GROWTH WITH PURPOSE ANNUAL REPORT 2024
At IHH Healthcare, we are charting a path forward by placing clinical excellence at the heart of everything we do, expanding capabilities, and ensuring every initiative enhances patient care and deliver meaningful impact. With a strong focus on innovation, we are redefining healthcare standards to create a future where lives are not just touched but transformed through care that truly makes a difference.
1 Content Group Overview 2 A Purpose-Led Approach 4 Navigating This Report 5 Investment Case 6 Clinical Excellence 10 IHH at a Glance 12 Financial Highlights 14 Operational Highlights 16 Our Sustainability Approach 18 Corporate Milestones 2024 20 Awards and Accreditations Other Information 110 Additional Compliance Information 112 Directors’ Responsibility Statement Financial Statements 114 Directors’ Report 120 Statement by Directors 121 Statutory Declaration 122 Independent Auditors’ Report 125 Statements of Financial Position 127 Statements of Profit or Loss and Other Comprehensive Income 128 Statements of Changes in Equity 134 Statements of Cash Flows 136 Notes to the Financial Statements Additional Corporate Information 237 Analysis of Shareholdings 239 List of Top 30 Largest Shareholders 241 List of Top 10 Properties 243 Notice of Fifteenth Annual General Meeting Form of Proxy Strategic Report 24 Chairman’s Statement 28 Group CEO’s Message 32 Business Strategy 34 Business Model 36 Impact of Value Creation 38 Operations Review 38 Malaysia 39 Singapore 40 Türkiye and Europe 41 India 42 Greater China 43 Parkway Life REIT 43 Laboratories 44 Financial Review 46 Market Outlook 50 Our Material Matters 51 Risk Management 52 Principal Risks Governance 57 Board of Directors 65 Group Management 69 Country Leadership 71 Corporate Governance at a Glance 72 Corporate Governance Overview Statement 89 Nomination and Remuneration Committee Report 94 Audit Committee Report 97 Risk Management Committee Report 99 Statement on Risk Management and Internal Control 107 Investor Relations Report
IHH Healthcare Berhad | Annual Report 2024 2 A Purpose-Led Approach Our Purpose At IHH, we are united by our shared commitment to touch lives and transform care for patients and communities worldwide. Our values serve as a north star for our actions, strategy, decision-making and policies. We are committed to fostering excellence, innovation, and patient-centricity in every aspect of our work, across all markets, functions, and levels, by embodying these principles. Our Commitment Group Overview To our patients and their loved ones We will put our patients’ needs first and go the extra mile to provide quality and exemplary care. To our people We will build a caring and inspiring environment for our people to succeed and shape the future with us. To our partners We will work together with respect and honesty for mutual benefit. To our shareholders We will build long term sustainable growth and shareholder value. To our communities We will do good beyond our healthcare services. To our planet We will make choices that protect the environment and preserve it for future generations. Patients First We put patients’ needs first Integrity We do the right thing Empathy We listen with our hearts Teamwork We are better together Excellence We champion continuous improvement and innovation Values
3 ACE Framework Our refined strategic priorities, implemented through the ACE framework in 2024, have yielded outstanding results, significantly enhancing investor confidence and generating sustainable growth and lasting value for our stakeholders. Our Strategic Priorities Align to Propel Profitable Growth All IHH operations will be aligned with our aspiration to Care. For Good. and co-create a sustainable healthcare system while delivering profitable growth. Challenge to Transform We are challenging ourselves to transform and future-proof the organisation by initiating projects to enhance process efficiencies across the Group and in our markets. Empower to Excel We will adopt a localised approach, empowering all our markets and their operations and functions to chart and drive their growth trajectories. These are done in alignment with national healthcare agendas and our continued commitment to create quality care and outcomes for patients. Grow Organically IHH remains steadfast in expanding bed capacities, driving patient volume growth to increase occupancy and upgrading facilities and equipment to enhance revenue intensity. Expand Across Healthcare Continuum We will grow our ambulatory care offerings and improve primary care clinic penetration in selected markets, in line with national healthcare agendas. Capture Inorganic Opportunities We continually explore and evaluate earnings-accretive assets in existing and new markets to capture new opportunities. Develop New Growth Engines We are expanding vertically into the laboratory and diagnostic business, alongside targeted investments in innovative healthcare solutions and seamless digital services to complement our existing offerings. Turnaround Underperforming Assets We endeavour to maximise the potential of our underperforming assets.
IHH Healthcare Berhad | Annual Report 2024 4 Navigating This Report Navigation Icons Refer to this guide while traversing the report. Group Overview Principal Risks Geopolitical Climate Change Cybersecurity and Data Privacy Artificial Intelligence (AI) Inflation Workforce Management Five Strategic Priorities Grow Organically Expand Across Healthcare Continuum Develop New Growth Engines Capture Inorganic Opportunities Turnaround Underperforming Assets ACE Framework Align to Propel Profitable Growth Challenge to Transform Empower to Excel Please scan the QR code to refer to our Sustainability Report. Our Reporting Suite IHH Healthcare Annual Report for the financial year ended 31 December 2024 is supplemented by our standalone Sustainability Report 2024. Our reporting suite can be accessed online. Reporting Suite Annual Report 2024 Sustainability Report 2024 Disclosure • Chairman’s Statement • Group CEO’s Message • Operations Review • Financial Review • Corporate Governance Overview Statement • Audit Committee Report • Statement on Risk Management and Internal Control • Directors’ Report • Independent Auditors’ Report • Financial Statements • Global Reporting Initiative (GRI) • Sustainable Development Goals Disclosure (SDGD) • In preparation for disclosing ISSBcompliant information, we have begun to assess our sustainability disclosures against the SASB Standards for Health Care Delivery to identify areas of alignment. Details on this mapping can be found in the GRI Content Index on page 70 of the Sustainability Report Reporting Frameworks • Main Market Listing Requirements of Bursa Malaysia Securities Berhad (MMLR) • Malaysian Code on Corporate Governance 2021 • Companies Act 2016 (CA 2016) • Malaysian Financial Reporting Standards (MFRS Accounting Standards) • International Financial Reporting Standards (IFRS Accounting Standards) • Main Market Listing Requirements of Bursa Malaysia Securities Berhad (MMLR) • SGX Listing Rule 711 (A) and (B) • Global Reporting Initiative Universal Standards 2021
5 With over 140 healthcare facilities across 10 countries, including over 80 hospitals, clinics, and ambulatory care centres across Asia and Europe, IHH is one of the world’s largest and most trusted healthcare networks. Our trusted healthcare brands are highly established and provide patients with a comprehensive range of integrated services, all delivered with exceptional care. We maintain our reputation over time through these competitive advantages. Investment Case Our success isn’t just measured in numbers — it is embodied in the lives we touch and communities we impact. While boasting a distinguished portfolio of brands, global reach and clinical excellence, IHH stands apart from its powerful aspiration to Care. For Good. Our brands – Acibadem, Fortis, Gleneagles, Island, Mount Elizabeth, Pantai, Parkway, Prince Court – are well-known for their clinical excellence and outstanding patient experience. We are passionate about fostering a healthier and more sustainable future for our patients, people, public and planet. By making a positive impact at each touchpoint with our stakeholders, we stay true to our aspiration to Care. For Good. while driving business performance. Innovation is at the heart of value creation. We form strategic partnerships to stay abreast of the latest technologies to improve patient care and operational capabilities. IHH was one of the first healthcare groups in the world to use artificial intelligence (AI) for accurate bill estimation, providing patients with peace of mind. IHH offers accessible, efficient and high-value healthcare services across our extensive network. The exceptional care that patients experience in all our markets is a result of IHH’s remarkable ability to achieve an optimal balance of value and quality. IHH brands set the gold standard in medical excellence, whether it is the implementation of cutting-edge technologies or personalised patient care. With continual improvements in operations and digital transformation, we are regularly recognised as trailblazers in the industry. Eight Prestigious and Trusted Hospital Brands Embodying Care at Every Touchpoint Global Scale and Influence At the Forefront of Change Commitment to Sustainability Deep Operating Capabilities Our Purpose
IHH Healthcare Berhad | Annual Report 2024 6 Group Overview Clinical Excellence At IHH Healthcare, we are steadfast in our commitment to delivering superior clinical outcomes and exceptional patient experiences through targeted initiatives, strategic investments and a robust governance framework. We aim to raise the bar for excellence across our global network, delivering on our promise to being an accountable and trustworthy healthcare provider. These efforts solidify our leadership position and ensure we meet the evolving needs of patients and other stakeholders. As a group, IHH is committed to ensuring accountability, continuous improvement and delivering evidence-based care. The following efforts align with our targets to achieve 90% of quality indicators at or above international benchmarks. • Expanding Clinical Quality Indicators (CQIs): We started with 113 CQIs across eight Value-Driven Outcomes (VDO) procedures in 2022 and ended Q3 2024 with 170 indicators. We expect to reach 236 CQIs by 2025, reflecting our enhanced capabilities in data collection and analysis and maintaining the target of delivering a high standard of care. • Clinician Engagement and Collaboration: Across markets, we facilitated discussions on case selection, indicators for new procedures and data presentation for four key conditions, Total Knee Replacement (TKR), Anterior Cruciate Ligament Reconstruction, Colonoscopy and Percutaneous Coronary Intervention. Such sessions foster collaboration and knowledge sharing, which drive clinical improvements, ensure consistent care delivery and identify actionable improvements. • Patient-Reported Outcome Measures (PROMs): For TKR procedures, we have implemented PROMs to collect patient experience data, enabling greater patient-centred care by capturing patients’ own experiences and priorities, enabling healthcare teams to tailor treatments, improve communication and make informed decisions for more personalised and effective care. Tracking and Measuring Clinical Performance and Outcomes Innovation remains at the heart of IHH’s strategy to improve patient outcomes: • Pioneering Upright Photon Therapy: IHH became the first in Asia to explore this cutting-edge treatment for cancer patients, marking a significant milestone in oncology care. • Expanding Medical Services: Across markets, we have introduced new treatment centres and integrated advanced technologies like artificial intelligence (AI) to enhance disease diagnostics, ensuring patients have access to world-class care. Investing in Advanced Medical Technologies and Clinical Offerings By proactively facilitating knowledge sharing, we draw inspiration from counterparts, promote professional growth and enhance the performance of the whole organisation. • Quality Summit 2024: Our ninth summit in Mumbai, India was themed “Redefining Healthcare for a New World”, bringing together almost 500 staff from across IHH. The event featured five pivotal tracks – Clinical Quality, Service Quality, Innovation, Laboratory, and Sustainability – and allowed delegates to network, share best practices and tackle key challenges in healthcare delivery. We also held an awards ceremony for outstanding achievements, motivating staff to strive for excellence. • Medical Symposiums: Two major symposiums in 2024 – one in Malaysia on neurology and another in Türkiye on arthroplasty – showcased medical best practices, advanced capabilities, and fostered community-building for knowledge sharing and patient referrals. Empowerment through Training and Knowledge Sharing Upholding Excellence through a Robust Clinical Governance Framework Our governance framework emphasises stringent quality standards, continuous monitoring and evidence-based practices to foster a culture of accountability, transparency and ongoing improvement. • Conducting of clinical audits: In 2024, we conducted clinical audits in Singapore, Malaysia, and India, spanning 10 clinical areas and utilising 24 selected indicators. These audits helped validate data integrity, identify gaps, and address them. They also facilitated the sharing of best practices across markets. • Implementation of Clinical Risk Assurance Framework: Since its phased implementation in 2023, our Clinical Risk Assurance Framework has provided a structured approach to managing and mitigating clinical risks. This multi-tiered framework involves meticulous checks at the hospital, country, and group levels, ensuring compliance and driving continuous improvement. In 2024, we established and implemented controls for each clinical risk category by assigning responsibilities to risk owners, training them on implementation and monitoring, tracking effectiveness and continuously assessing and improving risk controls.
7 India Gleneagles • A 15-year-old from Mumbai, Anamta Ahmad became the youngest person in the world to receive a shoulder-level limb transplant, after a tragic accident that took her right arm. She was discharged a month after undergoing the milestone surgery. • In Chennai, we successfully removed a large brain tumour measuring 7 by 6.5cm, improving a 20-year-old patient’s prognosis for a rare and aggressive cancer. • Gleneagles in Chennai was also the seventh in India to perform renal artery denervation, a minimally invasive procedure that lowered blood pressure and improved glucose metabolism for the 69-year-old patient. Türkiye Acibadem • A severely hearing-impaired 15-month-old Leia Dynnk heard her mother’s voice for the first time after undergoing cochlear implant surgery at Acibadem Kent Hospital in İzmir. The implant bypasses non-functioning inner ear cells and directly stimulates the brain to enable hearing. The transformative surgery was performed by Ear, Nose and Throat specialist Professor Mehmet Ziya Özüer. Pantai • We performed the first artificial skin grafting in Northern Malaysia on two patients in 2024. Both cases involved wounds with exposed tendons and made use of two types of graft. The first graft was a matrix that promoted granulation over the tendon, while the second was an endofoam, which promoted the growth of new skin cells. The patients’ wounds healed in under three months – a quicker recovery time thanks to techniques utilised and optimal post-operative care. TRANSFORMATIVE TREATMENTS 2024 Malaysia Prince Court • Prince Court’s Nuclear Medicine department performed its first Yttrium-90 Radiosynovectomy (RSV) treatment for Pigmented Villonodular Synovitis (PVNS), a rare benign tumor at the joint. Yttrium-90 was injected into the left knee of the patient, minimising the common risk of disease reoccurrence. Island Hospital • Island Hospital’s Cancer Centre team was the first in Malaysia to receive the Australian Council on Healthcare Standards (ACHS) 2024 Clinical Excellence and Patient Safety Award in December 2024, demonstrating our commitment to maintaining the highest level of clinical excellence.
IHH Healthcare Berhad | Annual Report 2024 8 India Fortis • Across India, Fortis hospitals have performed over 7,000 da Vinci robot-assisted surgeries to date. At Fortis Mohali, 595 procedures were carried out in the first nine months of 2024 alone, making it the second highest globally in volume for a single da Vinci robot. • Between June and November 2024, Fortis Gurugram performed over 120 procedures using the Gamma Knife, a non-invasive highly precise treatment for brain tumours and other neurological conditions. Singapore Parkway • We’ve embraced AI-powered tools like SenseCare Chest CT to detect lung conditions earlier and more accurately. In breast cancer screening, Lunit INSIGHT MMG helps radiologists identify potential concerns up to 12% more effectively, giving patients faster, more precise diagnoses. We’re also proud to introduce Southeast Asia’s first Photon-Counting CT (PCCT), offering clearer images with less radiation exposure. Parkway Radiology is committed to using the best technology to support doctors and provide patients with the best possible care. Group Overview Clinical Excellence INNOVATIVE TECHNOLOGIES 2024 Malaysia Gleneagles • In Johor, we became the first hospital in Malaysia to use artificial intelligence (AI) to detect anomalies in chest and brain imaging, setting a new standard in accuracy and efficiency. The Annalise AI can detect up to 124 abnormalities in under 20 seconds for chest X-rays, and up to 130 abnormalities in under two minutes for brain CT scans. Pantai • We were the first hospital in Melaka to introduce robot-assisted surgery, and have successfully completed these high-tech procedures in diverse specialties including urology, gynaecology, hepatobiliary, colorectal surgery and general surgery. Based on early data, these advanced surgeries have led to a shorter length of stay and reduction in rate of blood transfusion. Greater China Parkway Shanghai Hospital • Using advanced AI in low-dose chest CT scans, clinicians can screen for lung nodules, bone fractures and pneumonia in under two minutes, making clinical assessments more accurate and comprehensive. The system can analyse lung nodules in detail, classify them and track changes over time; distinguish between fresh and old rib injuries; and locate pneumonia with greater precision. Brunei Gleneagles • Dr. Billal Patel and his expert team at Gleneagles JPMC performed their first-ever procedure using the world’s smallest heart pump, known as the Impella device. The device provides critical heart support during a high-risk procedure. The successful landmark procedure sets the precedent for improving patient outcomes and enhancing our cardiac care capabilities.
9 Brunei Gleneagles • Since June 2023, we have collaborated with Brunei’s Ministry of Health to streamline and transform heart attack care, cutting treatment times from 150 to 25 minutes. This has not just saved lives, but also set new standards in rapid cardiac response and public awareness. India Fortis • The Cerebral plus Outpatient (OP) module, an electronic medical record system, is now operational across 11 Fortis hospitals. Additionally, the Inpatient (IP) module was launched at Fortis Hospital Manesar. The modules are designed to streamline patient care with more efficient management of medical records. They enhance workflow and ensure seamless integration of clinical data across outpatient and inpatient settings. Singapore Parkway • Caring for patients goes beyond hospital walls, which is why we embarked on our first Transitional Care Facility (TCF). We ensure that patients with chronic conditions recover comfortably while easing the pressure on public hospitals. In line with Singapore’s broader healthcare strategy of strengthening community care, Parkway Shenton takes pride in the Healthier SG initiative, providing quality chronic disease management care through being patient-centric. Additionally, in 2024, Shenton Homecare was introduced, bringing services directly to patients’ homes – making healthcare more accessible, affordable, and personalised for those who in need. Türkiye Acibadem • We are enhancing care for non-communicable diseases by integrating treatment pathways into our information management system to facilitate medical decision-making and enhance lifestyle change messages. This also helps empower patients to take charge of their health. • To enhance care of breast cancer and diabetes, our Information Technologies and Medical Affairs teams are building a database of real-world patient data to inform performance indicators and align with patientcentric treatment pathways. Through such initiatives, we create new benchmarks for improvement. Hong Kong Gleneagles • We are the first private hospital in Hong Kong to be fully accredited as a “Baby Friendly Hospital”. Our commitment to clinical excellence is demonstrated through our innovative services including private and cross-border ambulance medical escort for non-emergency care. EXPANDING ACCESS AND QUALITY 2024 Malaysia Gleneagles • Our hospital in Kuala Lumpur offers two Super Induction System (SIS) units to treat pain and stimulate or relax muscles. This advanced technology uses high-intensity electromagnetic fields not just provide pain relief but also condition the muscles and enhance therapeutic treatment outcomes.
IHH Healthcare Berhad | Annual Report 2024 10 Group Overview IHH at a Glance With a network of 57 hospitals throughout the region, including Malaysia, Singapore, India and Greater China, Parkway Pantai is one of Asia’s largest integrated private healthcare groups. Acıbadem Holdings is Türkiye’s leading private healthcare provider, offering integrated healthcare services across 24 hospitals in Türkiye, North Macedonia, Bulgaria, the Netherlands and Serbia. The Acıbadem brand is renowned for its clinical excellence in Europe and North Africa. 100% 31.17% 100% 32.95% 90% 100% As at 28 March 2025
11 Since opening its first hospital in 1991, Acibadem has emerged as Türkiye’s most successful and visionary healthcare brand, combining top experts and the latest technology with the contemporary sophistication of a five-star hotel. Acibadem Mount Elizabeth Hailing from Singapore, the Mount Elizabeth brand is recognised for high clinical standards as well as consistent medical innovations and technology. Founded in Singapore, Gleneagles has become the signature international brand of IHH Healthcare, offering a wide range of medical services backed by deep clinical expertise. Gleneagles We are proud of our leading brands in our various markets, each underpinned by an outstanding reputation for clinical outcomes and quality care. Our Portfolio of Excellence in Healthcare Pantai Across Malaysia, Pantai is synonymous with quality and trusted care, providing excellence in healthcare close to home and close to patients’ hearts for over 50 years. Fortis is synonymous with superior healthcare in India across its wide network of hospitals, day care specialty facilities, and Agilus Laboratories, making it one of the largest healthcare players in the country. Fortis As the largest private hospital in Penang, Malaysia, Island Hospital has a legacy spanning almost 30 years, renowned for its comprehensive medical services and high-quality patient and clinical care. Island Prince Court Medical Centre delivers outstanding personalised care to patients in Kuala Lumpur, Malaysia. Prince Court A leading healthcare brand in Singapore with a presence in Greater China, Parkway is committed to delivering high-quality, personalised healthcare services. Parkway An established brand in Kuching, Sarawak, Timberland Medical Centre boasts a rich 30-year legacy and a wide range of medical and surgical services. Timberland
IHH Healthcare Berhad | Annual Report 2024 12 Group Overview Financial Highlights Revenue by Strategic Business Units Singapore RM6,131 million (FY23: RM5,573 million) Malaysia RM4,154 million (FY23: RM3,684 million) India RM4,028 million (FY23: RM3,555 million) Türkiye and Europe RM7,238 million (FY23: RM5,943 million) EBITDA by Strategic Business Units Singapore RM1,825 million (FY23: RM1,627 million) Malaysia RM1,060 million (FY23: RM937 million) India RM723 million (FY23: RM600 million) Türkiye and Europe RM1,489 million (FY23: RM1,249 million) RM1,685 million (FY23: RM1,280 million) RM56,759 million (FY23: RM50,192 million) 19.13 sen (FY23: 14.53 sen) Profit After Tax and Minority Interest (PATMI) excluding exceptional items Total Assets Basic Earnings per Share excluding exceptional items See pages 44 to 45 on Financial Review for more information.
13 Notes The above financial summary may not be comparable across the periods presented due to the changes in the Group structure. For changes in the accounting policies, adoption of new and/or revised accounting standards, as well as changes in presentation of financial statements for the current financial year, only the comparative figures for the previous year are restated to conform with the requirements arising from the said changes or adoption. Comparative figures for the previous year are restated, where applicable, upon the completion of the Purchase Price Allocation on the Group’s acquisitions of subsidiaries as required under MFRS 3, Business Combinations. 1. Labs comprise the Group’s diagnostic laboratory business. In the table above, prior to FY2022, Labs was classified as part of Malaysia, Singapore, India and Türkiye and Europe healthcare services. 2. Others comprise mainly corporate offices as well as other investment holding entities. 3. Arises from the application of MFRS 129, Financial Reporting in Hyperinflationary Economies for component entities whose functional currency is the Turkish Lira. 4. Being earnings before interest, tax, depreciation, amortisation, exchange differences, share of results of associates and joint ventures and other non-operational items. 5. Being net assets attributable to ordinary shareholders (excluding non-controlling interests). 6. Being net assets attributable to ordinary shareholders (excluding non-controlling interests) less goodwill and intangible assets. 7. Being PATMI for the year over average of equity attributable to owners of the Company as at year-end and beginning of the year. 8. Debt includes loans and borrowings as well as lease liabilities and bank overdrafts. FY2020 FY2021 FY2022 FY2023 FY2024 A. Income Statement (RM Million) Revenue by Strategic Business Units Singapore 3,887 5,033 4,913 5,573 6,131 Malaysia 2,187 2,727 3,074 3,684 4,154 India 2,656 3,729 3,175 3,555 4,028 Greater China 662 877 998 1,307 1,529 Türkiye and Europe 3,462 4,347 4,455 5,943 7,238 Southeast Asia 138 – – – – Hospital and Healthcare 12,992 16,713 16,615 20,062 23,080 IMU Health 249 258 261 54 – Labs total revenue – – 1,662 1,665 1,779 Less: Labs inter-segment revenue – – (603) (685) (747) Labs1 – – 1,059 980 1,032 Others2 9 8 5 6 7 13,250 16,979 17,940 21,102 24,119 PLife REIT total revenue 367 371 376 408 414 Less: PLife REIT inter-segment revenue (212) (218) (227) (255) (266) PLife REIT 155 153 149 153 148 13,405 17,132 18,089 21,255 24,267 Hyperinflationary adjustment3 – – (101) (320) 116 Total 13,405 17,132 17,988 20,935 24,383 EBITDA4 by Strategic Business Units Singapore 1,359 1,693 1,484 1,627 1,825 Malaysia 556 760 847 937 1,060 India 201 665 492 600 723 Greater China (147) (70) (60) 75 145 Türkiye and Europe 796 1,199 1,058 1,249 1,489 Southeast Asia 46 – – (2) (2) Hospital and Healthcare 2,811 4,247 3,821 4,486 5,240 IMU Health 76 87 85 13 – Labs1 – – 369 345 375 Others2 (107) (186) (171) (121) (159) Eliminations – – 9 – (1) 2,780 4,148 4,113 4,723 5,455 PLife REIT 309 350 278 326 291 Eliminations (212) (218) (234) (262) (276) 2,877 4,280 4,157 4,787 5,470 Hyperinflationary adjustment3 – – (106) (141) (31) Total 2,877 4,280 4,051 4,646 5,439 Profit After Tax and Minority Interest (“PATMI”) Including Exceptional Items 289 1,863 1,548 2,952 2,657 Excluding Exceptional Items 715 1,595 1,381 1,280 1,685 B. Financial Position (RM Million) Total Assets 44,534 45,510 48,467 50,192 56,759 Net Borrowings 7,441 5,856 7,170 7,672 13,270 Equity attributable to Owners of the Company 21,740 22,425 26,192 29,106 30,140 C. Financial Ratios Basic Earnings per Share (sen) Including Exceptional Items 2.27 20.20 17.00 33.52 30.17 Excluding Exceptional Items 7.13 17.15 15.09 14.53 19.13 Net Assets5 per Share (RM) 2.48 2.55 2.97 3.30 3.42 Net Tangible Assets6 per Share (RM) 0.87 0.94 1.16 1.35 1.16 Return on Equity7 (%) Including Exceptional Items 1.3% 8.4% 6.5% 10.7% 9.0% Excluding Exceptional Items 3.2% 7.2% 5.8% 4.6% 5.7% Return on Total Assets (%) Including Exceptional Items 0.6% 4.1% 3.2% 5.9% 4.7% Excluding Exceptional Items 1.6% 3.5% 2.8% 2.5% 3.0% Net Debt Equity Ratio8 (times) 0.28 0.21 0.25 0.24 0.39
IHH Healthcare Berhad | Annual Report 2024 14 Group Overview Operational Highlights FY2020 FY2021 FY2022 FY2023 FY2024 Malaysia No. of hospitals at end of year 16 16 16 16 18 No. of licensed beds1 at end of year 2,908 2,961 3,000 2,951 3,558 No. of operational beds1 at end of year 2,696 2,676 2,731 2,822 3,324 Inpatient admissions2 158,944 151,944 205,459 241,123 256,745 Average length of stay3 (days) 2.9 3.1 3.0 3.0 3.0 Occupancy rate4 49% 48% 63% 72% 70% Average revenue per inpatient admission (in RM) 8,428 10,346 9,587 9,925 10,667 Singapore No. of hospitals at end of year 4 4 4 4 4 No. of licensed beds1 at end of year 998 1,039 1,017 1,017 950 No. of operational beds1 at end of year 991 989 907 793 697 Inpatient admissions2 64,071 64,227 61,951 61,197 61,909 Average length of stay3 (days) 3.1 3.0 3.1 3.0 2.9 Occupancy rate4 55% 54% 56% 61% 66% Average revenue per inpatient admission (in RM5) 38,724 39,576 49,921 54,994 61,528 India No. of hospitals at end of year 31 31 31 29 28 No. of licensed beds1 at end of year 6,154 6,011 5,952 5,888 5,916 No. of operational beds1 at end of year 5,004 4,756 4,880 4,991 5,008 Inpatient admissions2 270,581 320,543 298,437 299,506 313,973 Average length of stay3 (days) 3.7 3.8 4.0 4.2 4.2 Occupancy rate4 54% 66% 69% 70% 72% Average revenue per inpatient admission (in RM5) 6,581 7,577 8,738 9,154 9,902 Türkiye and Europe No. of hospitals at end of year 21 22 24 24 24 No. of licensed and operational beds6 at end of year 4,189 4,202 4,780 5,196 5,216 No. of overnight beds6 at end of year 2,893 2,997 3,211 3,450 3,315 Inpatient admissions2 186,662 219,582 234,831 249,829 254,243 Average length of stay3 (days) 3.8 3.8 3.5 3.4 3.4 Occupancy rate4 67% 77% 74% 70% 71% Average revenue per inpatient admission (in RM5) 4,754 5,422 6,723 9,187 13,294 Notes The above information comprise operational data relating to hospitals owned by subsidiaries in the Group’s home markets only. It does not include data relating to hospitals owned by joint ventures and associates of the Group, and does not include hospitals that are managed for third parties. Hospitals in Türkiye and Europe do not compile certain operational data, including number of operational beds, the average length of stay and occupancy rate, on the same basis as the rest of the regions and therefore, these numbers may not be comparable. For changes in classification/definitions for the current financial year, only the comparative figures for the previous year are restated to conform with the current classification/definitions. 1. Licensed beds are approved number of beds by the Ministry of Health that the hospital regularly maintains and staffs. Operational beds is an internal measure which includes licensed beds utilised for patients. 2. Represents the total number of overnight inpatients admitted. 3. Represents the average number of days an overnight inpatient stays. 4. Represents the percentage of hospital operational/ overnight beds occupied by inpatients. Occupancy rate may be lower due to new hospitals that are in the ramp up stage. 5. Prior years’ average revenue per inpatient admission had been translated using the exchange rates as at 31 December 2024, so as to be comparable across periods. 6. Under Turkish Law, “licensed beds” refer to the approved number of beds used for observation and treatment of at least 24 hours, including intensive care, premature and infant unit beds, beds in the burn care units and as indicated in the hospital operation licenses. In addition to licensed beds, "operational beds" include beds used for treatments of less than 24 hours such as chemotherapy, radiotherapy and sedation or other beds such as incubators, labour beds, beds for examination, minor treatment and relaxation, from which Acibadem derives revenue and does not require licensing. “Overnight beds” comprise beds used for observation and treatment of at least 24 hours.
15 Our Planet Commitment to achieve Net-Zero by 2050 The Public >3.1m health screenings and cancer screenings conducted since 2022 Our People >1.2m training hours achieved in 2024 Our Patients >8m patients have access to their medical records online 1 Fortis Healthcare and Gleneagles Hospitals (India). 2 Includes 5 hospitals managed for third parties. 3 Europe includes North Macedonia, Bulgaria, Netherlands and Serbia. 4 Overnight beds comprise beds used for observation and treatment of at least 24 hours. Türkiye and Europe3 24 hospitals 3,315 overnight beds4 254,243 inpatient admissions RM13,294 average revenue per inpatient admission Malaysia 18 hospitals 3,324 operational beds 256,745 inpatient admissions RM10,667 average revenue per inpatient admission Singapore 4 hospitals 697 operational beds 61,909 inpatient admissions RM61,528 average revenue per inpatient admission India1 33 hospitals2 5,602 operational beds2 313,973 inpatient admissions RM9,902 average revenue per inpatient admission
IHH Healthcare Berhad | Annual Report 2024 16 Group Overview Our Sustainability Approach As a global healthcare leader, we are passionate about fostering a healthier and more sustainable future for all. After all, “doing no harm” is one of the key principles of the Hippocratic Oath. At IHH Healthcare, sustainability is about going beyond “doing no harm” and is aptly summarised in our aspiration to “Care. For Good.” We believe that a solid sustainability framework allows us to not only achieve our purpose of touching lives and transforming care, but also encourages good business performance. This framework is underpinned by a robust governance structure to keep us on track in our sustainability journey. It is also tied to performance and remuneration in the Group’s Balanced Scorecard as part of our wider business strategy. Robust governance with clear accountability and ethical conduct is the foundation that keeps us on track in our sustainability journey, whilst ensuring that all legal and regulatory obligations are met. People Patients Planet Public Governance Empowering Our Patients We focus on delivering better, faster, more convenient, and transparent care through a variety of initiatives that range from striving for better clinical outcomes to empowering patients via innovation and technology and safeguarding data privacy. Protecting Our Planet We are progressively advancing in environmental stewardship by focusing on waste and water management, reducing our carbon footprint through energy efficiency projects, bolstering climate resilience, and integrating sustainability into our supply chain management practices to ensure responsible sourcing and operations. Nurturing a Healthier Society We focus on tackling antimicrobial resistance, reducing disease burden through health literacy and screening (for cancer and cardiovascular diseases), enhancing emergency preparedness, and making quality healthcare accessible to underserved communities through free or subsidised treatments. Shaping the Best Place to Work We enhance our programmes and policies to foster a safe culture and workplace environment that prioritise employee total well-being, that nurture diversity and inclusion, and that continuously engage and develop our people to bring out the best in them. Our Sustainability Framework Scan to view the IHH Healthcare Sustainability Report 2024, which contains our full suite of sustainability disclosures. Our Sustainability Report 2024 details the progress we have made across our four sustainability pillars Patients, People, Public and Planet, as well as our progress towards our long-term targets.
17 Sustainability Snapshots To “Care. For Good.”, IHH Healthcare is focused on delivering sustainable value to our Patients, People, Public, and Planet through initiatives that go beyond the delivery of healthcare services. Here are a few sustainability highlights from 2024. Patients Leveraging AI-Driven Technology to Improve Diagnostic Results Across our global operations, we are integrating AI to enhance, patient care, improve operational efficiency, and drive innovation. IHH Malaysia: Gleneagles Hospital Johor has reduced reporting turnaround time while delivering highly accurate diagnostic results to patients by adopting AI-driven Imaging solutions. IHH Singapore: Gleneagles Singapore has integrated AI-powered mammography analysis solution into its breast screening workflow. Gleneagles Hong Kong: The hospital is utilising an AI-powered solution to enhance diagnostic accuracy and speed up report preparation for chest X-rays and CT brain scans. Public World Antimicrobial Resistance Awareness Week 2024 Celebrated from 18 to 24 November every year, the World AMR Awareness Week (WAAW) is a global campaign to raise awareness and understanding of AMR and promote best practices among stakeholders to reduce the emergence and spread of drug-resistant infections. At IHH Healthcare, we are proud to take a leading role in this fight. Through our Antimicrobial Stewardship Programme (ASP), we are the first private hospital network in Asia to implement AMR interventions in line with the Centers for Disease Control and Prevention (CDC) guidelines across all of our hospitals. These initiatives, aligned with the World Health Organization’s recommendations, aim to optimise antibiotic use, prevent infections, and enhance patient safety – all while tackling the root causes of AMR. Planet Spotlight on Large-Scale Solar Farm and Rooftop Solar With Scope 2 emissions accounting for 72% of IHH Healthcare’s total Scope 1 and 2 emissions, expanding the use of renewable energy is a crucial step in reducing our carbon footprint. In 2024, we achieved a major milestone in Türkiye by signing a contract for the development of a large-scale solar farm. Scheduled for completion in 2025, this solar project is expected to generate up to 80% of the annual energy needs for our Türkiye operations, significantly lowering our reliance on fossil fuels. In Malaysia and Hong Kong, rooftop solar installations are being progressively deployed to complement renewable energy adoption. WorkWell Leaders Award The WorkWell Leaders Awards is one of the most recognised industry events on workplace mental well-being. This year’s event saw a 50% increase in awards nominations from the previous year. Our very own Group CEO, Dr Prem Kumar Nair, was presented with their prestigious Wellbeing CEO Award. Over 400 CEOs and their teams, representing 46 organisations, were also present to celebrate best practices in addressing systemic change in workplace well-being. People Kindly refer to our Sustainability Report to view the full list of sustainability highlights.
IHH Healthcare Berhad | Annual Report 2024 18 Group Overview Corporate Milestones 2024 Photo: Proton Therapy machine • 21 March: Brand Launch for Gleneagles Healthcare India Jan • 29 Jan: IHH Singapore has signed a memorandum of understanding with Nhà Thuốc FPT Long Châu, Vietnam’s largest pharmaceutical retail chain Mar May Jun • 7 Jun: Gleneagles Hospital Singapore marks its 65th anniversary • 10 May: Official launch of Mount Elizabeth Proton Therapy Centre • 23 May: Parkway Medical Services signed an MOU to redevelop Precious Blood Hospital • 24 May: IHH announced that all its Malaysia hospitals will transition to solar power Feb Apr Photo: Gleneagles Hospital Singapore 65th anniversary Photo: Gleneagles Healthcare India brand launch ceremony • 24 Jun: Gleneagles Health City in Chennai completes over 100 robotic cancer surgeries in a year, enhancing precision and patient outcomes
19 • 5 Sep: Fortis Memorial Research Institute, Gurugram, unveiled North and Central India’s first MR Linac • 14 & 15 Sep: IHH SG Sea Regatta 2024 • 19 Sep: The Acibadem Ataşehir Breast Clinic in Istanbul, Turkey, officially opened • 20 Sep: Opening of the Aorta Centre at Fortis Escorts Hospital Okhla • 24 Sep: Unveiling of Gleneagles Clinical Trials Centre, Hong Kong • 26 to 28 Sep: IHH holds flagship events (IHH Healthcare Quality Summit and IHH Igniting Innovation in Healthcare Conference) in Mumbai, India for the first time Jul • 1 Nov: Parkway Radiology’s Medi-Rad turns 40 • 4 Nov: Island Hospital becomes the 18th hospital in IHH’s Malaysia network • 26 July: Ground-breaking ceremony of Transitional Care Facility – TCF@East • 21 Aug: Gleneagles HealthCity Chennai celebrated a significant milestone in completing over 100 robot-assisted cancer surgeries within a year • 28 Aug: Fortis Hospital, Manesar, Gurugram, commenced operations Aug Sep Oct Nov • 1 Oct: IHH Healthcare joins global alliance, first in Asia to explore upright photon treatment for cancer patients Photo: Island Hospital, Penang Dec • 11 Dec: Parkway Shanghai 20th Anniversary and brand relaunch Photo: Quality Summit Photo: Fortis Hospital, Manesar launch ceremony Photo: Parkway Shanghai brand relaunch
IHH Healthcare Berhad | Annual Report 2024 20 Group Overview Awards and Accreditations 2024 Awards IHH Healthcare TIME “World’s Best Companies 2024” • Ranked 679 out of 1000 FORBES “World’s Best Employers 2024” • Ranked 357 out of 850 National Corporate Governance & Sustainability Awards (NACGSA) 2024 • Excellence Award 2024 Top 50 – rank 29 2024 Brandon Hall Group™ HCM Excellence Awards® • Best Unique or Innovative Leadership Programme – Gold (I.GLOBE Custom Hospital Business Simulation) • Best Measuring the Impact of Leadership Development – Gold (I.GLOBE Custom Hospital Business Simulation) • Best Leadership Development Programme – Silver (Nursing I-LEAD Programme) • Best Use of Games or Simulations for Learning – Bronze (Nursing I-LEAD Programme) The Edge Billion Ringgit Club 2024 • Healthcare: RM10 billion and Above Market Capitalisation – Highest Growth in Profit After Tax Over Three Years FORTUNE Southeast Asia 500 • Ranked 82 out of 500 among largest companies in Southeast Asia Corporate Governance Asia – Asian Excellence Award 2024 • Asia’s Best CEO – Dr Prem Kumar Nair, Group CEO of IHH Healthcare • Asia’s Best CFO – Dilip Kadambi, Group CFO of IHH Healthcare • Best Investor Relations Professional • Best Investor Relations Company FinanceAsia Asia’s Best Company Awards 2024 • Most Committed to DEI • Best Investor Relations • Best Managed Company • Most Committed to ESG • Best CFO – Dilip Kadambi, Group CFO of IHH Healthcare WorkWell Leaders Award 2024 • Wellbeing CEO Award – Dr Prem Kumar Nair, Group CEO of IHH Healthcare Malaysia Baby Talk Readers’ Choice Awards 2024 Pantai Hospital Ampang • Best Paediatric and O&G Hospital GlobalHealth Asia-Pacific Healthcare and Hospital Awards 2024 IHH Healthcare Malaysia • Hospital Group of the Year Asia-Pacific Gleneagles Hospital Kuala Lumpur • Hospital of the Year in Malaysia Gleneagles Hospital Penang • Medical Tourism Hospital of the Year Asia-Pacific Gleneagles Hospital Johor • Minimally Invasive Surgery-Hospital of the Year Asia-Pacific Prince Court Medical Centre • Orthopaedic Service Provider of the Year Asia-Pacific Pantai Hospital Kuala Lumpur • Cancer Centre of the Year Asia-Pacific Healthcare Asia Awards 2024 Prince Court Medical Centre • Medical Tourism Hospital of the Year and Clinical Service Initiative of the Year Premier Integrated Labs • Diagnostics Provider of the Year Malaysia Technology Excellence Awards 2024 Gleneagles Hospital Kuala Lumpur • Medical Technology (Healthcare) • Robotics – Healthcare Newsweek’s World’s Best Hospitals 2024 Gleneagles Hospital Kuala Lumpur • Top 250 World’s Best Hospitals globally Gleneagles Hospital Kuala Lumpur, Pantai Hospital Kuala Lumpur, Prince Court Medical Centre, Pantai Hospital Ampang, Pantai Hospital Penang, Gleneagles Hospital Penang, Pantai Hospital Ayer Keroh and Pantai Hospital Cheras • World’s Best Hospitals 2024 – Malaysia category UNIVANTS of Healthcare Excellence Award 2024 Premier Integrated Labs • Winner Singapore IHH Singapore Hospitals • MOH Nurses’ Merit Awards Healthcare Humanity Awards 2024 Gleneagles Hospital Singapore • Singapore Workplace Safety and Health Award for Supervisors Mount Elizabeth Novena Hospital • Singapore HEALTH Award: Workplace Organisational Champion (Excellence) Türkiye & Europe Acibadem Brandverse Awards Turkey 2024 • Gold Award in the “Healthcare Institutions” category Capital 500 • Acıbadem is ranked 84th among the top 500 companies in Turkey India Fortis Healthcare • Newsweek’s Best Specialised Hospitals – Asia Pacific 2024 Gleneagles Healthcare India Outlook Health Ranking Awards 2024 • Best Plastic Surgery and Best Liver Transplantation Hospitals • Best Neurology, Pulmonology, and Organ Transplants Greater China Operations Gleneagles Hospital Hong Kong • Gold Award in the Healthy Corporate Award Scheme 2023 Parkway Shanghai • Clinic Healthcare Provider of The Year – Shanghai 2024 Lifestyle Awards
21 2024 Accreditations Joint Commission International (JCI) Malaysia Pantai Hospital Kuala Lumpur Gleneagles Hospital Kuala Lumpur Gleneagles Hospital Penang Türkiye Clinical Hospital Acibadem Sistina (North Macedonia) Acibadem Altunizade Hospital Acibadem City Clinic UMBAL (Bulgaria) Acibadem Maslak Hospital Acibadem Kent Hospital Acibadem Mehmet Ali Aydınlar University Atakent Hospital Acibadem Adana Hospital India Gleneagles Hospital, Mumbai Fortis Hospital, Mohali Fortis Memorial Research Institute, Gurugram Fortis Hospital, Mulund Fortis Hospital, BG Road, Bengaluru National Accreditation Board for Hospitals and Healthcare Providers (NABH) India Gleneagles BGS, Kengeri Bengaluru Gleneagles Healthcity, Chennai Gleneagles Mumbai Gleneagles Richmond Road, Bengaluru Fortis Hospital, Kangra, Himachal Pradesh Fortis Escorts Hospital, Amritsar Fortis Hospital, Ludhiana Fortis Hospital, Mohali Fortis Hospital, Anandapur, Kolkata Fortis Escorts Heart Institute, Delhi Fortis Flt Lt Rajan Dhall Hospital, Vasant Kunj, Delhi Fortis Escorts Hospital, Faridabad Fortis Hospital, NOIDA Fortis Hospital – Greater Noida Fortis Hospital, Shalimar Bagh Fortis Memorial Research Institute, Gurugram Fortis La Femme, Greater Kailash, Delhi Fortis Escorts Hospital, Jaipur Fortis Hospital, Kalyan, Mumbai Fortis Hospital, Mulund SL Raheja Hospital – A Fortis Associate Hospital, Mahim, Mumbai Fortis Hospital, Vashi, Navi Mumbai Fortis Hospital, BG Road, Bengaluru Fortis Hospital CG Road Bengaluru Fortis Hospital, Nagarbhavi, Bengaluru Fortis Hospital, Rajajinagar, Bengaluru Malaysian Society for Quality Health (MSQH) Malaysia Gleneagles Hospital Kota Kinabalu Gleneagles Hospital Kuala Lumpur Gleneagles Hospital Johor Gleneagles Hospital Penang Island Hospital Pantai Hospital Kuala Lumpur Pantai Hospital Ampang Pantai Hospital Ayer Keroh Pantai Hospital Batu Pahat Pantai Hospital Cheras Pantai Hospital Ipoh Pantai Hospital Klang Pantai Hospital Laguna Merbok Pantai Hospital Manjung Pantai Hospital Penang Pantai Hospital Sungai Petani Prince Court Medical Centre Australian Council on Healthcare Standards International (ACHSI) Malaysia Island Hospital Prince Court Medical Centre
IHH Healthcare Berhad | Annual Report 2024 22 Building trust among our stakeholders is a critical foundation of our strategy. In doing greater good by our patients, our people, the public and our planet, we build strong and sustainable growth. CARE. FOR GOOD. Strategic Report 24 Chairman’s Statement 28 Group CEO’s Message 32 Business Strategy 34 Business Model 36 Impact of Value Creation 38 Operations Review 38 Malaysia 39 Singapore 40 Türkiye and Europe 41 India 42 Greater China 43 Parkway Life REIT 43 Laboratories 44 Financial Review 46 Market Outlook 50 Our Material Matters 51 Risk Management 52 Principal Risks
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IHH Healthcare Berhad | Annual Report 2024 24 Strategic Report Chairman’s Statement “As a trusted healthcare leader, IHH Healthcare is poised to reach greater heights in the coming years and beyond. With our commitment to excellence and innovation, we strive to deliver long-term value to all stakeholders, drive profitable growth and positively impact the markets we serve.” Tan Sri Dr Nik Norzrul Thani bin N Hassan Thani Non-Executive Chairman
25 Dear Stakeholders, I am truly honoured to have stepped into the role of Chairman at IHH Healthcare in June 2024. As a leading healthcare network, our focus is on delivering world-class healthcare, growing sustainably and creating long-term value for our stakeholders. Several of our long-term large-scale initiatives have served well in driving strategic growth and transformation. FY2024 has been another year marked by exceptional performance, even as healthcare institutions worldwide grapple with a global shortage of healthcare workers and high inflation. As One IHH, we once again rose to the occasion and met challenges with adaptability, innovation and resilience, proving that we are worthy of the trust that has been put in us by all stakeholders. Our accolades affirmed our outstanding efforts across the year. We were ranked among Newsweek’s World’s Best Hospitals 2024 (Gleneagles Kuala Lumpur) and World’s Best Specialised Hospitals 2024 (Mount Elizabeth Hospital and Gleneagles Hospital in Singapore). On the laboratories front, IHH’s Premier Integrated Labs won the prestigious UNIVANTS of Healthcare Excellence 2024, which is yet another testament to the Group’s unceasing drive to positively transform healthcare. Putting Patients First Our unwavering dedication to uplifting the patient experience cannot be overstated. We have put in place strong clinical frameworks to ensure the outstanding quality in all our hospitals, with practices that align with our rigorous code of conduct. The renown and longevity of all our brands speak volumes of the high standards we bear in this regard. Each anniversary we celebrate and every new innovation we adopt underscore our commitment towards patientcentric care. For instance, the newly upgraded Ward D7 in Pantai Hospital Kuala Lumpur provides a soothing and enhanced recovery area for patients. In Singapore, Mount Elizabeth Hospital has introduced technologies to improve patient care and experience, including an artificial intelligencedriven fall prevention and detection system and the LizWorld patient entertainment system. These are but a handful of significant developments that took place across our vast network in FY2024. More than feathers in our cap, these achievements show our continuous evolution to meet the needs of our patients. Empowering Our Healthcare Professionals On top of tackling increasingly complex patient needs, IHH is faced with a competitive healthcare landscape. To adequately meet these demands and deliver the best possible value for patients, we must keep our organisation at the forefront of change. We do this by fostering an environment where our employees have equal access and opportunity to upskill and future-proof themselves. Our award-winning IHH Global Leadership of Business Enterprise (I.GLOBE) Programme equips leaders with the skills and knowledge to drive change and nurture talents. Additionally, Project Nightingale helps attract, engage, retain, develop and promote nursing talents from within IHH – since 2022, IHH has had a 14% increase in nurses even amid global talent shortage. In December 2024, IHH earned a spot on the FTSE4Good Bursa Malaysia (F4GBM) Index and the FTSE4Good Bursa Malaysia Shariah (F4GBMS) Index for the first time, a resounding affirmation of our commitment to sustainable and responsible business practices.
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