Half-year results at the end of December 2018

Communiqué Financier le

Solid results were recorded in the first six months, and, moreover, the successful acquisition of the CAPIO Group opens up bright prospects

  • Published half-year turnover up 25.7% to EUR 1,340.1 million, showing a net increase on a like-for-like basis (+2.9%) with two additional business days;
  • Increase in reported EBITDA of 18.7% to EUR 123.1 million and improvement in EBITDA margin on a like-for-like basis;
  • Group net profit at break-even compared with a loss of EUR 22.1 million at end December 2017;
  • Deployment of the 2020 strategic plan in line with the objectives to transform, digitize and restructure the company;
  • Capio Group integration process well under way.

According to Pascal Roché, Group Chief Executive Officer:

“The acquisition of CAPIO on 7 November 2018 opens up very encouraging strategic prospects, a confirmed potential for financial synergies and quality of care, and the first few months are fully in line with our expectations. Our strongly improved results reflect the integration of this acquisition. On a like-for-like basis, despite weak growth in volumes and a pricing environment that continues to be adverse, our turnover increased by 2.9%, also buoyed by two additional business days. Similarly, the operating margin improved slightly, reflecting the merits of the diversity of our business segments, geographic positioning, quality of care and constant search for efficiency. The group’s transformation continued, in particular through the digitisation of the patient's journey and a high level of investment.”

The Board of Directors, meeting on 27 February, approved the consolidated financial statements for the semester ended December 2018. The accounts were subject to a limited review by the statutory auditors.

In € millions 

From 1 July 2018
to 31 December 2018


From 1 July 2017
to 31 December 2017





Gross Operating Profit (EBITDA)




Current operating profit




As a % of turnover


+0.1 point


Operating profit




Net income - Group share




Net earnings per share (in €)





In € millions

From 1 July 2018
to 31 December 2018

From 1 July 2017
to 31 December 2017










Nord - Pas de Calais - Picardie




Provence Alpes Côte d'Azur




Bourgogne Franche Comté




Other regions




Other activities








Published turnover




Of which: - Organic




Of which organic within France




Of which organic within Italy




- Changes in scope of consolidation





Important event during the half year:

On 8 November 2018, following the closing of the acceptance period for its public takeover bid for Capio shares, Ramsay Générale de Santé announced that on 7 November 2018, it had acquired 98.51% of the capital of Capio, one of Europe’s leading providers of healthcare and health services, enabling the Group to position itself as one of the pan-European leaders in private hospitalisation and primary care, present in six countries with a prominent role in Scandinavia, notably in Sweden, and in France.

The public takeover bid by RGdS concerned all of Capio’s shares at a price of SEK 58 per share. The price of the Capio acquisition thus amounted to EUR 779.7 million (fair value of the 139,050,816 Capio shares at 58 SEK per share converted at the hedging rate of 10.3437 SEK/EUR).

The valuation of the identifiable assets acquired and the liabilities recognised at their fair value at the date of acquisition in the financial statements as at 31 December 2018 is provisional, and is therefore subject to review based on the definitive valuation of the fair values.

Operations and turnover:

During the half year ending on 31 December 2018, Groupe Ramsay Générale de Santé generated consolidated turnover of EUR 1,340.1 million, compared with EUR 1,066.4 million from 1 July 2017 to 31 December 2017. 

Since 7 November 2018, Capio entities have contributed EUR 247.2 million to Group consolidated turnover. 

In addition to this major acquisition, the consolidation strategy for the divisions’ medical projects in the territorial division in France led to the takeover in July 2017 of Hôpital Privé de l’Est Lyonnais (Lyon Cluster), followed by the buyout of Clinique La Parisière in July 2018 (Drôme-Ardèche Cluster).

After adjustment for changes in the scope of consolidation, turnover showed a net growth of 2.9% to EUR 1,092.2 million.

At the end of December 2018, total activity (excluding emergencies) effectively increased by 2% in terms of hospital admission volume, benefiting from two additional business days. The breakdown by business segment is as follows:

  • +2,5% in Medicine-Surgery-Obstetrics
  • +2,4% sub-acute care and rehabilitation
  • -1,2% in mental health

With regard to the public service tasks managed by the group, the number of emergencies increased, up 1.7% over the past half year with close to 302,000 cases registered by the emergency services of our facilities.


EBITDA for the half year ending on 31 December 2018 was EUR 123.1 million, up 18.7% on a reported basis. At constant scope and accounting methods, EBITDA increased 8.5% over the period. EBITDA margin as a percentage of sales was 9.2%, contracting from the previous year (9.7%), but improving at constant scope and accounting methods.

The published operating profit for the period 1 July 2018 to 31 December 2018 reached EUR 48.9 million (or 3.6% of sales), up 31.5% from EUR 37.2 million recorded for the half year ending on 31 December 2017. 

The other non-current income and expenses resulted in a net expense of EUR 14.0 million for the year ended, consisting almost entirely of costs related to the acquisition of the Capio Group. From 1 July 2017 to 31 December 2017, the amount of other non-current income and expenses represented a net expense of EUR 43.7 million.

The cost of net financial debt amounted to EUR 27.6 million for the six months ended 31 December 2018, compared with EUR 20.2 million the previous year. This consists primarily of interest on senior debt and includes the cost of the subordinated bonds subscribed to by the shareholders of Ramsay Générale de Santé as part of the acquisition of the Capio Group.

In total, net profit attributable to the Group was at break-even as at 31 December 2018 compared with a loss of EUR 22.1 million for the period from 1 July 2017 to 31 December 2017.


Net financial debt at 31 December 2018 greatly increased to EUR 2,252.5 million compared to EUR 965.2 million at 31 December 2017. This debt includes, in particular, EUR 1,501.4 million in non-current borrowings and financial debt, EUR 1,087.4 million in current financial debt, balanced by EUR 274.6 million in cash.

This change in the Group’s net financial debt naturally reflects the impact of the takeover of the Capio Group, including its own debt. Financing for the Capio acquisition has been secured

  • thanks to the issue of subordinated bonds subscribed to by its two majority shareholders, Ramsay Health Care (UK) and Prévoyance Dialogue du Crédit Agricole (“Predica”), to the amount of EUR 550 million,
  • and through the establishment of a term loan of up to EUR 750 million, the terms of which are governed by an Incremental Facility Notice dated 13 July 2018, as amended and restated, and by the 2014 Credit Agreement, as amended. This term loan was used at the end of December 2018 for EUR 266 million to finance the purchase of securities.

ISIN Code and Euronext Paris : FR0000044471
Website : www.ramsaygds.com

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