Good day, ladies and gentlemen. Welcome to the Life Healthcare unaudited group interim results for the six months ended 31 March 2021. All participants will be in listen-only mode. There will be an opportunity to ask questions later during the event. If you should need assistance during the call, please signal an operator by pressing star and then zero. Please note that this call is being recorded. I would now like to hand the conference over to the Head of Investor Relations, Mark Wadley. Please go ahead, sir. Good morning. Thank you, Irene, and thank you, everyone, for joining us this morning. We're delighted to present a very positive set of results for the six months to 31st of March 2020. The order of precedence today will be led by Peter Wharton-Hood, our Group Chief Executive, who will take us through an overview of the business, followed by Mark Chapman, who will give us an overview of the international operations, which saw very, very good results for the period. Adam Pyle will then take us through the South African operations. Pieter van der Westhuizen will then take us through the financials, and we will close up again with Peter Wharton-Hood on growth initiatives and the outlook for the rest of the year, and then we'll have an opportunity to take questions. It gives me great pleasure to hand over to Peter Wharton-Hood, our Group Chief Executive. Thank you. Thank you, Mark, and a warm welcome to all of you on the call as you join us for our interim results presentation. At the outset, please let me express my thanks and appreciation to all our teams around the world for their tireless efforts during the course of the six months, taking care of our patients and delivering this strong set of results. At a headline level, I think you'll see our story tells that Life Healthcare has benefited from its geographical and business line diversification strategy, an excellent international result, a strong and improving South African result, and a very strong balance sheet and financial position. Our strategic focus areas and vision remain unchanged. As a global, we see ourselves as Southern Africans with a strong presence in Western Europe. As integrated, we see acute and complementary services registered diagnostic capability where our CT, MRI, and PET-CT scanning capabilities through Alliance Medical and Life Molecular build a balanced global organization. Yes, we are a diversified offering with a move away from non-acute sources. You'll see our revenue outside of the hospital settings increases in complementary services, diagnostic, and imaging, taking on ever-increasing proportions in our company. Our focus on clinical excellence and our people focus remains unchanged. We put the patient first. We rely heavily on our nurses, our doctors, and clinicians to deliver these results. With measurable quality clinical excellence as an outcome, we're very proud of the results we now produce. Moving on to our strategic pillars, you'll see that quality underpins everything that we do, and the key indicators will be described to you by both Mark and Adam in sufficient detail later on. From an efficiency perspective, we're seeing improved margins both domestically and abroad. From a sustainability perspective, our engagement with stakeholders domestically and internationally, more specifically with government, has taken on new and increasing levels of proportion, from the COVID-19 cooperation in South Africa, the vaccine rollout in South Africa, the progress with radiology in South Africa, and also the delivery of an increased level of service to the in the U.K. We'll talk about our growth initiatives later on in the presentation, and we are flattered by the number of growth opportunities that this business has at its disposal. If we then move to the group overview, we'll see that revenue increased to ZAR 13 billion by just a shade over 4%. That's a direct beneficiary of our diversification strategy. Earnings per share from continuing operations up 4.1% to ZAR 0.559, and that off the back of a strong performance by Alliance Medical, where the revenue increased by 17% and their normalized EBITDA by 38%, supporting the South African performance, which improved in Southern Africa despite the severe impact of the second wave, which Adam will describe in detail for us later. All wrapped up a very strong financial position, undrawn banking facilities of ZAR 6.4 billion, and a normalized debt to EBITDA ratio of 2.78x. If we then look at the key objectives, they also remain unchanged, and our progress that we can report for the period with high margins in AMG and margin improvement in South Africa, consistent clinical quality outcomes across the spectrum. From a radiology perspective, we are the partner of choice in U.K. and Europe, with additional contracts during the period for COVID-19 solutions provided more specifically to the NHS. Domestically, we made good progress with our SA Radiology project, and our HPCSA application to employ radiographers has gained momentum. As previously reported, our Scanmed disposal has been completed. If we then move on to the picture that is painted from a diversification perspective, revenue has achieved that 70/30 split between Southern Africa and international revenue outcomes. From an EBITDA perspective, international moving closer to a 40% contribution during the period, and the split between acute and non-acute revenue getting closer to that 60/40 split that we spoke about six months ago. I am now going to hand over to the two Chief Executives of our major business units. Mark Chapman is first up, CEO of our international business, to take us through the strong set of results posted during the six months. Over to you, Mark. Okay. Thank you, Peter, and good morning, everybody. I'd like to go through an overview of the international business. Moving on. Predominantly, the Alliance Medical Group. That picture was actually one of our expandable mobiles, which we do have the exclusivity in the U.K., and we're seeing very high demand for it. It's hard to see, it's all in a mobile. If I move on to H2, and what I think it's shown is how resilient the diagnostic business has been and delivered a very strong overall performance. Alliance Medical continues to see an improvement in demand for its services across all territories, and this is during the pandemic and seeing many restrictions throughout the regions. If I draw your eyes to the chart on the right. This is the activity from the beginning of the pandemic, and you'll see in wave one where we saw a Classic V effect when the majority of our clinics were closed. Volumes in Italy actually went down to 15%, but I'm pleased to say it was almost a Classic V effect, and the volumes and activities came back as restrictions were released. Indeed, during the waves 2 and waves 3, we saw in Ireland, you can see how resilient the business has been. The last lockdown and restrictions, as you can see to the right, certainly for Italy, Ireland, and the U.K., were experiencing volumes that were below the pre-COVID levels. Pleasingly, at the end of March, you can see the trending as restrictions were easing and the activity was going ahead of the pre-COVID. This was supported by, to what Peter said, the ongoing sort of supply of choice to a number of government provisions across Europe, predominantly the NHS, HSE in Ireland, and also the ASL budgets in Italy. It was also supported by robust and continuing growth within the PET-CT business, which I'll come onto shortly. We did see diagnostic imaging having a little bit of a lag below the line, but again, that's now coming forward to pre-COVID-19 levels. Ireland has had a very strong performance throughout the year and has continued to grow, and in addition, has been awarded public contracts from the HSE to support their waiting lists. Italy, which had very strong lockdowns in wave 2, has now subsequently rebounded and is seeing volumes above the pre-COVID-19 levels in March. I think it's also important to say that our staff, circa 72% across the group, have now been vaccinated with the first vaccine, and indeed in the U.K., circa 84% of staff are now fully vaccinated. Moving on. The overall performance, I know Pieter will go through this in a lot more detail, but I just wanted to draw your eyes to a very strong set of results. Importantly, you'll see that the revenue growth at 17% year-on-year is strong, and more importantly, the conversion to EBITDA at 38% is very encouraging. This has been supported by the resilience of the PET-CT volumes coming through the U.K., the strong growth in Ireland, and across Europe, we've seen high demand for CT imaging. This isn't just around the CT support that we mobilized very quickly for the NHS. It's across all our regions. The mobile business, again, across the regions, has become very buoyant as there's been an increased need for scanning capability while waiting lists are being stretched across most of the region. Also very encouraging is to see the EBITDA margin growing to 25.4%. That's with Dinnington coming on board, which has had a dilution effect of about 1% to the margin. I'm also pleased to report with Dinnington, with that site coming on board, the reliability of the radiopharmacy in the U.K. at the end of March was at 98.7%. That's certainly a record that we've seen within that part of the business. Moving on. Just wanted to highlight the impact of COVID in this half- year results, and it's in four main blocks really. We have seen a drain still on the volumes coming through. Predominantly, that was in the U.K. and Italy, which you saw on the previous slides with the chart, and they were tracking at pre-COVID level around 90%. Encouraging it's now coming back at the end of March, it has had an impact of about ZAR 3.5 million over this period. We are also starting to see pent-up demand and solutions being supported there. Again, when we look at our mobile provisions in the U.K. and Ireland, you can see that the expectations are slightly ahead of what we'd have expected. Hence, we're starting to feel this pent-up demand and need to provide solutions to governments coming through, and that contributed ZAR 2.7 million. We've then got the bigger sort of support systems that we have with the healthcare providers across Europe. You've heard me talk about the CT mobiles in the U.K., and I'll come onto that shortly. The HSE contract that's been awarded in Ireland, and also Petrucci in Italy working with the ASL. We've also mobilized very quickly early on was COVID-19 blood testing in Italy, which remains strong, and has certainly supported that part of the business, while some of the activities in diagnostic imaging were below the line. The last point is that we continue to see costs due to COVID, predominantly around the PPE, and also the time to clean the facilities in between patients. Another example is within Italy, where we have to have a triage at the front of all our clinics before patients can enter the facilities. All bearing costs, but are being managed accordingly and appropriately. Overall, that's leading to an EBITDA margin of ZAR 45.1 million, which is very encouraging. Moving on, I think what this is telling us is that we have a very strong platform to work with public health services. You'll know from the very early stages moving into COVID, we reacted with pace and delivered a very robust service to the NHS, which was the first time we've offered a 24/7 provision across England, and we also mobilized the diagnostic facilities within the Nightingale Hospitals. In Italy, the team introduced blood testing very quickly, and robust solutions were put in place across a number of centers. In Ireland, when the clinics were closed, Malcolm and the team offered services and our staff to go and work within the Government Hospitals. I think this early support has certainly cemented the relationships that we have across a number of national healthcare providers. This is now showing further opportunities as we continue to support the NHS with CT mobiles, not on a 24/7 basis, but more on a 12-hour rota. We've also seen significant awards of activity coming through the Irish business with the HSE. I think what this is also now telling us is we're moving into a position where we see very high waiting lists across all regions and the short-term solutions that are being put in place. There's further conversations now looking at the medium to long-term opportunities of how we can support these health economies and services and systems, to provide support around the pent-up demand and the waiting lists. You'll see as we move away from the short-term COVID-19 support measures, that's probably going to be more normalized in 2022. We are now in discussions about how we can become more business- as- usual to support services to address the pent-up demand. Next slide, please. If I just move on to the key regions, and I think everybody's seen this slide before. I think the subtleties here is that you'll see the mobile numbers increasing in the U.K. as we support the solutions required there, and also across most of the regions. That public-private split is increasing to the public, which is no surprise when we've had a year of supporting the National Health Service across the regions with COVID solutions. Next slide. Drilling down a little bit more into the U.K. and the molecular imaging part of the business, which is the PET-CT, and again, you've heard me say it's been a very strong half year for PET-CT. What we have seen, though, is that the percentage of revenues which were growing and the marginal economics were coming through that business over the 50% has gone down to 47%. That skew is through the short-term solutions for COVID-19, which is to be expected. Very encouraging, if you look at the bottom- right chart, the average growth rate across the PET-CT volumes over the last four years has remained at 10%, and that's including the impact of COVID-19 in the last 12 months. The bottom left, I'll just draw your eyes to that, really, as well. If you look at the half year, the growth on the previous year is at 6.1%, but more encouraging is that the figures in March were at 19% growth against the previous period. I think it's also worth noting that within PET-CT, there is no waiting list because the service from a referral is reported to that patient within seven days. We do know, certainly in the U.K., that estimated patients not having their cancer treatment is touching 50,000 and beyond. Again, we do expect, as GP practices and primary care start opening up the facilities, we expect further volumes to come through accordingly. Next slide, please. Staying in the U.K., looking at the diagnostic imaging part of the business, the strategy is still very firmly looking at how we focus on long-term partnership solutions with the hospitals and also the ICS now, which is the Integrated Care Systems within the U.K. If you look at the chart to the right, you can see how we are growing that long-term contract. Again, in the last 12 months, that's been skewed by the solutions that we've offered for COVID-19, certainly within the U.K. and the NHS. Those conversations remain about looking at long-term partnerships. If you look at the chart to the right, I think this is certainly a powerful picture. You can see how the waiting lists are now touching 52 weeks in the U.K., and the number of patients on that waiting list is touching 5 million, and that's expected to increase over the coming months as full restrictions are eased. What's that telling us? That the NHS is going to have pressure points. They are looking to create a number of community diagnostic hubs. This is where there's 44 Integrated Care Systems, ICS, are looking to commission those. One, to support the long-term diagnostic plan. I think it's become an accelerator due to the pressure points within the system around the waiting lists. I'm pleased to say Richard and the team in the U.K. are having a number of conversations with the ICSs because, again, through this COVID experience, what we have seen is relationships between public-private partnerships strengthening, and I'd like to see over the next 12 months at least some positive results coming out of that. Move on to the next slide, if I could. Just a quick overview, and just try to pull out the main highlights within the key territories. Within Italy, Patricia and the team have had a strong recovery in volumes. Overall, 13.7% growth in revenue. You heard me talk about there was a bit of a lag on the DI and tracking at 90%, but the Italian team have supported that revenue with supplementary blood testing for COVID-19, as I explained. The focus remains on growing the volumes back to the pre-COVID levels and starting to see the growth come through. They continue to support the public volumes accordingly. I think it's also worth noting and very encouraging that the previous acquisitions initially are performing very well, and the team are now looking at the consolidation of activities across clinics and also driving the cost base and the efficiencies that come with that. In Ireland, Malcolm and the team, as I explained, have had a very strong 12 months. Growth at 22.6% across the period, which is very encouraging. There's still strong demand, and we are seeing the self-pay market increase slightly as patients are looking to bypass the waiting list, which in parts of the Republic of Ireland, again, is over 12 months. On the back of that, the team have worked very closely with the HSE and have been awarded additional contracts to support the waiting list that we know will be growing in the Republic of Ireland and Northern Ireland as well. Looking just briefly on some of the other regions. Axel and the team within Northern Europe have had a very robust business throughout this with the radiopharmacy and the cyclotrons across the region, again, minimum impact and starting to see some growth come through. Likewise, within the U.K. and Ireland, we're seeing very strong demand for the intra mobile solutions. No supplies that's around CT, and also growing within the MRI business. I'm pleased to say during this period, we've also had an acquisition of a further cyclotron to support the Life Molecular Imaging strategy within the group. We acquired that facility in January of this year, and I'm pleased to say it's performing very well and on a business case. Next slide, please. Last but not least, our quality indicators. It's very important to say that the quality does underpin all our operational decisions, and I'm pleased to say that every quality indicator within this chart is ahead of the target. Very pleasing to see is the patient experience indicator, if we can pull people's eyes to that. Across all levels and across all the regions, the patient experience data is very encouraging. I think this just supports the high-quality services that all the businesses are delivering and continue to deliver in these very difficult COVID times. Okay, thank you for that. I'd now like to pass you over to Adam. Thank you, Mark. Good morning, everyone. I'll go through and give an overview of the operations of the Southern African business. If we can move on to the next slide. Thank you. What this slide shows is it gives a brief overview in terms of the COVID numbers that we experience in the South African business within Life Healthcare. You can see on the graph on the left is the familiar sort of graph and look of the COVID waves. I just want to point out that between wave 1 and wave 2, what we saw in wave 2 was a far more intense wave with an increase of over 25% in terms of COVID admissions that came through in wave 2, and it certainly placed the business under considerable stress and strain in the months of December and January. What we are seeing now is that if you look on the right-hand side of that graph, you see a concerning upward trend in hospital admissions. Whether we are technically in a third wave or not, what we are seeing is a current increase in admissions. What we saw in both wave one and wave two, it plays out differently across each of the provinces in our country. Wave one started in the Western Cape, and wave two for us started in the Eastern Cape. What we see now, if you look at the graph on the right-hand side, is an increase in admissions, and it's really playing out in Gauteng, the Free State, and the North West, and Mpumalanga, with still a low number of COVID admissions happening on the coast. Those are the provinces where we're seeing the current increase in COVID admissions. If we move on to the next slide. What this slide shows is actually we try to show something slightly different in terms of how COVID has played out in H2 2020 and H1 2021. If you look at the first of all, you look at the graph on the top left, and this shows our total PPDs over a 12-month period from April 2020 to March 2021, and the difference between our COVID PPDs and non-COVID PPDs. You can see the sort of waves in between. You can see the increase in wave 1 in July, and the COVID PPDs increasing, and the decrease in the non-COVID PPDs. As the sort of COVID PPDs drop and the increase in the non-COVID PPDs, it flows through in September, October, and then the pickup into COVID wave two and the high number of COVID PPDs that played out in January, and then dropping off again. What you'll also see from that graph on the top left is the overall high number of PPDs the group has had in H1 2021 versus H2 2020. If you look at the graph on the bottom left, what's interesting for us is over these six-month periods, the COVID waves actually played out in a very similar fashion. In both periods, the COVID waves peaked in months three and four. In other words, the months of June and July in H2 2020, and the months of December and January in H1 2021. What you can see from that is the more rapid increase in wave 2 of the number of admissions and also a faster drop-off. In months five and six, in other words, in months February and March, compared to August and September in the prior six months. What you can also see from the graph is the high number of COVID admissions we've had to deal with. When we look at the business and compare these two halves, actually, the fact they were quite similar in terms of the COVID timing, and what we saw in the last six months was a far more intense number of COVID admissions. When we go through and discuss some of the numbers, I think what we've seen across our business is what you see is a business that has learned, it's adapted, and certainly the results we've come out with H1 2021 are a far improvement in terms of H2 2020. Just the graph on the top right shows the theater minutes, and that for us is a good indication of the sort of underlying surgical activity outside of COVID. Again, you can see the high number of COVID, well, theater minutes that took place in H1 2021 versus H2 2020. In particular, with the high intensity of COVID wave 2 in months three and four, in other words, December and January, what we did see, though, is a drop in theater minutes. What's interesting is as we adapt to our business, we saw a much faster ramp-up of theater minutes. You see that coming through in months five and six, so that's February and March this year versus August and September prior year. That's as the business learned and adapted how to deal with COVID in terms of turning on the theaters. For us, it's a good sign in terms of how you learn and adapt. If you go to the next slide, please. This shows the overall improvement in our business. If you look at the graph on the bottom left in terms of occupancies, so you can see occupancies have improved from H2 2020 to H1 2021 across all the lines of business. We're still off where we want to be, and you can look at the H1 2020 occupancies, and you can see where we'd like to get back to. This improvement occupancies feeds into our revenue numbers. If you look at the chart on the right, you can see an overall improvement from H2 2020 now to H1 2021 in terms of our revenue. If you look at the actual lines of business, you can see that healthcare services is actually higher than it was in H1 2020. Our complementary lines of business are where they were in H1 2020, so good improvement for those two businesses. It's only the acute business which is lagging behind H1 2020. That business has shown a really good improvement where we were in H2 2020. Across all three lines of business, a good performance over the last six months. If you go on to the next slide, please. I will touch briefly on the numbers because I know Pieter van der Westhuizen will deal with these numbers in more detail. I also know he gets a little bit nervous when I start talking about numbers in detail. I will be fairly brief on this slide. What you see is that our PPDs are 14.9% down on H1 2020. What we continue to see is a fundamental underlying change in our case mix, and that is reflected by an over 12% increase in our revenue per day, and that results in our revenue only being roughly 3% down on the prior period. That feeds down into a normalized EBITDA of ZAR 1.5 billion, which is over 30% down on the prior period and a normalized margin of 16.6%. This is a function of the sort of lower activity as well as the increased costs associated with COVID-19. We are becoming a lot better at managing these costs, and I'll touch on that in terms of the next slide. You can move to the next slide now. Thank you. This is a slightly busy slide, and in the next few slides, I'll split the business between the acute, the complementary, and the healthcare service businesses. Just touching on the acute business first. You can see from the acute PPDs graph how the business was impacted by the drop in PPDs from H1 2020 to H2 2020. You can see the recovery that's coming through now into H1 2021 with a 14.5% improvement. I've just taken two parts of theater minutes and cath lab cases as a reflection of the underlying sort of surgical activity. Again, you can see for both of those the sharp drop-off experience from H1 2020 to H2 2020. Again, the good improvement in theater minutes of 16.7% and the cath lab cases at 21%. You can see that improvement coming through in the last six months. What we've shown in the table on the right is, if we just take the month of March, because the month of March is probably the most normal month we've had in the last six months, and I do use that term normal very carefully because we're not exactly in a normal environment. It was the month with the lowest number of COVID-19 PPDs. In that particular month, it's interesting because our revenue for that month was 0.6% higher than in March 2020. I know our March 2020 numbers were impacted by the start of the stop of surgical procedures, but our revenue was also higher than in March 2019 as well. What was pleasing was our SA operational EBITDA percentage was around the 22% mark, which is a good improvement, and it shows the lessons the business has learnt in terms of trying to manage the additional PPE costs that come through because of COVID, how to change your activities within the COVID environment. This is despite that our PPD has been down 11% in March 2020. What you see underneath that is the change in activity. Theater minutes are only 2% down, but our cath lab cases were nearly 2% up on the prior month or the prior period. What's interesting is our length of stay came down to roughly three point eight days, which is a more normalized length of stay for the period, which is at four point three two. Again, our normal length of stay is around three point six days. Having a length of stay of three point eight is a good reflection of heading back to a more normalized environment. Just a point to that -11% PPDs, it does show a change in case mix, and the biggest impact for us here is the drop in medical cases. We talk about the surgical cases, but the biggest impact for us here is the drop in medical cases, and that's medical outside of COVID. For us, that's reflective of what's going on in society, the increased social distancing, the hand washing, and the fact that, as a society, we're still not back to normal. That's the primary reason we see behind our reduction in PPDs. Can we go onto the next slide, please? We just touched on the complementary services business, and we just showed the four businesses: the mental health, the acute rehab, the renal, and the oncology business. What you see here is that the mental health business is really severely impacted by COVID. We saw a 30% decrease into H2 2020. Despite the severe COVID-19 wave 2, we have pleasingly seen an 18% increase in our mental health PPDs over H1 2021, which is pleasing to see. In terms of the acute rehab business, we saw a smaller drop-off in terms of from H1 2020 to H2 2020, but we have seen a slower increase in terms of the recovery. That improvement has continued to increase in the months of April and May. In terms of both renal dialysis treatments and oncology treatments, it's pleasing to note for both those businesses, we now have higher underlying activities than what we saw in H1 2020, and so both those businesses are performing extremely well. Can we go to the next slide? In terms of the healthcare services overview, what we see is a really strong performance from Life Esidimeni and the Life Health Solutions businesses. Esidimeni had a stable growth in revenue and stable margins. What we saw in Life Health Solutions was a good increase in revenue based on an increased number of services we offered to cover the COVID-19 epidemic. That has resulted in a 12% increase in our revenue and pleasingly good management of cost because what you see is a 72% increase in the normalized EBITDA for those businesses. The healthcare services businesses, although fairly small in the overall SA business, have really performed exceptionally well under a difficult six months. Can we go to the next slide? Thank you. Lastly, the quality slide for the Southern African business. What you see under a difficult six months, I think, what you see is a really good set of quality scores. Our patient adverse event rates are down. Our patient experience rates were stable on prior year despite the difficult circumstances. What we see in our clinical outcomes is a number of them impacted by COVID, for example, your VAP, your CLABSI, and your CAUTI, those measures being impacted by COVID. What you see overall is an improvement in the overall trends and those trends heading in the right direction. The last point, we put up a slide, I just wanted to talk about the employee safety measures. You can see the improvement, but that chart excludes COVID. If you include the COVID scores in our employees, that number jumps from, it's roughly 3.8 to over 11. That shows the burden that COVID-19 has placed on the healthcare workers in this country. On that note, I just wanted to say that I'd like to thank the Life Healthcare staff for the role they played in dealing with this COVID-19 pandemic over the last six months. It has been a difficult six months, in particular, I'd like to thank the frontline workers and the frontline doctors. They worked under extreme pressure. They showed amazing resilience and courage, and they delivered outstanding care under difficult circumstances. I wanted to thank them before I hand over to Pieter van der Westhuizen. Thank you very much. Thank you, Adam. Good morning, all. Just in summary, we had a strong H1 considering the environment that we traded in. It's a testament to what Adam has said in terms of our people. Under difficult circumstances, the SA business have continued to improve performance against H2 2020 exceptional good performance from the international team. Just to remind us as well, in terms of last year, at the end of the year, we had the vicious cyberattack, and it put pressure on our working capital as well as on the finance teams in the Southern Africa business. The recovery of that has been exceptional, and that resulted in our cash generated from operations at ZAR 2.3 billion, roughly 95% of EBITDA. Normally, for the first half of the year, we had between 85%-90% of EBITDA, and this has been an exceptional performance. Also, net debt to normalized EBITDA improvement. The financial strength of our balance sheet strengthened in the first half from around 2.96x at the end of September to 2.78x, largely driven by two or three factors. One is the improved performance from the operations. Two is the impact of exchange rates to some extent, where we benefited. Thirdly is the disposal of Scanmed, where we had net proceeds of ZAR 680 million that we then applied to reduce our debt levels. Next slide, please. Just to put the results in context. Firstly, the comparative numbers for 2020 have been adjusted to take into account the disposal of Poland or Scanmed, that's reflected as a one-liner you'll see almost at the bottom of the slide: a profit and loss from discontinued operations, a profit in the current year, and a loss in the prior year. All the numbers are now comparable, excluding Poland. Secondly, the results for 2020, they reflected the impact of COVID only for roughly about a month, compared to in the current year, where it's been in for a full six months. We had strong revenue growth. That's driven by good recovery in scan volumes, as Mark Chapman showed, in the international operations, as well as the benefit that we received through our partnership with providing pandemic solutions to our various customers internationally. The higher acuity of cases that we've seen in South Africa that resulted in a higher revenue per activity in the SA operations, resulted in the revenue growing at 4%. Normalized EBITDA down by 14% due to the impact of COVID-19. That's largely because of the high costs associated with COVID-19 in the SA operations, as well as the loss in operational leverage because of our activity levels being lower and the high fixed cost nature of our business. Normalized EBITDA margin at 18.6%, down against last year, showing good improvement from H2 2020. A testament to the learnings that we've taken out of the first wave, but also the good management in both our segments, international as well as South Africa. Lastly, just in terms of this, you'll see that interest costs coming down because of a reduction in our debt levels, but also because of improved performance of the international as well as the Southern Africa operations. Attributable profit up 4% at ZAR 812 million against ZAR 781 million for the prior financial year. Next slide, please. This slide we're trying to show what the estimated impact of COVID-19 has been on our business for 2021, as well as for our comparative period for 2020. Currently, the impact is roughly ZAR 400 million at attributable profit loss, compared to the prior year of ZAR 120 million. As you can note, that is a significant impact. Underlying business, good results at a 36% improvement against the prior year if we strip out COVID. Obviously, one can't do that because it's part of the business. Just to show you that the underlying business has done well, except for COVID. Next slide, please. Total EPS up 4%, and that includes the impact of Poland at 55.9% against 53.7%. Stripping out the discontinued operation, EPS from continuing operations at ZAR 0.499 against ZAR 0.551, 9.4% down against the prior year. We look at the business at a normalized EPS from continuing operations basis, consistent treatment in terms of the prior year, ZAR 0.528 per share compared to ZAR 0.541 per share, 2.4% down against the prior year. Next slide, please. I just want to start on the right-hand side, the graph showing the good recovery in the international as well as in the Southern African operations between H1 2020, H2 2020, and then H1 2021. We can see that the EBITDA margin in the Southern African business is now north of 15% compared to just below 10% for H2 2020. SA business, the biggest impact has been COVID at 33.6% down against last year for the same period. International business, on actual exchange rates, roughly 50% up against last year. Constant currency, it's 58.7% up. Included in the results is also, you'll note that the corporate cost has increased by 17%, driven by largely the increase in cost- related to IT spend. After the cyber incident, we increased some of the IT spend. The cost of licensing is mainly denominated in foreign currency, and that had an impact on the results. That resulted in our costs increasing by 8.8%. Income is up 2.2%, but that's a factor of revenue. In the SA operations, if revenue is down, the head office charges a management fee, and it's revenue- linked, and hence it's got an impact on the income that's generated at corporate. Overall, normalized EBITDA margin at 18.6%. The SA business, including the corporate, is at 16.6% EBITDA margin, and the international operations just south of 25% at 24.8%, exceptional performance for international operations. Next slide, please. As I said, the balance sheet strengthened with net debt to EBITDA at now 2.78x against 2.96x at the end of last year, the financial year. We still have all the bank facilities that we arranged during the COVID period available. Total bank facilities as at the end of March was undrawn at ZAR 6.4 billion. We are now in the process of reviewing those facilities to make sure that we've got sufficient facilities, only what we need for the next six months, although it's difficult to forecast. In terms of our bank covenants, amendment to the bank covenants came to an end at the end of March. It was amended to 4.5x, and it's now back to the 3.5x net debt to EBITDA. In terms of our latest forecast, no concern in terms of meeting these bank covenants. Next slide, please. Overall debt improved due to three factors. You'll see on this slide that debt at the end of September last year was ZAR 16.4 billion, roughly, and it's now down to ZAR 13.6, versus gross debt. Driven by good performance in the business, as well as benefiting from exchange rates, so strengthening of the rand against the pound, and then largely also because of applying the proceeds from Poland to reduce our debt levels. There is a small improvement in the weighted average cost of debt from 2.85% at the end of last year and 2.84% in the current year. Next slide, please. Lastly, in terms of our debt repayment profile, we have got another roughly ZAR 1 billion that comes up for repayment in the current period. As I have shown earlier, we do have bank facilities, shorter bank facilities available to repay these. In addition to that, we are in the process of entering into additional term debt that we will then apply to extend our maturity profile, but also to reduce our banking facilities overdraft position of ZAR 1.8 billion. We expect that to be completed within the next few weeks. Thank you. I'm now going to hand you over to Peter to take you through the outlook. Thank you very much, Pieter, and to Mark and Adam. As far as growth initiatives are concerned, the one we do want to just re-explain in some detail relates to Life Molecular Imaging. In red, you'll see that the seventh of June 2021 is a key date in our company. This goes to the heart of an approval process currently being assessed by the FDA as to whether or not to approve Neuraceq, yes or no. We might liken it to a coin toss, but in advance of that decision, important for us to just re-explain exactly what it is. Neuraceq is a trademarked, approved amyloid imaging tracer, which we own in Life Molecular. An amyloid imaging tracer is used in a PET-CT scan to help diagnose Alzheimer's disease. We are currently in conversations around commercial sales contracts for the use of Neuraceq, both in research and hopefully, in diagnostics. What then happens is if this is then approved on the seventh of June, we can move into a more commercial stage of the deployment and sale of Neuraceq on a further and more widespread basis. While the current focus is on Neuraceq, it's also important to see that Life Molecular has a pipeline of other products, which we've tabulated below. You'll see that there are eight different products spanning dementia, cardiovascular, and oncology diagnostic profiles. They're all in various stages of development. It's important for us to see that Life Molecular hasn't just got one trick. Certainly, if the seventh of June rules in our favor, we're onto a commercialization path. If that goes against us, there are other competing products being developed for the treatment of Alzheimer's, and there's certainly other opportunities that rest along the other three categories that I have described. Moving along into Southern Africa, you'll see the growth initiatives across the whole spectrum span the business lines that we have spoken about in some detail. We see good growth opportunities within our existing South African market, but our focus is not to explore for new ones. Our focus is now on execution. We will invest in our IT infrastructure to enable further digital innovations at the clinical and non-clinical levels. Our SA Radiology project has not gone quite as fast as we would have hoped. We're making good progress. You would have seen some of our public profile statements on bringing skill sets and technologies home, continuing to exert some influence in the local market. We're hopeful for a positive outcome in our discussions with the HPCSA. We expect operations to commence during the balance of the six months of this year. Other growth prospects at the acute hospital level, we are reinitiating some of them that we put on hold due to COVID-19. We see significant growth opportunities in mental health, acute rehab, renal dialysis, and oncology. Rounding that off, as you saw from Adam's graph, our healthcare services business in Life Esidimeni and Life Health Solutions also are demonstrating future potential. We do need to complete our vaccination update to you. From an international perspective, Mark did give you the update that they've made good progress, and approximately 72% of all AMG's healthcare workers have received their first vaccine. Locally, 75% or thereabouts of our healthcare workers, employees, doctors, and contractors have been vaccinated. We have volunteered assistance to the government in the countrywide vaccination program in phase II, and you'll see they annotated the 22 hospital vaccination sites, in addition to nine secondary sites and 20 EHS sites that we volunteered into the program, which should get up and running at scale towards the end of this month. From an outlook perspective, we can see in international we are looking towards a more normalized operating environment as the vaccination efforts across the continent start to normalize the incidence of COVID-19. We see a continued growth in scans We've reported that Dinnington is operational and will commence with the maintenance program within Sutton, which will stabilize our radiopharmacy production capability. Of course, we're investing in LMI, given the update that I provided to you a little bit earlier to drive the sales of Neuraceq, and we've annotated a capex spend of just short of ZAR 1 billion for FY 2021. In Southern Africa, the business is well prepared for the third COVID wave. Adam has said that the learnings in waves one and two have been translated into an operational plan in anticipation of this third wave. We do expect a continued improvement in both PPDs and margins, but we're not sure exactly how wave three will pan out, so the timing of that is somewhat under review. We will continue to focus on our internal optimization programs, execute the radiology project, and deliver on the growth opportunities discussed a little bit earlier. Capex for the year in South Africa will be just over ZAR 1 billion. In aggregate, the group's outlook is somewhat cautious, but it's mixed with optimism that our diversification strategy is working. We do expect a continued improvement in underlying business. We have and will enjoy a renewed focus in executing on growth opportunities, but we are also continuing with our cash preservation strategies. With that in mind, the dividend distribution at the half year we have set to zero, but of course, we will review that at the end of the financial year when we have some more certainty around the impact of wave three. Our outlook and future is therefore all focused on people. We put our patients first. Our quality scores, which we have proudly reported to you, and our patient experience scores are certainly in the vein of making life better. We strive to deliver and will continue to deliver these quality clinical outcomes and patient experience. Irrespective of the geography or business lines we choose to pursue, growth opportunities cannot be delivered without our people. Adam, and Mark, and I, and all of the executive team, once again express our appreciation to our nurses, our clinicians, and appreciation for our partnerships with doctors and our key relationships with government and other key stakeholders around the world. We remain focused on our strategy and will be execution-oriented to deliver on our promises. With that, we'll take questions. Thank you. Operator, could we take questions from the dial-in call first, as we collect questions from the webcast? Thank you. Thank you. Ladies and gentlemen, on the conference call, if you would love to ask a question, you are welcome to press star and then one on your touchtone phone or on the keypad on your screen. If you wish to withdraw the question, you may press star and then two to remove yourself from the question queue. For those on the webcast, you may submit your question by the text box at the bottom of the page. Our first question is from Anuja Joshi of Absa. Hello. Good morning, everyone. Thanks for the presentation. Just two questions. The first is on revenue per PPD growth, and the second is on recovery in non-COVID cases. Your revenue per PPD growth was 12% in the first half, and your peers have reported around 9%. Could you please elaborate on what is driving your revenue per PPD, your case mix better than peers, and what sort of trend do you anticipate in the second half and beyond? The second question is on recovery in non-COVID cases. I just want to understand where do South African hospitals stand compared to other countries, and what is driving that trend? I'm asking because if I look at the graph shared by one of your peers, recovery in their non-COVID cases in South Africa was lower compared to other countries. I'm sure you will be following what's happening to other hospitals in other geographies. I just want to understand where South African hospitals stand compared to other countries in terms of recovery in non-COVID cases, and what is driving that trend, and what kind of trend do you anticipate over the next one to two years? Thank you. Thank you, Anuja. Adam, do you want to take revenue per PPD and non-COVID cases, please? Okay. I was hoping to get the second question from someone else, Mark, but I'll deal with the first question. Hi, Anuja Joshi. The revenue per PPD at 12%, as I said, it reflects a sort of fundamental change in the underlying case mix. That's based on a number of factors. Firstly, you've got a high number of or a longer theater stay, showing that more complicated cases in theater, one. Secondly, what it does show is a lower percentage of medical cases. We know that medical cases come at a lower revenue per PPD than a surgical case. That's why you get a sort of high revenue PPD. I do think as a business, we've always had a, I think, probably more exposure to medical cases. I don't know what other groups are present in terms of medical cases, but certainly in terms of the profile of our membership, the network deals we have, and the location of hospitals and the mix in hospitals. Typically, we have on a PPD basis, historically, 54%, 55% of our PPD is in medical, and that includes mental health and acute rehab. What we've seen over the last 6- 12 months is a drop in that ratio. That feeds into our revenue per PPD is higher, probably higher than our peers that's coming through in terms of the increase. In terms of the recovery of non-COVID cases, I'm not sure what other international hospital groups have seen in other countries. I suppose how we recover non-COVID cases is reflective in terms of where we are as a country in terms of dealing with COVID. What we see is we're still behind other countries in terms of vaccine rollout. We are, excuse me, even though like a low form of lockdown, we still have a society which is not back to normal. For example, we still see our admissions into our accident or emergency units are still well down on what it is in the pre-COVID world. You still have a society which is social distancing, not everyone's going to the office, et cetera. That, I think it all plays through into what we see in a non-COVID environment. As for trends, we're not sure. I don't know how the COVID wave 3 plays out. I do think that as the vaccines start to happen and more of the population gets vaccinated, hopefully we will return to more of the pre-COVID world, and then hopefully back to more of a pre-COVID type environment. There are so many factors in between which impact that. Yeah. Thank you, Adam. I think that helps. I'm just asking because I look at the recovery of non-COVID cases in other countries, because before the vaccination started in those countries, the cases over there, recovery was higher compared to South Africa. I was just wondering if there is something beyond this COVID-19 wave or vaccination, or is there anything specific to South Africa that is affecting that. Thank you very much for answering my questions. That's it. Thank you. Okay. Thank you. We don't have any other questions on the conference call at the moment. Thank you, operator. Perhaps while we wait for further dial-in questions, we do have a few on the webcast. I will start. There are two for Mark Chapman. The first is from Flo Lanark at Investec. Please, could you give us a sense of how sustainable revenue and profits from National Healthcare Support are in the medium term? Are these likely to decline once we return to a more normal operating environment? Allied to that, a question from Victoria Lambert at Bank of America. Does EBITDA margin in the range of 23%-24% look sustainable going forward for AMG? Okay. Thanks, Mark. To answer the first question on the sustainability of the National Health Service. We are seeing, and I think the story with the first six months on a 24/7 contract, then up to the end of this year, that requirement is still there. If you think about the pent-up demand, I do see the reliance on services going forward. The amount of scanning activity going through that provision of services is very high. They will be very hard-pressed to stop that activity and turn that tap off. One of the things that we did do for this contract was to acquire additional scanners and also do an intense training program with our radiographers from MRI to CT. That did incur costs, and that was reflected in the first six months' worth of revenues. That will be normalized going through the period, as it's been sustained for the second half of the year. Going into the next financial year, I think there will be some pressure points on that. Hard to say what figure at this stage, but the actual demand for scanning, I think, will still be there. Those are conversations we need to have. It does link into the margin as well. One question was the sustainability of the margin around the 23%, 24%. I think that is deliverable. Yes, we'll see some pressure to the point I've just talked about. Actually, as we start continuing to manage the cost base and some of the costs associated to COVID as we normalize, I think that will help the margin as well. Relatively confident around those levels. I think there's also just a question from Roy as well around the 50,000 backlog of cancer patients in the U.K., being asked if that's starting to come through. I don't feel it's coming through at the pace it should at the moment. I think what is encouraging, if you look at some of the activities in the last two to three weeks, there have been record levels of activity on a daily basis. I think that just starts to show that level of activity and need coming through the service and the system, which is encouraging. I've seen a question from Grant as well, and I think I'll pass it back to you, Mark. There's a question around what does AMG sees as a long-term and a short-term partnership. The long-term partnerships which we look at are similar to Colchester, this [automotive] community diagnostic center, where it's a 10-year contract. There are some that sort of form from a sort of 5 + 5. That's what we start seeing as a sort of medium to long-term contract. The short-term provisions are very much similar to what we're seeing with some of the mobile contracts at the moment, which are sort of six months. Some of them are up to 12 months, which is classed as short-term. As we move through to the opportunity that I think community diagnostic hubs will bring to the business, they are certainly long-term provisions integrated into the integrated care system of a region and very much integrated into the infrastructure of the NHS, and to support their diagnostic challenges that I'm sure they're going to have over the next two months to two years. Hopefully, that's answered those questions. Thank you. Thank you, Mark. One further question from Victoria Lambert at Bank of America. What occupancies did Life South Africa see in May? Adam, do you want to take that, please? Yeah. Look, our occupancies in May are sitting at 61 odd% at the moment. We probably expect that to continue through the rest of the month. Certainly an improvement from what we've seen in H1 2021. Hopefully, that's a continued trade. Look, let's see how the COVID wave three, if we do get it, all plays out, but it's roughly 61%. Okay. Thank you, Adam. Operator, do we have any further questions from the call? We don't have any other questions on the conference. Okay. Thank you. That does appear to be all the questions at the moment. Peter Wharton-Hood, do you want to make any remarks in closing? Yes, thank you very much, Mark. I think it was all wrapped up in my opening statement. My thanks to the team and to those who may not have had all your questions answered. We do remain available as a team. If you contact Mark, we will address your questions. Thank you to all. Thank you, operator. I think we can wrap up. Thank you very much. Thank you. Ladies and gentlemen, that does conclude this event. Thank you for joining us. You may now disconnect.
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