The many extracts on these pages are from copyright material. They are owned by the reference given or its owner. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes.

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Vista Healthcare
and its
National Medical Enterprises (NME)

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Vista Healthcare was formed in Singapore in 1996 by Chase Manhattan bank and the core of Tenet/NME's international division. It expanded rapidly across Asia. These people who had been pressured out of Australia in 1995, because of their conduct, very quietly bought back into Australian hospitals in 1999. BUPA bought Vista in 2001.





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Criticism written in 2000
(This material was obtained in 1997 and this first section written in 2000)

The Links to Tenet/NME

I found the formation of the new company Vista Healthcare in Singapore in October 1996 disturbing because it seemed to be a reformation of the team which made such large profits for the infamous company National Medical Enterprises (NME).

Singapore is a referral centre for the region. Patients in these countries are trusting and unsophisticated in medical matters. Patients also come from many foreign countries, insured tourists and traveling businessmen. They are consequently vulnerable to deceptive practices.

Five of the seven directors of Vista are past NME staff who worked in Singapore, including the president of NME's international division, Michael Ford and his vice-president Carl Stanifer.

NME, now renamed Tenet Healthcare has paid somewhere in the region of $1 billion in fraud related settlements and over half of its hospitals were listed in a guilty plea in an criminal action brought by the US department of justice in 1994. This raises issues about probity in regard to Vista staff.

Five of the directors are from the USA and the major financial backer is a US group "CHASE ASIAN EQUITY ASSOCIATES". Parkway Holdings had some sort of management contract with Tenet/NME and this probably expired in 1997. Vista may have been formed to fill the vacuum and run the hospitals for Parkway but I do not have information. (Note this was not so. It was a breakaway group)

CLICK HERE -- to access the pages about Tenet/NME

Michael Ford one of Vista's directors was accused in a Singapore court by a doctor of attempting to make an unethical financial deal which included a guaranteed number of admissions. While the hospital denied this neither Ford nor any of his staff who were present at the meetings gave evidence to refute the allegations. The doctors attorney surmised that had they done so then deplorable business practices would have been revealed.

CLICK HERE -- to go to the allegation made about Tenet/NME staff in Singapore

Other than the past association of their directors with Tenet/NME and their links with the fraud ridden US system there is no evidence to suggest that Vista plans to introduce those practices for which NME was convicted. However the establishment of a company controlled by US financial interests and staffed with past Tenet/NME staff is I believe disturbing.

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International health care consultants

The extent to which Vista acts as an international health care consultant to US companies entering international markets is not clear. Ford would certainly be knowledgeable about countries in the region including Australia. He has acted as an International Health Care consultant and was contracted by NME in 1997 when they planned to expand internationally targeting Singapore, South Africa and Europe. He was quoted in Modern Healthcare in 1997.

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1997 Directors

The directors of Vista and their past probable associations with NME or Parkway linked groups are listed below. (information obtained 1997)

Mount Elizabeth Hospital Ltd
East Shore Hospital Pte Ltd
Medi-Rad Associates Pte Ltd
Mount Elizabeth Healthcare Services Pte Ltd
Khim Medicare Pte
Mount Elizabeth Healthcare Holdings Ltd
Mount Elizabeth Ophthalmic Investments Pte Ltd
Radiology Consultants Pte Ltd
Parkway Group Healthcare Pte Ltd

Mount Elizabeth Laboratories


THOMAS EGGER LEE# * @ -- US Citizen
East Shore Hospital Pte
Medi-Rad Associates Pte
Khim Medicare Pte
Renalcare Mt Elizabeth Pte
Mount Elizabeth Ophthalmic Investments Pte
Radiology Consultants Pte
Parkway Managed Care Pte
Gleneagles Technologies Services Pte Ltd

Past Vice President of NME international division

MICHAEL H FORD # * -- US citizen
Past President of NME international division



# Also a shareholder
* National Medical Enterprises linked
@ Parkway linked

This distribution to NME or Parkway made in 1997 is based on the names of the corporations and on the involvement of NME staff as directors when they operated in Singapore. I cannot guarantee that all are correct. Parkway bought the Mount Elizabeth and East Shore hospitals from NME. Several of these companies operated within the Mount Elizabeth complex and Parkway staff may well have taken over the directorships of previous NME staff. The association with Parkway may be much closer than suggested. Five of the seven directors were probably associated with NME, at least two with Parkway and five are US citizens.

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Major shareholder

380 Madison Avenue - 12th Floor
New York

Note. The information was obtained in 1997, the page was written in 1998 and modified in April 2000 before being put on the www. There probably have been changes but I do not know of them.


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UPDATE April 2002

A report "Healthy Outlook" in Shares Magazine, 1 September 2001 indicates that UK health giant BUPA has acquired Vista Healthcare.


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UPDATE Oct 2005

Vista did buy in Australia

Vista Healthcare and Ford described themselves as international health care advisers in an 1997 article in Modern Healthcare's International edition in which their advice to those planning foreign investment is given. I have long believed that they had continued to advise multinationals planning to enter Australia. Perhaps they were advising government ministers too?

In doing a search for other material in October 2005 I came upon an article which indicated that our FIRB and our determined, never to be proven wrong, politicians had quietly allowed Vista to buy a foothold in Australia in 1999 - in spite its close links with Tenet and its management by Tenet/NME's Singapore team including Michael Ford. There was no publicity and no opportunity to object.

It (BUPA) entered the Australian health-care industry last July when it acquired the Singapore-based Vista Healthcare, now renamed BUPA Asia, picking up Hurstville Community Private Hospital in Sydney as part of the deal.

Chief executive Louis Dudley said yesterday that Hurstville was a middling operation with 57 beds, specialising in orthopaedics, obstetrics and ophthalmology.

He said that since Vista acquired Hurstville late in 1999 - before BUPA acquired Vista - revenue had risen 80 per cent.
Loyal Brits give health giant a broad base The Age June 6, 2002

I did a search of Australian, Asian and US newspapers looking for information. To the best of my knowledge not one Australian newspaper reported Vista's purchase in Australia at the time although the Asian press did.

In Singapore, Vista has tied up with dental group Atria-Pan. The firm also marked its entry into Sydney's healthcare sector with the acquisition of Hurstville Community Private Hospital. An imaging clinic has been set up in Hongkong.
Vista Healthcare to beat S$50m revenue forecast Business Times Singapore May 10, 2000

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Chase Manhattan

One suspects that Tenet Healthcare was the vehicle for financiers Chase Manhattan's health investment in Asia although I have no information for this. The reports confirm that Vista was their new vehicle for this purchase and that they picked Tenet's team in spite of Tent's recent fraud and the unconfronted allegations against Ford and his Singapore team. Note that like their competitors these financiers had a health care investment section.

Chase Capital Partners and Management, a venture capital company belonging to America's biggest banking group, has teamed up with a breakaway group from the Mount Elizabeth Hospital chain to enter the regional healthcare market.

The founders of Vista Healthcare Asia intend to give their former employer, Parkway Healthcare group, a run for its money in a wide spectrum of medical services. Parkway took over the Mount E group last year from US' Tenet Healthcare Inc.

Vista's partners said they aim to own and manage tertiary hospitals, clinical laboratories, radiology clinics, diagnostic and day surgery centres as well as offer healthcare consultancy.
Chase Capital, with a 40 per cent stake currently, is prepared to invest more than US$100 million (S$140 million) in Vista projects over the next several years. It has committed over US$260 million in over 30 healthcare companies. It is represented on Vista's board by its executive partner, Dr Mitchell Blutt, and John Lewis, its Singapore-based principal. An independent director is Carl Stanifer, who is chief financial officer for Tenet Physician Services in Texas. Vista has a paid-up capital of US$1.2 million and currently has six people in its office here. Its strategy is to work with local partners in target markets of Singapore, Malaysia, Thailand, India and the Philippines. It hopes to seek a listing in three to five years.
CHASE UNIT TEAMS UP WITH MT E BREAKAWAY GROUP Business Times Singapore October 10, 1996

Chase Capital Partners, the private equity investment arm of US giant The Chase Manhattan Corp., has announced the formation of a company here to build an Asian healthcare business.
Thomas Lee, executive director of VISTA, said the company hoped to benefit from its affiliation with Chase "not only as a substantial source of capital" but also from the expertise of its physician-led investment team.
Chase Manhattan in Asian healthcare venture Agence France-Presse October 13, 1996

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Michael Ford sinks into oblivion

A 1997 press release from Tenet reported that Ford who had close associations with Chase Manhattan was leaving to join Vista. Modern Healthcare's 1997 international edition contains charts prepared by Ford (not clear whether he wrote the articles). He advised corporations to be low key about their US operations and hide behind local company partners so as to avoid criticism. Vista followed this advice in entering Australia. Equally interesting is that although Ford was a director of Vista it was his previous Tenet/NME international vice president, Carl Stanifer who became president of Vista. I could not find a single report in the Asian press linking Ford to Vista. Perhaps his conduct at the Mount Elizabeth had made him unwelcome!

Tenet believed that it had been a victim and never accepted that it had done anything to be ashamed. Naively it hired Ford to act for it in an unsuccessful attempt to reenter the international marketplace. Perhaps it did not know that most countries and their medical associations had been briefed on its conduct and the unconfronted allegations against Ford's Tenet/NME team.

Chase Capital Partners, the investment branch of Chase Manhattan Bank, is backing a venture known as Vista Health Care, which is based in Singapore and plans to invest in healthcare projects.

Chase's initial investment is $2 million, "but there is no limitation of funds from Chase," says Michael Ford, who works as a consultant for Vista and Chase.

Ford, 55, is the former president of Tenet Healthcare Corp.'s international division. - - - - He joined Vista earlier this year.

"If there is a capital call for an acquisition or a start-up, Chase will come up with the capital for it," Ford says.
Recently, Tenet said an improved financial position has allowed it to begin looking at overseas opportunities again, and it has rehired Ford as a consultant.

The Tenet executives who made up the international division now work for Vista and remain bullish on emerging markets.
U.S. firms planning to replicate American healthcare overseas shouldn't bolt onto the scene waving the stars and stripes.

"We must do a lot to adapt our system," Ford says. "You cannot go over there with the idea that we are the best. You do not take the attitude that we are an American hospital company. You want to joint venture and build a Chinese hospital with the help of American know-how."

Investors also should be aware that private hospitals can be lightning rods for criticism.

I searched US reports to see if I could find out what had happened to Ford. There were many Michael Fords in politics, law, universities, medicine, psychiatry, nutrition, religion, prison and even in the obituaries but none matched him. There was an August 2002 report of a Michael Ford as a controller in a government/business feasibility project for a petrochemical venture in Yugoslavia. A 2004 business reports lists a Michael Ford as a director of a health care company called Sunlink.

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Vista's rise and rise (1996 to 2001)

Chase Manhattan poured funds into Vista Healthcare and it rapidly set about a plan to expand throughout the region with a diverse collection of health services ranging from hospitals and specialist services to general practice. It made no secret of the fact that Australia was on its list.

HOMEGROWN newcomer Vista Healthcare Asia plans to set up Singapore's second standalone day surgery and diagnostic centre at a cost of about $11 million, - - - - - -
Vista is also considering adding a medical oncology centre which will do routine-type therapy treatment for cancer patients.
Vista Healthcare to set up S$11m facility Business Times Singapore August 20, 1997

For the longer term, Vista has its eye on a public listing within five to seven years, probably on the Singapore bourse, said Vista executive chairman Carl Stanifer in an interview with BT.
"We want to have a complete healthcare delivery system in each of our key markets of Singapore, Malaysia, Indonesia, the Philippines, Australia, Hongkong and later China and India," said Mr Stanifer.
Since then, Vista has bought Quest, a reference laboratory here.
In Singapore, the company is negotiating to acquire a chain of medical and dental clinics, said Mr Stanifer. But he declined to name the chain.
Vista is 40 per cent owned by CCPM, a venture capital company belonging to America's leading banking group.

The balance is owned by the group of former Mount Elizabeth executives and Mr Stanifer, who joined the company early this year.
Plans to pump US$150m into Asian projects. Business Times Singapore August 20, 1997

HOMEGROWN medical firm, Vista Healthcare Asia, has teamed up with a Philippine consortium to build a S$126 million tertiary hospital and medical centre in Metro Manila. The Singapore company and its seven Philippine partners plan to use the proposed hospital as a flagship to build up a healthcare network in Manila, which will see the group acquiring three to four general hospitals and setting up outpatient clinics and diagnostic centres.
S'pore firm to launch hospitals in Manila Business Times Singapore October 6, 1997

It is understood that homegrown medical firm Vista Healthcare Asia, which teamed up recently with a Philippine consortium to build a hospital and medical centre in Metro Manila, is in talks with hospitals in Thailand.

Vista executive director Thomas Lee said the company was also exploring opportunities in China, Indonesia, Malaysia and Australia.
Health-care groups seek out bargains in region Straits Times October 16, 1997

One result is that joint ventures are proliferating between Asian groups and US companies. The latest to get into the picture is Vista Healthcare Asia Pte. Ltd. of Singapore which is backed by Chase Capital Ventures Partners whose sole limited partner is Chase Manhattan Corp., the largest bank holding company in the US. The principals of Vista previously managed the Mount Elizabeth Hospital group of companies, Singapore's most prestigious, and had oversight of the international operations of the group's former American parent in Malaysia, Australia, Thailand and Spain.
WEEKENDER Health care - Asia's next business boom BusinessWorld December 12, 1997

VISTA Healthcare Asia has acquired stakes in 19 medical clinics in Singapore and Hongkong.
Vista also owns two laboratories in Singapore Quest Laboratories and The Medical Laboratories
Vista buys into 19 S'pore and HK clinics Business Times Singapore April 25, 1998

HOMEGROWN healthcare company Vista Healthcare Asia has bought a 26 per cent stake in IBC-Asia Healthcare (IBC), which plans to invest up to US$55.5 million (S$96.2 million) to set up eight to 15 eye centres in China.
Based in Hangzhou, China, IBC's other owners are Chase Capital Partners and a group of investors, including the founders of IBC
Vista Healthcare buys into IBC, eyes China Business Times Singapore August 4. 1998

Vista Healthcare Asia Pte Ltd, an integrated healthcare services group in Asia, has invested RM3.2 million in Malaysia's Megah Medical Specialist Group (MMSG).
Under a separate agreement, Vista Healthcare will also provide management services to MMSG, a year-old ambulatory surgery centre located in Petaling Jaya.

Vista Healthcare said its stake in MMSG represents its first venture into the Malaysian healthcare business.
VISTA INVESTS RM3.2 MIL IN MMSG (198) BERNAMA Malaysian National News Agency September 9, 1998

Baltimore-based Johns Hopkins Medicine will invest in a 200-bed hospital with the Singapore Economic Development Board (EDB), Vista Healthcare Asia and Arcasia Land. It will provide treatment for patients with complex and rare cancers and heart diseases. Vista Healthcare will manage the hospital. Arcasia Land will build the hospital on the National University Hospital grounds. Arcasia Land, high-tech industrial park developer, is owned by Jurong Town Corporation, a Singapore government company which is Singapore's largest industrial landlord. The hospital will focus on local and regional patients and be staffed by Johns Hopkins doctors.
International Market Insight Trade Inquiries November 2, 1998

Started only three years ago, Vista is now the largest unlisted healthcare company in Asia, and has operations in Singapore, Hong Kong,the Philippines, Malaysia, and China. It is planning to move into Thailand and Australia next.
Singapore DBS Land Takes 18% Stake In Vista Healthcare Dow Jones Business News September 23, 1999

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Adverse factors for health

Managed care and HMO's were sold to Asian countries and enthusiasm spread across Asia. This cut into hospital profit and it is not clear whether it ever built a promised day surgery centre in Singapore. There was considerable opposition to HMOs, particularly from doctors but Vista accepted the inevitable and defended the system forming its own HMO subsidiary. The Asian economic collapse probably also cut into profits but Chase Manhattan and Vista both claimed they were capitalising on the opportunities to buy at low prices.

The private healthcare sector in Singapore could be adversely affected as the concept of managed healthcare and indemnity insurance spreads in Indonesia.
Chia Chee Keong, executive director with Vista Healthcare Asia, a leading venture capital company said: "Its impact in Singapore will be immediately felt as the healthcare market here is small."

Indon schemes could hit S'pore healthcare revenue Business Times Singapore January 5, 1998

On its proposed day surgery centre at Cairnhill Place, Mr Chia said the project is on hold until the region's economic situation picks up.
Vista buys into 19 S'pore and HK clinics Business Times Singapore April 25, 1998

However, when considering the role of managed care, it is important to understand that the increasing public desire for regulatory reform in the US results from the few "bad apples" who operate such schemes without a social conscience, rather than an overall indictment of the various forms of health benefit coverage described loosely as "managed care".
LETTER - US generally happy with managed care by DR LIONEL CHADWICK Vice-President Health Benefits Management Vista Healthcare Asia Pte Ltd. Straits Times July 31, 1998

Vista Healthcare Asia Pte. Ltd. is doubling its paid-up capital to more than US$50 million, to take advantage of bargain-basement investment opportunities created by Asia's downtrodden economies, the company president told Dow Jones Newswires.
Singapore's Vista Healthcare Taps Private Equity To Expand Dow Jones International News September 16, 1998

Now a new Singapore-based company, Vista Healthcare Asia, claims it can deliver some of the cost-control ability of an HMO without compromising on quality. It offers a medical benefits plan, but its main business is owning and marketing a growing network of clinics, laboratories and hospitals in Singapore, Hong Kong, Manila and Kuala Lumpur. Launched in 1996, Vista calls itself an `integrated healthcare provider', which gives large corporate buyers one-stop shopping for employees' medical services.
Putting care first Asian Business May 1999

Mr Stanifer, who entered the healthcare profession because it "paid the highest paycheque when I left school with a wife and kid", is unfazed by the competition in Singapore.
Vista Healthcare to beat S$50m revenue forecast Business Times Singapore May 10, 2000

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Vista and Parkway

Parkway was the health care brainchild of the developer Tan and Ang families. In 1995/6 it bought Tenet's Asian holdings including those in Singapore. The company lost heavily during the Asian market crash of 1997 and 1998. Wealthy neighbours could no longer afford Singapore priced care. Tan and Ang sold out to the Australian Schroders Capital Partners in 1999. (The chairman of Parkway's 1995 target, Australian Medical Enterprises {AME} had been from Schroders). Major investors in Parkway included DB Land (19%) in which the Singapore government was a major investor. DB Land was also a major investor (18%) in Vista. It hoped to bring the two companies together. This did not happen.

Many at the table read this as a signal that DBS Land may sell its stake in listed Parkway as well as its 18 per cent interest in unlisted Vista Healthcare Asia. - - - - - - For one, many analysts have never really found DBS Land's healthcare strategy clear or convincing. - - - - - - - DBS Land's involvement in Parkway began in May 1997 with its purchase of a 19 per cent stake in the latter for $391.2 million, or S$6.50 per share, from Hospital Pantai. - - - - - -

Then came the regional crisis, which forced many rich Indonesian patients to stay away from Parkway's hospitals in Singapore and sent stock markets in the region on a tailspin. Parkway's share price plunged to a low of S$1.39 in September 1998. DBS Land ended up writing off a total of S$232.7 million relating to its Parkway investment during financial years 1997 and 1998.
That was to be DBS Land's ambitious healthcare strategy with Parkway, with its hospitals forming the tertiary end of the chain, and Vista Healthcare Asia serving the primary end. Vista has a chain of 40 medical clinics, dental clinics and diagnostic centres in Singapore and Hongkong.

Tapping synergies: DBS Land had grand visions of tapping synergies between Vista and Parkway. But few analysts were convinced. First, what benefit would there be for Parkway's management from such a tie-up as the healthcare giant practically has its own IDS, including diagnostic centres, dental clinics, dialysis centres and hospitals?

Secondly, what incentive does Parkway's management have to co-operate with Vista, whose founders include ex-staff from the Mount Elizabeth and East Shore hospitals who left after Parkway bought the two from Tenet of the US?
DBS Land shedding Parkway? It'd be a right move. Business Times Singapore May 24, 2000

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Vista sells to BUPA

The economic downturn, managed care and competition probably were cutting into profits. but exactly why Chase Manhattan decided to get out is not clear. In 2001 it sold Vista to the British BUPA.

Bupa, Britain's largest independent health-care company, has paid US$35.5 million to acquire Vista Healthcare Asia as it makes its first steps into China and other regional markets.

This is Bupa's first foray into the health-care business in China and Hong Kong, which are undertaking reform of their medical plans, saidAndrew Kielty, managing director of Bupa's Asia operations.
Bupa provides medical insurance and health-care services - including privately run clinics, hospitals and care houses - worldwide.
The acquisition also includes Vista's 31 clinics in Singapore; a private hospital in Sydney, Australia; and a day-care medical centre in Malaysia.

Bupa looks after regional concerns with acquisition of Vista Healthcare. South China Morning Post July 19, 2001

The purchase brings into the BUPA network 31 general-practitioner or pathology clinics in Singapore, 16 primary care, pathology, physiotherapy or ophthalmology centers in Hong Kong and the Hurstville Hospital in Sydney. BUPA will also get minority stakes in an eye-surgery center in Hangzhou, China, and a specialist practice center near Kuala Lumpur. BUPA already owns a primary care and diagnostic polyclinic in Bombay and has health-insurance operations in Thailand and Hong Kong, covering more than 270,000 people.

On Wednesday, company executives said that BUPA, which by British law must reinvest any profits back into its health-care business, was unique among its Asian peers for having both insurance and newly acquired health-care businesses in one market, Hong Kong.
BUPA to Acquire Vista Healthcare For $35.5 Million The Asian Wall Street Journal July 19, 2001

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Web Page History
This page created April 2000 by Michael Wynne
Modified April 2002, Oct 2005 & Feb 2007