Netcare Ltd Unsp/Adr

Good morning, ladies and gentlemen, and a very warm welcome to NetCare Limited's interim group results presentation for the six months ended the 31st of March, 2025. May I also welcome our chair of NetCare, Alex Medici, members of the NetCare board, our EXCO, and our senior management teams. As always, let me express my very sincere thanks to our management teams and NetCare staff across all of our divisions for their hard work, collective efforts and commitment over the past six months. And also thanks to our board members for their support and guidance. I'm going to begin with an overview of our group results and the operational performance of our various divisions before handing over to our Chief Financial Officer, Keith Norman Gibson, who will unpack our financial results in more detail. I will then conclude by providing more detail on the progress we have made on certain key strategic areas and present our guidance for the remainder of the year. Now, just a quick reminder of the extensive and growing array of facilities and services we provide within the NetCare ecosystem across 10 unique divisions. Looking at our overall results, despite a very challenging macroeconomic, regulatory and competitive environment, The past six months for NetCare has been characterized by a strong, consistent operational and financial performance, continued operating leverage supported by efficiencies, digitization benefits, and lower strategic costs, maintenance of a strong statement of financial position, and further improvement in the ROIC to 11.9%, The return of 984 million to shareholders through ordinary dividends and share buybacks, which is over 60% more than the 613 million distributed in the same period last year. Phases two and three of our strategy are gaining momentum, leveraging off the solid foundation set in phase one. We're now generating over 50 gigabytes of clinical data daily as we continue to build up our capability in data analysis and predictive analytics. The second phase of our environmental strategy is firmly on track to achieve our 2030 targets. We remain firmly committed as Netcare to transforming our company and making a positive contribution to our society. We are a level three triple BEE accredited company and if we were permitted to train the number of nurses we have trained historically, we would comfortably achieve a level one rating. We remain the largest employee of disabled people in the healthcare sector and listed entities that employ more than 10,000 people. This solid operational and financial performance translates into the improvement in our key financial metrics. Revenue rose 5.3% to 12.7 billion, and we achieved very good operating leverage as evidenced by the 8.3% increase in EBITDA to 2.3 billion rands. The EBITDA margin improved 50 basis points to 18.5%. Adjusted headline earnings per share rose by 20% to 58.8 cents. Our net debt to EBITDA ratio strengthened from 1.3 times in the comparative period to 1.2 times, even after returning over 980 million to shareholders in ordinary dividends and share buybacks. And as a result of all of this, We're pleased to declare an interim dividend of 36 cents per share, representing 61.2% of adjusted headline earnings per share. Let's unpack now the operational performance of our respective divisions in more detail. And focusing on our hospital and emergency services segment, we experienced steady growth in acute patient days, aided by sector seasonality with the Easter holidays falling in April 2025. Total patient days for the first half of 2025 increased by 1.1%, which comprises a 1.4% increase in patient days across our acute hospitals and a 1.3% decline in mental health. Demand, however, for mental health services remains robust. However, the temporary unavailability of beds at certain high-occupancy sites for essential refurbishment work constrained capacity. This work completes in August of this year. Average acute hospital occupancies improved to 63.1% from 62.1% in the comparative period. Mental health occupancies declined slightly for the six months to 68.2%, from 69.3%. Importantly, paid patient days and occupancy metrics in half one of 2025 have been normalized to exclude NetCare Pretoria East Hospital, which was impacted by a fire in December 2024. In terms of the financial performance of this division, revenue grew by 5.5% to 12.3 billion, and we achieved excellent operational leverage, resulting in an EBITDA growth of 8.1% to 2.3 billion. Operating profit rose by 10.2% to 1.6 billion. Unpacking the elements that impacted revenue, the average price increase aligned to CPI Acute revenue per patient day increased by 4.1%, impacted by data-driven clinical efficiencies which were passed on to medical schemes, and higher volume growth from lower cost network options. Lower revenue medical cases are growing at a faster pace than surgical cases. However, surgical cases still contribute more than 70% of revenue. and acute length of stay decreased to 4.4 days, driven by an increase in less severe medical admissions. EBITDA margin improved by 50 basis points to 18.4%, and margin accretion was underpinned by stringent cost management, digital efficiencies, and lower strategic costs. Pleasingly, NetCare was the preferred choice for a net 64 new specialists to whom we granted admitting privileges over this period. NetCare was chosen primarily due to our fully integrated digitized ecosystem, our cutting edge equipment, our focus on centers of excellence, including four level one accredited trauma facilities. Turning now to our primary care division, revenue remained flat at 337 million compared to the same period last year. Same-store medical and dental patient visits declined by 0.9% as financially constrained consumers elected to self-medicate before visiting their GPs. Despite this top-line pressure, EBITDA increased by 14.1% to 81 million from 71 million in the comparative period, and the EBITDA margin improved by 290 basis points to 24% from 21.1% in H1 of 2024, largely due to cost control. I will now hand over to Keith to unpack our financial performance in more detail.

Thank you, Richard, and good morning, ladies and gentlemen. It's my pleasure to talk you through NetCare's financial performance for the six months ended 31 March 2025. Total paid patient days for H1 2025 grew by 1.1%, reflecting resilient demand for private healthcare services in a tough economic climate, with the mismatched timing of the Easter school holidays working in our favor this year. The business was able to expand its EBITDA margins, keeping a tight rein on costs, aided by digitization benefits and lower strategic costs. NetCare's state into financial position remains strong, and its return on invested capital, or ROIC, improved by 100 basis points since March 2024 to 11.9%. And in line with our capital allocation practices, we continued our share buyback program, which commenced in September 2023. And to date, we've invested over 1.6 billion rands to repurchase 130.7 million shares in the market, which represents 9.1% of the total ordinary shares in issue at the end of September 2023 when the program commenced. This next slide illustrates the consistent track record of the business in delivering meaningful operating leverage while maintaining a conservative level of gearing. And notwithstanding the constrained and competitive operating environment, the graph reveals that the business has converted a 5.3% growth in revenue into 8.3% EBITDA growth and 10.7% growth in operating profit, which is approximately two times operating leverage. And the last graph on the bottom right reflects the group's net debt of 5.6 billion rands at 31 March 2025. And even after funding the substantial share buybacks of the past 18 months, the group's gearing levels, as measured by the net debt to EBITDA metric, remain conservative at 1.2 times, which has been relatively consistent since emerging from the COVID-19 pandemic. And this brings us to the group statement of profit or loss for the six months ended 31 March 2025. And to aid comparability, the numbers reflected in the slide exclude the impact of exceptional items unless otherwise indicated. Beginning with revenue, revenue for the period amounted to 12.7 billion rands compared to 12 billion rands in the prior period, growing by 5.3%. EBITDA for H1 2025 grew by 8.3% to 2.3 billion rands against just under 2.2 billion rands in the first half of 2024, with EBITDA margin improving by 50 basis points to 18.5%. Strategic costs for the first half of 2025 amounted to 31 million rands, reducing notably from the prior period's 87 million rands. The lower incidence of load shedding in the current period required less use of generators and consequently expenditure on diesel reduced. However, as communicated in our November 2024 results release, this benefits has been largely offset by the substantial increase in electricity tariffs. Operating profits increased by 10.7% to almost 1.7 billion rands compared to 1.5 billion rands in H1 2024. Other net financial expenses of R270 million were marginally higher than the prior period's R267 million. The IFRS 16 interest charge attributable to lease liabilities of R269 million has increased from R251 million in the prior period. Earnings from associates and joint ventures showed pleasing improvement to R30 million, largely driven by an improved contribution from national renal care who experienced strong growth in their renal dialysis services. Profit before tax increased by 15.4 percent to 1,154 million rands, and the group's tax charge amounted to 328 million rands at an effective rate of 28.4 percent, which is in line with the prior period. Profit after tax before exceptional items amounted to 826 million rands, representing a 15.4% improvement from the 716 million rands in the comparative period. There were no exceptional items in the current period. However, in the prior period, exceptional items comprised property impairments of 11 million rands with an offsetting 3 million rand tax impact. And profit for the period inclusive of exceptional items amounted to 826 million rands, being 16.7% higher than the prior period's profit of 708 million rands. Next, we move on to headline earnings per share. And as can be seen on the table on the top left-hand side of the slide, HEPs amounted to 59.1 cents for the half year, which is a 20.9% improvement on the 48.9 cents reported in H1 2024. Adjusted HEPs, which is the primary measure used by management to assess performance and strips out exceptional and unsustainable items, amounted to 58.8 cents for H1 2025, increasing by 20% from the prior period's 49 cents. And the Board is resolved to pay an interim dividend of 36 cents per share, equating to 61.2% of adjusted HEPs. In addition, we continued with our share buyback program, which commenced in September 2023, and the details of this are set out in the table on the top right-hand side of the slide. During the current reporting period, 35.6 million shares were acquired at an average price of 13 rand 20 per share, utilizing 473 million rands. And since the half-year end, we've repurchased a further 10.3 million shares at an average price of R12.75 per share, utilizing a further R132 million. And therefore, collectively, since the commencement of the share buyback program, the group has repurchased 137 million shares on the market for just over R1.6 billion, equating to an average price of R12.56 per share. Lastly, turning to the table in the bottom right section, we see that between the 2024 final dividend and the shares bought back in H1 of 2025, R984 million was returned to ordinary shareholders in the current reporting period. If we add the R444 million in respect of the 2025 interim dividend, that is to be paid on the 14th of July 2025, and the further 132 million rands of share buyback since the half year end, a grand total of almost 1.6 billion rands will have been returned to shareholders. Moving on to the group statement to financial position. We remain aligned to our capital structure policy of maintaining a strong statement of financial position and retaining an investment grade credit rating while reducing the cost of capital with a safe level of debt. As at 31 March 2025, total assets amounted to just short of 27.8 billion rands, decreasing from 28.4 billion rands at September 2024. CapEx spend during the six months amounted to R434 million, of which R54 million relates to expansionary projects, and the balance of R380 million relates to replacement CapEx. Total shareholders' equity decreased to R10.8 billion from just under R11 billion at September 2024, with the benefits of an improved operating performance being offset by ordinary dividend distributions and share buybacks. of 984 million rands during the period. And finally, since March 2024, the group has experienced an increase of 100 basis points in its ROIC to 11.9%. Next, let's review the group's debt position. Gross debt amounted to 6.9 billion rands at 31 March 2025, offset by cash balances of 1.3 billion rands. Therefore, net debt totaled 5.6 billion rands at the half-year end, increasing by 320 million rands from September 2024, remembering that 984 million rand was outlaid in the current period in ordinary dividends and share buybacks, along with capex of 434 million rands. Net debt to annualized EBITDA remained at a comfortable 1.2 times coverage at March 2025, in line with September 2024, and slightly stronger than the 1.3 times at March 2024. This metric is calculated in EBITDA measured after the adoption of IFRS 16 against bank debt only. Inclusive of lease liabilities recognized under IFRS 16, net debt to EBITDA coverage is 2.3 times, improving from 2.4 times at September 2024. In line with our policy, we retained our credit rating of AA minus for long-term and A1 plus for short-term, as published by GCR in February 2025. The cost of debt at 8.8%, reduced by 30 basis points from 9.1% at September 2024. And if we compare this to the position a year ago at March 2024, the cost of debt has decreased by 60 basis points. Currently, approximately 26% of the group's debt is at fixed interest rates, which is achieved with the aid of interest rate swaps. And the business continues to generate strong cash flows, which is aided by disciplined working capital management. Moving on to our debt facilities, at the half year end, NetCare had cash balances of 1.3 billion rands on hand, and we also had committed but undrawn debt facilities of around 1.1 billion rands. And this therefore gives the group access to collective resources of 2.3 billion rands of cash on hand and committed debt facilities from which to fund our future needs. The debt tenure, as set out on the right-hand side, reflects a manageable and appropriately staggered maturity profile, noting that there are minimal maturities in age two of 2025. And the group, therefore, has sufficient capacity to manage its future operating and capital requirements. And finally, I'd just like to squeeze in a brief word of recognition and appreciation to our finance staff for their efforts and their assistance in compiling the results and the related material. And I'll now hand back to Richard, who will update you on the progress of our key strategic projects and our guidance for the remainder of the 2025 financial year.

Thank you, Keith. Let's now take a closer look at the progress made across some of our key strategic initiatives. And in this section, I'll give a brief recap of our strategy and focus on progress in key areas. As you are now aware, our strategy is a 10-year journey to transform the way we deliver health and care. Our strategy responds decisively to the three global healthcare megatrends of customer centricity, digitization, and data, and leverages off our unique ecosystem of assets and services to transform the way we deliver health and care. In NetCare, we call this person-centered health and care that is digitally enabled and data-driven. And through this, we are intentionally committed to creating a sustainable, competitive advantage for the group. As you will see, over the past six years, we have completed the first phase of the strategy, enabling us now to embark on the very exciting second and third phases, which are underway and making good progress. Our strategy is divided into three clearly defined but inextricably linked phases. This slide provides a brief overview and I will unpack each phase in more detail in the slides that follow. The first phase, what we call digitally enabled, is now complete and it entailed the implementation of electronic medical records across all of our operating platforms and services. This took us six years to achieve having been delayed by the COVID-19 pandemic. The focus here has been on delivering operational efficiencies, and these have been achieved according to plan and budget every year. We have already demonstrated the savings to you in a number of areas as we rolled out care on in the hospital division, and we fully expect these to continue. As the digital foundation of our ecosystem is now complete, we've embarked on the next phases of person-centered engagement that will be digitally enabled and data-driven, providing improved access, ease of use, and engagement across our ecosystem. This will allow us to move away from a siloed and episodic model of care towards an engaged and retention-led model of care over a person's lifetime. The second and third phases occur coterminously. The second phase, what we call data driven, is currently being rolled out and will be completed over the next two to three years. Here, the focus is on clinical efficiency, and this will be measured by our ability to substantially improve patient safety and clinical outcomes, make a significant contribution to clinical research, both locally and globally, attract even more clinicians to work within our ecosystem, and grow our market share. The third and final phase of our strategy, person-centered health and care, is currently in progress and will be completed over the next three to four years. Here, our focus is on patient acquisition, engagement, and retention. And this will be measured by ability to retain patients within our ecosystem over their lifetimes, what we define as the patient embedded value, as well as increasing their participation in our various service offerings and enhancing our digital engagement with them. In terms of the financial performance of this first phase, the table on the left-hand side sets out the cost of implementation in terms of both OPEX and CAPEX. with rollout capex amounting to 320 million and implementation OPEX of 350 million. Efficiency savings of 439 million have been achieved over the past three years, inclusive of 108 million delivered over the past six months. As reported in our year-end results last year, IRR has improved from 21% to over 23%. The graph on the right-hand side demonstrates the trajectory of efficiency benefits achieved to date in the solid white line and the projected efficiency benefits in the white dotted line against the original estimate of efficiency benefits represented by the yellow dotted line. The underlying costs initially of implementation are demonstrated by the blue bars. And then, since completion, the cost of ongoing support and maintenance by the beige bars. Let's take a look at the early benefits of our phase two, or the data-driven elements of our strategy. I'm going to demonstrate examples of clinical outcome benefits, our ability to now analyze the effectiveness of therapeutic interventions, our ability to utilize data to develop cost-effective products, and reduce the cost of treatment by analyzing clinical outcomes, and finally, the use of AI and machine learning to enhance the safety and care of our patients. In national renal care, nephrologists are now provided with monthly clinical reports per patient in order to monitor and inform treatment. Our electronic medical records not only include pathology results, but also detailed recordings of the dialysis machine sessions and parameters. Over 95% of our patients are now engaged with the Nephron app, and this has enabled them to actively participate in monitoring and managing their condition, resulting in improved outcomes. The graph on the left-hand side from Discovery Health demonstrates that NRC's value-based care quality scores versus that of the rest of the renal sector. And as you can see, NRC has outperformed the sector with an improvement in outperformance year on year. Medical schemes also assess the performance of patients on chronic dialysis using a standard hospitalization rate, which is a proxy for complications. The graph on the right-hand side of the slide from a very large restricted medical scheme demonstrates NRC's quality by its outperformance compared to the rest of the sector in terms of a lower hospitalization rate for renal patients. In terms of measuring the effectiveness of therapeutic programs or interventions, nowhere is this more relevant than in mental health. And as we all know, mental health conditions are pervasive, ever-increasing, and now rank in the top three leading causes of disability. And therefore, it becomes absolutely critical to understand the effectiveness of programs provided by NetCare Akiso. NetCare KISO is collecting anonymized data and using AI-enabled machine learning to improve treatment pathways. We are now measuring clinical improvement of patients admitted for treatment. For example, on admission, patients with depression complete an assessment to determine the severity of their depression. This assessment is repeated on discharge. We are able now to measure that NetCare KISO is achieving a 75% improvement. We're also measuring the readmission rates of patients with mental health challenges using our own risk-adjusted readmission rate model. This model is also driven by AI-enabled machine learning. NetCare KISO now shares these anonymized 30-, 60-, and 360-day readmission rates with medical schemes. the only provider to do this. NetCare's unique access to rich data is now enabling us to develop new product offerings focused on specific market needs. We launched NetCare BirthWise in January this year, which is an innovative data-enabled model that offers a high-quality maternity experience with no out-of-pocket expenditure for patients. It provides patients with the entire antenatal birth and postpartum journey and relies on a multidisciplinary team resourced by clinicians, including obstetricians, GPs, and midwives. By appropriate assigning of duties and following a defined care pathway, all costs are controlled within scheme benefits. We're also focused on encouraging, where appropriate, behavioural change among our clinicians. To this end, data analysis has become an indispensable tool. For instance, we all know that generic drugs are cheaper than the originated drug. However, clinicians are often reluctant to use generics, citing inferior quality and perceived poorer outcomes. This slide demonstrates an example of two case studies in which we were able to utilize our data resources to objectively and statistically compare the clinical outcomes of patients with comparable conditions and complexity on the original, on the originated drug versus those on generics. In the first case, we examined anticoagulant or anti-clotting drugs. Hospitalized patients are at risk of developing deadly blood clots. Injectable anticoagulants are the standard of care in high-risk cases. A generic equivalent drug is 14% cheaper than the established originated drug. Data-driven evidence across all of our hospitals using a statistical model now demonstrates no difference in risk-adjusted mortality rates between the originator drug and a generic equivalent anticoagulant. In the second case on the right-hand side, we compared the use of antibiotics. The high utilization of antibiotics results in high treatment costs. However, generic equivalent drugs are between 64% and 70% cheaper than the originator drug. Data-driven clinical analysis across all NetCare hospitals using a statistical model comparing six generics to the originator drug demonstrated that their efficacy is the same as the originator drug in terms of risk-adjusted mortality rates. The objective statistically valid analysis of the clinical data captured on our electronic medical records creates an enormous opportunity reducing costs without compromising clinical outcomes. The two examples I've mentioned here, we are already beginning to see changes in clinician behavior because of the power of data. NetCare has also developed AI and digital solutions to combat sepsis, or bloodstream infections and other infections in hospitals. Sepsis is associated with significant patient morbidity, mortality, and high in-hospital costs. Early identification and intervention may reduce mortality by between 5 to 20%. Now, we've previously reported on our AI-enabled predictive sepsis model which can predict sepsis risk in ICU patients up to 8 to 10 hours before clinical onset using real-time care-on data. The development and performance of this model was published in the Journal of Clinical Medicine in January of this year. The South African Health Products Regulatory Agency, SAPRA, has granted approval for the algorithm to be embedded as a medical device into care-on to be used in all of our ICU and high care units. Coupled to our AI predictive tool, NetCare's bespoke infection management tool also uses care-on data to track bacterial culture results, informing time-less infection identification and enabling targeted intervention. It also enables electronic antibiotic stewardship, ensuring the delivery of the right drug to the patient in the right dose, at the right time. And finally, our data has allowed us to develop algorithms to identify abnormal infection clusters, and importantly, enable early detection of a potential infection outbreak. These algorithms now report on the number, duration, and characteristics of a potential outbreak, allowing targeted interventions aimed at reducing morbidity, mortality, and the costs typically related to these outbreaks. Let's now turn our attention to our final phase and end goal of person-centered health and care. And whilst there is still so much more to achieve in this phase, we've made significant progress here in rolling out our NetCare app with over half a million downloads to date. Let's watch a brief video outlining where we are heading with this. I'll turn to an update on two other strategic projects. We've made steady progress in rolling out NetCare Plus in a highly competitive and crowded healthcare market. What has become increasingly evident to us is that our products offer genuine, differentiated value, setting us apart in ways that matter to consumers. The graphic on the left-hand side illustrates both NetCare Plus gap care claims by benefit category over the past three years and the difference in product design. As you can see, the dark blue segments represent what is available in the market, and the light blue segments show the additional benefits offered by NetCare Gap Cover. These benefits are firsts for the insurance sector. We've experienced claims across all of our benefit categories demonstrating how important these benefits are. Importantly, these additional benefits provide 33% more value when compared to standard gap cover products, underscoring our commitment to broadening cover in meaningful ways. Now on the right-hand side, the second graph presents NetCare Plus emergency care claims. Many competing products in this space provide limited emergency cover, which is often insufficient to treat a patient who has been in a severe accident or traumatic event. In contrast, NetCare Plus Emergency Care is the only product on the market offering unlimited emergency cover, a unique advantage made possible through the integration and strength of the NetCare ecosystem. A quick reminder of our environmental sustainability program and where we currently are. We remain on track to achieve our 2030 goals. Our targets for phase two remain to reduce scope two emissions to zero and reduce scope one and two emissions by a combined 84% by 2030. Our strategy is closely aligned with the JET IP We're also aiming to achieve 100% renewable energy utilization, zero waste to landfill, and a further 20% reduction in water utilization by 2030. The Renewable Energy Wheeling Agreement concluded in 2023 reached unconditional status in September 2024 and now extends to all six phase one sites. These locations will receive up to 100% renewable power by September 2026. We are also piloting an aerobic digestion plant at Netcare Alberton Hospital. This innovative system transforms food waste into methane, which is then captured and converted into usable energy for the facility, further reducing our environmental footprint. Our commitment to sustainability extends well beyond operational practices and continues to receive international recognition. In April of this year, NetCare was honoured as the global winner of the Association of Energy Engineers 2025 Corporate Energy Management International Award. This award, ladies and gentlemen, spans all sectors, not just healthcare, which makes this global recognition a powerful testament to the pioneering work Netcare continues to deliver. Before turning to our guidance for the remainder of the year, we thought it may be helpful to shed some light on the current operating environment within South Africa. Notwithstanding a largely stagnant medical scheme population, the demand for health care continues to rise year on year due to the impact of aging and the burden of disease. This graph indicates that health care inflation, as reflected by medical scheme contribution increases, is driven 3% to 4% above inflation due to the utilization of health care services. The aging of the medical scheme population is exacerbated by the fall in younger lives. This is reflected in the lower ratio of admissions at NetCare in younger age bands as reflected in the graph on the left-hand side. The average scheme pensioner ratio, which has increased from 6.2%, to 9.4% between 2008 and 2023 is reflected in the higher ratio of admissions in the older age brackets. Interestingly, 36.3% of NetCare's admissions are from patients over the age of 60 years versus 29.4% in 2014. The ageing impact is further exacerbated by the significantly higher average cost per admission for patients aged between 60 and 85 years, which is between approximately 125% and 185% higher than the average cost per admission of a 40-year-old. Medical schemes have noted significant increases in the burden of diseases in South Africa. Aging has historically shown strong correlation with growth in comorbidities. But what the data from a leading health insurance administrator in South Africa shows, as per the graphs on this slide, is a significant growth in chronic disease prevalence, including cancer and mental health. This is not only in the age bands over 60, but also, alarmingly, in younger age bands. This trend is supported by the growth in NetCare's renal dialysis, mental health, and cancer treatments, and increasing acute care case mix. And finally, in terms of the NHI, or National Health Insurance, NetCare has long recognized the pressing need to address the deficiencies and inequities in healthcare access and delivery in South Africa, the private sector is well positioned to support government's efforts to expand access to quality healthcare for all South Africans. Several legal actions have been initiated against the NHI Act by various stakeholders, including Solidarity, the Board of Healthcare Funders, the South African Private Practitioners Forum, the Hospital Association of South Africa, and the South African Medical Association. The Board of Healthcare Funders and the South African Private Practitioners Forum requested the High Court to set aside the decision of the President to assent to and sign the NHI Bill. The President argued that only the Constitutional Court has jurisdiction on the matter. The High Court has now ruled that this does not that it does have jurisdiction on the matter, and the President must furnish the record of his decision. And as we saw last week, the President has now appealed this decision. We firmly believe, as NetCare, that a collaborative partnership between the public and private sectors is absolutely essential to developing sustainable and affordable solutions that advance the goal of universal healthcare. Notwithstanding all of these legal proceedings, NetCare remains absolutely committed to constructive engagement and stands sincerely ready to work in partnership to meaningfully reform and strengthen South Africa's health system. And lastly, let's turn to our guidance for the remainder of the financial year. Our guidance remains unchanged from that published in our November 2024 results. Our total patient day guidance remains full year growth of between 0.8 and 1.3%. Group revenue is expected to grow between 5 to 6% versus last year. In terms of our strategic projects, we're expecting to spend 60 million of OPEX. Our normalized EBITDA margin is expected to benefit from operational efficiencies of last year's base of 18%. And finally, we expect to spend 1.5 billion on CAPEX in this financial year. And that concludes, ladies and gentlemen, the formal presentation of our interim results, and we're happy to now open the webcast to questions. Thank you.

Thank you, Richard. We don't have any questions at the moment, so I'm just going to pause for a minute or two to see if anything comes through.

Thank you very, very much, ladies and gentlemen, for your time and attention. And we remain available throughout the course of this week and the weeks that follow to answer any follow-up questions you may have. Thank you for your attendance.