• Singapore’s healthcare sector is typically viewed as a defensive segment, and poised to enjoy multi-year growth prospects. Drivers of Asia’s increased healthcare spending levels include accelerated ageing rates, the rise of lifestyle diseases, and growing disposable incomes.

• Healthcare service providers listed on SGX operate patient care services and facilities, both locally and worldwide. Two of three largest healthcare services providers – IHH Healthcare Bhd and Thomson Medical Group were also among the 30 stocks that saw the highest net institutional inflows in the 2020 YTD.

• Although the trio reported net losses in 1H2020 due to COVID-19, their operations remain cash-generating, with healthy cash positions underpinning their strong balance sheets. They have also rolled out initiatives to mitigate revenue declines, including telemedicine and diversifying service offerings.

Singapore’s healthcare sector is typically viewed as a defensive segment, and poised to enjoy multi-year growth prospects. Drivers of Asia’s increased healthcare spending levels include accelerated ageing rates, the rise of lifestyle diseases like diabetes and hypertension, as well as growing disposable incomes.

The listed healthcare sector in Singapore, as tracked by the benchmark iEdge SG All Healthcare Index, comprises companies that operate in the segments of pharmaceuticals and biotechnology, healthcare and patient services, as well as medical equipment and supplies.

Healthcare service providers listed on SGX operate patient care services and facilities, both locally and worldwide. These facilities include laboratories, hospitals, nursing homes and clinics that offer services and treatments ranging from family medicine, dentistry, endoscopy and aesthetics to gynaecology, oncology, paediatrics, orthopaedics, ophthalmology and even cord blood banking.

Healthcare service providers listed on SGX operate patient care services and facilities, both locally and worldwide. Two of three largest healthcare services providers – IHH Healthcare Bhd and Thomson Medical Group were also among the 30 stocks that saw the highest net institutional inflows for the first eight months of 2020.

IHH Healthcare Bhd

• Revenue and EBITDA for 1H 2020 declined 16% and 37% y-o-y respectively on COVID-19; profit after tax and minority items (PATMI) registered a loss of RM440.4 million.
• PATMI (excluding exceptional items) decreased 75% to RM105.2 million, mitigated by foreign exchange gains recognised in H1 2020 and lower net interest expenses from repayment of loans in 2H 2019.
• Balance sheet remained strong, with net cash generated from operating activities of RM728.5 million and an overall cash balance of RM4.3 billion.

Source: Company data

Raffles Medical Group

• Revenue fell 5.4% y-o-y to S$241.4 million in 1H 2020.
• EBITDA registered a decrease of 13.9% at S$41.9 million in 1H 2020, while  profit after tax decreased by 41.6% to S$16.3 million, due to higher depreciation charges and interest expense.
• Although revenue for the Hospital Services division decreased 14.5% y-o-y  due to the deferment of elective surgeries and fewer offshore patients, the Group’s overall business remained resilient, with the Healthcare Services division recording a revenue growth of 6.8% to S$124.6 million in 1H 2020. This was bolstered by mitigating activities such as air-border screening, swabbing of foreign workers, teleconsulting services, as well as supporting the Government’s Changi Exhibition Centre – Community Care Facility for COVID-19 positive cases.
• In China, Raffles Hospital Chongqing and our clinics had to operate with a significantly smaller patient load as the movement of people was curtailed for much of 1H 2020.
• Excluding the results of China Healthcare Division (Raffles Hospital Chongqing, Raffles China Clinics and Raffles Medical Hong Kong), which had been severely impacted by COVID-19 in 1H 2020, the Group’s profit after tax would have been S$31.2 million as compared to S$32.3 million in 1H 2019, a decline of 3.7%.
• Healthy cash position of S$151.5 million.

Source: Company data

Thomson Medical Group

• Group revenue decreased by 12.3% to S$98.0 million.
  • Revenue from Hospital Services declined by 8.5%.
  • Revenue from Specialised Services decreased by 18.6%.
• Adjusted EBITDA for healthcare operations decreased 32.1% to S$16.2 million.
• Excluding the effect of the one-off non-cash impairment recorded on the freehold land located within the Iskandar Development Region in Johor Bahru, Malaysia, the Group would have recorded an operating profit of S$10.8 million.
• Operations remain cash-generative with healthy cash position of S$160 million.

Source: Company data

Outlook

IHH Healthcare

• Amidst COVID-19, patients postponed semi-elective and elective during lockdown while foreign patients, which make up between 5% and 25% of revenue, could not travel to our facilities.
• With the gradual easing of restrictions starting in June, IHH has seen occupancy in home markets recover to between 40%-60% in June compared to pre-COVID-19 levels of 65-70%, and reported positive net profit for that month
• The Group has seen the progressive recovery to occupancy continue across July and August.
• We proactively mitigated the short-term decrease in patient volumes and revenue by:
  • Creating new revenue streams by diversifying service offerings.
    • Rendering COVID-19 treatment and testing in support of the public healthcare sector:
    • Caring for COVID-19 patients in Singapore, India and Turkey.
    • Providing COVID-19 screening services and laboratory testing in all markets.
    • Taking in non-COVID-19 patients from public hospitals in Singapore and Hong Kong.
    • Collaborating with governments to manage care facilities and border screening in Singapore.
  • Rolling out new initiatives
    • Telemedicine was launched across IHH’s key markets to connect with patients virtually and give them peace of mind to still seek hospital care as needed.
  • Undertaking strict cost controls and cash management
    • Deferring non-critical purchases and capital expansion projects, including at Parkway Shanghai and Pantai Ayer Keroh. 30% of the Group’s annual capex has been deferred to after 2020.
    • Leveraging economies of scale to extract synergies and improve procurement costs; this includes our increased focus on digitisation such as telemedicine and digital integration.
    • Proactively managing interest costs and foreign currency exposure.
    • Utilising various government aid programmes across markets.
• In February 2020, IHH announced a “Refreshed Strategy” to sharpen its focus on improving returns while delivering growth and achieving stronger synergies. This has enabled it to remain resilient amid COVID-19 while pursuing longer-term growth.
• To leverage IHH’s international scale and achieve stronger synergies, India’s Fortis Healthcare – in which IHH is the largest shareholder – announced its intent to rebrand as “Parkway” to leverage IHH’s strong suite of brands, on 14 August.
• To pursue a metro cluster strategy for more efficient growth, the Group received final approvals on 14 August to complete its acquisition of Prince Court Medical Centre, which will be part of the Klang Valley cluster in Malaysia.
• In the short term, the Group expects impact from the COVID-19 pandemic for FY2020, especially if there are further disruptions from subsequent outbreaks and renewed lockdowns.
• It will continue to mitigate the impact by creating new revenue streams, improving case mix, keeping tight cost and capital discipline while supporting governments.
• Overall, the Group is optimistic that it will remain resilient – it is encouraged by the fact that patient volumes have started recovering from June onwards and expects continued progressive recovery.
• It remains in a strong financial position and is well-prepared to ride out this pandemic and deliver long-term growth by continuing to deliver on its “Refreshed Strategy”.

Click here for the full results statement.

Raffles Medical Group

• Based on the current conditions, and barring unforeseen circumstances, including the deterioration of the COVID-19 situation, the Group expects to remain profitable for the rest of the year
• In June, all key services of Raffles Medical have resumed operations with the relaxation of the Circuit Breaker
• The Group has also obtained a Ministry of Health (MOH) license on Molecular Microbiology services for COVID-19 polymerase chain reaction and serology testing, to support MOH’s efforts to expand Singapore’s testing capacity for COVID-19
• The Group will continue to invest and develop its digital platform – Raffles Connect – to provide enhanced access to services, improve customer experience and offer up-to-date authoritative medical information. During the CB, Raffles Connect offered our patients online access to doctors and medical professionals for comprehensive and seamless care
• In response to the COVID-19 situation, Raffles Health Insurance had adjusted its marketing initiatives to focus on digital platforms, with a view to create a seamless digital journey for its customers
• China
  • The Group will continue to focus on fulfilling the demand for high quality healthcare services from affluent Chinese and the expatriate community in the country
  • It is in the process of completing the renovation of its 54,000 square feet medical centre in Beijing
  • Located at its existing Beijing International Clinic, the medical centre will offer minimally invasive surgeries to complement its clinical services when it opens in 2H 2020
  • Preparations are on track for the opening of Raffles Hospital Shanghai
  • Currently, fitting-out works and recruitment are in progress; however, in view of the COVID-19 situation, the actual date of commencement will depend on Shanghai’s return to normalcy

Click here for the full results statement.

Thomson Medical Group

• With the gradual easing of restrictions in Singapore and Malaysia from June onwards, the Group has resumed operations of healthcare services that were previously closed or operating under restricted conditions and has observed a gradual recovery of patient volumes across most segments.
• The Group continues to generate sufficient cash flows to finance its operations and has adequate cash and bank resources to fund its working capital needs as well as its committed business growth plans – as at 30 June 2020, the Group has a healthy cash position of S$160 million.
• Amidst the challenging business environment due to the COVID-19 pandemic, the Group will continue to remain focused on its long-term strategy to grow the Group’s business.
• Singapore
  • To meet the burgeoning demand of younger families in the Northeast region of Singapore, the Group has established a new Thomson Women’s Clinic at Punggol Waterway Point to bring its services and brand of care closer to home.
  • Further growing its core competencies, the Group announced the development of the Thomson Kids platform, aimed at providing an ecosystem of synergistic services where children’s developmental health and well-being are taken care of in a holistic and multidisciplinary way.
• Malaysia
  • The expansion works of the new wing at Thomson Hospital Kota Damansara that will add 400 beds has resumed following the easing of the Movement Control Order and is on track for completion in the next financial year.
• In response to the COVID-19 pandemic, the Group has pivoted into the digital space to continue to bring services to patients.
  • Though telehealth solutions under appropriate conditions, the Group’s partnering doctors will be able to continue consultations with patients remotely, with necessary medication delivered to the patient’s doorstep.
  • Public education for parents and parents-to-be are now delivered via online pregnancy webinars, allowing its healthcare professionals to continue to reach out to patients despite restrictions on large scale physical events.
• Barring another wave of community infections which might bring about new public health measures or any other unforeseen circumstances, the Group remains cautious in the outlook of its performance in FY2021.

Click here for the full results statement.