Netcare Names First Female CEO

Netcare has appointed Melanie da Costa as its next chief executive, ending a succession process that had been in motion since the group’s co-founder and long-serving chief executive, Dr Richard Friedland, signalled his intention to retire. Da Costa, who has spent two decades at the group, will assume the role on 1 January 2027. She will take up the position of CEO designate from 1 June 2026, working alongside Friedland for six months to ensure continuity of leadership.

Friedland had originally been due to step down on 30 September 2026 but agreed to extend his tenure to 31 December 2026. He will remain available to the board on a consultancy basis until 30 June 2027. His departure closes a chapter that stretches back to Netcare’s founding in the mid-1990s. Under his stewardship, the group grew into South Africa’s largest private hospital operator, with 49 acute hospitals, approximately 9,900 beds, 14 mental health facilities, and a workforce of more than 18,000 people. Netcare holds roughly 31% of private hospital beds in South Africa, ahead of Mediclinic at approximately 27% and Life Healthcare at around 23%, in a market that has long been dominated by these three groups.

Da Costa’s professional background spans finance, health policy, and operational leadership. She holds a Bachelor of Commerce with Honours from the University of the Witwatersrand and a Master of Commerce from the University of South Africa, and is a Chartered Financial Analyst. Before joining Netcare in 2006, she spent six years as a fund manager at Liberty. At Netcare, she established the group’s health policy unit and has since been a central figure in shaping its engagement with government regulators and policymakers. She led the acquisition of mental health provider Akeso and served as its managing director. She currently serves as executive director of strategy and health policy, sits on Netcare’s finance committee, serves on the National Renal Care board, and is a former chair of the Hospital Association of South Africa.

The appointment comes as Netcare reports a period of solid financial performance. For the year ended 30 September 2025, the group posted revenue of R26.3 billion, up 4.5% on the prior year. Normalised EBITDA grew 8.4% to R4.9 billion, with the EBITDA margin expanding 60 basis points to 18.6%. Adjusted headline earnings per share rose 20.7% to 137.2 cents. The group returned R1.8 billion to shareholders through dividends and share buybacks during the year, and its net debt to EBITDA ratio improved to 1.1 times. A fire at the Netcare Pretoria East Hospital in December 2024, which disrupted activity across multiple wards and theatres, was managed without materially derailing the group’s annual performance.

Da Costa inherits a business navigating several structural pressures. The most politically charged is the National Health Insurance Act, which the government has committed to implementing in phases, with the first phase running from 2023 to 2026. The private sector has broadly accepted the principle of universal healthcare but has mounted sustained opposition to the Act’s current design, citing unresolved questions about funding, administration, and the future role of medical schemes. The Constitutional Court is scheduled to hear procedural challenges to the Act from the Western Cape government and the Board of Healthcare Funders, following a February 2026 concession by the state to suspend certain implementation steps. Netcare, through its health policy engagement, has been among the most active private sector voices in this debate — a function that da Costa helped build and has led for years.

Beyond the policy environment, the group faces the structural challenge of medical inflation. South Africa’s projected medical trend rate for 2025 was approximately 9.5%, against a general inflation rate of around 4.5%, according to industry data. Globally, healthcare cost increases are running at double-digit rates in several regions, driven by ageing populations, rising drug costs, and the capital demands of new medical technology. Da Costa has specifically identified digital and data-driven care as the next frontier for the sector, a view consistent with Netcare’s existing strategy, which the group credits with delivering a measurable “digital dividend” in the form of improved operational efficiency and margin expansion in recent years.

Netcare: Key Financial and Operational Metrics (FY2025)