CIEL HEALTHCARE BUSINESS MODEL INPUT VALUE WE DRAW FROM FINANCIAL CAPITAL Recognised and solid shareholders facilitating expansion International Finance Corporation ( IFC ), Proparco, Investment Funds for Health in Africa II, The Kibo Fund II SOCIAL & RELATIONSHIP CAPITAL Strategic partnerships with Fortis, IFC, Investment Funds for Health in Africa, etc. Two Health Membership Organisations Our Value Proposition A unique investment portfolio of prime hospitals and Health Membership Organisations in the Indian Ocean and Strategic investors and a solid shareholders base International and experienced partner bringing world-class standards and processes to reinforce operations Synergies across our network HUMAN CAPITAL Over 2,700 medical and non-medical staff INTELLECTUAL CAPITAL Medical expertise in over 40 specialties WHO WE ARE Investors in & operators of private healthcare facilities in VISION Create an integrated network of private healthcare service provision in 72 MANUFACTURED CAPITAL Strategically located prime facilities - 497 operational beds, 35 clinics, and several laboratories NATURAL CAPITAL Energy, water 35 clinics 3 countries 6 Hospitals 1 Lab 2 Health Membership Organisations Our Network
MAIN OUTPUT DURING THE YEAR FINANCIAL CAPITAL Revenue: MUR 1,730M Profit after tax: MUR (194M) Early repayment of the US$ loan for Hygeia investment given depreciation of USD SOCIAL & RELATIONSHIP CAPITAL Implementation of Fortis Operating Systems ( FOS ) and Medical Operating Systems ( MOS ) scorecards Over 13,000 surgeries performed c. 320k lives covered Hygeia Health membership organisation awarded best Health Membership Organisation and Lagoon Hospitals voted Private Healthcare Provider of the Year in Nigeria HUMAN CAPITAL Key Management hires at operational level Employee engagement surveys conducted/in process at Fortis Clinique Darné, Wellkin Hospital and International Hospital Kampala INTELLECTUAL CAPITAL New Wellkin Hospital brand launched Process of re-accreditation of International Hospital Kampala and Lagoon Hospitals, for Cohsasa and Joint Commission International underway MANUFACTURED CAPITAL Acquisition of state-of-the-art healthcare facility (Wellkin Hospital) and Gold Cross Hospital in Nigeria 7 high-end medical equipment purchased NATURAL CAPITAL Emissions/energy consumption, wastewater, solid medical waste MAIN OUTCOMES DURING THE YEAR Consolidation of leadership position in Mauritius with acquisition of state-of-the-art hospital Expanded network with new facilities i.e. acquisition of 35 bedded-hospital in Nigeria and new clinics in Uganda Introduction of new medical services Focus on patient centric initiatives TARGETS Achieving operational excellence across our facilities Performance Stablisation Turnaround of Wellkin Hospital Improve patient experience across our facilities Improve employee engagement scores Develop Mauritius as a regional healthcare hub to attract medical tourism Stronger brand equity 73 ABOUT CIEL STRATEGY & PERFORMANCE PORTFOLIO REVIEW RISK MANAGEMENT SUSTAINABILITY CORPORATE GOVERNANCE FACTS AND FIGURES
Progress Report Last Year s Priorities Progress Report Strengthening of operational excellence across all investments Progress made in terms of better financial management; Further efforts needed in terms of operational excellence. Acquiring talent to strengthen top management Key Management hires at operational level at International Medical Group, Hygeia Nigeria Limited and Wellkin Hospital Stronger Governance with the appointment of Hélène Echevin as Chairperson of CIEL Healthcare Limited and The Medical and Surgical Centre Limited ( MSCL ) and with the appointment of Roger Hogarth as Chairman of CIEL Healthcare Africa (the management company of CIEL Healthcare) Introduction of new specialties in Mauritius Acquisition of Wellkin Hospital (Ex-Apollo Bramwell Hospital) reinforcing our service offering Various measures taken to improve patient experience Further cluster-wide implementation of patient-centric initiatives Implementation of Fortis Operating Systems ( FOS ) and Medical Operating Systems ( MOS ) to track clinical outcomes and Service Quality System. Implementation of a performance optimisation plan for Hygeia Plan implemented; however, given the persistent challenging macro-economic situation in Nigeria, close performance monitoring is required together with additional support to the team on the ground. 74
2017 Financial Performance Income Statement MUR M MUR M MUR M The Healthcare cluster s results include the newly acquired (January 2017) Wellkin Hospital ( Wellkin ) and, therefore, cannot be compared directly with last year s results. The 40% year-on-year increase in revenue can be primarily attributed to the consolidation of Wellkin in The Medical and Surgical Centre Limited s ( MSCL ) figures and to a higher contribution from the cluster s Ugandan operations. The drop in the profitability reflects the recently acquired Wellkin and a MUR 138M impairment of an associated undertaking, Hygeia Nigeria Limited ( HNL ), due to the significant depreciation of the Nigerian Naira. Management has started to deploy a turnaround plan to drive sustainable operational efficiencies at Wellkin while enhancing optimal synergies between Fortis Clinique Darné 2017 2016 Var Revenue 1,730 1,224 506 EBITDA 134 174 (40) Non-Recurring Items (175) (30) (145) Profit after Tax (194) 69 (263) Profit attributable (98) 35 (133) ( FCD ) and Wellkin. MSCL remains entirely focused on clinical excellence as the group nurtures a strong patient-centric culture. Despite the stable performance of hospitals and clinics, the International Medical Group ( IMG ) has been impacted by the lower performance of its Health Membership Organisation ( HMO ) - a wholly owned subsidiary. The operations of HNL have slowly started picking up as the economy improves though the depreciation of the Naira remains a challenge. A performance optimisation plan has been put in place during the year and HNL is working on the integration of the newly acquired Gold Cross Hospital. 75 ABOUT CIEL STRATEGY & PERFORMANCE PORTFOLIO REVIEW RISK MANAGEMENT SUSTAINABILITY CORPORATE GOVERNANCE FACTS AND FIGURES
Focus Areas for 2018 Develop operational efficiencies, reducing expenses at all operations Develop synergies between Fortis Clinique Darné and Wellkin Hospital in Mauritius Optimise reporting system for timely and effective information Implement proper internal controls and procedures Focus on talent management and team strengthening Nurture strong patient-centric culture for improved patient experience Nurture confidence in our facilities Welcome new doctors and specialities Increase focus on quality Consolidate investments in Nigeria and Uganda Stabilise existing operations Grow Hygeia business with Gold Cross Hospital Outlook Current Market Dynamics Growing private healthcare market in Limited number/fragmentation of healthcare operators Significant interest from investors Macro-economic instability in certain African countries Talent shortage Performance improvement in our n operations: Stabilisation of the Nigerian economy Improved management in Nigeria and Uganda Improved reporting Transition year for The Medical and Surgical Center Limited following acquisition of Wellkin Hospital, which will have an overall impact on performance. 76
77 ABOUT CIEL STRATEGY & PERFORMANCE PORTFOLIO REVIEW RISK MANAGEMENT SUSTAINABILITY CORPORATE GOVERNANCE FACTS AND FIGURES