The ESG risks (particularly social) naturally associated with the healthcare sector and governance risks arising from the company's structure (controlling shareholder) were initially felt to be satisfactorily mitigated through a strong management record and positive value drivers for the business.
Over the course of ownership, the company began to face progressive problems. News reports highlighted poor patient treatment, which led the manager to engage seeking reassurances and initially it was possible take comfort from the company's response.
The company was placed under monitoring which increasingly confirmed the management team's execution of the business strategy was failing to live up to expectations. The presence of a controlling shareholder also meant the company's response to the manager's engagement efforts became increasingly less satisfactory and less fruitful.
Failure to make sufficient progress with engagement objectives targeting material risks for long term shareholders has ultimately led the manager to exit their position.