Ardmore Medical rebranded as Livingstone Health, mulls IPO again

The group’s chief business officer Dax Ng says the original listing plan was spiked because of poor market sentiment. “We were cautious because valuations were low,” he tells The Edge Singapore in a recent interview.

“We feel our business is viable and profitable, so we did not want it to be disadvantaged by listing it at a time when the market was not doing so well.”

The company known as Ardmore had made headlines when a patient under the care of the group’s founder and CEO Dr Sean Ng died in November 2016 after a total knee replacement procedure he performed resulted in a surgical complication.

With Dr Ng’s orthopedic business business accounting for some 42.9% of Ardmore’s FY2018 revenue, there were concerns over how the business would perform.

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To mitigate the risks to investors, the company reduced Dr Ng’s contribution proportionally in 2019 by recruiting more doctors.

As of this year, Dr Ng has fully deconsolidated his shares in Ardmore and is practicing on his own. This move “was the collective decision of the board,” says Dr Rachel Lim, the group’s chief operating officer who is also the wife of Dr Ng. She says both Dr Ng and the board believe this move will be “better for the company”.

“We said we needed to focus on our business development and have executed that on point with these two areas,” says Dax Ng. He adds that the business has been growing – despite the exit of Dr Ng – and has clocked an estimated $10 million in revenue for the FY2019, as opposed to the $8.8 million it logged in FY2018, which included Dr Ng’s contribution.

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This was made possible because of an increase in the number of doctors from five in 2018 to 11 now, says Dr Lim, who also helms the group’s aesthetics and wellness arm.

“Our management team comprises mostly doctors and this has seen us prioritising enhanced patient care. This allows doctors to put their trust in us and has made them more keen to come on board” she adds.

Inquiry

But there is no denying that the death of the patient has caused a stir in the former Admore. A seven-day coroner’s inquiry last September found that the blood vessels of Mrs Yuen Ingeborg, then 78, had been cut during the operation causing internal bleeding. She eventually died of multiple organ failure. In her findings, State Coroner Kamala Ponnampalam said theincident “goes beyond human error”. There was also a lack of post-operative care for the patient as the inquiry heard that Dr Ng had gone abroad shortly after the operation, without ensuring adequate handover of the case to another surgeon.

Dr Ng was subsequently suspended from admitting and operating on patients at the local hospital where the incident took place. The hospital also lodged a separate complaint with the Singapore Medical Council (SMC) in May 2017 for insufficient documentation and medical assessment, including making certain retrospective entries, among other things. The SMC have since convened a Complaints Committee to investigate.

For now, the group is moving forward and intends to reach out to more patients through its focus on the entire healthcare spectrum ranging from primary to tertiary care. Its new family medicine clinics, which are located in the various heartland housing estates, serves to bring medical services closer to patients, to prevent delayed detection of illnesses. These clinics are in addition to the group’s three specialist centres.

“Our focus on intergenerational family medicine will reach out to generations from grandparents, to parents and children,” explains Dr Sebastian Chua, the group’s chief medical officer. “Seeing patients across generations allows the group to have access to their family history and the type of illnesses they are more prone to”. This way, specialists can provide more targeted care to patients, especially if they require specialised treatment, he adds.

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Going regional

Along with its expanded suite of specialisations, Livingstone Health has also moved regionally.

In 2019, the group entered into a partnership with the privately run Soriya Hospital in Phnom Penh, Cambodia where it provides aesthetic and wellness treatments.

Following this, the group was also given an advisory role for the construction of Olympia, a medical centre by Cambodia’s Canadia Bank. The partnership will see Livingstone Health advising on areas such as proper patient flow and reputable brands of medical devices.

Cambodia was a natural choice for Livingstone Health since its medical industry is not as saturated as Vietnam, Thailand and other Asean countries, says Dr Wilson Tay, the group’s chief executive officer.

With its population of 16.4 million, of which 89.7% are below the age of 55, the doctors see much potential in the healthcare market to be tapped.

But Cambodia is just a stepping stone in the group’s goal of reaching out to Asean’s upper middle-income population demanding better healthcare. United Overseas Bank estimates that the region’s middle-income population will increase from 29% of the total in 2014 to 65% in 2019.

“We want to bring good medical practices to the upper-middle class in Asean, because unlike the rich, overseas travel is not so convenient for this group who still want good healthcare” says Dr Tay.

With medical tourism to Singapore becoming less cost-effective for Asean nationals, he says it is even more critical for Livingstone Health to avail itself of this demographic by venturing abroad.

Looking back, the doctors claim that the withdrawal of its first IPO attempt is a blessing in disguise. “While some others may have seen it as something negative, we believe it has allowed us to grow from strength to strength,” Dr Lim says.

And so, with its healthier financials and stronger presence both locally and abroad, the company is considering an IPO in the next 12 to 18 months to raise funds to spur further growth.

As Dax Ng puts it, “2020 is looking up for the capital market,” and so he is keen for the IPO to be “earlier rather than later”