms and conditions

Managerial and administration fees were bought on a cost-plus basis. All other transactions were made on normal commercial terms and conditions and at market rates.

The loan to Wits University Donald Gordon Medical Centre (Pty) Ltd is interest free and repayable on demand. The loan to Bourn Hall LLC earns interest at a rate of 7% per annum and is repayable in March 2022. The loan to Zentrallabor Zürich ZLZ is interest free and repayable in August 2022.

 

END

 

 

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