The many extracts on these
pages are from copyright material. they are owned by the reference
given or its owner. They are reproduced here for educational purposes
and to stimulate public debate about the provision of health and aged
care. I consider this to be "fair use" in the common interest. They
should not be reproduced for commercial purposes. The material is
selective and I have not included denials and explanations. I am not
claiming that all of the allegations are true. The intention is to
show the general thrust of corporate practices as well as the nature
and extent of any allegations made.
Healthscope started as a private hospital group in the early 1980's. It owned 5 hospitals by the time it floated a $70 million capital raising on the stock exchange in May 1994 and then entered into a treacherous relationship with the South Australian government. It had an extremely rocky ride and made multiple errors barely surviving. After some years and extensive restructuring it became profitable. It embraced the grow or go under philosophy and has embarked on a program of expansion. The allegations about it illustrate in Australia the consequences of economic marketplace pressures for care, something we are only too familiar with from the USA.
The rhetoric Healthscope uses and some of the statements made by analysts are remarkably similar to those used by large corporations and market analysts in the USA. There is no suggestion that Healthscope; its directors and managers are planning to misuse or exploit patients. But then neither did the founders and directors of the US giants that actually did so.
It was the business policies, the business decisions, and the blindness to alternate points of view and contrary evidence which resulted in the problems in the USA. In Tenet/NME for instance the pressures for profit and the boards glib and plausible marketplace culture were passed on down through all levels of management and into the ranks of health professionals. Those with insight left and those who spoke out were fired.
Those who remained identified
enthusiastically with the company's financial objectives. They
gloried in its success. They accepted the incentives they received as
a measure of their worth. They placed a mental barrier between what
they were doing and the consequences for their patients.
Healthscope's response to the economic pressures generated by their
experience with the Modbury hospital is not reassuring.
My criticism of Healthscope is therefore harsh. It is not personal. Healthscope got themselves into a very difficult position and probably did their best. The problem is that they were the wrong people in the wrong place. Their thinking was inappropriate for the context. They should never have been running hospitals and certainly not a public hospital. It is the application of corporate principles to health care that is the problem. Healthscope is very much part of that system and identifies with it. They cannot be separated from it. As the visible manifestation of that system they are in the line of fire.
He important issue here is that the steps to reduce services for the sick were taken to generate a profit for shareholders and not in order to stretch limited resources for maximum benefit. This is sick and to praise the reduction of services to the sick as good management and reward those who do so with bonuses is dystocian. It may be an unfortunate necessity but that is another matter. "Business-think" distorts what is actually happening.
Examine what is happening and ask yourself what all this has to do with society's response to the misfortunes of its members and their vulnerability? What has happened to our Samaritan traditions?
The possible consequences of Healthscope's
policies and practices may sound dystocian but this is exactly what
happened when similar corporations, adopted similar patterns of
thinking, similar policies, and similar practices. If we are to
ensure that this does not happen again then these must be attacked
and discredited.
Healthscope started its corporate life by buying seven hospitals from South Australia's State Government Insurance Commission (SGIC) using script from its float to pay $15 million. In doing so it formed an unhealthy relationship with the government which now owned 14% of Healthscope - the largest shareholder. Healthscope expected its revenue to rise from 29 million to over $80 million with a net profit of 10.8 million.
Healthscope's facilities span a range of in- patient and out-patient services, including medical, surgical, obstetrical, psychiatric and rehabilitation services. With the SGIC, the group will have 800 private beds, or just below 10 per cent of the national market.
Hospital Group Goes To Public For $70m, The Age 28 February 1994
The share float was fully subscribed but
shareholders got their first of many shocks when the price promptly
fell 15 cents then dropped another 40 cents in the next 3 weeks.
The unhealthy relationship continued with Healthscope entering into a disastrous confidential Agreement to run the Modbury public hospital and to open a colocated private hospital on the site. The region motivated for a private colocated hospital but instead it got an ultimately disastrous privatisation of its public hospital. The privatised hospital was soon plagued by cost cutting, reduced services and alleged problems in care. The company was first allowed to postpone the building of the private hospital and then allowed to renege without penalty.
This was the first privatisation of a public hospital in Australia and in the resulting mess the requested private hospital was never built. At the time South Australia's elder statesman, former South Aust Premier Don Dunstan accused the SA Govt of pursuing a "Dickensian ideology". How right he was!
The agreement with Healthscope was confidential and in the scandal that eventually occurred even a parliamentary enquiry was unable to get the contract and details of what happened from the company and the cabinet. It illustrates very well the problems which arise when publicly accountable services paid for by citizens are provided in through the market.
On 27 October 1998, the South Australian Auditor-General again raised lack of accountability concerns about outsourcing in SA. - - - - - He was particularly critical of its handling of the EDS(Australia) computer contract and the Modbury Hospital one with Healthscope.
Watchdog's spotlight on government outsourcing, The Advertiser October 28, 1998 (quotes from ABSTRACT by Australasian Business Intelligence)
Healthscope made huge losses running this hospital. The company almost went under. In early 1995 it was also shortlisted to build and run a new public hospital at Port Augusta but as far as I am aware this privatisation never eventuated, perhaps because Modbury was very soon very painful for all parties.
CLICK HERE for a page describing the privatisation of Modbury public hospital.
It soon became clear that the company would not reach its financial targets by about 38% and the share price fell again to 50% of its original %1.75 value and eventually as low as 66 cents. Healthscope was shortlisted to manage the Sir Charles Gairdner hospital in Perth. The government eventually backed away from this claiming the companies had not met requirements.
Healthscope was soon seen as a takeover target. Fifteen months into its corporate life its Managing Director "quit the board" and it took 5 months to find a replacement. Healthscope fell almost 50% short of its projected profits.
Managing director Mr Bill Kricker said the $38 million-a-year outsourcing contract for Modbury Hospital was "bleeding the company of profit and management time".
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Mr Kricker said Healthscope was still negotiating with the SA Government to improve the economics of the Modbury contract "but we don't want to be confrontationist - going to court for five years is not the way to go."
Healthscope Looking Sick, Australian Financial Review March 12, 1997
By the end of1996 the Modbury hospital was bleeding and the company was soon pressing government for relief. The government, a shareholder was now accused of trying to prop up the company and the first of a series of unsavoury political brawls commenced.
The continuing losses associated with the Modbury Public Hospital in South Australia and weaker results from several other Healthscope hospitals overshadowed stronger performances by a number of hospitals within the group.
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"To this end, the company has stepped up its marketing program and undertaken new initiatives with doctors and surgeons to improve earnings," he said.
AUSTRALIA'S HEALTHSCOPE POSTS HALF-YEAR NET LOSS, ASIA PULSE March 11, 1997
It was not only Modbury hospital which was losing money. By 1996 private health insurance was at an all time low. Competition was intense so that general hospitals were bleeding. Alpha and Healthscope were not competing successfully. In the second half of 1996 Healthscope lost $22 million. It wrote down $24 million and started restructuring planning a $25 million asset sale.
Healthscope adopted the US formula, increasing its marketing activities and targeting doctors. In little more than a year the new M.D. had gone and the company had gone through three CEOs. It put up 4 of its Victorian hospitals for sale, Mildura, Wangaratta, Bellarine and Bellbird private hospitals. It closed its loss making Ulverstone hospital in Tasmania, the Hutt Street hospital and the Vales Private Hospital, both in Adelaide.
Having entered into the damaging deal to run the Modbury public hospital more than two years ago, Healthscope has realised just how awful it is to have your business tangled up in politics.
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South Australian Health Minister Mr Michael Armitage has said publicly the contract has saved the South Australian Government about $7 million a year.
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- - - shares in Healthscope hit an all-time low of 53cents.
Thorn In The Side May Prove Lethal, Australian Financial Review July 18, 1997Healthscope Ltd has reached an in-principle agreement with the South Australian Health Commission that will curb the company's multimillion-dollar losses from its disastrous contract to run the Modbury Public Hospital.
Healthscope Pins Hope On SA Deal, Australian Financial Review August 19, 1997
Healthscope sold its Mildura and Wangaratta hospitals but after renegotiating its contract for the Modbury hospital it withdrew the others. During 1997 it lost $21.6 million. The restructuring was effective and by February 1998 it was able to record a $1.75 million profit in spite of a poor performance by its Darwin Private Hospital. In August 1998 it posted a year's profit of $A3.6 million. Healthscope's M.D. claimed that the improved figures were the result of harsh cost cutting and the stopping of loses previous experienced at the Modbury Hospital
Healthscope had a close working relationship with the Northern Territory government who were pursuing privatisation enthusiastically and rather unrealistically. Healthscope participated in the development of a cardiac catheterisation service.
The Modbury hospital continued to lose money with a potential June 1999 overrun of $1.8 million. It October 1998 Healthscope went back to the government cap in hand, but the government was increasingly unsympathetic. In March 1999 the company announced a loss of $11.1 million to accommodate this.
Australian private hospital group Healthscope is making a $A13.5m abnormal provision for losses on March 1, 1999. Healthscope says the provision is due to its Modbury Hospital contract, which it admits will continue to make losses until the end of the contract in 2010.
Hospital pact a millstone, The Australian March 2, 1999 (quote from ABSTRACT by Australasian Business Intelligence)
Experience tells us that cost cutting will have an adverse impact on care. The company attempted to reduce services. Reports suggest that it cut intensive care services and physiotherapy services in the Modbury hospital. It closed beds for long periods of time. Emergency services were reduced and ambulances put on bypass.
The government had to pay more and/or force the company to provide these services - but the negotiations like the contract are confidential. In October the company was back negotiating for more money and it subsequently set aside $13 million to cover the ongoing losses from Modbury alone.
Cost cutting resulted in reduced staffing and increased on call. Staff were overstretched. There were allegations of poor care and of less than adequate monitoring of care. Allegations suggest that morale deteriorated and there was soon conflict with the nursing unions. The press reports speak for what was happening.
Despite all these concerns the market and its analysts turned a blind eye. To them Healthscope became a "star performer" because these changes made money - how was irrelevant as market analysts don't look or ask.
Modbury Hospital, in Adelaide, South Australia, is faced with
reductions to its casual and agency nursing staff to offset a budget over-run. - - - - - - The reduction in casual and agency staff is expected to place more burden on the existing staff.
Nurses fear cuts, The Advertiser October 10, 1998 (quote from ABSTRACT by Australasian Business Intelligence)An article in the Leader Messenger newspaper (18-9-96) highlighted numerous concerns about the operation of the hospital, including:
On 10 February 1999, South
Australian Human Services Minister, Dean Brown, ordered a private
hospital to reinstate a service. Private operator of the Modbury
Hospital, Healthscope, had - at the end of January, 1999 - cut out
physiotherapy services at the hospital because they were losing
money.
Order on hospital
services, The Advertiser February 11, 1999 (quote from ABSTRACT by
Australasian Business Intelligence)
On 11 October 1999, nurses
at the Healthscope-run Modbury Hospital decided to impose an
indefinite strike. It - - is in protest at company plans to cut
two weeks from nurses' annual leave entitlement of six weeks. The
additional two weeks has traditionally been granted in return for
nurses' preparedness to accept rostering on any shift on any day
of the year. According to hospital manager, Jill Michelson, the
attempted cut-back, is in response to a $A2m hospital loss, in
1998-99.
Surgery doubt as
nurses vote to strike, The Advertiser October 12, 1999 (quote from
ABSTRACT by Australasian Business Intelligence)
On 5 April 2000, South Australian Coroner, Wayne Chivell, harshly criticised Modbury Hospital nursing staff. This was the second time the Healthscope-operated hospital has faced his criticism, since January, 2000. He condemned them for failing to appreciate the significance of mental detention requirements, failure to carry out instructions from drowned patient, June Sanders' psychiatrist, for the inadequacy of case notes and a failure to react sufficiently urgently to her absence. Sanders drowned in September, 1997, after discharging herself from the hospital.
Chivell's report has
sparked an inquiry, by SA Human Services Minister, Dean Brown,
into procedures at that and other SA hospitals
Coroner not happy with
procedures, The Advertiser April 6, 2000 (quote from ABSTRACT by
Australasian Business Intelligence)
THE Ombudsman has begun
inquiring into the death of a patient at Modbury Hospital.
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The move came as it was learned another 16 beds will be closed and
outpatient appointments reduced at the hospital.
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- - - Labor MP Jennifer Rankine's telling State Parliament on
Thursday that patient James Queenan, 61, spent his last day of
life in August, 1999 naked on a mattress on a floor of the
hospital.
---------------------------------
Ms Rankine also said that, in a separate case, a 67-year-old
patient was given morphine despite his medical chart showing he
was allergic to the drug.
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"The community must be told why three to four patients a night
have been sent to the Royal Adelaide Hospital and why patients
requiring urgent attention are being distressed," Ms Stevens
(Opposition health spokeswoman ) said
Man's death taken up
by Ombudsman The Advertiser May 6, 2000, Saturday
Modbury came under renewed
fire from a doctor who contacted The Advertiser this week to
complain that the hospital had minimised waiting lists by cutting
back on the number of patients allowed on waiting lists for
appointments
No private facility
for Modbury, The Advertiser July 15, 2000
Allegations were also made suggesting illegal double billing by billing Medicare for services provided under contract for Modbury hospital. They were denied. The nurses claim that the hospital underpaid them.
A SOUTH Australian senator has accused Modbury Hospital of "double-dipping" the public health system by bulk-billing patients to Medicare.
Hospital 'cheating system', The Advertiser February 9, 2000STAFF at Modbury Public Hospital protested yesterday over the hospital's delay in paying $200,000 in back wages.
The protesters claim 40 clerical and administrative staff have been denied overtime and were paid the wrong award rate since the hospital was privatised in 1995.
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Modbury Public Hospital general manager Jill Michelson said the dispute was "affecting staff morale"
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Protester Steve Brooks, 28, of Valley View said "staff morale has been terrible".
Hospital pay protest, The Advertiser May 12, 2000THE privately run Modbury Hospital cost more to administer than a public hospital, federal Opposition health spokeswoman Jenny Macklin claimed yesterday.
A federal Labor Government would establish an independent inquiry into privatised public hospitals, including Modbury, she said.
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Ms Woodman (federal Labor candidate for Makin) claimed one Modbury woman, who was due to give birth at the hospital, had been told she must bring her own bottles, formula and nappies. "She was properly cared for when she had her first baby some years ago," she said.
Labor queries privatised hospital, The Advertiser October 24, 2000The report (by Senate Community Affairs Committee) said since then concerns had been expressed about the level, variety and quality of services provided at the (Modbury)hospital.
For example the Australian Nursing Federation reported that the 24-hour emergency surgery service had been reduced.
Fed: Privatising public hospitals should be abandoned, AAP NEWSFEED December 7, 2000
It is predictable that the market would take a positive view of these money saving strategies. This company about which there is so much concern and which has lost so much money is referred to as a "star performer" and as having a "strong management team". Words and reality are seldom connected. We might expect a "strong" management team providing health care to consist of people who would protect patients and services from market pressures.
The star performer has been the smaller hospital operator Healthscope, which was 28cents in June and is now 70cents.
Private Hospitals In Recovery Ward, Business Review Weekly 7 November 2000A contract to manage the 235 bed Modbury Public Hospital in Adelaide led to losses until rationalisation of clinical services and outsourcing of cleaning and catering in 1999. Last financial year, the group experimented with activity levels at the facility, running them at high levels in the first half and then reducing capacity by 100 beds and minimising patient flows in the second period so as to allow it to define the optimum operational configuration. The contract is now being brought to account evenly over the financial year which, given its high first half skew and the stable group result (EBITDA up 3 per cent to $6.9 million) for the six months to December 2000, spells a much improved second half.
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Healthscope is our preferred play since it has latent profit upside from a string of recent acquisitions, a strong management team and it is also the most vulnerable player in the sector to takeover.
Hospitals Bed Down Better Margins, Shares Magazine 01 September 2001
As in the USA hospital managers have been rewarded with bonuses based on their financial performance and not for the care they provide. This has been a major sweetener for those ignoring the care of their patients in order to meet financial objectives. The manager who brought Modbury's losses under control received a big bonus,
LABOR has questioned why the Modbury Hospital's boss was given a $100,000 bonus
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"In its annual report Healthscope says it is pleased that the Modbury Hospital has achieved a break-even result for the first time since it took on the management contract in 1995," Mr Stanley (federal labour candidate) said.
Labor queries bonus, Sunday Mail (SA) September 2, 2001
The situation which existed in 1998 was not dissimilar to that which existed in the USA in the mid 1980's. The response was the same. The Australian government and insurers were closely monitoring services in general hospitals. DRG's were being introduced to counter the cost blow out associated with fee for service payments. Private insurance was at an all time low and the government's rescue package had not worked. Competitive pressures made it difficult to make a profit.
Some analysts see rationalisation of the sector as inevitable, with the assets of small operators such as Alpha Healthcare and Healthscope coming into play. They are expected to face increasing pressure as health funds impose tougher performance benchmarks on hospitals.
The Prognosis For Health-care Stocks Australian Financial Review 5 January 2000
The company followed the US solution and like Tenet/NME it branched out into markets which were more easily exploited, where there was less oversight, and where there was little or no competition. These included psychiatry, substance abuse, rehabilitation and rural hospitals, areas where there were few competitors.
On 27 October 1998, hospital group, Healthscope, announced plans to focus on rehabilitation and psychiatric services. Chairman, Kevin McCann, said the decision had been made after unacceptable results from its mainstream hospital operations.
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The direction change will also reduce Healthscope's reliance on revenue from private health insurance funds
Diagnosis is for a full recovery, The Advertiser October 28, 1998 (quotes from ABSTRACT by Australasian Business Intelligence)Hospital operator Healthscope Ltd will spend $2.3 million expanding its Griffith Rehabilitation Hospital in Adelaide's south-western suburb of Hove. (the only recognised private rehabilitation hospital in South Australia.) - - - - - the 55-bed hospital had been an outstanding performer for the group - - - - .
BRIEFS ::: Griffith hospital to expand, Australian Financial Review December 2, 1998Hospital operator Healthscope Ltd has bought the 120-bed Ivanhoe Manor and Olympia group of private rehabilitation hospitals in Melbourne for $11.5 million. It marks a swing towards rehabilitation services for the company,
Companies And Markets; Briefs, Australian Financial Review February 11, 1999The company has shifted away from its dependence on health funds, by acquiring the Ivanhoe Manor and Olympia Group of rehabilitation hospitals for $12 million, selling facilities in South Australia and downsizing Modbury.
Healthscope Hopes For Quick Recovery, The Age (Melbourne) October 27, 1999
This strategy proved successful and the company started to make money for the first time. In February 1998 it was still "focusing on public hospital management opportunities in Victoria" and in December 1998 it tendered for the Royal Darwin public hospital. Privatisation of public hospitals was a disaster area and governments were already backing away. The Northern Territory soon followed.
Healthscope solved its problems in Darwin by restructuring and by reaching a deal with Indonesia's largest health insurer to send patients to their hospital in Darwin. It joined the state in developing a Cardiac catheterisation service for the Northern Territory.
Hospital operator Healthscope Ltd will sign an agreement today which paves the way for Indonesia's largest health insurer, PT Askes, to send patients to Darwin for treatment at the Australian company's 150-bed hospital.
Companies And Markets; Briefs, Australian Financial Review April 17, 1998Darwin Private Hospital will be able to provide cardiac catherisation diagnostic services. Northern Territory (NT) Health Minister Steve Dunham said in the NT Parliament on 11 May 2000 that the service would be a joint venture of the NT Government, Healthscope and NT Cardiac Services.
$1.5m boost for NT's heart centre, Northern Territory News May 12, 2000 Friday (quotes from ABSTRACT by Australasian Business Intelligence)
Healthscope started talking about expansion and of targeting aged care and retirement villages. I can find no record of their actually doing so. Their interest was in the profit which could be made and not the needs of the elderly.
Hospital operator Healthscope Ltd is set to diversify into aged care and retirement villages as part of an expansion phase which also includes plans to acquire private hospitals in Melbourne and Adelaide.
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Healthscope owns or operates 13 hospitals in Australia and Mr Dixon said aged care was a priority as it would produce "a nice flat income" and was not subject to the volatility of hospital earnings. - - - - - - The company was conducting a feasibility study on turning its Kiandra 40-bed hospital in Adelaide into an aged care facility - - - -.
Ailing Group Targets The Aged, Australian Financial Review April 24, 1998
The company tried to sell the Darwin Hospital to Ramsay and buy Melbourne hospitals from them but Ramsay backed away when the Northern Territory government threatened to privatise five public hospitals.
Modbury continued to be a problem and dragged the company into a $11 million loss for 1998/99.
Healthscope would have recorded a profit but for an abnormal loss of A$ 19.305 million associated with future losses from the Modbury Public Hospital contract in South Australia, a write down in the value of The Geelong Clinic and other costs.
AUSTRALIAN HOSPITALS GROUP HEALTHSCOPE POSTS NET LOSS, ASIA PULSE September 13, 1999
Some of Healthscope's statements show the same sort of thinking which led to the abuse and misuse of patients in US hospitals particularly those operated by Tenet/NME. These include an emphasis on demand and increasing census rather than meeting need. The company even expressed its interest in the US model where psychiatrists are marginalised and referrals come from other sources. Healthscope's emphasis on marketing and help lines is particularly worrying as US psychiatric, rehabilitation and substance abuse giants used this to fan anxieties, increase demand and funnel patients into company hospitals. Tenet/NME for example marketed its community books to its psychiatric hospitals as "Books as Hooks" on the basis that they increased hospital admissions if sold to patients.
US corporations took control of psychiatric admissions by marketing, using help lines and sending bounty hunters into the community to recruit patients. By allocating patients to doctors companies were able to control doctors income and use this to control the treatment they prescribed and induce them to indulge in unethical conduct. Those who complied became rich and those who did not starved. As one whistle blower explained the company bought the use of the doctors M.D. degrees and their signatures. These "golden handshake" agreements made them both wealthy.
Treatment was restructured using a corporate "programmatic" system designed to maximise profits rather than meet the clinical needs of patients. Large numbers of trusting people were misused and abused. Vast profits were generated. The market was ecstatic in its praise. It remains to be seen whether the pressures for profit will similarly distort psychiatric and rehabilitation care in Australia. Healthscope's interest in psychiatry, chemical dependency, and rehabilitation, the areas where this occurred is worrying.
Healthscope sees drug abuse not as creating a need for care but as a demand offering commercial opportunities. Note that as in Tenet/NME the company's hot line and not doctors will be admitting patients. The company not clinicians will be offering "programs" of care. Doctors have to sign for care. Who will be allocating the patients recruited by hot lines and marketing to doctors and how will the doctors willingness to sign for treatment influence this? One must ask if these programs of care will be "programmatic" and designed to make money or to care for patients.
"The only way to combat that is through increased volume. We are chasing more volume," he said.He added that changes made to the group's hospital mix towards increasing specialisation would help this process.
Restructure Hits Healthscope Result, Australian Financial Review September 14, 1999According to its managing director, Bruce Dixon, last year's results reflected the benefits from the previous year's marketing campaigns as well as cost-cutting. "We put a lot of effort into getting our occupancy rates up, generating a market for our hospitals."
Private Hospitals In Recovery Ward, Business Review Weekly 17 November 2000"With nearly eight per cent of Australia's adult population suffering from substance abuse, we believe there is a huge unmet demand for the programs we will be offering," he said.
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Mr Dixon said patients would be referred through a national call centre, which would be set up and manned at The Melbourne Clinic in Richmond, which is also run by Healthscope.
Vic: Betty Ford Clinic for Australia, AAP NEWSFEED May 22, 2001Like Ramsay, the group is identifying significant scope for organic growth within the psychiatric area. In the relatively mature US market only 20 per cent of patient referrals are sourced from psychiatrists, compared with close to 100 per cent in Australia. That equates to a major disparity in marketing and hence in consumer attitudes towards the quest for psychiatric help. Healthscope has already established a call centre for its psychiatric operations and it can be expected to superimpose a number of marketing initiatives to increase awareness of its services.
Hospitals Bed Down Better Margins Shares Magazine 1 September 2001
It was not until well into 2000 that the support which government had given to private insurance filtered through to the hospitals and they began to make money. That is all except Mayne Nickless. Never popular with doctors Peter Smedley's appointment in 2000, and his cost cutting and aggressive business solutions frightened doctors away. They took their patients elsewhere. By 2002 the giant Mayne Nickless was in serious trouble as a consequence. The much smaller Healthscope and Ramsay Healthcare undoubtedly benefited from this by picking up patients, perhaps more than they did from the increased funding for private care. Disilusioned Healthscope shareholders were initially sceptical. Healthscope reported a $5.9 million profit for 1999-2000. Modbury had broken even probably the result of cost cutting and bed closures.
HEALTHSCOPE surprised long-suffering investors earlier this week by revealing that its earnings in the half year just ended will at least triple those of the same period a year ago, yet its share price barely moved.
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Still, Mr Dixon believes government initiatives are fixing the problems by encouraging people to take up private health cover.
XCHANGE :: STILL AILING, Sydney Morning Herald January 21, 2000While two of the smaller listed hospital operators, Healthscope and Alpha Healthcare, have flagged healthier first-half results following restructuring last year, they remain under pressure to remedy their languishing share prices.
In the case of Healthscope, a board shake-out - - -
---------------------------------
Healthscope managing director Mr Bruce Dixon identified psychiatric care, rehabilitation and extended care as growth areas for the company.
Health industry ills, Australian Financial Review January 29, 2000Victorian-based hospital operator Healthscope, 20 per cent-owned by businessman Ron Evans, has enjoyed a sudden bout of investor confidence for almost the first time since it went public. The shares have almost doubled in little more than a month.
A run sans news, Sydney Morning Herald August 4, 2000Australian Hospital Care and Healthscope have both bettered the 38 per cent gain in Mayne over the past three months, while Ramsay and Sonic Healthcare haven't done that badly either.
Health Stocks In Fine Fettle, Sydney Morning Herald 31 October 2000Healthscope, based in Melbourne, has been attracting interest because of its vastly improved profitability. In 1998-99, the company reported a loss of $11.6 million.
Private Hospitals In Recovery Ward, Business Review Weekly 17 November 2000The results for the half show that despite the rapid profit turnaround in the pure-play hospital operators Healthscope and Ramsay Healthcare, Mayne's hospital network managed to increase margins from 7.9 per cent previously to just 8.8 per cent in the December half.
Under The Weather At Mayne, Australian Financial Review February 28, 2002
After its $5.9 million profit in November 2000 Healthscope went on a buying spree. It bought Victoria House Private Hospital in Melbourne. This was associated with a sports medicine centre and orthopaedic surgeons specialising in a number of areas. The attraction and the enthusiasm were for the potential profit not to serve to the community.
Healthscope bought Queensland's largest private psychiatric hospital, the Palm Beach Currumbin Private Hospital at Queensland's Gold Coast, and Dubbo Private Hospital in central NSW from Sun Healthcare when they left Australia. It then bought The Sydney Clinic, a private psychiatric hospital. It opened a drug and alcohol rehabilitation unit in the former Warburton Hospital, in Melbourne. Its public relations blurb promoted this as Australia's own version of the United States' Betty Ford Clinic.
The innocent sounding company release reminds me of Tenet/NME's activity in the 1980's. Tenet/NME used marketing and public education to fan anxiety. It capitalised on the community's anxiety about drug abuse and teen-age behaviour by exploiting the commercial possibilities of hot lines and screening mental health programs to their commercial limits.
One is reminded particularly of the US "800 Cocaine" hot line promoted by the highly suspect Dr Gold in his book of the same name. The sole purpose of this hot line was not to help sufferers but to funnel unsuspecting inquirers into Tenet/NME's New Jersey and Florida hospitals where Drs Gold and Pollock worked and where their insurers were fleeced. As a 1993 report on Tenet/NME by the West Australian Health Department revealed there is a real danger that this sort of thing will happen in Australia when large corporations operate and control hot lines.
Victoria House is unique in its degree of specialisation in
musculoskeletal and sports medicine. While providing a strong revenue stream for the company.
Acquisition of Victoria House Private Hospital, Company News - AUSTRALIAN ASSOCIATED PRESS November 30, 2000Healthscope is a major provider of private psychiatric care. It owns Australia's largest private psychiatric hospital, The Melbourne Clinic as well as The Geelong Clinic in Victoria and Palm Beach Currumbin Private Hospital on Queensland's Gold Coast. With hospitals in Victoria, SA, NSW, QLD, Tasmania and the NT, the acquisition of The Sydney Clinic marks Healthscope's entry into Australia's largest private health care market - - - .
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"Healthscope's growth strategy is based on the company's traditional strengths in the fields of psychiatry, rehabilitation and regional hospitals" Mr Dixon said.
Acquires The Sydney Clinic, Company News Release AAP NEWSFEED May 18, 2001"Dubbo Private Hospital provides exceptional facilities and lacks competition in its market catchment.
Acquires hospitals at Palm Beach Qld & Dubbo NSW, Company Release to ASX 26 Apr 2001
In March 2001 the price of Healthscope shares had risen to $1.20. This was sufficient for the South Australian government agency to disengage from Healthscope and sell its 10% share in the company - recovering some of its losses. It had bought at $1.75. By July the shares exceeded their 1994 listed price reaching $1.84. By now analysts were full of praise and the banks were investing in the company. It raised $10.7 million from the market and went looking for more acquisitions.
Analyst's rhetoric is usually lifted from company reports. The comments about Healthscope mimic the distorted phrases employed in the USA in the late 1980's. Examples include "a very high end orthopedic facility", "high profile sports professionals", "a pace-setter in terms of psychiatric programs", "specialised rehabilitation services" and "dominates the treatment of". Most would infer that these comments refer to the care provided and suggest quality. In the USA such terms used in corporate reports and by analysts were no more than a code for potential profits. Care was often substandard and exploitative. Tenet/NME's psychiatric hospitals, its "Books as Hooks" program, and its "programmatic" system of care were praised in a similar way.
These phrases were taken from a single paragraph about Healthscope in Shares magazine. Even the word "orthopaedic" is spelt "orthopedic" the American way! Note also that care is no longer a professional cooperative service. It has become a niche market to be "defended" - presumably against anyone who might compete.
This same commercial defensive approach led Tenet/NME and other US corporations to deny patients second opinions. They also failed to transfer patients to competitors when they could not provide required services themselves. Columbia/HCA hospitals that did not treat certain conditions failed to transfer patients to local competitors across the road. Instead they transferred them long distances to a Columbia/HCA hospital away from family and friends. This is what corporatisation and competition does for health care
Note the rhetoric "leading private provider" below. Sadly our community swallows this sort of rhetoric uncritically. It is a claim made by a supposedly objective journalist advising the public. Most would think that this was because Healthscope provided good care and would not realise that it was a consequence of marketing skills and a policy of securing market share in niche markets. It might well reflect cost cutting and poor care. Healthscope may of course provide good psychiatric care. I don’t know but the words make me suspicious.
Healthscope now operates almost 900 beds with a fairly even mix of income from five psychiatric facilities, five rehabilitation hospitals and seven medical/surgical hospitals. It is the leading private provider of psychiatric services in Victoria and of rehabilitation care in Adelaide and Melbourne. Indeed, the corporate strategy is very much based around building highly defensible niches within the broader private hospital sector.
Hospitals Bed Down Better Margins, Shares Magazine 1 September 2001
Healthscope went on to buy Northpark Private Hospital in Melbourne from Mayne Nickless, a general hospital in Bundoora, and Sydney's South West Private Hospital from Sun Healthcare. It had purchased 7 hospitals in less than a year.
There have been ongoing rumours of mergers and takeovers involving Healthscope since 1995 but none have eventuated. It was reported as entering into negotiations for a merger with Ramsay and then as a potential takeover target for Mayne Nickless. Later it was named as a participant in a group planning to buy and dismember Mayne Nickless. The reports also suggest that Healthscope was deliberately making itself an attractive takeover target and courting the process as a means of making money for shareholders.
It is market wisdom that smaller companies have difficulty in competing and that large corporations benefit from economies in size. Analysts welcome rationalisation and consolidation and the sharemarket rewards those who do so.
Experience from the US certainly shows that size gives power and credibility but that the claimed economies in size are minimal. Care is no less costly and often of poorer quality. If you are a patient there is a greater risk of being exploited for profit. A prime consequence of consolidation has been the removal of decision making from the community.
Decisions which vitally affect the services provided and the sort of care given are not made by the local hospitals or the doctors at the bedside but in distant boardrooms. These are based on profit considerations and are often at the expense of the care provided. They often have disastrous consequences (see Tenet/NME, Columbia/HCA and Aged care in the USA). Modbury may well be an example of this.
It is no coincidence that the most serious problems have occurred in the largest and most successful US corporations. Misusing the medical system for profit is very good for the bottom line.
Since the announcement of the Federal Government's 30 per cent tax break on private health insurance, effective from January 1, Australian health stocks have enjoyed a good run.
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Other, smaller pure hospital plays enjoyed share price success, with Healthscope climbing 6 per cent and Ramsay Healthcare adding 7.3 per cent, while Alpha Healthcare posted a flat performance.
Tax Rebate Fuels Healthy Performance Australian Financial Review January 22, 1999Speculation was mounting yesterday that a predator may be building a stake in struggling hospital operator Healthscope Ltd after Bankers Trust sold an 8.3 per cent stake in the group.
Buyer Builds A Healthy Stake, Australian Financial Review May 28, 1999Ramsay Healthcare and Healthscope are in talks regarding a merger
--------------------
It doesn't matter that the two are the best managed for-profit hospital operators in Australia, they're too small and illiquid for fund managers to take legitimate positions.
Mayne pain, The Australian Financial Review January 5, 2001
Healthscope, with $120 million in revenues, is said to be shopping itself around and was in talks with AHC before the Mayne bid. It is still talking to various parties and is said to be pitching for prices of $1.10 to $1.20.
Investment-ST_CLM-Street Talk, Australian Financial Review January 18, 2001- - - but it is understood that it (Ramsay Healthcare) has withdrawn from merger talks with fellow operator Healthscope Ltd.
Ramsay Enjoys Healthy 60pc Profit Jump, Australian Financial Review February 28, 2001The industry generates more than $A3 billion a year in income, yet there are only three listed players: Mayne Nickless, Ramsay Healthcare and the smallest member of the group, Healthscope.
Hospitals bed down better margins Shares 30 September 2001 (quote from ABSTRACT by Australasian Business Intelligence)
At the end of all this Healthscope remains intact, possibly in spite of its wish to merge. Out of all the US and Australian companies who have operated in Australia, Healthscope is one of only three surviving publicly listed corporations providing private hospital care in Australia.
Of the other two the oldest, Mayne Nickless has antagonised doctors who are concerned that care for their patients might be compromised by Mayne's business practices. Healthscope has a competitive advantage.
Paul Ramsay's Ramsay Healthcare is a well-established company but has only recently listed on the sharemarket so that it has been subjected to fewer commercial pressures in the past. As a provider of psychiatric care in the USA in the 1980's it did not join in the unethical feeding frenzy and to the best of my knowledge it has provided adequate services in its Australian hospitals. If Healthscope chose to adopt Tenet/NME style management practices as the reports about it suggest is happening then it could secure a competitive advantage over Ramsay similar to that which ruthless for profit companies attained in the USA.
We should watch Healthscope carefully and ensure that this does not happen.
HOSPITAL group Healthscope has settled its acquisition of Peninsula Private Hospital and Riverview Private Hospital in Brisbane.
Healthy acquisition, The Advertiser June 19, 2002Healthscope has offered to hand back management of the hospital (Modbury) to the State Government without penalty and the issue is being reviewed
Contracts stay, The Advertiser May 30, 2002Healthscope managing director Bruce Dixon said the company would not be easing back on its growth strategy despite acquiring nine hospitals in the past 18 months, and it continued to look for more acquisitions.
Healthscope seeks buys, Townsville Bulletin May 29, 2002
Note that I have not accessed the full text of all these articles and on a number of occasions I examined only the abstracts made by Australasian Business Intelligence
HOSPITAL GROUP IN APRIL
FLOAT
The Australian Financial Review 18 Feb 1994
HEALTHSCOPE OPENS UP PRIVATE HEALTH
Sydney Morning Herald 28 Feb 1994
Hospital Group Goes To Public For $70m
The Age 28 February 1994
$10M PROFIT AIM FOR HEALTHSCOPE
The Australian Financial Review 23 Mar 1994
Healthscope fully subscribed
The Age 21 Apr 1994
FIRST DAY SICKNESS
The Australian Financial Review 04 May 1994
Ex-premier attacks "secret" hospital sale
The Advertiser February 6, 1995
Low investor confidence holds back Healthscope
The Advertiser March 23, 1995
Three chosen for hospital tender
The Advertiser March 31, 1995
Healthscope to fall 38pc and cut dividend; shares dumped
Sydney Morning Herald 21
Jun 1995
Healthscope amends forecast
The Age June 22, 1995
Four vie for hospital management contract
The West Australian August 3, 1995
Acquisition fever hits health-care companies
The Age August 23, 1995
Mayne Aims For Health Sector
Sydney Morning Herald 23 August 1995
Welcome tonic
Sydney Morning Herald August 25, 1995
Chief quits troubled Healthscope
The Advertiser August 26, 1995
Healthscope still in good shape
The Advertiser September 4, 1995
One-off costs rein in Healthscope outlook
The Advertiser September 13, 1995
Faulty vision
The Age November 1, 1995
SCGH privatisation plans shelved
The West Australian December 20, 1995
(STRICTLY PRIVATE)
The Age 31 Jan 1996
AHC Ready For Float If Health Care Booms
Sydney Morning Herald 18 July 1996
A Private BONANZA
Australian Financial Review 11 September 1996
Hospital's managers 'propped up'
The Advertiser October 29, 1996
Taxpayers lose $A6.4m on hospital firm shares
The Advertiser November 14, 1996
Healthscope reviews SA operations
The Advertiser November 26, 1996
AUSTRALIA'S HEALTHSCOPE POSTS HALF-YEAR NET LOSS
ASIA PULSE March 11, 1997
Healthscope Looking Sick
Australian Financial Review March 12, 1997 Wednesday
Healthscope plans sales after $22m interim loss
The Age March 12, 1997
Healthscope hospital sale to bury debt
The Advertiser March 12, 1997
Healthscope hit by $23m loss for half
Sydney Morning Herald March 12, 1997
Modbury Hospital's $1m loss
The Advertiser March 12, 1997
Healthscope plans sales after $22m interim loss
The Age March 12, 1997
REAR WINDOW :: DOUBLE DEPARTURE
Financial Review April 22, 1997
Healthscope CEO Agrees To Resign
Australian Financial Review April 22, 1997
Healthscope reassures investors as chiefs quit
The Australian April 22, 1997
BRIEFS :: Mildura Hospital sold
Australian Financial Review May 15, 1997
Healthscope to cut debt $10.7m by hospital sale
The Australian May 15, 1997
Healthscope gets in shape
The Advertiser May 28, 1997
Briefs :: Clinic chief named
Australian Financial Review July 15, 1997
Thorn In The Side May Prove Lethal
Australian Financial Review July 18, 1997
Hospital off market
Herald Sun July 25, 1997
Healthscope ends asset amputations
The Advertiser July 25, 1997
Hospital sales off as debt steadies
The Daily Telegraph July 25, 1997
Healthscope Pins Hope On SA Deal
Australian Financial Review August 19, 1997
Hospital deal re-negotiated for Modbury
The Advertiser August 20, 1997
Backlash at health insurer's changes
The Advertiser August 23, 1997
Healthscope has relapse
The Australian September 11, 1997
Poorly result for operator of hospitals
The Advertiser September 11, 1997
Ulverstone hospital set to close
The Mercury October 11, 1997
Hospitals Operator In Recovery
Australian Financial Review October 15, 1997
BRIEFS :: HEALTHSCOPE SAYS IN BETTER SHAPE
Australian Financial Review October 29, 1997
More of less a money matter at Healthscope
The Age October 29, 1997
Healthscope shows some good signs
The Advertiser October 30, 1997
Briefs :: HEALTHSCOPE SPOTS NEW CEO
Australian Financial Review November 21, 1997
QUEENSLAND NURSES UNION WWW SITE 1998
Hospital Group Fit For New Ventures
Australian Financial Review February 25, 1998
Hospital operator on the mend
The Advertiser February 25, 1998
Healthscope up after abnormals extraction
The Australian February 25, 1998
Healthscope recovers, eyes Victoria
Herald Sun February 25, 1998
Briefs :: HEALTH PACK WITH INDONESIA
Australian Financial Review April 17, 1998
Ailing Group Targets The Aged
Australian Financial Review April 24, 1998
Hospital operator Healthscope hopes
Australian Financial Review 24 Apr 1998
Briefs ::: HEALTHSCOPE PLANS HOSPITAL UPGRADE
Australian Financial Review April 29, 1998 Wednesday
Briefs :: Profit Tables
Australian Financial Review September 1, 1998
Hospital group's healthy recovery
The Advertiser September 1, 1998
Case Studies of Public Hospital Privatisation by Meredith
Carter
Health Issues Centre September 1998
Hospital seeks funds to retain special beds
The Advertiser October 1, 1998
Nurses fear cuts
The Advertiser October 10, 1998
US chief forecasts Adelaide will grow
The Advertiser October 14, 1998
Diagnosis is for a full recovery
The Advertiser October 28, 1998
Watchdog's spotlight on government outsourcing
The Advertiser October 28, 1998
Health group ready to expand
Herald Sun October 28, 1998
Privatisation of Public hospitals
Centre for Development and Innovation in Health ? 1998
http://www.cdih.org.au/marketplace/case.htm#Modbury
Chartbusters
The Sunday Age 8 Nov 1998
Hospital Reshuffle At Healthscope
Australian Financial Review November 10, 1998
BRIEFS Griffith hospital to expand
Australian Financial Review December 2, 1998
Healthscope in $2.3m Hove expansion
The Advertiser December 2, 1998
Ramsay Calls Off Hospital Deal
Australian Financial Review December 15, 1998
Fate of hospital in doubt
Sunday Mail - South Australia January 10, 1999
BRIEFS Healthscope review
Australian Financial Review February 8, 1999
BRIEFS :: Healthscope into rehab
Australian Financial Review February 11, 1999
Healthscope shift to mental health.
The Advertiser February 11, 1999
Order on hospital services
The Advertiser February 11, 1999
BRIEFS :: Healthscope into rehab
Australian Financial Review 11 Feb 1999
Hospital pact a millstone
The Australian March 2, 1999
Hospital causes suffering
The Advertiser March 2, 1999
HEALTHSCOPE
Australian Financial Review March 2, 1999
ASX hospital buys
Hospital & Healthcare April, 1999
More hospital beds to go
The Advertiser April 24, 1999
Healthscope looking down the barrel?
The Age May 27, 1999
Buyer Builds A Healthy Stake
Australian Financial Review May 28, 1999
MAKING THE NEWS :: Beaconwood lifts Healthscope stake
Australian Financial Review May 29, 1999
BRIEFS :: Scope for health
Australian Financial Review May 31, 1999
Spotless twins down for double in hospital
The Age June 1, 1999
New face
Hospital & Healthcare July, 1999
Maternity unit threat to hospital contract
The Advertiser July 16, 1999
Hospital operator to bear losses
The Advertiser July 29, 1999
Health group keeps losses under control
The Advertiser August 19, 1999
AUSTRALIAN HOSPITALS GROUP HEALTHSCOPE POSTS NET LOSS
ASIA PULSE September 13, 1999
Reporting season ends mainly in a sea of red
Courier Mail September 14, 1999
Ailing Healthscope in rehab
The Advertiser September 14, 1999
Restructure Hits Healthscope Result
Australian Financial Review September 14, 1999
Hospital fears nurse shortage
Northern Territory News September 17, 1999
Sector grows healthy 10pc
The Australian October 4, 1999
Walk out threat by nurses over holiday cuts
The Advertiser October 8, 1999
Surgery doubt as nurses vote to strike
The Advertiser October 12, 1999
Healthy respect
The Advertiser October 13, 1999
Healthscope Hopes For Quick Recovery
The Age (Melbourne) October 27, 1999
Making The News :: Chairman chosen
Australian Financial Review October 30, 1999
NT tender is $100m shot in arm
The Advertiser December 19, 1998
The Prognosis For Health-care Stocks
Australian Financial Review 5 January 2000
Profit Upgrade
Australian Stock Exchange Announcement January 18, 2000
Group gets clean bill of health
The Australian Financial Review January 19, 2000
A healthy profit
The Advertiser January 19, 2000
XCHANGE :: STILL AILING
Sydney Morning Herald January 21, 2000
Boardroom shuffle at Healthscope
The Age January 26, 2000
Health industry ills
Australian Financial Review January 29, 2000
Healthy feeling
The Advertiser February 5, 2000
Hospital 'cheating system'
The Advertiser February 9, 2000
Healthy future
The Advertiser March 1, 2000
BRIEFS :: HEALTHSCOPE
Australian Financial Review March 2, 2000
Coroner not happy with procedures
The Advertiser April 6, 2000
Man's death taken up by Ombudsman
The Advertiser May 6, 2000
$1.5m boost for NT's heart centre
Northern Territory News May 12, 2000
Hospital pay protest; Staff owed $200,000 in back wages
The Advertiser May 12, 2000, Friday
PLAN FOR $12.6M PRIVATE HOSPITAL IN LIMBO
Messenger - Leader May 24, 2000, Wednesday
BROWN DENIES DEFERRAL
Messenger - Leader June 7, 2000
No private facility for Modbury
The Advertiser July 15, 2000
No private facility for Modbury
The Advertiser July 15, 2000
A run sans news
Sydney Morning Herald August 4,
2000
Healthscope
The Australian Financial Review August 30, 2000
Briefs :: HEALTHSCOPE
Australian Financial Review August 30, 2000
Labor queries privatised hospital
The Advertiser October 24, 2000
Health Stocks In Fine Fettle
Sydney Morning Herald 31 October 2000
Healthscope test was no accident
The Age November 9, 2000
NAB Takes Fortune To Town And Buys Big
Australian Financial Review November 10, 2000
Private Hospitals In Recovery Ward
Business Review Weekly 11/17/2000
Acquisition of Victoria House Private Hospital
AUSTRALIAN ASSOCIATED PRESS :: Company News November 30, 2000
Fed: Privatising public hospitals should be abandoned
AAP NEWSFEED December 7, 2000
Talking health
The Australian Financial Review January 5, 2001
Mayne pain
Australian Financial Review January 5, 2001
Trio Tossed Aside In Merrill Purge
Australian Financial Review January 18, 2001
Mayne chance
Australian Financial Review February 27, 2001
Ramsay Enjoys Healthy 60pc Profit Jump
Australian Financial Review February 28, 2001
Healthy future
The Advertiser February 28, 2001
Mayne Nickless On $1bn Acquisition Trail
Australian Financial Review 03/01/2001
Mayne fighting fit and on prowl
The Australian March 1, 2001
Mystery buyer for Healthscope
The Courier-Mail March 2, 2001
Mystery buyer for Healthscope
Courier Mail March 2, 2001, Friday
Healthscope activity makes a spotless day
The Age March 2, 2001
Mayne deal near?
Australian Financial Review March 12, 2001
Heart machine to attack death rate
Northern Territory News March 15, 2001 Thursday
Pacman's midas touch pulls Mayne shares to 2-year high
AAP NEWSFEED March 19, 2001, Monday
Healthscope buys into Qld, NSW hospital markets
AAP NEWSFEED April 26, 2001
Healthcare investors zero in on Queensland's potential
The Courier-Mail April 30, 2001 Monday
AUSTRALIA S HEALTHSCOPE BUYS THE SYDNEY CLINIC
Asia Pulse May 18, 2001 Friday
Acquires The Sydney Clinic
AAP NEWSFEED May 18, 2001
Vic: Betty Ford Clinic for Australia
AAP NEWSFEED May 22, 2001
A response to the IPPR's Commission on Public Private
Partnerships
British medical Journal June 2001
Acquires hospitals at Palm Beach Qld & Dubbo NSW
ASX release 26 Apr 2001
Acquires The Sydney Clinic
ASX release 18 May 2001
HEALTHSCOPE EXPANSION CONTINUES
ASX release Tue 22 May 2001
Local version of Betty Ford clinic
Sydney Morning Herald June 20, 2001
PMP Directors Keep The Faith
Australian Financial Review June 29, 2001
Healthscope cures ills
The Age July 11, 2001
Becoming a substantial holder from AMP
Australian Stock Exchange Announcements July 24, 2001
HEALTHSCOPE SHARE OFFER CLOSES OVERSUBSCRIBED
Asia Pulse 1 August 2001
Healthscope's hot
Australian Financial Review August 1, 2001
Healthscope on acquisition path after $10.7 mln raising
AAP News 1 August 2001
$10.7m war chest
Herald Sun August 2, 2001
BRIEFS :: HEALTHSCOPE
Australian Financial Review August 29, 2001
Healthy growth
Courier Mail August 29, 2001, Wednesday
Healthy return
The Advertiser August 29, 2001
Smedley Wets The Baby's Head
Australian Financial Review 30 August 2001
Hospitals Bed Down Better Margins
Shares Magazine 1 September 2001
Labor queries bonus
Sunday Mail (SA) September 2, 2001
Latest hospital buy won't slow Healthscope's shopping spree
AAP News 21 November 2001
Mayne cures its ills.
Herald Sun 22 November 2001
Hospital chain buys 7th private facility this year.
Adelaide Advertiser 19 December 2001
Trifecta For ICSGlobal Software
Australian Financial Review January 14, 2002
HEALTHSCOPE
Australian Financial Review February 21, 2002
Under The Weather At Mayne
Australian Financial Review February 28, 2002
Lower Valuations Fillip For Cheap Shares
Australian Financial Review March 21, 2002
This page created June 2002 by
Michael Wynne
