Thank you for standing by and welcome to the Healius H1 2024 results call. All participants are in a listen-only mode. There will be a presentation followed by a question-and-answer session. If you do wish to ask a question, you will need to press the star key followed by the number one on your telephone keypad. I would now like to hand the conference over to Ms. Sharon Ng. Thank you. Please go ahead.
Hello and welcome everybody to the Healius H1 2024 results presentation. Today we have Maxine Jaquet, our CEO and Managing Director, Paul Anderson, our Group CFO and Head of People, and Steve Humphries, our Deputy CFO, as well as members of the management team. I will now hand you over to Maxine Jaquet to start off.
Thank you, Sharon, and good morning, everyone. Just one year ago we embarked on foundational work required to set the business up for the next phase of growth. We refreshed our leadership team with relevant growth and restructuring experience, reset Agilex with a team and a plan to deliver its investment case, set in motion an ambitious growth plan for our imaging business, and recapitalized the balance sheet. We are already seeing some of the benefits of these changes. Imaging is achieving revenue growth ahead of its growth plan.
Agilex has set up a partnership that will provide it with a global proposition from phase one to three. It is clear imaging and Agilex will both be key drivers of earnings growth. However, the contribution of the pathology division is stark. The challenges of the GP market, declining growth, growing coning, have all been well canvassed, as has Healius's exposure to this.
I don't intend to labor this point. What is relevant is how we view the outlook of the market and how we are planning to manage the business to achieve a sustainable economic return. I will address this later. Turning to Lumus Imaging, where the increase in both revenue and EBIT is demonstrating the delivery of the five-year growth plan. This performance has been driven by the delivery of the community growth strategy, where revenue is ahead of target at 15% growth, successful implementation of additional out-of-pockets, improvement in support labour margins of 40 basis points with a reduction in FTEs, successful recruitment of radiologists with 19 new radiologists onboarded in the half and a similar number in the pipeline. These first-half achievements are not fully recognised in H1 earnings but will be in second-half margins and beyond.
In addition, a number of initiatives were embedded that support the growth strategy, specifically in community, where we are expanding our penetration of higher-margin modalities, which includes three new MRI services being launched and two greenfield sites being commissioned—one with a PET in the H2 of the year. A further four comprehensive greenfield sites are planned for the H1 of 2025 financial year. For our hospital channel in 2H24, we have the opening of two new hospitals at Ramsay's Northern Private and Healthscope's Latrobe, the launch of a new PET at Northern Beaches Hospital, and a successful contract win North Sydney Local Health District. In medical centers, we are working to improve this low-margin division and will see substantial margin uplift when we exit the underperforming sites in 2027. There are also significant clinical and productivity benefits to be had with the adoption of AI.
We already have the Qure.ai partnership for tuberculosis screening, and we now have a preferred aggregator, Blackford, to draw on the best on offer from an ever-changing suite of AI developers. We are trialing a number of AI solutions currently, and we are working as part of an Oxford University International Consortium developing a product targeted at replacing ionized contrast with digital contrast. We are also adopting workflow utilization tools to improve the productivity of the clinical workforce. Turning to Agilex. In the half, there was a significant increase in revenue and earnings. We expect this trajectory to continue. This is supported by our current pipeline and expected additional upside from the SGS partnership.
As we announced this month, we have entered into a commercial agreement with SGS, which will enable Agilex to offer an end-to-end global trial solution and provide Agilex with access to new markets and a larger business development network. We expect this partnership to make a material contribution to earnings. Turning now to pathology. Our revenue growth is reflective of the market and our revenue mix. Specifically, GP attendances are down by 3.9% in the half, which, given our disproportionate share of this segment, has had an impact on our revenue recovery. We see this bifurcation in the market and our own business, with growth in hospitals and specialists up more than GPs. We are working actively to improve our mix.
Specifically, we are investing in new areas of testing, and we have made inroads in growing our active specialist referrer base, and have also added new commercial contracts. We have also lifted our out-of-pockets and will continue to do so. Fundamentally, we believe that pathology is the foundation of evidence-based medicine and pivotal for most health decisions. That is why we have commissioned research and economic modeling to support the case for sustainable pathology sector. We are now engaging actively as an industry with the government and believe our funding ask is reasonable, aligned to other areas of Medicare indexation, and should be supported. Given the prevailing growth rates, particularly in the GP segment, and the current levels of inflation, we are looking at the business through a different lens. We recognize to achieve a sustainable return for pathology there needs to be structural measures to change the cost base.
This will be managed in two phases. Our immediate focus involves rationalizing regional labs and the flow of work between labs, rationalizing ACCC, changing rostering structures, increasing our out-of-pocket fees for services, and improving productivity of frontline staff with the application of digital work tools. We have a clear line of sight of these initiatives, which will work to offset the inflation in our business. As these initiatives are rolled out, we will have run-rate benefits to report. Over the FY26 to FY27 horizon, we are working to achieve a step change in our core lab operations by leveraging our maturing digital capability and new ILAs to change the structure of our cost base.
This will be achieved by a zero-based design of operational workflows, removing manual touchpoints, increased use of robotic track automation, targeted adoption of digital pathology and use of AI-assisted reporting tools, and significantly reduced management overhead as we operate one consolidated lab network. This will be timed with our instrumentation renewal cycles to optimize our CAPEX. Fundamentally, we believe the underlying demand for diagnostic services and clinical trials is strong. We need to support the growth available in imaging and Agilex and focus on pricing and cost restructuring to live at sustainable economics for pathology. I am happy to take questions later, but I will hand over to Paul, who will take you through the financial results in more detail and, in particular, capital management. Thank you.
Thank you, Maxine, and good morning to everyone. Starting on slide 15 with the first-half group results. Group BAU revenues were up 4.9% for the half. The COVID-19 revenues reduced by 97%, or $ 54.4 million. In terms of the business units, pathology continued to experience slow GP referral softness and margin compression due to strong cost inflation. Agilex Biolabs had strong growth both in revenue and EBIT. Lumus Imaging's top-line gross revenue growth was up 3.5% but was up 8.5% growth in community and hospital channels. D&A increased 4.8% due to the four-year impact of increases in rental costs and our ACC footprint. We had non-underlying items of $ 16.1 million, which was a consistent allocation with prior periods. We had an impairment charge of $ 603.2 million, which I will talk about later on.
We had discontinued operations of $ 5.8 million, which was a number of items and partly a warranty claim that was settled. In terms of the next page on pathology, BAU revenues were up 3.6%. The strong growth rate and volumes that we saw in Q1 FY24 didn't continue into Q2, as we have set out before. MBS benefits paid reduced significantly in the November and December 2023 months to low single digits. The margins were impacted by inflationary cost pressures. Labor was 2.1% down on PCP with labor savings and COVID cost outs being offset by EA rate increases and legislated increases. Property costs included CPI rate increases with additional depreciation and amortization costs coming through for new ACCC rolled out in FY23. Consumables remained stable at 16.2% of revenue, with volume increases offsetting our COVID reductions.
In terms of Agilex Biolabs on the following page, it had strong revenue and margin improvements. Revenue was up 19.5%. EBITDA was up 105% and EBIT up 250% on PCP. The new business development structure that we have is showing positive signs. We announced to the market that we have a new commercial agreement with SGS that Maxine just spoke about. We still believe in the market fundamentals and strategic rationale for this business and note that we still expect to achieve the original business case, albeit in a slower timeframe than we set out. In terms of Lumus Imaging, we had top-line growth, as we said, of 3.3%. The growth revenue in community and hospital channels was 8.5% and in line with market after adjusting for Bupa and the closed sites during the year.
Our community sites are growing above market at circa 10%. The Bupa contract has shown a strong recovery following the resumption of testing requirements in November 2023, which was suspended for a year. Our volume growth has been supported by indexation of 4.1% and investment in higher-value modalities. The radiologist recruitment program has been supported by a new engagement model with 19 new radiologists put on in H1 and a solid pipeline for H2. We have a greenfield pipeline of two clinics at Dakabin and Narangba opening in Q4 2024, along with the new Northern Private and Latrobe contracts in February 2024. In terms of cash flow and CAPEX, we had $ 114 million of gross operating cash flows in the H1.
We had a cash conversion of 83%, which was below what our normal run-rate would be, which we would expect to be in the mid-90s. The differential between the 83% and that is working capital related and is around $ 15-$20 million. In terms of CapEx, this has reduced. Maintenance CapEx for the H1 was $ 18 million and growth CapEx was $ 16 million. That $ 34 million was down from $ 43 million in the prior corresponding period. We have reduced our maintenance CapEx across that period by 25%. Our guidance for maintenance CapEx for FY2024 now is expected to be $ 30-$40 million, and that has been reduced from $ 40-$50 million. In terms of the balance sheet and this non-cash impairment in goodwill, we announced this last week.
The non-cash impairment charge was $ 603.2 million and relates to near-term lower volumes and cash flows at a point in time as required for accounting standards, along with an increase in the weighted average cost of capital from 8.5%-8.8%. In terms of debt management, in the H1, net debt reduced to $ 327 million. Gearing was at 3.17 x. We did expect to receive a tax refund in December, which we got in the first week of January, which would have reduced that gearing to 2.99 times. Interest cover was 3.49 x, and we had 76% of our debt hedged as at 31 December. In terms of our second-half 2024 outlook, as we have set out before, our maintenance CAPEX guidance is now $ 30 million-$ 40 million, and our gearing and interest cover is expected to remain within those banking covenants.
In terms of our debt facilities, in November, we reduced that bank facility by $ 250 million to $ 750 million. Our refinancing discussions are underway with our banking group, and as we have set out in our ASX release today, asset reviews form part of our capital management focus. In terms of the outlook, we put out a market update last week, and our group EBIT guidance is now $ 70 million-$ 80 million for the year. Significant changes, as Maxine has set out earlier, have been undertaken to our cost base and structure of the pathology operations, matching those costs to the volume environment. The imaging market continues its current momentum throughout 2024, and Agilex, we expect to continue that revenue and EBIT growth and perform in line with our expectations.
As I said earlier, we continue to assess our balance sheet flexibility and review our assets, as we have set out in our ASX release. Our plan is to be flexible and maintain optionality. As we said earlier, gearing and interest cover is expected to remain within those bank covenants. In terms of guidance, our depreciation and amortization for FY24 is expected to be $ 289 million. Our interest costs are expected to be $ 71 million for the year, and as we said earlier, CAPEX from a maintenance perspective is expected to be $ 30 million-$ 40 million. That's it. Thank you.
Thank you, Paul. Now we'll go on to questions.
Thank you. If you do wish to ask a question, please press the star key, then one, on your telephone and wait for your name to be announced. If you wish to cancel your request, please press star two. If you are on a speakerphone, please pick up the handset to ask your question. In the interest of time, we ask that you please limit questions to two per person. If you would like to ask further questions, please requeue. Thank you. Your first question is from David Low from JP Morgan. Go ahead, thank you.
Thanks very much. Maxine, could we start with the funding negotiations? So I hear that it's been done by the industry and it's been well received. In terms of the decision, are you expecting, hoping for something in the May budget?
Look, it has been a big effort from we started this engagement six months ago directly and then the industry fairly recently. The engagement has been good. We've supported it with a lot of research and modeling, which I think has been well received. We do expect an outcome for in the May budget this year.
Okay. And can I get you to talk a little bit about the comment in the slide deck about out-of-pockets being lifted? Would that be in routine pathology or that's very selective in specialty tests or non-Medicare tests?
Look, it has so there's non-MBS items. So that's the first area that we have started charging in and lifting prices. There are areas which we are looking at lifting pricing on. Obviously, it's a question of elasticity and probably a bit commercially sensitive, David, so I probably won't go into the details today. But look, the reality is we do need the support of indexation, and short of indexation, pricing is going to be a bigger theme for this sector.
Okay. Look, and just the other topic I wanted to touch on, perhaps for Paul. I mean, I see the slide back, and I was thinking of your comments there about refinancing being underway. Just trying to understand what you're aiming for, given the refinancing in December. I thought, probably settled things for a bit.
Oh, it's sorry, David. The facility that we have is split into two, and one of those facilities is due, expires in March 2025. So that is the facility that we are currently discussing the refinancing for.
Okay. Very clear. Thanks very much.
Thank you. Your next question is from Lyanne Harrison from Bank of America. Go ahead, thank you.
Yeah. Good morning, all. You shared quite a few slides about the cost out or the transformation program. Could you give us an indication because there was no, I guess, quantitative information in there about what you think about the cost to deliver, whether it's in the phase one, phase two, and what you might think the annualized savings might be?
Lyanne, we might split that question into two. We might split it into what we have communicated in terms of 2H, which I'll get Paul to speak about, and then I'll talk about from there on.
Yes, I did. So we set out in our market update last year, we talked about $ 15 million of both revenue and cost initiatives for the remainder of FY24. So some of those have been delivered in the H1, but the lion's share of them are embedded in the guidance that we gave last week for the remainder of this year. So they are well progressed. They're embedded into our market update but clearly form part of the transformation program for pathology as well.
And just to add to that, Lyanne, so the initiatives that I talked about before being ACC rationalization, closure of labs, rostering, so those initiatives will be partly seen, and we will have a Q4 run-rate for those, and then an annualized benefit of those going into FY25. So when we've got that run-rate benefit in Q4, that will give us a very precise guide as to what we should expect in FY25, and we'll hold off giving those results until we've got clarity on the run-rate benefits.
Thank you. A follow-up on, I guess, trading update in January and February, can you share anything with us in particular for pathology?
Look, so pathology volumes for the last 4 weeks or so are running at around about 2% up on BAU. So it's been relatively consistent, probably over the last 7 or 8 weeks. So yeah, look, that's about as much visibility as we have.
Okay. Thank you very much.
Thank you. Your next question is from David Stanton from Jefferies. Go ahead, thank you.
Morning, and thanks very much for taking my questions. Look, perhaps to ask Lyanne's question in a different way, to get to the midpoint of guidance for the full year, it looks like you'd have to do about $ 30 million of EBIT in pathology in the H2. I understand there's maybe $ 10 million coming from what you've talked about in terms of restructuring and the like. Can you step through how you get the rest of that uplift, please?
So I think, look, that's broadly right. I guess the way that I would look at it is we gave guidance in November last year that we expected the market to be up 6%-8% in H2, and the mid-range of that guidance was 100. So the guidance now is between 70-80, then the midpoint of that is 75. And we also said that 1% BAU volume uplift in pathology was worth $ 5 million of EBIT. That's a 1%-3% range rather than a 6%-8% range, if that makes sense.
Sure. What else should we be thinking in terms of so it's just a straight volume game from here, is basically what you're saying. If it gets any others that we should be thinking about trying to get you that sort of, call it, $ 20-odd million worth of extra EBIT in the H2 as a follow-up, please?
Look, that part is volume related. Obviously, we've got the cost program as well, which is now being overtaken with this pathology reset transformation program. So that run-rate that we will be aiming for there will be significantly higher. But look, the focus for us is on we can't control market volumes, but the other things that we can control are things like labor.
Understood. My last question, please. Given the new focus on lab rationalization, how much of that $ 94.6 million that you talked to in pathology, right-of-use depreciation, relates to labs, and how much relates to collection centers? Can you give us some kind of split, please?
Sorry, can you just ask that again?
Right-of-use assets.
Yeah. So you've got, maybe we should take us offline, but you've got, there's a $ 94.6 million in pathology right-of-use depreciation. How much of that relates to labs versus collection center rationalization?
Okay. Yeah, maybe we should take that offline. Happy to have a chat about that after the meeting.
Good on you. Thanks a lot, guys.
Thank you. Your next question is from Gretel Janu from UBS. Go ahead, thank you.
Thank you. Good morning. Just want to start with the balance sheet. So you raised equity in November. Balance sheet is still stretched. Can you just remind us what your target gearing levels are and when you expect to get down to the target levels? Thank you.
Well, I don't think we've actually set out target levels for gearing in recent times. We're kind of trading around that. Our target was just under 3x at the end of the year. Absent that tax refund, that's exactly where we would have been. Ideally, we would like to be in that kind of 2-2.5 range. And there's two components to that. One is what volumes do. It's obviously a highly leveraged business. And the second part of that equation is what we do with our cost base, which is what Maxine has gone through this morning.
Okay. And then just in terms of asset reviews that you've mentioned, can you please elaborate on that? What assets are you potentially looking at divesting? What's your timeline for review of those assets? Thank you.
Look, we probably won't go into specific detail today, just to say that we have done a preparatory work on all the assets within the business, and we'll be doing more work on that as trading evolves and as we have a discussion around what the balance sheet looks like and what the needs of the business are. So there has been quite a lot of work done, but probably nothing to, I think, clarify further on that at this point.
Just in terms of timeline as to when we should hear, is that in the next six months or longer?
Look, I think that depends. I think it could be a few months, but I think it's more for us internally to be working through that, and it depends where we land in terms of a decision.
Okay. Thank you very much.
Thank you. Your next question is from Andrew Goodsall from MST. Go ahead, thank you.
Thanks very much for taking my questions. Just in terms of your submission to or the Australian Pathology Submission to the Government, just trying to get a sense of what you're looking for in terms of sort of indexation, would it be straight-up indexation similar to radiology? Because when I looked at the submission last year, it did seem to be slightly lower. So I'm just trying to understand how reasonable your claim is to them.
Look, we probably won't go into the details of it. I mean, the imaging one is definitely where we are targeting, but Andrew, I'm sure you'll appreciate, it depends in what form it comes. There could be different segments that are indexed and not the whole schedule. That's a work in progress with the Health Minister and the Department of Health, so I probably can't go into any further details on that at this point.
Just the warranty claim that you closed out during the period, could you just explain if that closes out at legal risk with BGH?
Look, I think we're not providing details of that other than it's kind of made up of a bunch of matters within that, but primarily it was one matter. But look, we haven't disclosed details of that for obvious reasons.
Maybe just for our purposes, it's well, I don't know whether it closed out, but is it safe to say that's all sorted now?
Yes.
That's an ongoing issue?
Correct. Correct.
Okay. That's sufficient. Thank you.
Thank you. Your next question is from Mathieu Chevrier from Citi. Go ahead, thank you.
Good morning. Thanks for taking my question. My first one was on what share of revenue in your past BAU business is from GP versus specialty?
It's about 2/3, Mathieu.
How do you think that compares to the market generally?
Well, we definitely are the lowest of all players, I think, of the two bigger players in terms of our share of GP. But obviously, no one reports that, so it's pretty hard to say. But I think if you look at the ACCC of each provider, that gives you a pretty good idea of what the average revenue per ACC is and the balance of revenue pools are made up of commercial, clinical trials, private hospitals, specialists.
Okay. Got it. And then moving on to your outlook, you're saying 1%-3%. Is that for the H2, or is that for the full year in terms of the volume growth that you're expecting?
That's just for the H2.
Got it. Okay. Thank you. And then just one final one on the impairment charge. Could you elaborate on the other assumptions that you've made outside of the WACC to change that valuation of that Symbion business?
Look, it's a bit hard to elaborate too much on all of the detailed assumptions that go into that other than to say it's an impairment model that's driven by an accounting standard at a point in time. So it is not supposed to be a proxy for anything other than that, so.
Got it. Okay. Thank you.
Thank you. Your next question is from Saul Hadassin from Barrenjoey. Go ahead, thank you.
Thanks. Good morning. Paul, just a quick question on the guidance. Just what are you assuming for BAU pathology revenues in the H2? I mean, is there an expectation that you would see an increase in those revenues coming through?
Our assumption is between 1% and 3% of BAU volumes on PCP. We know that revenues in the H2, it has a higher base, so therefore, we would expect the revenue to be higher in that H2.
Yeah. I guess where that goes is that it doesn't seem like a very large increase in revenues in that BAU, but the EBIT uplift you need, going back to David's question, we actually get a much higher EBIT contribution that you need to deliver for pathology of about $ 45 million-$ 50 million to get to your full year midpoint of your full year guidance range. So I guess the question is, how do you deliver that if revenues only step up maybe $ 5 million-$ 10 million in H2? It does require a significant amount of cost out or leverage to achieve that EBIT uplift. So just again, wondering how you get there.
Well, I think it's a combination of the different parts of the business, and I think we did set this out when we gave the guidance in November, the difference between pathology. Obviously, imaging has a much bigger contribution in the H2 as well and also Agilex, so.
Okay. Thanks. Just one more question.
Sorry. Go on.
I just wanted to ask this notion of lack of GP referrals. If I go back and look at Medicare outlays for what I would consider routine work, so chemistry, hematology, microbiology, those three categories have grown about 15% in the H1 2024 versus pre-COVID. I think your revenue growth, BAU, is about 2% over that window. So I'm wondering if the issue here is actually more share loss to new entrants and growth of an incumbent as opposed to just that softness in the GP channel.
Look, I think it is. If you look at our share of MBS, it has been stable at 24%. So I don't know whether you're looking at items, Saul, or whether you're looking at episodes. The consumption of services between pre-COVID and now is exactly the same. It's 1.7 services per head of the population. But what has happened is that coning is growing at a CAGR of 4%. So what you're seeing is a significant lift in unpaid work.
Which I assume impacts on all providers rather than just impacting on health.
No, it certainly impacts on all providers. It's something we've discussed as an industry. It just depends on what your proportion of exposure is to the GP market because obviously, as you know, this is not something that is a part of the specialist segment.
Sure. Okay. Thanks very much.
Thank you. Your next question is from Craig Wong-Pan from Royal Bank of Canada. Go ahead, thank you.
Thanks. Just on slide 8, it mentions there are some underperforming imaging sites in medical centers that are dragging on earnings. Wondered if you could quantify what that earnings drag is?
Well, look, we have a portfolio of sites within the medical centres. And I think, as we've explained before, each of those sites has a separate lease. Some of them are performing very well, but there is a substantial tail of sites that we are underperforming. We are working to improve those, but I think our current view is that we will be exiting out of those sites. And when we exit out of those sites, it has a 1 percentage point improvement in our EBIT margin, so it is quite material.
And then just thinking about Agilex, could you talk about the potential profitability there if work does come from SGS and if you get the kind of business case around the existing business, what the sort of potential earnings are for Agilex?
Look, we're not giving any guidance as to the level of earnings that we get out of the SGS commercial agreement other than to say everything that we've set out to the market makes super sound commercial sense and having two providers that provide this seamless phase one to phase three clinical trial. So we've seen some work come through already on that basis. But I think what it does, it allows us, from a business development perspective, to actually have a much greater net to cast in terms of work globally without actually having to pay for that. So that's a bit of a roundabout answer, but we're not going to set out any targets at the moment, if you like.
Okay. Thanks.
Thank you. Your next question is from Sean Laaman from Morgan Stanley. Go ahead, thank you.
Good morning, Maxine and team. Hope everyone's well. First question on your Greenfield sites in diagnostic imaging. According to your business case, how many radiologists may you need to recruit outside of the firm currently to make sure that they're not dilutive or that you can get a good margin, and what's your confidence around that?
Hi there. It's Phil Lucas, Group Executive, Imaging at Lumus. So the Greenfields will need each of those will need one or two radiologists, full FTEs. We certainly have a good pipeline. Our recruitment model is certainly working, and we believe that we'll get the people into these hospital sites, the two that we've started down in Melbourne as well as these Greenfields. Some of these Greenfields are in regions like southwest Sydney where we already have a network of radiologists that will spread, as well as in Queensland where we have additional radiologists who will fill these places. So we have confidence that we'll definitely cover these Greenfield sites, and that's part of our community strategy, which we're confident in and that we're following.
Great. Thank you, Phil. Next question, just with respect to the negotiations with the government and PATH and indexation. I'm just wondering if you know yet what kind of level the government dredges up, what could be deemed as generous funding for COVID testing, irrespective of how it might have been spent, and essentially the high rents that are prevalent across collection centres. And could there be an argument the industry's done to itself, what it's done to itself? Just wondering those as two points for the government to counter an increase to indexation.
Look, we've addressed, I think, those two points. We certainly did get substantial support from the government in terms of funding, which enabled us to do the testing that we were asked to do by the government. But 2-3 years of funding doesn't make up for 25 years of no indexation. And what we're focusing on is where we're at today with where growth is and where inflation is and what is required to make pathology sustainable. So that's the first thing I would say. And sorry, your second question was relating to?
To rents. So you could argue that the industry's done to itself what it's done to itself with rents and the impact on margins. So is there any, perhaps, government focusing on rental regulation again, for example, as a counter to offering better indexation?
Oh, well, look, we would welcome rent regulation as an industry. You're right. As volume hasn't been growing strongly, the fight for share is occurring in that space and through rents. You definitely see rents that are not appropriate for the return. That's something that we would definitely like to see. I mean, that has a flow-on impact to the funding of GP practices as well, which is something the government has to contemplate.
Sure. Thank you. I'll jump in the queue. Peg, thank you.
Thank you. Your next question is from David Bailey from Macquarie Bank. Go ahead, thank you.
Yeah. Thanks. Good morning. Just on the 23rd of November, you gave guidance for that H2 pathology growth of 6%-8% at a time when growth October and November was moderating, low single digits. I'm just sort of wondering what's changed around your expectations there and in particular with genetic carrier screening, not the benefit that you were perhaps expecting?
No, that's not true. So Q1, our volumes were up 6.5%. In Q2, they moderated to something like 1.9%. They were still around 4% for October. So that first quarter or the first four months, we're still around those levels. And then we saw quite a moderation in November and December, which lines up with where Medicare was around 2.9% and 3.1%, I think, for November and December, respectively. So that was kind of the sequence of events, if you like.
Genetic carrier screening?
Yeah. Look, genetic carrier screening, no, that's going well. So the volumes for genetic carrier screening have—I think when we spoke to you in November—we're ramping up, and they've ramped up significantly higher since then. So that's part of our forecast and our average fee assumptions in the H2 of this year.
Got it. And excluding any changes around indexation and based on your current business mix, is pathology a low single digit growth business over the next couple of years?
Oh, well, look, I think the ultimate question is, yes, what is growth over the next couple of years? And importantly, what is inflation? I mean, we would hope and expect that inflation does moderate below where it has been. I think that's important. But look, we've seen in the half 4% growth. That's not remarkably off long-term averages. So we would like to assume that it is going to be around that 4% mark. But as we said earlier, the way in which we are planning the business is for a lower growth rate rather than expecting a higher growth rate.
Does that mean with some of the initiatives you're putting in place, does that limit your ability to respond if volumes do come through more materially than sort of 4%?
No, I don't think so. Look, when you take capacity out of a business, you're generally taking capacity out of things that you have in place because you think the volume is going to be higher than what it is. So that's where we're taking and the areas that are just not as profitable. So I don't think that it limits our ability to grow. And I don't think there's been any demonstration in the past that we can't scale up. What we need to do is reset the baseline in terms of the cost base.
Got it. Thanks, Maxine.
Thank you. Your next question is from Steve Wheen from Jarden. Go ahead, thank you.
Yes. Good morning. Thanks for taking my question. I was just wanting to go back to the lease arrangements that you have with the imaging sites. My understanding was that you impaired those leases, the underperforming leases. Are you suggesting that they require further impairment as part of them continuing to be referenced as underperforming? Could you just help me understand that? And then your comment around the exiting of those sites, they go till 2027, I believe. What sort of break costs would you incur if you were to exit it?
So the answer to the first question is no. So there's no, they've been impaired, and that's the end of that for now, although we do review that.
There are no break costs. It's at our election. There are no break costs at the end. Each lease is negotiated separately. So yeah.
Just the end of the lease. Just the end of the lease.
Yeah. If there's no need to impair, how is that dragging them down onto the performance of the business?
It's just lower margin, right? So there are about 20-something which are just lower margin, lower revenue per site and substantially lower margin. So when you look at the overall margins and the growth of the business, it's impacted by those sites. Phil, I don't know if you want to add anything to that.
That's exactly right. Yeah, they're definitely lower margin. There's just not the volume that we need. We're aiming for community sites with $ 5 million in revenue. These are far, far below that. So it's, again, a volume game. And you want that larger revenue clinic so that you can get the margins. And that's our strategy, the community sites, the hospitals where we can get those sorts of margins. That's the main reason, that they're just lower margin facilities.
Okay. And sorry, Maxine, just on that comment you made about the break costs, you were saying at the end there's no break costs, which I'd assume would be the case. But aren't you looking to exit them sooner?
I'll get Phil to answer that question.
Yeah. So we've got leases for the majority out to 2027. There are a few that are coming up earlier. As the leases come up, we evaluate them. And if they're a marginal business, then we can exit. They're standard lease arrangements so we don't have to renew. And there'll be a few that maybe tail out after 2027, but the vast majority terminate in 2027 at the same time. And of the 50 clinics or so, there's about 19 or so that would probably selectively stay in. As Maxine's been saying, it's our choice which ones we continue on it.
Yep. Okay. And just while on this lease theme, if you're closing ACCC, is there any sort of implication from lease arrangements that we need to be cognizant of?
Oh, look, not at the moment. I think once we come to a landing on exactly what we're doing with those ACCC, we'll cost that up, and we'll probably talk about that at our full-year results.
Okay. Final question. Can I just ask around the definition of an asset review? Is that like a whole division is the part of the asset review, or are you talking about subsections within individual divisions?
It could be. Yep. Whole divisions, subdivisions.
All of it's on the table. Yep.
Yes.
Okay. Thanks, Ian. Helen?
Thank you. That does bring us to the end of our question time for today. I'll now hand back to Sharon Ng for closing remarks.
Thank you very much, everyone. That's all we have time for today, and we are happy to take any further questions offline after the call. We'll close the presentation now. Thank you for attending.