for the year ended 31 March 2016 ended 31 March the year for ANNUAL REPORT ANNUAL AND FINANCIAL STATEMENTS MEDICLINIC ANNUAL REPORT AND FINANCIAL STATEMENTS 2016 CONTENTS 1 Report Profile STRATEGIC REPORT 2 Highlights 3 At a Glance 6 Chairman’s Statement 8 Chief Executive Officer’s Review 11 About the Al Noor Combination 12 Five-year Summary 13 Investment Case 14 Business Model 16 Market Overview 18 Our Strategy, Progress and Aims 22 Key Performance Indicators 24 Risk Management, Principal Risks and Uncertainties 30 Clinical Services Overview 34 Divisional Review - Southern Africa 38 Divisional Review - Switzerland This Annual Report is published as part of a set of reports, all of which are available on the Company’s website at 42 Divisional Review - UAE www.mediclinic.com. The icons next to each of the following reports are used as a cross-referencing tool to refer to the 46 Sustainable Development Highlights relevant pages of these reports or within this report. 55 Financial Review Annual Report and Financial Statements 2016 GOVERNANCE AND REMUNERATION AR 60 Board of Directors Clinical Services Report 2016 CSR 62 Senior Management Sustainable Development Report 2016 SDR 63 Chairman’s Introduction Notice of Annual General Meeting 2016 64 Corporate Governance Statement AGM 74 Remuneration Report These reports were approved by the Company’s Board on 25 May 2016 and will be available on the Company’s website 100 Nomination Committee Report from the date of distribution of the Company’s Notice of Annual General Meeting by no later than 21 June 2016. 104 Clinical Performance and Sustainability Committee Report 107 Audit and Risk Committee Report GLOSSARY Please refer to the glossary of terms used in this report on 116 Directors’ Report pages 223 to 224. AR 123 Directors’ Responsibility Statement FINANCIAL STATEMENTS The Annual Report, including the Strategic Report from pages 2 to 59, was approved by the Board on 25 May 2016. 125 Independent Auditors’ Report AR For and on behalf of the Board. 136 Group Financial Statements 210 Company Financial Statements SHAREHOLDER INFORMATION 221 Shareholder Information Edwin Hertzog 222 Company Information Non-executive Chairman 223 Glossary REPORT PROFILE SCOPE, BOUNDARY AND This Annual Report was prepared in accordance with the International Financial Reporting Standards, the REPORTING CYCLE LSE Listing Rules, the JSE Listings Requirements, This Annual Report and Financial Statements the UK Corporate Governance Code, as well as the of Mediclinic International plc (formerly Al Noor UK Companies Act, where relevant. The Company Hospitals Group plc) (“Mediclinic” or “the Company”) has applied the majority of the principles contained presents the economic, social and environmental in the UK Corporate Governance Code – all the performance, and the financial results of the principles which the Company did not apply Mediclinic Group for the reporting period ended are explained in the Corporate Governance 31 March 2016, and covers all operations in Southern Statement in this Annual Report. The Company Africa, Switzerland and the UAE. has also considered and applied many of the recommendations contained in the International Integrated Reporting Framework issued by the SIGNIFICANT EVENTS DURING International Integrated Reporting Committee REPORTING PERIOD in December 2013. The Company’s reporting on sustainable development included in the The successful completion of the Combination of Annual Report, supplemented by the Sustainable Mediclinic International Limited and Al Noor Hospitals Development Report available on the Company’s Group plc by way of a reverse takeover of Mediclinic website at www.mediclinic.com, was done in International Limited, resulting in the continued accordance with the GRI G4 Sustainability listing of the enlarged Company on the London Stock Reporting Guidelines. Exchange and the secondary listings of the Company on the Johannesburg Stock Exchange and the Namibian Stock Exchange. EXTERNAL AUDIT AND Other noteworthy developments during the reporting ASSURANCE period include: The Company’s annual financial statements and the Group’s consolidated annual financial statements Acquisition of a 29.9% interest in Spire Healthcare • were audited by the Group’s independent external plc, a UK-based private healthcare group. auditors, PricewaterhouseCoopers LLP, in • Restructure of the MP1 Investment Holdings accordance with International Standards of Proprietary Limited black economic empowerment Auditing (UK and Ireland). transaction, initially implemented in 2005. Various other voluntary external accreditation, certification and assurance initiatives are followed REPORTING PRINCIPLES in the Group, complementing the Group’s combined The contents included in the Annual Report assurance model, as reported on in the Risk are deemed to be useful and relevant to our Management section of the Annual Report. We stakeholders, with due regard to our stakeholders’ believe that this adds to the transparency and expectations through continuous engagement, reliability of information reported to our stakeholders. or that the Board believes may influence the perception or decision-making of our stakeholders. The information provided aims to provide our stakeholders with a good understanding of the financial, social, environmental and economic impacts of the Group to enable them to evaluate the ability of Mediclinic to create and sustain value for our stakeholders. MEDICLINIC ANNUAL REPORT 2016 1 STRATEGIC REPORT HIGHLIGHTS STRONG PATIENT GROWTH across all Solid financial performance with the operating platforms STABLE MARGINS and good cash generation CONTINUED INVESTMENTS in patient experience and clinical qualities REVENUE GROWTH of 7% with stable initiatives margins at 20.3% driving strong underlying earnings growth SUCCESSFUL COMPLETION of Mediclinic and Al Noor Combination Underlying BASIC EARNINGS AND ACQUISITION of 29.9% stake in PER SHARE INCREASED by 3% Spire Healthcare Group to 36.7 pence PROPOSED FINAL DIVIDEND per ordinary share of 5.24 pence REVENUE (£’m)* OPERATING PROFIT (£’m)* UNDERLYING EBITDA (£’m)** UNDERLYING EARNINGS (£’m)** * IFRS measure ** Non-IFRS measure AR See the reconciliations between the statutory and underlying (non-GAAP) measures on pages 55 and 56. 2 MEDICLINIC ANNUAL REPORT 2016 STRATEGIC REPORT AT A GLANCE WHO WE ARE Mediclinic is an international private healthcare group founded in 1983, with operations in South Africa, Namibia, Switzerland and the United Arab Emirates. Subsequent to the Combination of Mediclinic International Limited and Al Noor Hospitals Group plc in February 2015, the Company’s primary listing is on the London Stock Exchange, with secondary listings on the South African Stock Exchange and the Namibian Stock Exchange. The Group’s registered offi ce is based in London, United Kingdom. WHAT WE DO Mediclinic is focused on providing acute care, specialist-orientated, multi-disciplinary healthcare services. Our core purpose is to enhance the quality of life of our patients by providing comprehensive, high-quality healthcare services in such a way that the Group will be regarded as the most respected and trusted provider of healthcare services by patients, doctors and funders of healthcare in each of its markets. Following the Combination, the enlarged Mediclinic Group now boasts 73 hospitals and 45 clinics: Mediclinic Southern Africa operates 49 hospitals and two day clinics throughout South Africa and three hospitals in Namibia with more than 8 000 inpatient beds in total; Hirslanden operates 16 private acute care facilities and four clinics in Switzerland with more than 1 600 inpatient beds; and Mediclinic Middle East (including the Al Noor facilities) operates fi ve hospitals and 39 clinics with more than 700 inpatient beds in the United Arab Emirates. Mediclinic also holds a 29.9% interest in Spire Healthcare, a UK-based private healthcare group listed on the London Stock Exchange. OUR VISION To be respected internationally and preferred locally. DISTRIBUTION OF THE GROUP’S DISTRIBUTION OF THE GROUP’S DISTRIBUTION OF THE GROUP’S 73 HOSPITALS 10 415 BEDS 32 884 EMPLOYEES 7% 7% 71% 77% 51% 21% 16% 22% 28% CONTRIBUTION TO GROUP CONTRIBUTION TO GROUP CONTRIBUTION TO GROUP UNDERLYING REVENUE (£’m) UNDERLYING EBITDA (£’m) UNDERLYING EARNINGS (£’m) TOTAL: £2 100m TOTAL: £428m TOTAL: £219m -4% 31% 3% 16% 16% 26% 29% 32% 53% 52% 46% Southern Africa Switzerland UAE UK Corporate MEDICLINIC ANNUAL REPORT 2016 3 HOLDING COMPANY: MEDICLINIC INTERNATIONAL PLC (formerly Al Noor Hospitals Group plc) OPERATING PLATFORMS MEDICLINIC MEDICLINIC HIRSLANDEN SOUTHERN AFRICA MIDDLE EAST COUNTRY OF South Africa and Namibia Switzerland United Arab Emirates OPERATION BRANDS BUSINESS www.mediclinic.co.za www.hirslanden.ch www.mediclinic.ae WEBSITES www.mhr.co.za www.alnoorhospital.com www.medicalinnovations.co.za www.er24.co.za HOSPITALS Operates 49 acute care private Operates 16 acute care private Mediclinic Middle East operates AND hospitals and two day clinics hospitals with 1 677 beds and two acute care private CLINICS IN throughout South Africa and four clinics in Switzerland. hospitals and eight clinics in OPERATION three hospitals in Namibia, with Dubai, UAE and two clinics in 8 017 beds in total. ER24 offers Abu Dhabi, UAE, with 371 beds emergency transportation services in total. from their 49 branches throughout Al Noor operates three acute South Africa. care private hospitals and 29 clinics, mainly in Abu Dhabi,