Ramsay Santé: Results Up, but Cash Flows Decline by €169 Million
The final accounts for the fiscal year ended June 30, 2026, approved by Ramsay Santé's board of directors on October 6, 2026, show two distinct trends. The income statement advances at each operating level and the net loss narrows. Net cash flows generated by operations, however, declined by €169 million to €524.7 million, due to working capital requirements. The group attributes this decline to the return of its working capital requirement to a level it describes as more normalized, following the previous fiscal year supported by cash advances in France. The adjusted net debt ratio (before IFRS 16) remained stable at 4.7x. The "Connecting Care 2030" plan, presented on September 17, 2026, targets a ratio below 4.0x by fiscal year 2029.
Revenue Up 3.3% and Net Loss Reduced to €48.3 Million
Consolidated revenue reached €5,381.1 million, compared to €5,207.9 million a year earlier, representing an increase of 3.3%. At constant scope and exchange rates, organic growth stood at 2.3%, with currency effects contributing €51 million. In France, revenues grew by 1.9%. Admissions in medicine, surgery and obstetrics increased by 2.5%, driven by outpatient care, and the group handled approximately 690,000 emergency department visits. The company noted that a three-day strike by physicians in January 2026 impacted volumes, an effect partially recovered in the following months. The Nordic countries posted growth of 6.5%, reaching €1,712.1 million, including 3.1% organic growth. In Sweden, the new St. Göran hospital contract has been operated since January 5, 2026 under improved tariff terms, according to the group. EBITDA increased by 2.6% to €637.7 million, with a stable margin of 11.9%. Current operating profit reached €196.9 million (+5.1%), or 3.7% of revenue compared to 3.6%. The Group's net loss narrowed to €48.3 million, compared to €54.1 million, and loss per share fell from €0.49 to €0.44.
Productivity and Cost Control Amid End of Guarantees
EBITDA growth occurred despite the elimination of financing guarantees in France, which represents a €20 million shortfall compared to the previous fiscal year. According to the group, increases in tariffs and public funding only partially covered inflation in medical personnel costs, consumables and outsourcing. Productivity and cost control plans enabled compensation for this gap. Excluding the financing guarantee, the group indicates a margin of 11.5% a year earlier. On the cash front, the change in working capital requirement amounted to -€44.0 million, compared to +€135.4 million in the previous fiscal year. The group identifies two main factors: €133 million related to cash advances received in France last year, and €74 million related to the implementation of receivables factoring at end of June 2025. Cash and equivalents stood at €302.2 million, compared to €366.5 million on June 30, 2025. IFRS net debt amounted to €3,584.9 million, compared to €3,647.5 million. Adjusted net debt fell from €1,675.9 million to €1,638.7 million. Property and intangible asset investments remained at €143.9 million, compared to €142.8 million. The sale-leaseback of four French facilities to La Française REM generated net proceeds of €45 million, and net financial debt costs declined to €191.2 million, compared to €194.4 million.
€1.75 Billion Refinancing and Targeted Deleveraging Below 4.0x by 2029
Following the close, the group completed on July 22, 2026 the refinancing of its senior debt for €1.75 billion. The transaction includes a Term Loan B of €1,550 million and a renewable credit facility of €200 million. It extends maturities from 2031 to 2033 and includes a change of control clause consistent with the distribution contemplated by its shareholder Ramsay Health Care. The latter plans to distribute to its own shareholders its 52.79% stake in the capital. According to information disclosed by Ramsay Health Care, the transaction could take place in the fourth quarter of 2026, subject to required approvals. Ramsay Santé has submitted an application for admission to the ASX to enable ownership of its shares in CDI form. The "Connecting Care 2030" plan sets, by fiscal year 2029, a compound annual revenue growth of approximately 3.0% excluding currency effects over fiscal years 2026 to 2029, as well as progressive improvement in EBITDA margin. No dividend will be proposed for the fiscal year. The deleveraging target is quantified: bringing the net debt to EBITDA ratio (before IFRS 16) below 4.0x, compared to 4.7x on June 30, 2026.
