Healthcare

Mediclinic International PLC (Mediclinic)

Mediclinic has a March year-end and therefore the results for the 12 months to 31 March 2018 have been equity accounted in Remgro's results for the year under review. Mediclinic's contribution to Remgro's headline earnings for the year under review amounted to R1 556 million (2017: R1 875 million).

Mediclinic's turnover for the financial year ended 31 March 2018 increased by 4% to £2 870 million (2017: £2 749 million). Adjusted earnings before interest, tax, depreciation and amortisation (EBITDA) increased by 3% from £501 million to £515 million, while underlying margins declined from 18.2% to 17.9%.

Mediclinic has an interest of 100% in Hirslanden, the holding company of the largest private hospital group in Switzerland. Hirslanden's revenue for the year under review increased by 2% to CHF1 735 million (2017: CHF1 704 million) and adjusted EBITDA was 7% lower at CHF318 million (2017: CHF340 million). The adjusted EBITDA margin decreased from 20.0% to 18.3% due to decreased revenue from changes in the regulatory environment and insurance mix and continued investment costs relating to a strategic programme. This was offset by cost management programmes and efficiency savings.

Mediclinic Southern Africa's revenue increased by 5% to R15 106 million (2017: R14 367 million) for the year under review, mainly due to a 6.7% increase in the average income per bed-day. Adjusted EBITDA increased by 6% to R3 245 million (2017: R3 049 million), resulting in the underlying EBITDA margin increasing from 21.2% to 21.5% due to cost management and efficiency initiatives, partly offset by the ongoing shift in mix towards medical versus surgical cases and lower patient volumes.

At 31 March 2018, Mediclinic Middle East owned and operated six hospitals and 22 clinics with a total of 748 beds in Dubai and Abu Dhabi. Revenue increased by 1% to AED3 134 million (2017: AED3 109 million) for the year under review. Adjusted EBITDA increased by 9% to AED397 million (2017: AED364 million), while the adjusted EBITDA margin increased from 11.7% to 12.7%. These increases were due to efficiency and cost management initiatives, as well as increased patient volumes.

The group is well positioned to continue to drive long-term value for its shareholders with a well-balanced portfolio of global operations in all three attractive healthcare markets. Together with the investment in Spire Healthcare Group plc, this portfolio provides the group with a sound platform for sustainable long-term performance.