longer, healthier, happier lives

128 Pages·2013·7.15 MB·English

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ANNUAL REPoRT 2012
LONGER,
HEALTHIER,
HAPPIER LIVES
2012 HIGHLIGHTS
GROuP REVENuES (uP 4%)
£8.4bn
GROuP uNdERLyING PROFIT BEFORE TAx (uP 8%)
£604.0m
Underlying profit is defined in the Financial review on page 19
REVENuES By MARkET uNIT PROFIT/(LOSS) By MARkET uNIT
43% 43% 48% 48%
30% 30% 19% 19%
14% 14% 19% 19%
3% 3% (2%) (2%)
10% 10% 16% 16%
Australia and New Zealand
United Kingdom
Spain and Latin America Domestic
International Development Markets
International PMI
See the full segmental results on page 69
TOTAL CuSTOMER NuMBERS (uP 9%)
2012 (11.8m)
2011 (10.8m)
PROGRESS TOWARdS OuR WELL WORLd GOALS
Keeping people well
By 2015, we will have enabled 60 million people to make positive changes
to be healthier and happier and to help protect the environment.
18 million
Supporting a healthy planet
By 2015, we will have reduced our absolute carbon footprint by 20%.
4.8%
Cover image: Jon Sinclair and family walking in Albert
Read more about Bupa’s Well World at bupa.com/wellworld Park, Melbourne, where they took part in the 2012 Memory
Walk organised by Bupa in partnership with Alzheimer’s
Australia. Jon is a resident of Bupa’s Windsor Care Home
in Melbourne.
Bupa annual report 2012 1
Strategic report S
T
r
Introduction 1 A
T
E
Bupa at a glance 2 G
IC
Our business model 3 r
E
Chairman’s statement 4 Po
r
Chief Executive Officer’s T
statement 7
Longer, healthier, happier lives:
Geoff’s story 12
Gita’s story 14
Sue’s story 16
Financial review 18
Market Unit reports:
Our purpose – longer, healthier,
Australia and New Zealand 22
happier lives – drives everything we
United Kingdom 24
do. Our new strategic vision defines Spain and Latin 26
America Domestic
how we will bring that purpose to International 28
Development Markets
benefit more people around the world.
International PMI 30
Our people 32
During 2012, we developed a new vision Our Well World goals – to have enabled Risks and uncertainties 34
for Bupa in 2020 that will enable us to 60m people be healthier and to reduce
reach millions more people. our carbon footprint by 20%, both by
governance report G
2015 – are integral to our business, which o
In it, we have set out our focus on being is why our Well World data is integrated Chairman’s introduction 38 vE
a healthcare partner to millions more throughout this report. to Governance rN
people around the world, on delivering A
The Board of Directors 40 N
extraordinary business performance, Our Annual Report and Accounts are C
and on being an organisation where also available online, where you can Governance leadership 42 E r
people love to work. access even more information on Bupa. Effectiveness 44 EP
o
Find out more on page 8 Go to annualreport.bupa.com Engagement 45 rT
Audit Committee report 46
To deliver our vision and bring us closer
Risk Committee report 48
to our customers, we reorganised
our business in 2012. Now operating Nomination & Governance 49
as Market Units, we are better Committee report
positioned to serve our customers Stuart Fletcher Medical Advisory Panel 50
as their healthcare partner. Chief Executive Officer
Remuneration Committee report 52
Find out more on page 9 Remuneration report 54
Report of the Board of Directors 59
Statement of Directors’ 60
responsibilities
FinanciaL StateMentS F
IN
Independent auditors’ report 62 A
N
C
Financial statements 63 IA
L
Five year financial summary 123 S
T
A
International Financial 124 T
E
Reporting Standards M
relevant to Bupa E
N
T
S
View our Annual Report and Accounts online
For video and other additional information, go to
annualreport.bupa.com
2 Bupa annuaL report 2012
STRATEGIC REPORT
BUPA AT A GLANCE
INTErNATIoNAL PMI
° Bupa International
° Bupa Latin America
Our 11.8 million customers live in over 190 countries.
Our services include health insurance and other Total customers: 0.7m
funding products, hospitals and primary care centres,
Total employees: 1,600
chronic disease management, home healthcare,
dental centres, prevention and workplace health,
and care services, including residential and nursing
homes and retirement villages. Our business is
managed in five Market Units.
UNITEd KINGdoM INTErNATIoNAL
° Bupa Health and Wellbeing dEvELoPMENT MArKETS
° Bupa Care Services UK ° Bupa Arabia
° Bupa Home Healthcare ° Max Bupa, India
° Bupa Cromwell Hospital ° Bupa Hong Kong
° Bupa China
Total customers: 2.8m ° Bupa Thailand
° Health Dialog, USA
Total employees: 31,700 ° New Market Development
Total customers: 2.2m
Total employees: 800
ToTAL CUSToMErS SPAIN ANd LATIN AUSTrALIA ANd NEw ZEALANd
11.8m AMErICA doMESTIC ° Bupa Australia
° Sanitas Seguros ° Bupa Care Services Australia
° Sanitas Hospitales and New Services ° Bupa Care Services New Zealand
ToTAL EMPLoyEES ° Sanitas Dental
54,000 ° Sanitas Residencial Total customers: 3.5m
° Latin America Domestic Development
Total employees: 10,400
ToTAL CoUNTrIES Total customers: 2.6m
190
Total employees: 8,400
Market Unit customers or employees
Total customers or employees
Bupa annuaL report 2012 3
STRATEGIC REPORT
oUr BUSINESS ModEL ProvIdING hEALThCArE
S
We deliver healthcare to customers T
r
in our own hospitals, clinics, dental A
T
centres and primary care centres, and E
G
Bupa is a global healthcare company. We fund and in a range of other settings. Our chronic IC
provide quality healthcare around the world in a range disease management services help rE
P
individuals make and sustain lifestyle o
of settings, including clinics, dental centres, hospitals r
changes to manage their condition and T
and care homes. Our services span complex acute improve their health. We also provide
treatment to patients at home, which
care to preventative wellbeing and we engage millions
can improve patient experience while
of people in their health, providing them with trusted also reducing costs.
information and advice. Bupa is a leader in care services,
providing nursing and residential care
to over 30,000 residents in the UK,
Spain, Australia and New Zealand.
our business model is shaped by FUNdING hEALThCArE
Our dementia expertise is world-leading.
our commitment to serve customers Through insurance, subscriptions
We are setting best practice in person-
as their healthcare partner. and other funding solutions, we fund
centred care, including through our
healthcare on behalf of our 11.8m
We are focused on creating person- dementia care nursing training.
customers across the globe.
centred health systems that deliver the
ENGAGING PEoPLE ANd
right intervention in the right place at the We have a network of 7,500 hospitals
SUPPorTING BEhAvIoUr ChANGE
right time. We are committed to meeting and clinics and more than 200,000
Our services also include preventative
customers’ needs across life stages. medical providers worldwide.
healthcare, including identifying high
As an expert in funding and in providing We partner with healthcare professionals risk groups and providing support
healthcare, we are able to deliver high to help us deliver the right treatment to and advice to improve their health.
quality patient care while managing patients and to design patient-centred
We reach out beyond our customers to
costs, essential to keeping high quality care pathways.
provide health information, advice and
care accessible.
support to people across the world.
This includes our online resources which
were accessed by 12m people in 2012.
In 2012, our Global Challenge helped
oUr BUSINESS ModEL
97,000 people to get walking, a simple
way to improve health. Under our Well
World goals, we will have enabled 60
million people to make positive changes
to be healthier and happier by 2015.
We will also reduce our carbon footprint
by 20% by 2015.
We fund Foundations in Australia,
ENGAGE Spain and the UK which provide grants
for healthcare research. Our total
PEOPLE AND
SUPPORT charitable donations in 2012, including
BEHAVIOUR to our Foundations, was £4.1m.
CHANGE
AN INTEGrATEd ModEL
Longer, healthier, While we adapt our business model
to reflect individual markets’ needs
happier
and opportunities, we believe that
an integrated approach – combining
lives healthcare funding and provision – offers
FUND PROVIDE significant advantages to customers.
It brings better oversight of the patient
HIGH QUALITY, HIGH QUALITY,
journey and this helps us to make
AFFORDABLE AFFORDABLE
HEALTHCARE HEALTHCARE better healthcare more accessible and
affordable. This has been demonstrated
in our work in Valencia, Spain on behalf
of the Valencian regional government.
Find out more on page 6
4 Bupa annuaL report 2012
STRATEGIC REPORT
ChAIrMAN’S I am more convinced than ever that
our status – without shareholders and
therefore free to reinvest profits into
STATEMENT
more and better healthcare – is critical
to the relationship we have with our
customers and business partners.
2012 was a year of considerable change for
Having no shareholders, we are held
Bupa, and at the same time we also reaffirmed to account by independent Association
Members, who receive no financial
our enduring purpose. In the year, pressure
benefit from Bupa. They are committed
on healthcare spending – and on provision to seeing us discharge our purpose
models – remained intense. We also saw effectively.
trends in health further converge across Our status is of particular value when
trust in other organisations has been
developed and developing economies.
questioned and eroded. People are
looking for new models and changed
cultures for value creation in society as
well as a different kind of accountability.
BoArd hIGhLIGhTS FroM 2012
° Stuart Fletcher and Evelyn Bourke
joined the Board as CEO and CFO
respectively. New to Bupa, they
bring with them rich experience
and expertise. They underwent
a detailed induction programme,
including one-to-one meetings,
site visits and detailed briefings on
Bupa’s performance and history.
As a Board, we welcomed Stuart
Fletcher as he took the role of Chief ° To strengthen our governance and
Executive officer. Along with his oversight, we split our Audit, Risk
Executive Team, he undertook extensive & Compliance Committee in two.
work in developing a vision for Bupa’s The Audit Committee now focuses
future. we now have a clear definition of on financial statements, and the
how we will pursue our purpose – longer, effectiveness of internal controls
healthier, happier lives – to benefit many systems and of auditors; the
more people across the world. Risk Committee focuses on risk
appetite, risk management
To position us better to deliver our vision,
and compliance.
we reorganised the business around
Market Units, bringing us closer to our ° Succession planning was a key
customers. We also welcomed a new theme for 2012, with three Board
Chief Financial Officer, Evelyn Bourke, members nearing the end of their
to the Board. term. Retirement dates have been
phased to ensure an orderly
Lord Leitch On governance, the Board made a series
succession.
Chairman of changes to strengthen our oversight
of the business. Following a review, we ° The Remuneration Committee
separated our Audit, Risk & Compliance undertook a review with external
Committee in two. We implemented support to benchmark its activities
an enhanced Corporate Governance and developed an action plan.
Statement, which includes more
° We adopted a new Corporate
disclosures. The Remuneration
Governance Statement with the
Committee also undertook a review
aim of increasing the disclosure
with support from external advisors.
of our governance arrangements
Combined, these and other actions and the workings of each of the
further strengthen Bupa’s governance Board’s Committees.
and transparency, both of which are
essential to safeguarding trust in read more in Governance on page 38
our organisation.
Bupa annuaL report 2012 5
STRATEGIC REPORT
These are areas where I believe Bupa’s Globally, the number of individuals
model has a lot to offer. with diabetes is projected to rise to ProjECTEd rISES IN ST
r
552m by 2030, or 10% of the world’s NoNCoMMUNICABLE dISEASES A
Bupa is at an inflection point in terms of T
the healthcare services that people need adult population, 80% of which will be Diabetes2 EG
and in Bupa’s development in meeting tinh ed eMviedldolpei nEga scto aunndt rsieusb.-2 SLaahtianr aAnm Aefrriiccaa, 371m IC rE
those needs. The Board is excited about 552m P
are predicted to see a near tripling of o
the impact the new vision – Bupa 2020 – r
ischemic heart disease and stroke T
will have, and the step change in delivery mortality over the next two decades.3 Dementia7
it signifies.
In 2008, cancer accounted for the 35.6m
oUr MArKETPLACE deaths of 7.6m people – 13% of all 65.7m
Bupa serves customers living in almost deaths worldwide. More than 30%
every country around the world. Across of these could be prevented, mainly
markets, we are seeing a number by reducing tobacco usage, but also
GLoBAL dEAThS CAUSEd
of key trends that drive individuals’ through a healthy diet and lifestyle and
healthcare needs. They are shaping moderating the consumption of alcohol.4 cancer4
our marketplace today and will see 7.6m
Growing global middle class
it radically transform over time.
As well as this convergence in health 13.1m
Converging global health risks risks, we are seeing a growth in middle
Health risks are converging across the classes in developing economies and an Heart disease8
world and across economies, underpinned associated trend of urbanisation, which 17.3m
by common risk factors, principally an itself can be a driver for behaviours
23.3m
unhealthy diet and physical inactivity. which negatively impact health. More
Changes to lifestyles and diets as people than ever now live in cities and by
 Current   2030
societies industrialise have significant 2050, around two thirds of the world’s
implications on populations’ health. population is expected to be urban.5
The impact is immense. By 2030, it is Middle class consumers have increased
estimated that chronic diseases will expectations of the services they want,
cost US$47trn and will represent a including from healthcare, as they
developmental as well as health challenge.1 become more aware of their needs
and their ability to afford choice.
Ageing and ageless societies “C hronic diseases
The global population is ageing sharply.
The percentage of those aged above 60 represent a
years at the turn of the millennium was developmental,
around 10% – this is projected to rise to
as well as health,
20% by 2050.6 This phenomenon is not
confined to developed economies, with challenge.”
many developing economies being only
a few decades behind as birth rates
decrease and life expectancy increases.
This demographic shift represents
both the success of, and a challenge
to, healthcare systems. The critical
challenge it presents is the increase
in the number of people living with
dementia. By 2050, more than 115m
UrBANISATIoN ANd hEALTh
people across the world are projected
The number of people living in cities is
to have the condition, raising massive
set to rise to 5bn worldwide by 2030.
challenges in care, treatment and cost.7
This growth will largely be unplanned.
A key trend that we are seeing 1 ‘The Global Burden of Noncommunicable Diseases’,
People who move to cities increase World Economic Forum, 2011.
associated with the ageing population
their chance of developing chronic 2 ‘ Atlas 5th Edition’, International Diabetes
is that people are thinking more about Federation, 2012 Update. 2012 data.
conditions, such as diabetes, through 3 ‘The Global Burden of Chronic Diseases:
the kind of old age they want. In reality,
greater exposure to risk factors including Overcoming impediments to prevention
they want to be ageless – they want to and control’, Derek Yach, 2011.
greater use of motor transport, too 4 ‘Cancer Factsheet’, World Health Organization,
keep well and they want to preserve
little physical activity and unhealthy 2013. 2008 data.
the independence and lifestyle they 5 ‘World Urbanization Prospectus: The 2011 Revision’,
diets, as well as increased exposure United Nations, 2011.
enjoyed while younger. There is a
to greenhouse gas emissions. 6 ‘ World Population Ageing 1950-2050’, United
growing need for care solutions that Nations, 2002.
7 ‘ Dementia: A public health priority’, World Health
preserve individuals’ independence.
Organization, 2012. 2010 data.
read more in Bupa’s win-win report on
8 ‘Cardiovascular Conditions Factsheet’, World
bupa.com/wellworld
Health Organization, 2012. 2008 data.
6 Bupa annuaL report 2012
STRATEGIC REPORT
ChAIrMAN’S Changing family structures Implications for Bupa
The impact of ageing populations, The challenge to deliver better health
STATEMENT
combined with increased expectations to more people has never been greater.
CoNTINUEd around lifestyle and independence, In each of these areas, we see huge
is exacerbated by changes in family potential for our business – to deliver
structures. At a time when growing the services that individuals need in a
numbers need support, family support way that they want at a price they can
is declining. This is not just for the elderly afford, be that directly, through their
but also for those with chronic conditions employer or via government.
or disabilities. These factors are creating
The great risk, which is not confined
a need for alternative care solutions.
to Bupa but extends across healthcare,
Price sensitivity is that a broad spectrum of quality
Increasingly, consumers only want to pay care ultimately becomes unaffordable.
for services that are relevant to them. This
We are addressing this challenge head
desire for more personalised services
on, as can be seen in the strategic vision
is linked to a focus on seeing value for
Stuart sets out for the business. I believe
money. New technologies contribute to
that our potential to make a significant
this growing expectation as individuals
difference to millions of people’s lives
have ever greater power to access the
across the world has never been greater
information and services they want.
and our focus never sharper.
Environmentalism and sustainability
Board news
Finally, consumers want to make
I want to take this opportunity to thank
sustainable choices. There is a much
the Board for the past twelve months –
greater understanding that lifestyle
particularly for their energy and passion
impacts the environment and that this,
in a year of huge change. Particular
in turn, impacts health and wellbeing
thanks go to Baroness Bottomley, whose
– from water use to food scarcity to
six year tenure on our Board concludes in
air pollution. Consumers increasingly
April 2013. She has been a great source
want to know that the products and
of wisdom and her contribution to this
services they use are economically
business has been invaluable.
and environmentally sustainable and
ShIFTING ThE vALUE FroM CUrE do not adversely impact on health. Finally, I want to thank our people. There
To PrEvENTIoN IN vALENCIA, SPAIN is a shared value of care – for customers,
A shift in value for healthcare
In Spain, Bupa’s Manises hospital covers their families and each other – and I
One consequence of these trends
14 towns and a population of 195,000 regularly see our people going well
is a shift from treatment to prevention.
people in Valencia, on behalf of the beyond what is expected and required.
We are beginning to see health systems
region’s government. We also manage This commitment is what makes Bupa
assessing healthcare risk and aligning
20 primary health centres and two extraordinary. I’m very proud of what
incentives to produce the best outcomes
speciality centres. we have achieved together and excited
at an affordable price. In Spain, for
about what is ahead.
As well as providing world class, example, we have seen the effective
innovative hospital care, Sanitas operation of an innovative Public-Private
works with the local population to Partnership (PPP) in Valencia which
keep them well and diagnose and has moved health management from
treat conditions early. the public to the private sector. The
Valencian government has reformed Lord Leitch
This can reduce the likelihood of health
the funding and provision of care – and Chairman
issues becoming critical and improve
Bupa is at the heart of this partnership.
health outcomes. For example, we have
improved our performance in controlling With the increased prevalence of chronic
the risk factors for cardiovascular diseases, managing health risk involves
conditions, compared to 2011. helping individuals to take steps to
reduce their risk indicators – namely
to be healthier. While breakthroughs in
areas like robotic surgery get headlines,
in many countries 70% of healthcare
costs are driven by chronic disease and
the most important levers to improve
outcomes and reduce costs are not
necessarily clinically sophisticated.9 They
can, however, be challenging to deliver
as they require individuals to make and
9 ‘ The almanac of chronic disease’, Partnership to
sustain significant lifestyle changes. Fight Chronic Disease, 2009.
Bupa annuaL report 2012 7
STRATEGIC REPORT
ChIEF EXECUTIvE We also announced our intention to
S
acquire Innovative Care’s care homes. T
r
Now completed, the deal added more A
oFFICEr’S STATEMENT T
than 1,100 beds and made us Australia’s E
G
largest private care services provider. IC
r
Organic growth in our development EP
We launched a new strategic vision, Bupa o
markets continued apace, with Bupa r
T
2020, accelerating our pace of growth and Mexico, one of our health insurance
operations, driving good growth in
delivery. In the year, we delivered strong
customer numbers as a result of
growth, with revenues up 4% and underlying opening six new sales offices and
launching new products.
profit up 8%, maintaining our record of
year-on-year growth since the start of We also accelerated our plans to make
quality healthcare more affordable and
the global downturn.
accessible, and ensure health insurance
delivers tangible value for money.
In the UK, we provided detailed evidence
to the Competition Commission to
call for remedies that deliver greater
competition, efficiency and transparency
in the private healthcare provision
market. There are no easy solutions,
but a lack of competition between
hospitals and information on quality
of care is pushing up the cost of
insurance premiums, which continue
to rise at unsustainable levels.
Also in the UK, we made changes to
address excessive claims inflation driven
both by private hospital and consultant
fees and practices. The changes, while
Bupa’s performance in 2012 was
not always popular, are necessary to
particularly strong given the economic
ensure more UK customers are able to
conditions in a number of our markets,
access affordable, high quality private
especially in Europe.
healthcare. There is still much to do but
We created new, innovative, lower we have created a foundation to turn
cost products for corporate customers, this market around.
for the self-employed and for individuals.
We grew our business in ways that, we
Our international private medical
believe, allow us to deliver quality health
insurance business developed products
outcomes. In Spain, our integrated
that are more flexible and tailored
health funding and provision model
to the needs of the individual.
continued to provide differentiation in
In Australia we supported families and the market, enabling growth. This model,
niche groups with specialist services based on quality of health outcomes, is,
and advice. we believe, a good model for the future
We expanded dental provision in of sustainable quality healthcare.
Stuart Fletcher Spain and the UK and are currently We acquired the remaining 40% share
Chief Executive Officer in negotiations with the shareholders in our Public-Private Partnership (PPP)
of Dental Corporation, Australia and in Valencia and purchased a 50% stake
New Zealand’s largest dental business, in Torrejón Hospital in Madrid, our
to purchase the business’s 190 clinics. second PPP. The business performed
The transaction is subject to the majority very well despite a challenging
of shareholders voting in favour of a economic environment.
scheme of arrangement.
In December 2012, we announced our
Also in Australia and New Zealand, intention to acquire LUX MED, Poland’s
we extended our retail offering with largest private healthcare company.
two new dental centres providing eye Subject to regulatory approval,
care, health screenings and nutrition LUX MED will make Bupa the largest
and wellbeing advice. New care homes company in Poland’s private healthcare
were opened or acquired across the funding and provision markets, adding
two countries adding 640 beds. 1m new customers.
8 Bupa annuaL report 2012
STRATEGIC REPORT
ChIEF ageing populations, rising levels of
chronic disease, and new treatments
EXECUTIvE
will continue to fuel demand for
oFFICEr’S healthcare and drive our growth.
STATEMENT Around the world, our combination
of healthcare funding and provision
CoNTINUEd
expertise, our integrated model, and
our international operations will
continue to differentiate us.
A NEw vISIoN For BUPA
In 2012, the newly created Bupa
Executive Team focused on creating an
ambitious vision for what Bupa will look
like in 2020. The development of Bupa
2020 was a major area of work. This new
strategic vision sets our direction and
In health funding, LUX MED is Poland’s As an executive team, in asking ourselves
focus for the next decade.
market leader in medical subscriptions. how Bupa will better fulfil its purpose,
In provision, it has a national network Bupa is a great company with a rich we challenged ourselves to identify
of outpatient clinics and diagnostic heritage. As CEO, I see my role as how to accelerate our growth to reach
centres, as well as a day hospital and a providing the leadership that will enable us millions more people in more places
large nursing and residential care home. to realise Bupa’s full potential; in essence, to more effect.
Its model aligns with Bupa’s ambition to fulfil our distinctive and inspiring
We also asked how we will make our
to see greater integration between purpose – longer, healthier, happier lives.
purpose count in the eyes of customers,
healthcare funding and provision.
An important enabler of our delivery healthcare systems and the communities
We are in a good position to grow our of that potential is our status, which within which we operate, and with our
business in 2013 through a combination was a great attraction for me when own people, the ingredient which truly
of organic growth, acquisition and deciding to join Bupa. It maximises makes Bupa special.
partnership. Difficult economic the degree to which we can pursue
We believe that the conclusions we
conditions will continue in Europe but growth opportunities for the benefit
reached are exciting and motivating for
increasing consumer expectations, of customers and society more broadly.
all our stakeholders around the world.
The key elements of Bupa 2020 are
BUPA 2020 summarised here:
we will deliver our purpose through
being a healthcare partner to millions
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To achieve this goal, trust is essential,
R T O and we intend our customers to trust
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As we can have a big impact on the
world’s health, we are also committed