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Mon 18 May 2009, 8:00 NTC - Netcare Limited - Unaudited group interim results for the six months
NTC
NTC                                                                             
NTC - Netcare Limited - Unaudited group interim results for the six months      
                        ended 31 March 2009                                     
Netcare Limited                                                                 
Registration number: 1996/008242/06                                             
(Incorporated in the Republic of South Africa)                                  
JSE share code: NTC                                                             
ISIN code: ZAE000011953                                                         
("Netcare", "the Company" or "the Group")                                       
Unaudited group interim results for the six months ended 31 March 2009          
+12% Revenue 2009: R11 619 million 2008: R10 343 million                        
+15% Operating profit 2009: R1 822 million 2008: R1 584 million                 
+14% Capital reduction 2009: 16,0 cents 2008: 14,0 cents                        
Commentary                                                                      
Netcare Limited announces unaudited group interim results for the six months    
ended 31 March 2009. These results have been prepared in accordance with        
International Financial Reporting Standards (IFRS) and are in compliance with   
IAS 34 Interim Financial Reporting, the Listings Requirements of the JSE        
Limited (JSE) and the South African Companies Act, 1973, as amended.            
Netcare is an investment holding company operating the largest private          
hospital network in South Africa (SA) and the United Kingdom (UK). The company  
has been listed on the JSE since 1996. In SA, Netcare operates a portfolio of   
private hospitals, a primary care network and medical emergency services. In    
the UK, through the General Healthcare Group (GHG), Netcare operates as a       
private acute care hospital provider and an independent service provider to     
the National Health Service (NHS).                                              
Group financial highlights                                                      
- Revenue up 12% to R11 619 million                                             
- EBITDA up 13% to R2 474 million                                               
- Basic headline earnings per share up 41% to 33.3 cents                        
- Completed sale of 50% interest in Ampath Holdings Trust                       
- Repurchased and cancelled 436 million treasury shares                         
- Interim capital reduction up 14% to 16 cents per share                        
Group business highlights                                                       
- Solid operational performance in both SA and UK                               
- Community Hospital Group acquisition cleared by Competition Appeal Court      
- Port Alfred Hospital PPP opened in February 2009                              
- Commenced construction of Lesotho Hospital PPP in March 2009                  
- Further enhanced GHG footprint in London and across other key regions in the  
UK                                                                              
- Rated the most empowered JSE-listed company in the healthcare sector          
Introduction                                                                    
The global economic downturn continues to affect the business climate and the   
Group`s operating environment remains challenging, particularly the UK.         
Netcare is therefore pleased to report a solid overall performance with         
operating regions either meeting or exceeding management guidance provided in   
November 2008.                                                                  
Group financial performance                                                     
Group revenue rose 12,3% to R11 619 million, supported by strong demand for     
private healthcare services in SA, solid core activity in the UK and the        
inclusion of hospitals acquired from Nuffield for the full six months.          
Group operating profit was up 15,0% to R1 822 million with the operating        
profit margin increased from 15,3% to 15,7%. In SA, strong patient volumes and  
improved hospital margins were tempered by underwriting costs and higher        
doubtful debt provisions in the Primary Care division. In the UK, efficiency    
improvements and cost savings resulted in improved operating profit margins.    
The Group results were positively impacted by the sale of Netcare`s 50%         
interest in Ampath Holdings Trust (Ampath) following Competition Commission     
approval of the transaction on 24 February 2009.  The sale realised gross       
proceeds of R1 027 million. The profit from the disposal amounted to R588       
million, after capital gains tax of R90 million, which is included in profit    
from discontinued operations.                                                   
Group net financial expenses were 5,7% higher at R1 252 million. This was       
mainly due to the acquisition of the Nuffield hospitals, which were financed    
by raising additional debt of R1 210 million (GBP82 million) in February 2008.  
The interest benefit arising from the Ampath sale proceeds will only be         
realised in the second half of the financial year.                              
Basic earnings per share rose 213,8% to 79.4 cents from 25.3 cents in the       
prior period. Basic headline earnings per share of 33.3 cents were up 40,5% on  
the 23.7 cents achieved a year before. The earnings growth is in line with the  
Group`s trading statement issued on 6 May 2009.                                 
An interim capital reduction of 16,0 cents per share has been declared,         
reflecting an increase of 14,3% over the prior period.                          
Net debt at 31 March 2009 of R30 361 million was 6,8% lower than the R32 589    
million at 30 September 2008, mainly as a result of the appreciation of the     
Rand against the British Pound (GBP) and the net cash proceeds of R852 million  
from the Ampath disposal. Equity decreased by R1 706 million arising from       
unfavourable non-cash mark-to-market fair value adjustments on the UK interest  
rate swaps recognised in the cash flow hedge accounting reserve.                
Cash generated from operations increased 13,2% to R1 788 million from R1 579    
million in the prior period as a result of the improved operating performance.  
The Group converted 72,3% of its EBITDA into cash which remains unchanged year- 
on-year. Pressure on working capital in the UK impacted negatively on cash      
flows, largely due to an increase in NHS debtors from the higher volumes of     
NHS patients seen.                                                              
Capital expenditure of R592 million was incurred, compared to R606 million for  
the six months ended 31 March 2008.                                             
During the reporting period, 436 million treasury shares, representing 23% of   
the shares in issue, were repurchased and cancelled. This has simplified the    
Group`s capital structure significantly, providing the opportunity for a        
potential repurchase of additional shares in future.                            
South Africa                                                                    
The South African operations performed solidly. Driven by an increased demand   
for private healthcare services, the results reflect almost entirely organic    
growth. The Hospital division has now implemented extensive changes to its      
business model which underpinned the excellent results achieved in the six      
month period. The results of the Primary Care division were impacted by prior   
year factors that have now largely been resolved.                               
Netcare was independently rated as the most empowered firm in the JSE`s         
healthcare sector and the eleventh most empowered listed company in SA in the   
Financial Mail`s Top Empowerment Companies 2009 survey. The company was rated   
third overall in skills development and training.                               
In November 2008 the Competition Appeal Court overruled the Competition         
Tribunal ruling on the merger with Community Hospital Group (Community),        
allowing for the full integration of the Community hospitals into Netcare.      
Financial performance                                                           
SA revenue grew 14,4% to R5 616 million from R4 907 million, while operating    
profit rose 18,9% to R756 million. The operating margin improved from 13,0% to  
13,5%. SA`s operating performance reflects strong patient volumes and improved  
efficiencies. Working capital was well managed and hospital debtor collections  
in March were at record levels.                                                 
A cash conversion ratio of 83,9% was achieved compared to 52,6% in the same     
period in 2008. The SA balance sheet strengthened with a 29,7% year-on-year     
reduction in net debt to R4 255 million.                                        
Hospitals and Emergency services                                                
The Hospital division recorded a 6,3% increase in patient days and occupancy    
increased across the hospital network. The medically insured population has     
also grown gradually over the last five years from 6.9 million to 7.8 million   
lives. Year-on-year revenue growth was further boosted by the timing of the     
Easter Holiday period, which fell in April this year and therefore outside the  
reporting period. Pharmacy operations continued to grow with a 5,3% increase    
in dispensed scripts.                                                           
Costs in the division have been tightly controlled and working capital          
management has improved substantially. Netcare continues to invest in capital   
infrastructure to meet growing demand while ensuring that facilities and        
equipment are maintained to the highest standards. Several projects are         
currently underway which will significantly enhance the division`s service      
offering.                                                                       
Netcare continues to maintain the highest standards of patient care and         
safety. A further six hospitals received international ISO 9001:2000            
accreditation through UK-based CHKS Healthcare Accreditation and Quality Unit   
(HAQU). This brings the total number of accredited facilities to 16 hospitals.  
Netcare has continued to foster strong relationships with government through    
Public Private Partnerships (PPP). The 91-bed Port Alfred Hospital PPP, with    
60 public and 31 private beds, was opened in February 2009 and the 249-bed      
Grahamstown Hospital is scheduled for completion in July 2009. After several    
challenges, the 214-bed Universitas/Pelonomi Hospital PPP has shown growth and  
a significantly better operating performance. Financing for the construction    
of the Lesotho Hospital PPP has been finalised and construction of this 425-    
bed referral hospital and the refurbishment of four primary care clinics        
commenced in March 2009.                                                        
The Emergency services division, Netcare 911, recorded growth in managed lives  
and continued to assist government by servicing indigent patients. The          
Aeromedical unit was negatively affected by unforeseen maintenance              
requirements on both fixed wing aircraft.                                       
Primary Care                                                                    
The Primary Care division posted strong revenue growth of 17,6% driven by       
solid demand in both Prime Cure (managed care division) and Medicross (GP,      
dental and pharmacy network).                                                   
Prime Cure`s lower income managed care lives grew by 15,6% year-on-year to      
over 240 000 lives. Medicross patient visits to GPs were up 5,6% to 1,4         
million and dental visits increased to over 250 000.                            
The Primary Care division`s results were severely impacted by significant       
provisions taken against prior year patient debtors in Medicross, as well as    
the increased provision for underwriting and servicing costs in Prime Cure.     
Consequently the division reported an operating loss of R25 million, compared   
to a profit of R43 million in the prior period. Within Prime Cure, the revised  
accounting reports and standards have been implemented and actuarial reporting  
significantly enhanced in line with best practice. Management is confident      
that accurate reporting and assessment of insurance risk are being              
appropriately monitored. During the reporting period, Medicross was             
restructured to realign its regional operating structures. Notwithstanding the  
poor half-year results, Netcare is committed to continue providing these        
essential services through the Primary Care division.                           
Health sector developments                                                      
The appointment of Dr Aaron Motsoaledi as SA`s new Minister of Health is        
welcomed and the launch of the Department`s Strategic Plan to 2012 is another   
positive indicator of the progress made to date.                                
Debate on the introduction of National Health Insurance (NHI) is expected to    
intensify with possible legislation to this effect promulgated as early as      
2011.                                                                           
United Kingdom                                                                  
Netcare owns a 50,1% stake in GHG which has 56 hospitals operating under the    
BMI brand name, in addition to an NHS outsourcing division known as Netcare     
UK.                                                                             
GHG acquired the Woodlands Hospital in Darlington and City Medical consulting   
suites in London in October 2008 as well as the Fitzroy Square Hospital in      
London in April 2009. GHG`s organic growth, coupled with an effective           
acquisition strategy, has continued to extend the Group`s geographic footprint  
in the UK, resulting in further cost and revenue efficiencies and a             
corresponding improvement in profitability.                                     
Financial performance                                                           
Revenue from the UK operations rose 10,4% to R6 003 million (GBP407.4           
million). The inclusion of the Nuffield hospitals for the full six months       
contributed 3,4%, to the revenue increase, while higher average exchange rates  
during the period resulted in an additional 2,1% in Rand denominated revenue.   
Operating profit was up 14,5% to R1 068 million (GBP72.4 million), which        
includes non-recurring items amounting to R51 million (GBP3.5 million)          
compared to R59 million (GBP4.1 million) in the prior period. Adjusted for      
these items, operating profit for the half-year amounted to R1 119 million      
(GBP75.9 million) compared to R992 million (GBP67.9 million) in 2008.           
Capital expenditure for the period was R299 million (GBP25 million), up from    
R292 million (GBP22 million) in 2008.                                           
Net debt rose by GBP34 million during the six months from GBP1 880 million at   
September 2008 to GBP1 914 million at March 2009. The combined effect of        
increased NHS volumes and associated delays in payments, as well as the         
introduction of the shared services function has increased working capital      
funding. The necessary measures have been implemented to rein in the            
additional investment in working capital, although certain structural factors   
will take some months to address.                                               
GHG continues to meet its financial covenants and has sufficient headroom for   
the rest of the financial year, even taking into account the challenging        
economic climate. Without any incremental EBIDTA growth, all covenants are      
fully met for the term of the debt.                                             
Hospitals (BMI)                                                                 
The overall caseload in the UK grew by 14,9% year-on-year. Continued decline    
in self pay patients was experienced, largely offset by a significant increase  
in NHS cases. With the formal introduction of the National Free Choice Network  
(FCN) Programme, the NHS is expected to be a key partner in delivering future   
caseloads, as the public through their GPs are able to select private           
facilities for their treatment. Effective negotiations will ensure that the     
work we undertake remains sufficiently profitable.                              
Operational costs were tightly controlled and the business delivered a further  
improvement in operating margin. A plan to contain costs has been introduced    
and is set to deliver a saving of GBP13 million for the full financial year.    
Planned savings of GBP3,8 million were delivered in the reporting period.       
Netcare UK                                                                      
Netcare UK continues to service existing Independent Sector Treatment Centre    
(ISTC) contracts such as the Greater Manchester Surgical Centre, the Commuter   
Walk-in-Centre in Leeds and the surgical initiative with the Scottish NHS in    
Stracathro. The five-year mobile ophthalmic contract to provide cataract        
operations was successfully completed in April 2009.                            
Outlook                                                                         
It remains difficult to predict the impact of various factors on the Group in   
the current volatile global economic environment. However, as the Group`s half- 
year results show, the demand for healthcare does not necessarily abate in an   
economic downturn.                                                              
Netcare remains confident that the demand for private healthcare will be        
sustained in SA, supported by a financially sound and growing medical scheme    
market. Netcare is hopeful that the positive approach by government, as         
outlined in the Strategic Plan announced by the Department of Health, will      
result in greater collaboration between the private and public sectors.         
In the UK, the recessionary environment is expected to continue to impact out-  
of-pocket spending on private healthcare. However, we expect this to be         
largely offset by growth in NHS activity through the purchasing of healthcare   
services by NHS Primary Care Trusts.                                            
Changes in directorate                                                          
Vaughan Firman was appointed Chief Financial Officer of the Netcare Group and   
Financial Director of Netcare Limited with effect from 12 February 2009,        
following the resignation of Peter Nelson on 5 December 2008.                   
Declaration of capital reduction number 20                                      
In accordance with the authority given to the directors by way of an ordinary   
resolution passed on 30 January 2009, the board of directors declared on 14     
May 2009 an interim capital reduction (number 20) out of share premium of 16    
cents per ordinary share (2008:14 cents), payable on 27 July 2009, to           
shareholders recorded in the register of the Company as at 24 July 2009.        
In compliance with the requirements of Strate, the following dates are          
applicable:                                                                     
Last date to trade "cum"                                                        
the capital reduction ("LDT")                     Friday, 17 July 2009          
Date trading commences "ex"                                                     
the capital reduction                             Monday, 20 July 2009          
Record date                                       Friday, 24 July 2009          
Date of payment                                   Monday, 27 July 2009          
Share certificates may not be dematerialised nor rematerialised                 
between Monday, 20 July 2009 and Friday, 24 July 2009, both dates inclusive.    
On behalf of the board                                                          
Jerry Vilakazi                                                                  
Chairman                                                                        
Dr Richard Friedland                                                            
Chief Executive Officer                                                         
Vaughan Firman                                                                  
Chief Financial Officer                                                         
Sandton                                                                         
15 May 2009                                                                     
Group balance sheet                                                             
Rm                           Note    Unaudited     Unaudited      Audited       
                                  31 March      31 March       30 September     
2009          2008           2008             
ASSETS                                                                          
Non-current assets                                                              
Property, plant and                  27 818        32 291         29 732        
equipment                                                                       
Goodwill                             16 271        18 800         17 555        
Intangible assets                    397           319            355           
Associated companies and     4       90            125            104           
loans                                                                           
Financial asset - Derivative                       973            558           
financial instruments                                                           
Deferred taxation                    638           517            689           
Total non-current assets             45 214        53 025         48 993        
Current assets                                                                  
Loans and receivables        4       67            91             75            
Inventories                          643           668            638           
Trade and other receivables          3 963         3 774          3 274         
Cash and cash equivalents            618           960            1 202         
                                    5 291         5 493          5 189          
Assets held for sale         5       4             617            304           
Total current assets                 5 295         6 110          5 493         
Total assets                         50 509        59 135         54 486        
EQUITY AND LIABILITIES                                                          
Capital and reserves                                                            
Ordinary share capital and           1 240         1 776          1 601         
premium                                                                         
Treasury shares                      (767)         (5 561)        (5 555)       
Option premium on                    175           172            172           
convertible bond                                                                
Other reserves                       (98)          1 914          1 685         
Retained earnings                    2 982         6 153          6 590         
Ordinary shareholders`               3 532         4 454          4 493         
equity                                                                          
Preference share capital and         644           644            644           
premium                                                                         
Minority interest                    2 070         3 690          3 714         
Total shareholders` equity           6 246         8 788          8 851         
Non-current liabilities                                                         
Long-term debt                       29 056        34 923         31 530        
Financial liability -                3 914         1 459          1 654         
Derivative financial                                                            
instruments                                                                     
Post-retirement benefit              132           123            126           
obligations                                                                     
Deferred lease liability             98            73             91            
Deferred taxation                    5 866         7 096          6 463         
Total non-current                    39 066        43 674         39 864        
liabilities                                                                     
Current liabilities                                                             
Trade and other payables             2 982         3 094          3 161         
Short-term debt                      1 871         2 494          2 021         
Taxation payable                     292           477            268           
Bank overdrafts                      52            377            240           
                                    5 197         6 442          5 690          
Liabilities in disposal      5                     231            81            
group held for sale                                                             
Total current liabilities            5 197         6 673          5 771         
Total equity and liabilities         50 509        59 135         54 486        
Group income statement                                                          
                                   Unaudited           Audited                  
six months ended    year ended                 
Rm                           Note   31 March  31 March   %        30 September  
                                 2009      2008       change   2008             
CONTINUING OPERATIONS                                                           
Revenue                             11 619    10 343     12,3     21 735        
Cost of sales                       (6 833)   (6 067)             (12 842)      
Gross profit                        4 786     4 276               8 893         
Other income                        111       127                 256           
Administrative and other            (3 075)   (2 819)    (9,1)    (5 779)       
expenses                                                                        
Operating profit             6      1 822     1 584      15,0     3 370         
Financial income             7      66        250                 279           
Financial expenses           8      (1 318)   (1 435)             (2 706)       
Attributable                        10        (3)                 2             
earnings/(losses) of                                                            
associates                                                                      
Profit before taxation              580       396        46,5     945           
Taxation                            (142)     (85)                (68)          
Profit for the period from          438       311        40,8     877           
continuing operations                                                           
DISCONTINUED OPERATION                                                          
Profit for the period from   5      634       50                  105           
discontinued operation                                                          
Profit for the period               1 072     361        197,0    982           
Attributable to:                                                                
Ordinary shareholders               1 002     319                 801           
Preference shareholders             37        32                  67            
Profit attributable to              1 039     351                 868           
shareholders                                                                    
Minority interest                   33        10                  114           
                                   1 072     361                 982            
Earnings per share (cents)                                                      
Basic                               79,4      25,3       213,8    63,5          
?Continuing operations              29,2      21,3       37,1     55,2          
?Discontinued operation             50,2      4,0                 8,3           
Diluted                             79,3      24,7       221,1    62,6          
?Continuing operations              29,1      20,8       39,9     54,4          
?Discontinued operation             50,2      3,9                 8,2           
Capital reduction per share         16,0      14,0       14,3     32,0          
(cents)                                                                         
Group cash flow statement                                                       
                                       Unaudited              Audited           
                                      six months ended       year ended         
Rm                                      31 March    31 March    30 September    
2009        2008        2008              
Cash flows from operating activities                                            
Cash received from customers             10 976      9 871       21 099         
Cash paid to suppliers and employees     (9 188)     (8 292)     (16 436)       
Cash generated from operations           1 788       1 579       4 663          
Interest paid                            (1 321)     (1 234)     (2 558)        
?Continuing operations                   (1 316)     (1 231)     (2 550)        
?Discontinued operation                  (5)         (3)         (8)            
Taxation paid                            (247)       (115)       (290)          
?Continuing operations                   (241)       (115)       (268)          
?Discontinued operation                  (6)                     (22)           
Ordinary dividends paid                  (3)                                    
Preference dividends paid                (37)        (32)        (67)           
Capital reductions paid                  (227)       (227)       (407)          
Net cash from operating activities       (47)        (29)        1 341          
?Continuing operations                   (44)        (59)        1 352          
?Discontinued operations                 (3)         30          (11)           
Cash flows from investing activities                                            
Purchase of property, plant and          (592)       (606)       (1 268)        
equipment                                                                       
?Continuing operations                   (581)       (591)       (1 240)        
?Discontinued operations                 (11)        (15)        (28)           
Proceeds on disposal of property, plant  5           236         708            
and equipment                                                                   
Additions to financial assets                        (49)                       
Additions to intangible assets           (53)        (6)         (148)          
Decrease/(increase) in investments and   30          (9)         128            
loans                                                                           
Proceeds from disposal of subsidiaries,  852         2           15             
net of cash                                                                     
Interest received                        65          64          134            
Realised gain on cross-currency swap                             324            
Dividends received                       1           39          44             
Acquisition of subsidiaries and          (9)         (2 084)     (2 112)        
businesses, net of cash acquired                                                
Net cash from investing activities       299         (2 413)     (2 175)        
?Continuing operations                   307         (2 398)     (2 147)        
?Discontinued operations                 (8)         (15)        (28)           
Cash flows from financing activities                                            
Proceeds from issue of ordinary shares   3           14          48             
Repurchase of shares                     (3)                                    
Long-term liabilities (repaid)/raised    (532)       1 802       974            
Short-term liabilities (repaid)/raised   (95)        235         (133)          
Net cash from financing activities       (627)       2 051       889            
?Continuing operations                   (623)       2 040       899            
?Discontinued operations                 (4)         11                         
Net (decrease)/increase in cash and      (375)       (391)       55             
cash equivalents                                                                
Translation effects on cash and cash     (21)        75          (32)           
equivalents of foreign entities                                                 
Cash and cash equivalents at beginning   962         900         900            
of the period                                                                   
Cash flows in disposal group held for                (1)         39             
sale                                                                            
Cash and cash equivalents at end of      566         583         962            
period                                                                          
Group statement of recognised income and expense                                
                                       Unaudited              Audited           
                                      six months ended       year ended         
Rm                                      31 March    31 March    30 September    
2009        2008        2008              
Effect of translation of foreign         (116)       1 031       130            
entities                                                                        
Fair value gains on investments                      86          93             
Effect of cash flow hedge accounting     (1 706)     (1 207)     (427)          
Dividends paid                           (3)                                    
Actuarial losses on defined benefit                              (24)           
plans                                                                           
Movement in contingency reserve                                  (9)            
Acquisition of shares in subsidiary                  5                          
Movement in employee share trust                                 30             
reserve                                                                         
Other reserve movements                              (3)         (20)           
Net loss recognised directly in equity   (1 825)     (88)        (227)          
Profit for the period                    1 072       361         982            
Total recognised (loss)/income for the   (753)       273         755            
period                                                                          
Attributable to:                                                                
Ordinary shareholders                    854         357         780            
Preference shareholders                  37          32          67             
Minority interest                        (1 644)     (116)       (92)           
                                        (753)       273         755             
Headline earnings                                                               
                                 Unaudited            Audited                   
six months ended     year ended                 
Rm                                31 March   31 March   %change  30 September   
                                2009       2008               2008              
Reconciliation of headline                                                      
earnings                                                                        
Profit for the period from         438       311         40,8     877           
continuing operations                                                           
Less:                                                                           
Preference shareholders            (37)       (32)                (67)          
Minority interest                  (33)       (10)                (114)         
Earnings used in the calculation   368        269        36,8     696           
of basic earnings per share from                                                
continuing operations                                                           
Adjusted for:                                                                   
Impairment of goodwill                                            1             
Impairment of investments                                         1             
Impairment of land and buildings   10        1                    1             
Reversal of impairment of                                         (17)          
property, plant and equipment                                                   
Profit on disposal of property,    (4)        (21)                (28)          
plant and equipment                                                             
(Profit)/loss on disposal of                  (3)                 2             
subsidiaries/investments                                                        
Tax effect of headline adjusting   1          3                   6             
items                                                                           
Minority share of headline                                        10            
adjusting items                                                                 
Headline earnings from continuing  375        249                 672           
operations                                                                      
Earnings from discontinued         634       50                   105           
operation                                                                       
Adjusted for:                                                                   
Profit on disposal of property,               (1)                 (2)           
plant and equipment                                                             
Profit on disposal of              (678)                                        
discontinued operation                                                          
Tax effect of headline adjusting   90                                           
items                                                                           
Headline earnings from             46         49                  103           
discontinued operations                                                         
Headline earnings                  421        298        41,3     775           
Headline earnings per share                                                     
(cents)                                                                         
Basic                             33,3       23,7        40,5    61,5           
?Continuing operations            29,7       19,8        50,0    53,3           
?Discontinued operation           3,6        3,9         (7,7)   8,2            
Diluted                           33,3       23,1        44,2    60,5           
?Continuing operations            29,7       19,3        53,9    52,5           
?Discontinued operation           3,6        3,8         (5,3)   8,0            
                                                                                
Notes                                                                           
1.  Basis of preparation and accounting policies                                
The interim financial information for the six months ended 31 March          
  2009 has been prepared in accordance with International Financial             
  Reporting Standards (IFRS) and are in compliance with IAS34 Interim           
  Financial Reporting, the Listings Requirements of the JSE Limited and         
the South African Companies Act, 1973, as amended.                            
  The accounting policies applied are consistent with those applied for         
  the year ended 30 September 2008.                                             
2.  Acquisition of businesses                                                   
The following business combinations took effect during the period:           
   2.1   Effective 1 October 2008, the Group acquired 50% of the shares in      
        The Thornbury Radiosurgery Centre Limited in the United Kingdom.        
   2.2   With effect from 17 October 2008, the Group acquired 100% of the       
shares in City Medical Limited in the United Kingdom.                   
   2.3   On 31 October 2008, the Group acquired 100% of the business,           
        excluding certain assets, of Woodlands Hospital in the United           
       Kingdom for a nominal consideration. A lease agreement was entered       
into with the seller for the rental of the premises and use of the       
       excluded assets.                                                         
         From the dates of acquisition to 31 March 2009, the following          
       amounts have been included in the Group`s income statement:              
Rm                  Woodlands   City        The                         
                         Hospital    Medical     Thornbury                      
                                    Limited     Radiosurgery                    
                                               Centre                           
Limited                          
        Revenue             40          3           4              47           
        Operating profit    2                       1              3            
        The following table reflects the fair values at acquisition:            
Rm                                        City Medical   The            
                                               Limited        Thornbury         
                                                             Radiosurgery       
                                                             Centre             
Limited            
        Property, plant and equipment                            15             
        Trade and other receivables               1                             
        Cash and cash equivalents                 1              4              
Long-term debt                                           (15)           
        Trade and other payables including short- (5)                           
      term debt                                                                 
        Fair value of net assets acquired         (3)            4              
Goodwill                                  10             3              
        Purchase consideration                    7              7              
        Cash and cash equivalents in acquiree     (1)            (4)            
        Cash outflow on acquisition               6              3              
The fair values reflected above are equal to the carrying values        
      at acquisition.                                                           
3. Reclassification of comparative information                                  
  In line with the treatment at 30 September 2008, the option on                
convertible bond has been separately disclosed on the face of the              
 balance sheet.                                                                 
 In addition, the following reclassifications to the 30 September 2008          
 balance sheet have been made:                                                  
Rm                            As previously   Adjustments     As              
                               reported                       reclassified      
  Assets                                                                        
  Deferred taxation              907             (218)           689            
Trade and other receivables    3 500           (226)           3 274          
  Liabilities                                                                   
  Deferred taxation              6 681           (218)           6 463          
  Trade and other payables       3 387           (226)           3 161          

Rm                                      Unaudited   Unaudited    Audited        
                                       31 March    31 March     30 September    
                                      2009        2008         2008             
4. Associated companies and loans                                               
  Non-current                                                                   
  Associated companies*                  70          117          89            
  Other loans and receivables            20          8            15            
90          125          104          
  Current                                                                       
  Loans and receivables                  67          91           75            
                                          157         216          179          
*Directors` valuation of associated    292         181          282           
 companies                                                                      
5. Disposal group and assets held for                                           
 sale                                                                           
Assets                                                                        
  Assets in disposal group - Ampath                  326          295           
 Holdings Trust                                                                 
  Asset held for sale - Gerrards Cross               291                        
Hospital                                                                       
  Land and buildings held for sale       4                        9             
                                          4           617          304          
  Liabilities                                                                   
Liabilities in disposal group -                    (72)         (81)          
 Ampath Holdings Trust                                                          
  Liabilities held for sale - Gerrards               (159)                      
 Cross Hospital                                                                 
(231)        (81)         
  5.1   Discontinued operation - Ampath                                         
      Holdings Trust                                                            
        Sale of our interest in Ampath                                          
Holdings Trust was completed in                                           
      February 2009, following                                                  
      Competition Commission                                                    
      approval. The sale of our units                                           
and claims amounted to R1 027                                             
      million.                                                                  
        Our 50% share of the                                                    
      discontinued operation was as                                             
follows:                                                                  
        Revenue                           267         263          563          
        Other income                                  2            2            
        Administrative and other          (198)       (192)        (426)        
expenses                                                                  
        Operating profit                  69          73           139          
        Financial expenses                (5)         (3)          (8)          
        Profit before taxation            64          70           131          
Taxation                          (18)        (20)         (26)         
        Profit for the period before      46          50           105          
      profit on disposal                                                        
        Profit on disposal of             588                                   
discontinued operation, net of                                            
      tax                                                                       
        Profit for the period from        634         50           105          
      discontinued operation                                                    
The profit on the sale of Ampath Holdings Trust can be reconciled       
      as follows:                                                               
        Rm                                                                      
        Sale of units and claims                                   1 027        
Less:                                                                   
        Carrying value                                            (349)         
        ?Claims settled                                            (174)        
        ?Net asset value                                           (175)        
Profit on disposal                                         678          
        Less: Capital gains tax                                    (90)         
        Profit on disposal of discontinued operation, net of    588             
      tax                                                                       
Rm                               Unaudited   Unaudited    Audited       
                                      31 March    31 March     30 September     
                                      2009        2008         2008             
        The assets and liabilities of                                           
the disposal group are as                                                 
      follows:                                                                  
        Property, plant and equipment                 56           71           
        Goodwill                                      72           72           
Investments and loans                         6            11           
        Inventories                                   10           10           
        Trade and other receivables                   127          116          
        Cash and cash equivalents                     55           15           
Long-term debt                                (4)          (8)          
        Post-retirement benefit                       (9)          (9)          
      obligation                                                                
        Trade and other payables                      (49)         (56)         
Taxation payable                              (3)          (4)          
        Short-term debt                               (7)          (4)          
        The cash flows are as follows:                                          
        Net cash from operating           (3)         30           (11)         
activities                                                                
        Net cash from investing           (8)         (15)         (28)         
      activities                                                                
        Net cash from financing           (4)         11                        
activities                                                                
   5.2  Asset held for sale - Gerrards                                          
      Cross Hospital                                                            
        Following discussions with the                                          
Office of Fair Trading,                                                   
      Gerrards Cross Hospital which                                             
      forms part of the Nuffield                                                
      Hospital Group in the United                                              
Kingdom was sold in April 2008                                            
      for R336 million (GBP23                                                   
      million).                                                                 
        The assets and liabilities of                                           
the hospital held for sale are                                            
      as follows:                                                               
        Property, plant and equipment                 267                       
        Inventories                                   5                         
Trade and other receivables                   19                        
        Trade and other payables                      (11)                      
        Financial liability -                         (2)                       
      Derivative financial                                                      
instruments                                                               
        Short-term debt                               (146)                     
Rm                                      Unaudited   Unaudited    Audited        
                                       31 March    31 March     30 September    
2009        2008         2008             
6.  Operating profit                                                            
   After charging:                                                              
   Depreciation and amortisation         652         602          1 244         
Operating lease charges               197         173          345           
7.  Financial income                                                            
   Dividends received                   1                         1             
   Fair value gain on cross-currency                 186          136           
swap contracts                                                                
   Fair value gain on interest rate                               8             
  swaps                                                                         
   Interest received                     65          64           134           
66          250          279           
8.  Financial expenses                                                          
   Foreign exchange losses (net)                     199          156           
   Fair value loss on interest rate      2           5                          
swaps                                                                         
   Interest paid                         1 316       1 231        2 550         
                                         1 318       1 435        2 706         
9.  Commitments                                                                 
Capital commitments                   951         814          753           
   ?South Africa                         401         353          258           
   ?United Kingdom                       550         461          495           
   Operating lease commitments           3 345       5 926        4 496         
?South Africa                         1 115       425          1 460         
   ?United Kingdom                       2 230       5 501        3 036         
10. Contingent liabilities                                                      
  (guarantees and suretyships)                                                  
South Africa                          601         104          253           
   United Kingdom                        109         129          118           
                                         710         233          371           
   The Group has guaranteed R410 million covering the obligations of            
pathologists to a banking institution following the sale of Ampath.           
Segment report                                                                  
                                 Unaudited                      Audited         
                                six months ended              year ended        
Rm                                31 March   31 March   %         30 September  
                                2009       2008       change    2008            
INCOME STATEMENT                                                                
Revenue                            11 619     10 343     12,3      21 735       
South Africa                       5 616      4 907      14,4      10 385       
?Hospitals and Emergency services  4 873      4 275      14,0      9 020        
?Primary care                      743        632        17,6      1 365        
United Kingdom                     6 003      5 436      10,4      11 350       
EBITDA                             2 474      2 186      13,2      4 614        
South Africa                       927        803        15,4      1 739        
?Hospitals and Emergency services  943        751        25,6      1 735        
?Primary care                      (16)       52         (130,8)   4            
United Kingdom                     1 549      1 368      13,2      2 885        
Capital items                      (2)        15                   (10)         
?South Africa                      (1)        17                   20           
?United Kingdom                    (1)        (2)                  (30)         
Operating profit                   1 822      1 584      15,0      3 370        
South Africa                       756        636        18,9      1 401        
?Hospitals and Emergency services  781        593        31,7      1 414        
?Primary care                      (25)       43         (158,1)   (13)         
United Kingdom                     1 068      933        14,5      1 979        
Capital items                      (2)        15                   (10)         
?South Africa                      (1)        17                   20           
?United Kingdom                    (1)        (2)                  (30)         
Net interest paid                  1 251      1 167      7,2       2 416        
?South Africa                      272        249        9,2       518          
?United Kingdom                    979       918         6,6       1 898        
BALANCE SHEET                                                                   
Total assets                       50 505     58 518     (13,7)    54 182       
?South Africa                      11 245     11 135     1,0       10 878       
?United Kingdom                    39 260     47 383     (17,1)    43 304       
Debt net of cash                   30 361     36 834     (17,6)    32 589       
?South Africa                      4 255      6 051      (29,7)    4 837        
?United Kingdom                    26 106     30 783     (15,2)    27 752       
CASH FLOW                                                                       
Cash generated from operations     1 788      1 579      13,2      4 663        
?South Africa                     778         422        84,4      1 974        
?United Kingdom                   1 010       1 157      (12,7)    2 689        
The segment report excludes the disposal group and assets held for sale,        
except for the cash flow.                                                       
Salient Features                                                                
                                         Unaudited            Audited           
                                        Six months ended     Year ended         
                                         31 March   31 March   30 September     
2009       2008       2008              
Share statistics                                                                
Ordinary shares                                                                 
Total shares in issue (million)            1 263      1 260      1 262          
Weighted average number of shares          1 262      1 260      1 261          
(million)                                                                       
Diluted weighted average number of shares  1 264      1 292      1 280          
(million)                                                                       
Market price per share (cents)             799        855        825            
Currency conversion guide (R:GBP)                                               
Closing exchange rate                      13,64     16,08       14,76          
Average exchange rate for the period       14,73     14,40       14,65          
Executive Directors: Dr RH Friedland (Chief Executive Officer), VE Firman       
(Chief Financial Officer), IM Davis, Dr VLJ Litlhakanyane                       
Non-executive Directors: SJ Vilakazi (Chairman), Dr APH Jammine, JM Kahn, MJ    
Kuscus, HR Levin, Adv KD Moroka SC, Dr AA Ngcaba, MI Sacks, N Weltman           
Company Secretary: J Wolpert                                                    
Registered Office: 76 Maude Street (corner West Street), Sandton 2196, Private  
Bag X34, Benmore 2010                                                           
Sponsors: Nedbank Capital, a division of Nedbank Limited. Registration number:  
1951/000009/06, 135 Rivonia Road, Sandown, 2196                                 
Investor relations: +27 11 301 0212;                                            
ir@netcare.co.za,www.netcareinvestor.co.za                                      
Our complete interim financial results are available at                         
www.netcareinvestor.co.za                                                       
Note regarding forward-looking statements: The company advises investors that   
any forward looking statements or projections made by the company, including    
those made in this announcement, are subject to risk and uncertainties that     
may cause actual results to differ materially from those projected.             
Factors that may affect the group`s operations are described under "Risk        
Factors" on the investor relations website www.netcareinvestor.co.za            
Johannesburg                                                                    
18 May 2009                                                                     
Sponsor - Nedbank Capital                                                       
Date: 18/05/2009 08:00:04 Produced by the JSE SENS Department.                  
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