Ramsay Health Care UK – a subsidiary of Ramsay Healthcare (Australia)
Established 1964 in Australia by Paul J Ramsay
Ramsay Healthcare operates 120 hospitals and day surgery facilities in four countries, with over 8000 beds and nearly 25,000 staff. In the UK Ramsay Health has a network of 27 hospitals, 5 treatment centres and 2 neurological units, delivering both private treatment and care under contract to the NHS. Ramsay Health Care UK also employs over 3500 staff.
Through a process of acquisition in its home market Ramsay Health has become Australia’s largest private hospital operator. Acquisitions have included other private hospital groups, with the largest being of Affinity Healthcare in 2005, which increased Ramsay’s hospitals from 35 to 69. Ramsay also has a history in Australia of moving into the public hospital sector. In 1994/1995 Ramsay Health Care won bids to privatise two government-owned repatriation hospitals (also known as veterans hospitals) – Hollywood Hospital in Perth and Greenslopes Hospital in Brisbane. This strategy has continued and in 2012 two private/public hospitals were in development.
Ramsay Healthcare’s first foray outside Australia was to Indonesia where it now runs three private hospitals; these were acquired with the acquisition of Affinity Health in 2005. Then in 2007 the company acquired Capio, at the time the fourth largest operator of private hospitals in the UK. The company’s focus for expansion switched to France in 2010, with the March 2010 acquisition of 57% of the French hospital company Group Proclif SAS, now known as Ramsay Santé. Ramsay’s expansion in France has continued, with the May 2011 acquisition of the Clinique Convert hospital, which Ramsay notes is a first step in expanding the Ramsay Santé business, with plans for further expansion. The company currently operates nine hospitals in France.
In the UK Ramsay’s growth has been driven by increasing volumes of NHS patients; as of 2016 they accounted for 77.3% -an increase from 75.5% in 2015. Self-pay customers are also integral and Ramsay puts focus onto its “premium care” advertising to private patients.
Recent years have been tough for Ramsay in the UK: in June 2018 Ramsay wrote down the value of six sites in the UK by £70m. The company welcomed the Government's June 2018 promise of more money for the NHS, but it does "not anticipate immediate benefits for us and expect operating conditions in the UK to remain challenging in the medium term.”
In the UK Ramsay’s business is conducted through Ramsay Health Care UK Operations Ltd. The most recent accounts available from Companies House are for the financial year ending 30 June 2017.
2017 (year end 30 June):
Revenue = £440.7 million
Pre-tax profit / (loss) = £14.6 million
Tax paid = £2.4 million
Profit / (loss) = £12.1 million
2016 (year end 30th June):
Revenue = £422.4 million
Pre-tax profit / (loss) = £15.6 million
Tax paid = £5.6 million
Profit / (loss) = £10 million
As you can see, while revenue has increased over time, profit for 2017 was lower than in the year prior.
Full accounts are published by the Australian parent company, Ramsay Health Care. Accounts are available for the financial year ending June 2017.
77.35% of Ramsay Health Care Ltd is owned by the top 20 shareholders. The top 5 shareholders are:
Paul Ramsay Holdings Pty Limited - 32.16%
HSBC Custody Nominees (Australia) Limited - 14.05%
J P Morgan Nominees Australia Limited - 11.31%
National Nominees Limited - 4.66%
Citicorp Nominees Pty Limited - 3.41%
According to the HSJ, of all the private providers delivering publicly-funded work, Ramsay is the most dependent on NHS outsourcing and the choose-and-book system.
Ramsay Healthcare runs NHS treatment centres (ISTC) and performs surgery at nearly all its hospitals and clinics for the NHS.
In 2010 Ramsay Health was a bidder in the tender process for running Hinchingbrooke hospital; Ramsay eventually withdrew from the process in August 2010. In October 2012 Ramsay Healthcare was reported to be one of the bidders for the new contract to run the Nottingham ISTC beginning in 2013; this is currently run by Circle Health.
Ramsay Healthcare is part of the Private Hospitals Alliance (formerly H5) which lobbies Westminster on issues regarding healthcare and the role of private companies in delivering NHS services.
In October 2017, Ramsay was fined £550,000 at Southwark Crown Court following a prosecution by the HSE. The HSE was alerted by a whistleblower in 2014 to deficiencies in the company's occupational health team and it subsequently found a string of problems, including failing to risk assess hazardous substances, including carcinogenic chemotherapy drugs, and failing to provide workers with adequate health surveillance.
In 2007, Ramsay Health agreed a 10-year deal with Bromley Hospitals Trust (now South London Hospitals Trust) for the Princess Royal University Hospital in Orpington to build a £4.2 million, 25-bed unit, which the trust would then rent to Ramsay Health UK for £500,000 a year. But in June 2009, just two years into the contract, Ramsay closed the unit saying it was no longer commercially viable. This has left the already deeply in debt South London Hospitals Trust having to pay back eight years rent that was paid upfront by Ramsay Health, and with no money to pay the running costs of the unit without impacting on its budget or to offset the £4.2 million the unit cost to build.In March 2011 Jill Watts CEO of Ramsay Health UK was called to give evidence before the Public Accounts Committee. Although Watts was at first evasive on the issue of failure, eventually she admitted that should a business be failing then the company would close it. When questioned on what would then happen to the patients she noted that that would depend “on what the marketplace is”.