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Improving healthcare outcomes for hospitals and their patients

SDG Alignment

Investment Summary




September 2019



Healthcare delivery


Access to affordable, quality healthcare



Pretoria, Malmesbury, Mokopane

CLASSIFICATION: Rural & Township

Crestcare at a glance

Crestcare, established in 2004, is a seasoned hospital operating management company providing services to both acute and day hospitals across Southern Africa. Since the Fund’s investment in Crestcare, the team has realigned its services strategy, focusing on Fund-owned hospitals. As a result, the Crestcare team has made substantial improvements to various aspects of the day-to-day operations, enhancing working standards and increasing revenue opportunities in Fund-owned hospitals, including ZPH and Apex Surgi Soweto.

With the Fund’s support, Crestcare is evolving from being solely a hospital operations service provider to becoming an owner and operator of its own hospitals. In 2021, Crestcare took a significant step forward by acquiring the license for a new 88-bed acute hospital in Malmesbury, Western Cape, and securing the license for a new 65-bed acute hospital in Mokopane, Limpopo. These new hospitals align with the Fund's healthcare thesis of providing access to healthcare services in underserved communities.

What is the Social Challenge?

Many communities in historically underserved areas of South Africa face significant barriers to accessing quality healthcare, resulting in compromised health outcomes and increased vulnerability. Limited infrastructure, scarcity of medical professionals, and inadequate resources exacerbate the situation, leaving individuals without timely and essential medical attention. The consequences of this healthcare disparity are far-reaching, impacting not only individual well-being but also the overall development and prosperity of these communities.

Our Response:

Summit Africa secured Twin City Developments to finance and build the Malmesbury Private Hospital (MPH) at ~R150 million. The commissioning costs of ~R112 million will be funded through equipment finance, and equity finance from Crestcare (80%) and doctors (20%), with the Fund financing R46.7 million of Crestcare's portion. Led by Summit, Crestcare has made progress in business requirements, stakeholder considerations, and planning for the new Crestcare brand and Hospital Information Management System. Summit has also assisted Crestcare in addressing environmental and social factors by selecting specialists for an ESMS framework.

Who Are the Stakeholders?

Malmesbury Private Hospital is strategically located to serve the 166,365 people who live within a 20 km radius of the hospital. This positioning allows MPH to serve not only the immediate community but also support populations further north, including towns like Bergriver and Cederberg. Currently, individuals from these areas have to travel long distances to access hospital care in Paarl and Cape Town. Malmesbury Private Hospital’s presence will significantly reduce the travel burden and bring much-needed healthcare services closer to these underserved populations.

What is the Scale of the Impact?

Malmesbury Private Hospital, as a National Hospital Network (NHN) facility, will have a significant scale of impact by providing increased access to quality healthcare for the local community. With 88 beds, four operating theatres, an emergency unit, and delivery rooms, the hospital will attract a diverse team of medical specialists, improving the responsiveness of the local healthcare system. MPH will offer a comprehensive range of specialized services, including Gastroenterology, Neurology, Paediatrics, Pulmonology, ENT, General Surgery, Maxi-Facial, Neurosurgery, Obstetrics & Gynaecology, Ophthalmology, Orthopaedics, and more. This expansion of medical disciplines and affordable rates will greatly benefit the community, ensuring access to a wide spectrum of expertise under one roof.

Job Creation:

The establishment of MPH will not only enhance healthcare services but also generate significant job opportunities. Upon opening, the hospital will create approximately 94 permanent jobs, consisting of 65 clinical positions and 29 non-clinical positions. As the occupancy rate reaches 65% after four years, the number of jobs is expected to increase to 161, with 103 clinical positions and 58 non-clinical positions. Moreover, during the construction phase, at least 150 temporary jobs have been created. These job creation prospects demonstrate the positive economic impact of MPH, providing both permanent employment and temporary opportunities, thus contributing to the overall socio-economic growth of the local community.

Community Upliftment:

Malmesbury Private Hospital’s presence and state-of-the-art facilities have garnered support from leading specialists, including renowned radiologist Schnetler Corbett, who will bring the latest diagnostic equipment, including an MRI scanner. Conservative estimates indicate that MPH will annually serve a growing number of community members, with patient days and total admissions projected to increase over the years. Starting from 10,279 patient days and 3,697 total admissions in 2024 (33.4% occupancy rate), these numbers are expected to reach 20,043 patient days and 7,208 total admissions by 2028 (65.2% occupancy rate). This significant growth in services showcases MPH's positive impact on community upliftment, providing advanced diagnostics, specialized care, and expanding healthcare opportunities for the local population.

Transformation, Diversity & Inclusion:

Crestcare will own approximately 80% of Malmesbury Private Hospital. Local doctors and specialists will own the remaining shares, demonstrating the Fund’s commitment to transformation and inclusion. With the Fund's equity position in Crestcare, MPH achieves black ownership, including significant representation of black women. The Crestcare team, in collaboration with Summit, has established targets for diversity and inclusion at MPH. These targets encompass having over 50% of employees as black and women, at least 25% representation of black women, 3% staff with disabilities by 2027, 25% representation of black and women in executive and senior management positions, and 25% representation of women on the board. These initiatives ensure a diverse and inclusive environment at MPH, fostering equal opportunities and representation for all.

What if the Crestcare Malmesbury Private Hospital Did Not Exist?

MPH's existence is crucial for the local community in Malmesbury as it provides them with immediate access to affordable and quality healthcare. Without this facility, the insured community would have to travel up to 40km for emergency care and various medical disciplines. Crestcare's acute hospital ensures convenient access to essential healthcare services, eliminating the need for long-distance travel and enabling prompt medical care. MPH's presence significantly improves the community's well-being and healthcare outcomes, meeting their needs directly in their local area.

What is the Risk?

Crestcare has addressed the need for more doctor support at the Malmesbury Private Hospital since identifying it in 2021. The hospital has received overwhelming support from local doctors and specialists.

Crestcare complies with labour laws and prioritizes empowering its employees.

As part of the Fund Healthcare strategy, Crestcare takes the responsibility of aligning all Fund-owned hospitals with a healthcare-specific ESG Risk Register and Compliance framework. To enhance this framework, Crestcare collaborated with IBIS Consulting to develop and standardize the Environmental & Social Management System (ESMS) and related policies, risk registers, incident registers, and training materials. This comprehensive approach ensures alignment with local regulations and international best practices, promoting a unified ESG framework across the hospitals.

Making Quality Healthcare Affordable and Accessible

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