Stringent regulations, hubris and an underestimation of a difficult market, along with a language barrier in one case, have combined to make a tough year for SA's three largest hospital groups' adventures outside their home market and in the developed climes of places such as Switzerland. Since the turn of the century, South African corporations that have chosen to move into Europe and other developed markets have seen less success than they achieved from their forays into other emerging markets. The return of Old Mutual from its London base was perhaps the biggest example of failure. The results from hospital groups Mediclinic, Netcare and Life Healthcare show that they are facing similar pressures in trying to establish themselves outside SA. The groups "clearly underestimated" the pressure they faced in the developed markets they invested in, said the deputy CEO of investment company Sentio Capital Management, Rayhaan Joosub. He singled out the regulatory pressures in those marke...

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