Christopher Rex, Managing Director
AGENDA FY2013 Year in Review Delivering on our Growth Strategy Development Update Outlook 2
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RAMSAY HEALTH CARE 121 hospitals in five countries Circa 12,000 beds Employs more than 30,000 people Admits 1.3 million patients per annum 4
QUALITY & SAFETY THE RAMSAY WAY Patient care and staff safety were our continued priority in 2013: Ramsay performed better than industry benchmarks in all key patient safety and quality indicators Hospital patient quality and safety data now published on our corporate and facility websites We aim to send our employees home at the end of every shift as fit and healthy as they were at the start of their shift In 2013, we continued to see reductions in workplace injuries with a fall of 12.9% in long term injury rate over previous year 5
AWARDS & ACHIEVEMENTS THE RAMSAY WAY Ramsay UK awarded Private Hospital Group of the Year for delivering outstanding healthcare All our hospitals in Indonesia have international accreditation with JCI (Joint Commission International) only 9 hospitals in Indonesia have been awarded this accreditation Premier Surabaya Hospital Achieved Joint Commission International Accreditation Ramsay selected in the 2013 Global 100 Most Sustainable Companies in the World for the second year in a row (1 of 9 Australian companies) Included in the FTSE4Good Index for meeting globally recognised environmental, sustainability and governance standards 6
EMPLOYEE RECOGNITION THE RAMSAY WAY The Ramsay Way culture recognises that our people are the key to our success Ramsay launched an employee share programme in July 2013 in appreciation of the key role our employees play in our Company The new share programme is designed to allow Ramsay staff the opportunity to acquire an ownership interest in the Company 7
FY2013 FINANCIAL HIGHLIGHTS Group Revenue $4.2 billion 5.5% Group EBITDA $627.7 million 7.6% Group EBIT $485.3 million 10.6% Core NPAT $290.9 million 15.1% Reported NPAT $266.4 million 9.1% Core EPS 135.9 cents/share 17.1% Full Year Dividend (fully franked) 70.5 cents/share 17.4% 8
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GEOGRAPHICAL SEGMENTS 2% Operating Revenue 13% 5% 2% Operating Profit Before Rent 19% 5% 80% 74% Australia Indonesia* United Kindom France Australia Indonesia* United Kingdom France Strong Australian business is the largest contributor to earnings and cash flow * On 1 July 2013 Ramsay s Indonesian operations were transferred into the new joint venture: Ramsay Sime Darby Health Care (RSDJV). From 1 July 2013 Ramsay s 50% share of the joint venture will be equity accounted and therefore the Revenue and EBITDAR (Operating Profit before Rent) of the RSDJV will not be consolidated in the Ramsay Health Care Group Accounts 10
OPERATIONAL/FINANCIAL HIGHLIGHTS AUSTRALIA Revenue up 7% to $3.3 billion EBIT up 11% to $410 million Australian hospitals EBITDA margin up 50 bps to 17.9% Completed major hospital expansions including $47m development at Greenslopes Private Hospital in Brisbane and opened the $133m Joondalup Private Hospital in Perth. Progressed strategy of public/private collaborations: Acquired Peel Health Campus, 152 bed public hospital Negotiated a new contract to operate Mildura Base Hospital, a 165 bed public hospital in Victoria, until 2020 Further opportunities announced by state governments for Northern Beaches Hospital (NSW) and Sunshine Coast University Hospital (Qld) 11
OPERATING ENVIRONMENT AUSTRALIA Market fundamentals remain strong Health fund membership continues to grow - now at 47% of the population State governments (WA/NSW/Qld) pursuing increased role for private operators in delivery of public hospital services 12
OPERATIONAL/FINANCIAL HIGHLIGHTS ASIA Solid performance for the year Revenue up 11.5% to IDR 673.2 billion EBIT up 28% to IDR 79.3 billion EBITDA margins increased from 16.5% to 17.8% The new joint venture with Sime Darby, commenced in July 2013, combines Sime Darby s health care assets in Malaysia (3 hospitals plus a nursing college) with Ramsay s 3 hospitals in Indonesia 13
OPERATING ENVIRONMENT - ASIA Ageing and increasingly affluent population Increasing sophistication of medical market Currently less well-served patient populations below average beds and doctors per population Desire to import western knowledge and experience Increasing GDP & affordability driving growth for private operators Growth in medical tourism expected to benefit high quality operators 14
OPERATIONAL/FINANCIAL HIGHLIGHTS Europe UK Ramsay s UK business exceeded expectations with EBITDAR rising 2.6% to 93.4 million off the back of marginal increases in revenue EBITDAR margin up 52 bps to 25.5% Private medical insured admissions remain subdued but continued growth from NHS admissions with 6.2% growth over the previous year NHS now comprises almost 70% of total admissions France Ramsay Santé performed well with EBITDAR increasing by 4.9% Ramsay Santé acquired Clinique de l Union, a 531 bed medical, surgical and obstetric hospital treating 43,000 inpatients and 26,000 emergency presentations per annum. 15
OPERATING ENVIRONMENT - EUROPE Health care reform is expected to provide continuing opportunities for the private sector Positive demographics will continue to drive hospital utilisation In the UK the Competition Commission has reported its interim findings Opportunity for further consolidation in the private health sector in France 16
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GROWTH STRATEGY Sustainable growth enhanced by focusing on hospitals and taking a prudent approach to acquisitions Organic Brownfield Capacity Expansion Public/Private Collaborations + + + Acquisitions Creation of Shareholder Value Underpinned by demographics, quality portfolio of hospitals, ongoing business improvement Unmet demand driving Ramsay s ongoing investment in capacity expansion Potential for more opportunities to develop/manage/ provide hospital services to publically funded patients in changing political and demographic landscape Exploring further acquisitions in existing and other markets Ramsay has proven it can export its management model Must add longterm value to shareholders 18
DELIVERING STRONG SHAREHOLDER RETURNS Ramsay Total Shareholder Return versus S&P/ASX 100 Accumulation Index (share price appreciation plus reinvestment of dividends) Ramsay TSR Compound Annual Growth Rate (CAGR) 25.2% 31-Oct-13 3,742% S&P/ASX 100 Accumulation Index (CAGR) 8.9% 31-Oct-13 394% Ramsay Health Care Listed on ASX 23 September 1997 Source: Orient Capital Pty Limited 19
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BROWNFIELD DEVELOPMENTS - AUSTRALIA Over $200m approved for new projects during the year including: $64m expansion of Hollywood Private, Perth $56m for expansion of Warringal Private, Melbourne $34m for expansion of Pindara Private, Gold Coast $20m for expansion of Kareena Private, south Sydney $10m for additional operating theatres at Strathfield, Sydney 21
BROWNFIELD DEVELOPMENTS - AUSTRALIA Completed projects during the year: $47m development at Greenslopes Private, Brisbane $10m expansion at Beleura Private, Melbourne $133m new Joondalup Private Hospital opened on the Joondalup Health Campus, Perth 22
BROWNFIELDS APPROVED SINCE JUNE $12m - rehabilitation development at Beleura Private, Melbourne $7.6m - theatre and ICU development at Lake Macquarie Private, Newcastle $5.9m - theatre development at Dudley Private, Orange $5.1m - day surgery development at Caboolture Private, Brisbane $4.4m - rehabilitation development at Port Macquarie Private $47m - development of Wollongong Private Hospital 23
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PUBLIC/PRIVATE COLLABORATIONS Existing public/private collaborations: Joondalup Health Campus, WA Noosa Hospital, Qld Mildura Base Hospital, Vic Peel Health Campus, WA Sunshine Coast University Private Hospital, Qld Northside Macarthur Clinic, NSW (opened early Nov 2013) Further opportunities starting to emerge for public/private collaborations: Northern Beaches Hospital announced by NSW Government in 2013 Sunshine Coast University Hospital announced by Qld Government in 2013 25
PEEL HEALTH CAMPUS WA Peel Health Campus in Mandurah, WA: 152 bed public hospital Located in southern Perth Offers medical, surgical, maternity and rehabilitation services Over 40,000 emergency presentations per annum Immediate opportunity to further develop both public and private 26
SUNSHINE COAST UNIVERSITY PRIVATE HOSPITAL 27
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EXPANSION IN ASIA JV with Sime Darby is first major step into Asia since acquiring Indonesian hospitals in 2005 Aim of the joint venture will be to build a quality portfolio of hospitals throughout Asia 600 million people in ASEAN with rising middle class demanding quality healthcare Leverages off Ramsay s management expertise and Sime Darby s Asian networks Opportunities for value creation via key synergies such as procurement; medical tourism and productivity benchmarking 29
EXPANSION IN FRANCE Clinique de l Union Toulouse, France: Acquired 7 June 2013 A leading 531 bed medical, surgical, obstetric hospital 43,000 inpatients and 26,000 emergency presentations pa Gross revenue circa 65 million pa Excellent addition to the French portfolio 30
EXPANSION OPPORUNITY IN FRANCE Medipsy, France In October 2013, Ramsay announced it has entered into exclusive negotiations with Générale de Santé Group to acquire its psychiatric division known as Medipsy. About Medipsy: 30 psychiatric clinics; 2,600 beds; Gross revenue circa 150 million pa. 31
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THE FUTURE Ageing demographic and growing disease burden leading to increased demand for healthcare Rising costs leading governments across the globe to consider healthcare reform Private sector offers efficient and effective models of healthcare delivery An expansion of the traditional private sector role by way of involvement in public health care delivery is inevitable 33
OUTLOOK Continue to produce increasing benefits from our successful capacity expansion programme in Australia In Australia, look to further our involvement in emerging public/private opportunities Further develop and execute a growth plan for Asia Integrate and grow the newly acquired hospitals in Australia, Asia and France Canvas further opportunities in France, UK and other markets Given strong industry fundamentals and continuing implementation of our successful growth strategy and barring unforeseen circumstances, Ramsay reaffirms it s guidance of Core NPAT and Core EPS growth for the Group of 12%-14% in FY2014 34