5. OPERATING AND FINANCIAL REVIEW
RAMSAY HEALTH CARE LIMITED
8 Ramsay UK
8.1 Overview of Results
Twelve months Ended 30 June $'m 2021 20201 Chg (%)
Revenue from patients and other revenue 606.5 770.8 (21.3)
Revenue from governments under COVID 19 support contracts 417.6 158.7 163.1
Total revenue and other income 1,024.1 929.5 10.2
EBITDAR 182.4 165.9 9.9
Rent (1.2) (1.3) (7.7)
EBITDA 181.2 164.6 10.1
Depreciation and amortisation (88.4) (93.2) 5.2
Impairment - (20.8) na
EBIT 92.8 50.6 83.4
Financing costs associated with leases (AASB16) (81.8) (85.1) 3.9
EBIT less financing costs associated with leases 11.0 (34.5) 131.9
Capital Expenditure 58.0 65.7 11.7
1 FY20 restated to reflect non-core items taken below the line in FY20 refer Group Performance for allocation of non-core items
Overview of Result in Local Currency
Twelve months Ended 30 June £'m 2021 2020 Chg (%)
Total Revenue and other income 567.7 494.8 14.7
EBITDAR 101.1 89.5 13.0
EBITDA 100.5 88.8 13.2
EBIT 51.4 26.9 91.1
8.2 Review of results
• Ramsay UK continued to support the NHS as further waves of
the pandemic impacted the public health system during the year.
Ramsay has treated 650,000+ NHS patients since the start of the
pandemic, performed 16,000+ cancer treatments for the NHS and
hosted 20+ NHS services including 50,000+ MRI and CT scans.
• In 1HFY21, Ramsay UK operated under an agreement with the
NHS1 covering the period 1 July 2020 to 31 December 2020.
The agreement provided for Ramsay UK to receive net cost
recovery for its services to NHS and allowed for the return of
some capacity for private patient activity and routine NHS elective
• In 2HFY21, Ramsay operated under a revised volume-based
agreement with the NHS, covering the period 1 January 2021
through to 31st March 20212. As a result of the jump in COVID
cases, the NHS triggered peak surge arrangements, resulting in
Ramsay capacity at 14 hospitals being utilised during the 3QFY21.
In these circumstances, Ramsay was paid on a cost recovery basis.
• In the 4QFY21, Ramsay provided activity to the NHS under a
new National Increasing Capacity Framework Agreement. This
operating arrangement with the NHS is expected to continue
• The net cost recovery paid under the NHS agreement for the
12 month period was A$417.6m and is reflected in revenue from
• Private admissions returned strongly post the lock-down easing in
April and the increased weighting to these admissions during the
4QFY21 improved payor and complexity mix.
• The 21.3% decline in net patient revenue reflects the capacity
restrictions under the various agreements with the NHS during the
12 month period.
• Neurological rehabilitation revenues over the 12 month period
increased 4.4% despite social distancing restrictions and reflected
an improved contribution.
• EBITDAR increased 9.9% and included a 10% increase in personnel
costs and an 18.9% increase in supplies and purchases, both
increases reflecting higher costs associated with operating in a
• The result includes A$8.7m of transaction costs associated with
the proposed scheme of arrangement with Spire, which was voted
down by Spire shareholders on 19th July 2021.3
1 ASX announcement 14 October 2020 “Ramsay Health Care Varies Agreement with NHS”
2 ASX announcement 22 December 2020 "Ramsay Health Care enters new agreement with NHS England"
3 ASX announcement 19 July 2021 "Results of Scheme Meeting"
20 Annual Report 2021