From a financial perspective, results were positively impacted by the weakening of the rand against the pound sterling and euro. However, regardless of this, both operations delivered robust performances during the year.

Alliance Medical’s revenue including LMI increased by 17.3% to R5.9 billion (2018: R5.0 billion). This was supported by the growth in PET-CT scan volumes, the acquisition of Italian clinics and three scanning facilities in the UK, as well as a solid underlying performance from Italy, Ireland and our mobile business in the UK.

Normalised EBITDA including LMI increased by 9.5% to R1.3 billion (2018: R1.2 billion), mostly driven by operational and clinical excellence, as well as improved performance in the PET-CT and mobile business. Alliance Medical experienced lower margins during the year, with EBITDA (excluding growth initiatives) margin down to 22.6% from 24.9% in the prior year. The margin was adversely impacted by the upgrade programme within radiopharmacy as part of the long-term commitment to PET-CT services in the UK, causing supply challenges, with additional costs to serve the PET-CT contract resulting in increased costs. Good performance in Italy, Ireland and northern Europe offset UK impact.

Scanmed revenue for the period increased by 7.1% to R1.4 billion (2018: R1.3 billion) and normalised EBITDA increased by 14.1% to R97 million (2018: R85 million). Scanmed continues to operate in an extremely competitive market, and experienced weaker performance in a number of its facilities during the year. Scanmed continues to optimise its operations to improve efficiencies and reduce costs.

Alliance Medical’s PET-CT services are centred around the UK, enabled by a 10-year PET wave 1 contract with the NHS, ensuring fixed prices until December 2025, as well as four PET-CT contracts awarded during 2019, each with a seven-year term and an option to extend for another three years. Together, these contracts allow us to serve around 70% of the population in England.

As the demand for molecular imaging services increases, it is imperative that our cyclotrons – which manufacture the radiopharmaceuticals used during PET-CT procedures – are maintained for optimal performance over the duration of our contracts with the NHS. To this end, we completed vital cyclotron upgrades during the year which, in addition to introducing new incremental capacity, will give us the longevity we need to deliver on our commitments.

While these upgrades will bear fruit in the long term, it had an unavoidable impact on our radioisotopes supply during 2019. The optimal opportunity to embark on such a project will never present itself; however, we believe that proactively managing the sustainability of our equipment is the right decision for the business. Our investment in the refurbishment of our cyclotrons will substantially increase our production capacity in the future, allowing us to keep up with increased demand. In 2020, we also plan on opening a new site at Dinnington, which will further allow us to address growing demand.

This is indeed a global challenge and one that remains a continued focus area for our business.

Alliance Medical is challenged by a shortage of radiographers across its geographies, while Scanmed continues to face a shortage of doctors and nurses. In the UK and Ireland, for example, demand and volume are growing at a rate higher than the number of newly qualified radiographers entering the market. These shortages remain a concern for the business, as it could potentially impact our growth prospects and ability to deliver quality care for our patients.

Alliance Medical continued to invest in a variety of recruitment, development and retention initiatives. Our partnership with universities continued to strengthen, with an increase in elective placement opportunities and graduate radiographer appointments. In Poland, we successfully hosted internships for selected specialisations.

Life Healthcare aspires to be an employer of choice across its markets to ensure it remains competitive. Additionally, in pursuit of enhancing our brand as an employer of choice with an extremely competitive market, we explored new opportunities to reach students and recent university graduates eager to start their professional career in the healthcare environment. We continue to invest in a variety of reward, development, recruitment and cultural initiatives.

We will continue driving operational excellence throughout the business. From a growth perspective, we will focus on operational growth initiatives and continue to explore opportunities to expand into new territories and replicate our successful partnerships globally. We see the opportunity to explore the expansion of our radiology footprint in southern Africa by leveraging the expertise of Alliance Medical.

We are committed to finding innovative ways to improve efficiency, while ensuring we maintain clinical excellence. The area of artificial intelligence (AI) remains an exciting field and, while we are already finding ways in which to increase efficiency through the use of AI, we believe there is still significant prospects to improve service and further increase efficiency.

Driving the continued revenue sales of LMI globally and focus on its products in the pipeline.

Recruiting and retaining suitably qualified staff will remain a priority for the business in the year ahead and we continue to explore new ways to enhance our employee value proposition to differentiate ourselves as the employer of choice in the geographies we operate. For example, Scanmed will focus on expanding its e-learning platform, which was launched during the year, to give our employees access to a range of training activities and programmes.

To our employees, thank you for the passion with which you tackle each day. Your commitment to providing quality care to our patients is key to the success of our business. Thank you to all our patients for their continued support.

I want to extend my sincere appreciation to the Group executive team for welcoming me as the Group’s International CEO. Their valuable input has been instrumental during the transition, and I look forward to working together as we navigate the business through any opportunities and challenges going forward.

Finally, thank you to our stakeholders for their continued support over the past year. We look forward to serving you in the future.