Good morning, everyone. On behalf of ACL, I'd like to start by acknowledging the traditional custodians of the land on which we meet today. I'm based in Sydney, on the lands of the Wangal people. Melinda and James are joining us from the lands of the Wurundjeri and Boonwurrung peoples of the Kulin Nation. We acknowledge the traditional custodians of country throughout Australia and the places from which our participants join us on this webinar, and their connections to land, sea, and community. We pay our respects to their elders, past and present, and extend that respect to Aboriginal and Torres Strait Islander peoples here today. Welcome to the investor webinar for Australian Clinical Labs Half-Year Financial Results. My name's Eleanor Padman. I'm the Company Secretary at ACL.
I'm joined today on this webinar by our Group CEO and Executive Director, Melinda McGrath, our CFO, James Davison, and our National Marketing Director, Joe Geran. Today's webinar will run for approximately an hour and will be recorded. A copy of the recording will be made available on ACL's website after the event. By choosing to attend, you are providing your consent to participating in the recording. If you would like more information, a copy of our privacy policy can be found on our website. During the webinar, you'll hear presentations from Melinda and from James, and then we'll have time for Q&A. To ask a question, you may raise your hand if you would like to ask your question live during the webinar.
Or if you'd prefer to submit a written question, which I will then read out, you can type it into the Q&A function that you will see at the bottom of your screen. Once we move to Q&A, we will focus on the more frequently asked questions and will try to get to as many as possible in the time available. I'd now like to hand over to our Group CEO, Melinda McGrath.
Thanks, Ellie. Welcome to Australian Clinical Labs' First Half Financial Year 2024 results presentation, and thank you for your time. To slide three, please, Joe. In the first half of financial year 2024, Australian Clinical Labs delivered our expected result for the half despite the challenging macro environment. ACL recorded an underlying EBITDA of AUD 87 million and an underlying EBIT of AUD 23 million, which was in line with company expectations on the profit phasing of the year based on exiting the pandemic and the COVID testing decline. In the first half financial year 2024, ACL achieved total revenue of AUD 337 million, underlying EBITDA of AUD 87 million, EBIT AUD 23 million, NPAT AUD 10 million, and free cash flow before interest, tax, and financing was AUD 18 million.
The half saw challenges in the macro environment with reduced referral availability and increase in GP private billing affecting patient attendances and hospital challenges with medical and nursing availability issues. Government initiatives introduced in November 2023 are expected to start having an impact in half two. Adjusting for the declining COVID revenue, the first half of 2024 underlying EBIT grew 16.5%, driven by a combination of BAU revenue growth, full-period impact of Medlab synergies, and efficiency initiatives. COVID revenue declined AUD 36.5 million, which had an impact on the EBIT of AUD 14.6 million. During the half, we chose not to renew collection centres with unattractive rent dynamics. We expect rent as a percentage of revenue to decrease as volumes revert to a more normal rate.
We follow a disciplined strategy of collections in a network optimization to protect margins, especially in an ongoing environment of subdued industry revenue and competition for collection centers. As a result, non-COVID MBS revenue growth for the half was 5.4% compared to reported MBS market growth of around 6%. The second half of financial year 2024 started strongly, with revenue in January up 8.6% on January 2023. The unaudited underlying EBIT for January was AUD 4.9 million, up over 200% on the prior year in what is a seasonally weak month for pathology volumes. Excellent labor management in a difficult month contributed to this result. However, volume has softened further in February. The board has declared an interim fully franked dividend of AUD 0.03 per share, which represents 59% of first half financial year 2024 underlying NPAT. The board target ratio is maintained at 50%-70% of NPAT.
Slide four, please, Joe. ACL expects financial year 2024 underlying EBIT of AUD 60 million-AUD 65 million. Half two is expected to be stronger than half one due to higher volumes typically experienced in half two and the run-rate impact of cost efficiencies implemented in half one exiting the pandemic. We have revised our guidance based on the following: half two underlying EBIT margin to return to double digits based on seasonally higher half two volume on a fixed cost basis at AUD 37 million-AUD 42 million. Half one underlying EBIT of AUD 23.4 million was in line with management expectations and was in line with the achievement of previous guidance based on anticipated half one/half two seasonality. Based on volatility in GP attendances in half one and MBS outlays through mid-February, we are taking a more conservative approach to anticipated growth in half two.
The revised guidance assumes revenue growth for February to June of between 4%-6% versus previous assumptions. Guidance assumes half two seasonal split of EBIT at 61%-64% of financial year 2024 EBIT, which is in line with financial year 2023 performance on an ex-COVID basis. Note that half one last financial year saw around AUD 13 million of EBIT COVID spillovers more than half two. Slide five, please, Joe. We continue to actively explore value accretive acquisition opportunities for the business as part of our growth strategy. We will continue to take a disciplined approach to acquisitions. In December, Clinical Labs withdrew its offer to acquire Healius due to concerns over Healius trading performance, a breach of conditions of the offer, and the ACCC rejection of the deal.
With the ACCC's rejection of the merger, ACL now has the ability to challenge the decision in the federal court if the board so chooses. The board has reserved its position in relation to Healius and will continue to review its ongoing performance. We note their results announced yesterday, which the board has not considered. The takeover was announced around this time last year, and it included an offer ratio and a number of conditions. As I mentioned, many of these have subsequently been breached. Our shareholders have made it clear that while they see the rationale for the merger and support the potential merger at the right ratio, they are very happy with our plans without the merger and do not want to see any value transfer. The board is acutely tuned into the relative valuation and risk-reward effort of each of our options for strategic acquisitions.
We've had discussions with related businesses that would grow Australian business, and a number of these discussions are ongoing. In addition, we believe our deep pathology experience as well as our unified pathology platform present significant value creation opportunities in higher-priced pathology markets with many untapped operational improvement opportunities such as the United States. In addition, I'll note these markets, while operationally very similar, in general do not have the added cost of collection center deregulation such as rent, laboratories, and other associated costs due to deregulation in the Australian market. However, the ACL board is very focused on considering risk and return of any potential international acquisition, and Australia is our strong preference for our next acquisition. Next slide, please, Joe. Slide six. The second year of execution of our ESG strategy continues to deliver strong performance across all areas of our ESG mission.
Our external audit has shown 1.25 kg of carbon dioxide per episode reduction from 1.4 kg in financial year 2021, the first year of measurement. We've made good progress on electricity and packaging reduction and have increased our hybrid cars while reducing our kilometers per episode. Our digital ordering process reduces paper usage as now up to 16% of referrals. 4.7 out of 5 patients responding to our SMS service feedback system rate a positive experience. The others are actively followed up for improvement opportunities. Our lost time frequency rate is two, down from 3.2 in December 2022. And two more to point out. The board has 43% female representation, up from 33%. Management is 57% females. And our Reflect RAP has been drafted and submitted to Reconciliation Australia for review. Next slide, please, Joe. Onto slide seven. Onto our operational and strategic highlights.
Material labor cost savings have been achieved through productivity improvements. Compared to the first half financial year 2020, that is pre-COVID, labor as a percentage of revenue is down 5 percentage points from 50%-45% in half one 2024 despite labor cost inflation over the intervening years and including the steep escalation during and post-COVID. We expect this ratio to improve in the second half based on the work we are doing and increase volume in the second half. As volume increases, we don't need to put on much labor, and we're dealing with an underutilized network due to the macro issues I mentioned earlier. Key drivers of the labor savings include a culture that understands the need to be dynamic and many digital solutions we've invested in and refined over the years.
Further refinement of our digital labor management tool enabled enhanced precision in matching volumes to labor, particularly over the holiday period. Advancements in lab productivity via machine learning, automation, and shift optimization with teams achieving record lab productivity in the first half with panels per work hour up 16%. Improvements in courier route efficiencies from our route planning optimization tool and centralization of back-office functions such as call center and data entry operations. I might just comment here that I'm sometimes asked by investors, "What more can we do on labor, and is there more?" I just want to have a reminder that we have a number of advantages that we have worked really hard to achieve. We have a commercially and service-focused management team with deep experience in pathology and what is possible and where the opportunities are. We continually look for opportunities.
We have one lab information system and have all of our pathology businesses integrated into one platform, which is a competitive advantage over our peers. It's very hard and disruptive to get to this position with a lab information system. As a result, we're able to drive performance improvement opportunities across the country at the same time, reduce duplicated cost, and move work around seamlessly. We benchmark best demonstrated performance for service, revenue by item or test combination, and cost per episode. We reward and enable best demonstrated performance. This is driven by leaders even to the lab floor. It's coupled with a very stable management team in each state and a culture of striving to be the best within our teams. I'll also make note that via our programs that we've instituted, many of our staff at all levels, but including middle management, are shareholders.
We have a team of business improvement managers who focus on and are incentivized by process improvement. We have a mix of people who have deep pathology experience coupled with lean qualifications and people from other industries who contribute to different thinking and who have engineering and science backgrounds coupled with process skills. Key strategic and growth initiatives progressed include ongoing investment in digitization initiatives, a major public hospital contract renewed at improved rates with further renewals expected in the next couple of months, growth in high-value niche testing with 25% market share in genetic carrier screening listed on the MBS in November 2023. On a different note, after 23 years in the industry, five acquisitions with ACL, an IPO, and other corporate activity, ACL CFO James Davison has resigned to take a period of extended leave and spend more time with his family, effective 26th of April.
The board wishes to thank James for his dedicated service, his work ethic, and drive, and his enormous contribution. I would personally like to thank James for his partnership with me in the past eight years. We've had great teamwork with many achievements. Recruitment has advanced, and an appointment is expected by the end of March. James is assisted by Lana Hudson, Deputy CFO, and Brad McCormick, Financial Controller, who are well placed to manage in any intervening period. Over to you, James, and thank you.
Thanks, Melinda. Next slide, Joe. Next slide, Joe. As Melinda has already discussed, the subdued trading conditions continued throughout the first half. For the half, we had revenue of AUD 337 million, which comprised of non-COVID revenue of AUD 314 million, which was up 4% on PCP, including as flagged at the full year.
We had planned a restructure of the Queensland business, which has had a positive impact at an EBIT level but reduced total revenue growth by a little over 1%. COVID revenue of AUD 12 million was 76% down on PCP. In terms of COVID revenue, to keep it consistent with how we'd previously reported, noting that it's now part of the respiratory ladder, we've just, sorry?
Sorry, Joe.
We've used the total number of COVID tests multiplied by COVID fee plus a PEI and BBI. Underlying EBITDA of AUD 87 million was down from AUD 96 million in one half 2023, but AUD 37 million. Are we still live?
We're still live. Joe, we've lost the presentation. Would you mind popping it back up again for us, please?
I think Joe might have frozen.
All right.
Do you have a copy handy, James, or do you want me to put it up on the screen?
Hello? Would that be possible? Yeah.
Just bear with me a second, everybody. Can you see that now?
Yeah. Slide nine, please, Ellie. I'm just going to make it full screen.
Sorry. Which slide number?
Slide nine. Oh, sorry. 10. Next one. Underlying EBITDA of AUD 87 million was down from AUD 96 million in one half 2023, but AUD 37 million or 72% up on the pre-COVID. Underlying EBIT of AUD 23 million was down from AUD 35 million corresponding period, but AUD 17 million or over 270% up on the pre-COVID amount. The reduction in COVID revenue of AUD 37 million at a 40% margin had a circa AUD 15 million impact on underlying EBIT. Adjusting for this, EBIT would have been up over 16% on PCP.
Non-recurring items of AUD 7 million have been excluded and comprise AUD 4 million in Healius transaction costs, AUD 1 million for an asset write-down for a piece of equipment that was damaged in a fire. And we have a pending insurance claim for that amount, AUD 1 million relating to the Medlab acquisition, and some legal and restructuring redundancy costs. A few key takeaways for the half. Firstly, in terms of the macro environment versus pre-COVID one half 2020, the two primary drivers of pathology volume being GP consults and specialist consults have only increased by a total of 1.5% or a CAGR of 0.4%. Over the four years, GP consults had a CAGR of just 0.2%, up from AUD 80.1 million - AUD 80.7 million, and specialist consults a CAGR of 1.1%, up from AUD 16.8 million- AUD 17.6 million.
In terms of pathology services, this has translated to a total increase of 1.1 million patient episodes, including COVID referrals, at a CAGR of just under 1.3%. Over the four years, ACC collects increased by 1.2 million, histology volumes increased by 100,000, self-collects were up 100,000, inpatient services were flat, and doctor collects decreased by 300,000. Doctor collects now represents a little over 17% of total episodes, down from almost 20% pre-COVID, with the number of ACCs increasing by 312 over the same period. It is expected the additional bulk billing incentives for GPs, which were introduced in November 2023, will have a positive volume impact plus further growth upside for us due to our strong private hospital positioning in private inpatient and histology work. In terms of our business, we had a strong uplift in outpatient specialist revenue of over 8% for the half.
Labor costs were flat on PCP and down 1.2% on one half 2022. Between June 2023 and November 2023, with December being favorably leave impacted, we reduced our total FTE by over 2%. Over the last four years, we've been able to reduce our total FTE, excluding collection center and back-office staff, by 13%, excluding acquisition synergy benefits, and including synergy benefits by over 17%. AASB 117 rent or cash rent was up 3.4% on PCP, which is a bit higher than normal but well managed in the high inflationary environment.
Looking at just our core pathology business units being Vic, New South Wales, SA and WA, from pre-COVID one half 2020 to one half 2024, we've been able to decrease labor as a percentage of revenue from 45% - 40%, hold consumables flat at 17%, decrease other costs from AUD .10 - AUD .09, with the only unfavourable movement being AASB 117 rent as a percentage of revenue, which increased by 1%, being negatively impacted by the below-trend revenue and high inflationary environment. Over the same period, labour efficiency as measured by episodes per work hour improved by 13%. The underlying EBITDA margin of 26% for the half is only marginally lower than our targeted sustainable level despite the significant gap to trend in Medicare revenue, highlighting our ability to manage our costs.
With rent primarily below EBITDA, we have reduced this group of costs by AUD 15 million or 5.5% on PCP, with labor flat, consumables down AUD 10 million or 3.7%, and general expenses down AUD 5 million or 10.6%. The underlying EBIT margin is lower than our targeted levels, wholly attributable to the soft revenue conditions, and the business remains well placed to maximize our operating leverage as the volumes return. We expect to see EBIT margin back in double digits for the second half. Next slide, please, Joe. For the half, ACL generated AUD 18 million of cash before financing and investing activities, which represents an 82% conversion ratio or excluding CAPEX, 100% conversion of cash EBITDA to operating cash flow. Working CAP for the half was flat, which is a positive as generally half one sees an unfavorable movement.
Non-cash items include share-based payment expense plus the non-recurring asset write-down. CapEx for the half was AUD 4 million or around 1% of revenue and included AUD 1 million for each of lab equipment, new and refresh of collection centres, and motor vehicles. The spend for the half is in line with the 8% annual maintenance spend, with the business continuing to invest in CapEx as required. Financing and investing includes dividend payments, debt drawdowns, and other investing-related activities. Next slide, please, Joe. Or Ellie, sorry. ACL has a very clean and strong balance sheet. The business is very conservative leverage, with net debt excluding lease liabilities of AUD 54 million being only 1.1x LTM AASB 117 EBITDA and total net debt including lease liabilities being 1.8 x LTM AASB 16 EBITDA at a statutory level or 0.8x and 1.7 x respectively at an underlying level.
We had minimal movements on the closing June balance sheet. After the final dividend, the final dividend will increase pro forma net debt to around AUD 60 million, which equates to a net debt to EBITDA ratio of only 1.2x its at. Back to you, Melinda.
Thanks, James. Onto slide 13, thanks. Just some more comments on market. Non-COVID pathology volumes continue to lag historical trends. These charts show dramatic changes in attendances and referral patterns in the last two years since the onset of COVID. Market volumes are around 3% below trend. For us, this is a AUD 40 million revenue shortfall. The downturn in GP attendances lags historical levels by around 25%. However, we continue to expect volumes to return to trend as GP shortages ease over time and government solutions take effect. Slide 14, please, Joe.
Australian Pathology has recently launched a national campaign, Keep Pathology Bulk Billed, which calls on the federal government to increase rebates for pathology patient services. Just reminding people, these are rebates that we collect on behalf of patients. It's a patient rebate. It's not a rebate to the companies. And just as a plug for the campaign, the QR code is right there on the slide if you're so inclined to sign up. We're asking for the same indexation as other healthcare services have been provided. We believe there's a compelling case for indexation to ensure pathology providers can continue to provide bulk bill services and regional and other services that Australians expect. Next slide, please, Joe. Onto slide 15. Our focus in the second half is on continuing disciplined footprint expansion and maximization, ongoing operational efficiency initiatives, and investment in the Lab of the Future program.
Our collection centre and hospital services are underutilized due to the macro factors I mentioned, and our focus will be on converting additional revenue to margin. Our business improvement activities will continue to optimize our cost base. With the Lab of the Future program, we are scoping a redesign of the business's lab operations to create a highly automated, orderless national lab network that capitalizes on our experience in COVID testing across borders. This will enable further footprint reduction. And this project includes opportunities for automation or further automation, further machine learning, and AI. Some of these opportunities are available now. Some are under development and a few years away. Geneseq. Just as a reminder, Clinical Labs made a strategic investment in a company called Geneseq in 2018. Its Melaseq test is a liquid and solid tissue microRNA genetic test for melanoma.
The test opens up the potential for earlier, less invasive, and more accurate screening and diagnosis of individuals at risk of melanoma. Importantly, it detects the cancer at all stages. Clinical Labs has convertible notes that provides with an effective 20% equity ownership of Geneseq and a 10-year exclusive Australasia license for the distribution of the Melaseq test. International patents are pending across several jurisdictions, including U.S., Europe, Australia, China, Japan, South Korea, and Canada. The test has achieved very high validation scores. In July 2023, Geneseq published groundbreaking research in the British Journal of Dermatology showing 93% sensitivity and 98% specificity for invasive melanoma detection. These are excellent results. In Australia, there are two million biopsies of melanoma per annum and around two million patients that are considered high risk for melanoma with 18,000 new cases per year.
Screening or testing 5% of these biopsies or at-risk patients per annum has the potential to generate revenue in the region of AUD 100 million per annum and materially reduce the costs associated with melanoma, social, medical, and economic. We estimate the U.S. market is AUD 2 billion and Europe AUD 1 billion. The test approach is applicable for other common cancers, and Geneseq is currently working on the development of a non-invasive ovarian cancer test. Moving on, we continue investment in digitized refer and patient processes, automation of functions, and e-result systems. As previously outlined, we continue to explore strategic inorganic growth opportunities that make sense financially for us. Before I finish, I would like to take the opportunity to thank our pathologists and scientists for their leadership and all Clinical Labs staff who come to work every day to positively impact our patients' lives. I would like to finish by again thanking James and wishing him well in his future. Applause now for questions. Thanks, Ellie.
Thank you. I'm just going to stop sharing this so I can manage the Q&A. Okay. So Lyanne, I think you were first to put your hand up. So Lyanne Harrison from Bank of America, please go ahead.
Hello. Can you hear me okay?
Yep. Hi, Lyanne.
Hi, Melinda. Hi, James. Can I start with guidance and your assumptions in the top line? I think there was a couple of points there. One pointed to guidance being based off MBS revenue growth in the half or the second half of 4%-6%. And then in the slides, it was saying guidance assumes revenue growth of 4%-6%.
So I was just trying to understand, have you factored in 4%-6% MBS revenue growth, but is there any expectation there that ACL can grow faster than that given their experience previously of being able to take market share and exhibiting above market growth?
Yeah. So the 4%-6% is revenue growth. But what we've seen recently is the non-MBS revenue's been growing the same sort of amount. So they kind of go hand in hand together. Absolutely. So we continue to obviously try and take share where it makes sense from a dollar point of view. The market, we aggressively compete for collection centers that we want to win. But obviously, it depends a little bit on offers that people have been receiving from other sites.
I guess the one important note I will make, and it's in the forecast, it's in the presentation, we had a particularly strong January in terms of revenue, favorably impacted by an additional day and also strong average fee. But in terms of the forecast for February through to June, for that period last year, we did just short of AUD 30 million at an EBIT level. So the forecast for the set for the remaining four months is not wildly dissimilar to what we did last year. So I think that certainly does offer us some upside both in terms of cost control and additional revenue growth.
I might just add to Lyanne. Lyanne, I'll just add to you. We can make our growth double digits if we want. In this industry, you can do that, but you do it at margin detriment.
So we're balancing revenue growth and responsible revenue growth so that we can maintain a profitable margin. So as you know, we could change that if we wanted to, but we're looking after our margins.
Okay. And then on that comment on margins, so based on your revised guidance, approximately 60% or a little bit more of 60% of EBIT will be delivered in the second half. And by my calculations, that works out to be maybe around 11% EBIT margin for that half. So I'm just trying to understand that to what extent is that driven by volume growth? To what extent is there more cost out in the business? And particularly what you're saying around labor and the savings you've achieved there, is there more to come in second half 2024 that helps expand those margins?
Yeah. So you're right on the number.
And obviously, there's market volume which is out of our control to a certain extent and then costs which are. So we've found a nice balance between we're fairly comfortable, I think, around the revenue number, but we've also left ourselves a little bit of room from a cost point of view just to make sure that we're comfortable with where the numbers land.
Just on a couple of those points, as I said, we expect the labor to improve as a percentage of revenue. That's due to activities that we've put in place from a labor-saving point of view in that first half that should flow through or are flowing through this half and increase in volume. And with rent, obviously, rent is we have really been refining our portfolio probably for the last five or six years.
So we're not making dramatic changes to our portfolio, but we're refining it gently and with a view to our margin. And then as volume comes back, we anticipate rent as a percentage of revenue to improve as well. So that's primarily where we've had the biggest issue aside from the macro volume. The biggest issue is rent escalation, which we can't really control if we want to keep our market share as it is or grow it.
And just one final question from me. Obviously, there's macro implications with the GP shortages and lower GP referrals. What proportion of your revenue is from GPs?
It'll be 2/3, probably.
Okay. Where will it?
So in the outpatient setting so if we leave aside commercial and hospital and just look at community work, it would be probably 80%, 85%, 80% maybe GP versus specialist.
But then once you add in the inpatients, the private hospitals, and everything else, which is all MBS as well, then obviously, it's a lot higher weighted towards specialists, and it'd bring it down. So in terms of MBS, it'd probably be two-thirds, one-third. But then there's commercial and veterinary and all the other avenues of revenue.
Okay. Great. Thank you so much. I'll leave it there.
Thank you. Andrew Goodsall, you're next. Go ahead, please, Andrew.
Thanks very much for taking my question and wishing you all the best, James, for your future directions. Just coming back to I've asked this question throughout reporting season, but just in terms of what you're expecting the government might be able to provide and the timing of that, I presume, around budget.
Andrew, the industry put in a proposal to government, which we think's quite reasonable.
We're asking for the same benefits or same increases that other healthcare services have already been provided. We think that's reasonable. As you know, we've been working with no price increase for 25 years, and we've absorbed inflation over that period, and we've absorbed the extra cost of deregulation of collection centres. So it's at a point in time where we need to really be saying to the government that something's got to change. It's either needs reinvestment or we have to change our models of service and/or the patient needs to pay for the service that we're giving. So I think the government is acutely aware of our proposal and what we're requesting, and we look forward to discussing it with them in terms of timing and amount, etc. I'm not going to foreshadow what the government may or may not do.
So it's a matter for the government to decide which way they want to go on the matter.
Great. Thank you. And just for James, you've dissected the EBIT ex-COVID, which I think I've sort of back solved and understand. But perhaps an easier way, if you have it, if you didn't have COVID testing in the first half 2023, what would the underlying EBIT margin have looked like?
I'm not sure I've got in front of me. So the way we've done it, the number's probably a little bit conservative because we've just used a flat 40% in terms of EBIT margin for COVID, whereas the first quarter of the first half was before the AUD 0.17 fee cut. But if I take off the COVID revenue.
I'm sort of guessing that it's probably pretty flat.
I mean, I'm sort of thinking we've got a 7% against a 7%, but I just didn't have all the facilities to do that.
Yeah. Give me one second, and I'll tell you. No, a 5%. If there's no COVID revenue if I back out COVID revenue and the margin of 40%, and it was probably a bit higher, it'd be 5%.
Sorry.
5%.
We can take it offline if you give me some time to check it. I didn't want to put you on the spot. But just trying to sort of see what you've done with the underlying business, which obviously.
Yeah. If margin improved, 16% conservatively increasing dollar terms, and the margin would have improved ex-COVID.
Okay. Okay. So directionally, you're traveling in the right direction on that front?
Yep.
Okay.
Like I said, on the cost front, across every line, we've managed it really well. We've taken out a bunch of additional labor. We were early to get all of our COVID costs out. Rent, even at 3.4%, while higher than we'd like, is being well managed at a cash level. So it's really just that macro environment being depressing top-line growth.
And then just finally, you've given some commentary on January and February so far and obviously these extra days and so on in there. But is there anything in the numbers you're seeing to sort of say year-on-year, you're sort of seeing a distinct pickup that might give us some hope that MBS will get back to that 4%-6% range?
Yeah.
Well, the thing was, and if we were having this conversation four weeks ago, six weeks ago, my view July was deeply strong, but July the prior year was obviously, there's a lot of COVID. August came down, but then so COVID was still strong in August the prior year. September was strong, but if you normalize to the additional Queen's Birthday or Queen's Memorial, sorry, in September the year before, then September was quite light. Then literally every month, September, October, November, December, we saw significant growth in like-for-like non-COVID referrals. And so I thought that we'd already seen it. Then January was soft. But Januarys, over my 23 years, Januarys are always a bit all over the shop. And so I wasn't that concerned with January in its own right. You have years where more people seem to take leave and years where they take less leave.
Then February started soft. It started to pick up a little bit and then moderated again. So it's trying, but it's still it's like we've gone back three months in terms of volume. But I think there's enough signs or early signs that we may be starting to see some uplift.
That's great. Thank you.
Do you have any other questions, Andrew?
No more from me. Thank you.
Okay. Fantastic. All right. So next on the list is Gretel Janu from Credit Suisse. So please go ahead, Gretel.
Hi. Good morning. So firstly, I just want to follow up with Andrew's question just there. So just in terms of just the bulk billing incentives that was increased from November, you expect to have a positive impact in the second half. Is that really one of the key drivers for you when you talk about a stronger second-half growth?
Do you think it's really coming from that, or is it from other macro factors out there? Thanks.
Yeah. So in terms of first-half, second-half, if we go back to pre-COVID or five years ago, 10 years ago, generally speaking, for a stable-half business, you'd be looking at probably a 45%, 55% split first-half, second-half anyway. Second-half has always been stronger. Fees much stronger through February, March than what it is through the winter months. And there's a number of reasons for that. So generally speaking, we'd expect to see a stronger fee through February, March, April, May, depending on Easter, and some volume uplift. And also costs tend to moderate a little bit. There's a couple of less working days in the second half.
So the combination of stronger average fee, a little bit of additional volume, and a couple of less working days generally points to a stronger second half anyway. And like I said before, for the remaining four months, February through to June, last year, we did just under AUD 30 million. At the bottom of the range, it's only AUD 32 million that we need to do for the balance. So it's not dependent on a miraculous uplift in volume growth or anything like that. And so we think, sorry, Gretel. And so we think December was certainly much stronger than November. And so we put down that part of that to maybe the incentives and things like that. And access to doctors kind of has to improve.
Even looking at histology numbers and stuff like that, there's going to be some pretty bad health outcomes if the government can't help sort some of these accessibility issues.
Sorry, but you have seen softness in February. I just want to confirm that.
Yeah. Yeah. Sorry. Yeah. Correct. Sorry. I thought I covered that. Yes. Yeah. Yeah. So Feb hasn't gotten worse than Jan, but it hasn't gone back to what it was sort of November, December.
Okay. Very clear. And then just in terms of the ACCs that you've exited in Queensland, can you just tell us how many you did exit? Is there more still to do on that front in the second half, or are you happy with your exposure?
No. All done in the first few months or primarily done in July.
So it was a favorable EBIT impact, but just had obviously that sort of a little bit over 1% impact on revenue, which will be a little bit less in the second half.
And in terms of the EBIT contribution?
It'll be positive. It's only a small business, the Queensland business, but it was a positive EBIT contribution in the first half compared to what it was in first half last year.
Great. Thanks. That's all I had.
Thank you, Gretel. So the next on my list is Craig Wong-Pan from RBC Capital Markets. So Craig, please go ahead.
Just wanted to clarify that AUD 30 million of EBIT that you generated in the four months to June in the second half of fiscal 2023, did that include COVID earnings as well? And are you assuming that COVID testing kind of stayed about the same versus PCP?
Yeah. Correct.
There wasn't a lot of COVID in the remaining in the balance of the 4 months of last year. From memory, it was give or take around about AUD 12 million and probably not going to be that dissimilar this year.
Okay. Thanks. And then there was a comment made in the presentation that you've been able to renew some public hospital contracts at better rates. Could you say kind of what EBIT benefit that might have?
Can I come back to you? I know what the rate change was. I just don't have the dollar number to mind. I'll get that between now and when we talk, Craig.
Yep. And then just lastly, I think you mentioned it, the cost inflation you're seeing on ACC. I didn't quite catch the figure, but could you just talk about generally sort of what kind of inflation you're seeing across the business?
Well, our cash range went up 3.4% on PCP. So that includes some exits, some renewals, and some wins. So to Melinda's point, we review every single collection center every month for opportunities and viability and the like. So there's certainly some where rent expectations or offers were outside what we were comfortable with. But for us, yeah, 3.4%.
And then inflation across other parts like kind of consumables or staff?
So consumables is still 17% of revenue, which is what it was pre-COVID. And that's noting that obviously the respiratory and COVID uplift, it has a higher consumable cost, but we've also got some procurement savings. So no change there. And other costs, like I said, we've reduced by AUD 5 million half-on-half our discretionary spend.
Okay. Thanks. That's all my questions.
Thanks, Craig.
Then moving now to Mathieu Chevrier from Citibank. Please go ahead.
Thanks for taking my question and all the best, James. Just had a quick one for you to start off with on the cash flow from investing. There's a cash advance of AUD 7 million. I was just wondering what that was related to.
Yeah. There was some management shareholders that were restricted from selling shares during the Hobart transaction. And for some of them, there was an exception made, and it was covered off by a loan. So that'll be repaid now that the trading window will reopen.
Okay. Sorry. I missed that. It's management shareholders, you said?
Yes. Yeah. Some of the management shareholders were restricted from being able to sell shares whilst the Hobart transaction was on foot.
Okay. And then your 4%-6% sorry if I missed it.
Does that include the COVID revenues? Are you looking at the AUD 337 million that you did in the second half last year and you're going to grow 4%-6% on top of that?
Yeah. For the last four months, total revenue growth of around 4% yeah, 4%-6%. Correct.
Got it. Okay. And then in terms of your labor costs, underlying labor cost growth, where's that sitting at currently?
That's flat. It's flat half-on-half.
Yeah. And in terms of underlying inflation, because I imagine you had to take some measures to control that, do you have a number in mind that you're able to share, or do you think you can manage that according to the volumes that you see?
A special case .
So we've certainly been able to and continue and have a number of additional labor-based initiatives that we will some were implemented during the half that we'll get obviously a full-half impact from. We've got some new ones that we're working on. And so we would expect that we might see a little bit of uplift through the second half. But I think taking into account the modern award, the EBAs that we have, and salaried staff, I think leaving aside efficiency gains and everything else, we've probably managed to sort of hold that in there somewhere between the 3%-4% mark, maybe leaning to the lower end of that, and then been able to offset that through initiatives.
Got it. And then just one final one on your expectations around finance costs and D&A. Thank you.
So I think D&A was up about 4.5%. I wouldn't expect it to be materially different in the second half to the first half. And in terms of the full year of finance costs? So the interest on the debt will obviously be a little bit higher than the first half as we're carrying a little bit more debt, but the AASB related interest costs not dissimilar to the first half.
Got it. Thanks very much.
Thank you. So I think we're at time, and we've answered all the questions with raised hands. So if there are any other questions you'd still like to raise, please email them through to us at investors@clinicallabs.com.au. You'll find that email address on our ASX releases. Thank you, Melinda. Thank you, James, for your presentations.
Thank you to our participants for attending and for showing such an interest in ACL. We hope to see you at our next investor presentation later in the year. Thank you and goodbye. Bye.