Welcome to the Medi Cover Q2 twenty twenty five Report Presentation. For the first part of the conference call, the participants will be in listen only mode. During the questions and answer Now I will hand the conference over to the speakers, CEO, John Stubbington and CFO, Anand Patel. Please go ahead.
Good morning, It's John here, and welcome to our presentation for Q2. As you can see here on the headline, we've sort of positioned this as sustained high growth with strengthening profit margins, which I think is really, really good. When asked to frame the first quarter from many people, I think I positioned it as strong. I think to frame the second quarter, our positioning would be actually, it's a little bit stronger. You can see strong growth coming through with good operational leverage, and and this, of course, is improving our operating cash flow, which we're we're very, very pleased with.
From a growth perspective, 17.1, you know, we're seeing growth in all markets, which is which is good. A little bit later on, we'll talk you through each of the markets and how it's progressing. But literally across the board, we're we're in a good good position. Most of this growth is organic. As you can see, there's a relatively small amount of revenue that's come through with recent acquisitions.
And then of growing rate revenue is one thing, but at the end of the day, we want to expand our margins. And again, that's really going well for us. All of our metrics from a profit perspective are up. I think I'll leave Anad to talk through that. And this is being driven by, you know, our strong Polish market as usual.
Pleasingly, our Romanian hospitals are starting to mature, which is what we expected. We brought in the acquisitions, which has been good for us, and we've got solid solid volume growth across the board. And what's really nice to see is that our Ukrainian business has has improved, and some of the initiatives that they put in some time ago are starting to pay off, which is excellent for them because if anybody in our operating sort of network needs good some good news, it's Ukraine. So, absolutely delighted for them. Health care services, pretty consistent in terms of robust organic growth and enhancing profitability.
Polish Ambulatory are doing very well. Sports and wellness, again, doing well, and our facilities continues continues to to support as well as the remaining hospitals that we we mentioned earlier. And diagnostics have have got growing momentum, which is really good good to see, and most of that coming through a fee for service, which, of course, would be our preferred our preferred revenue stream from a a ability to control pricing, etcetera. Leverage, as we talked about last time, is at 3.6, which is the the sort of zone we expected. We will notice that over future quarters start to come down.
So we advised last time that we go over our guidance and then slightly correct itself over the course of the year. Then if we look on the right hand side, you you know, I've got revenue, $5.96, up 17%, which is good, and organic growth 13.9, again, which is good. Really consistent revenue growth from the group, which is exactly what we want. In terms of our profit metrics, it's it's really strong, a 100.9, up 35, so that's great. And 16.9 in terms of margin, which is a nice improvement to see.
So congratulations to all the team that have contributed positively to that. And talking about positive things, it's nice to see the the cash flow improving at such a rate, which will stand us in good stead for the for the future. So I think we move on to look at the revenue and how the revenue is developed. As you can see here on the left hand side, we've got the graph which shows the previous performance over the same quarter. And what we see here is good, steady, consistent performance by us in terms of our positions being 17% growth, 20% growth, 17% growth.
So that that's really good to see. And if you look at the the pie chart in the middle, you can see that that growth is pretty much across the board, you know, 21% coming from Poland. Germany, slightly subdued, but again, we would expect that with the reform that's going on. And I would say that the team are navigating navigating some of those challenges really well. Romania, very, very strong there at 20 to 25.
India, again, looks relatively low, plus five. But what we've got to remember is in terms of last quarter was very low. But in local currencies, up to up to 13%, and we're we're quite pleased with the local currency 13% sort of jump. And we're monitoring this the start of this quarter, and we believe that that will continue to increase and improve our position, which is as expected from the commentary that we may that we made last time. And you can see a good contribution from Ukraine and and our other our other parties.
Our pay mix is pretty much unchanged. Good growth across the board, so it's nice and balanced. Strong fee for service, again, which is a positive for us in terms of our ability to be able to control pricing and some of the challenging dynamics, but supported well by the the funded business and the governmental pay, which, of course, is a steady consistent pay as for us. So that's really, really good. Health care services, you know, strong performance.
Poland continues to drive it. So nothing's really changed dramatically in terms of of health care services. You can see strong organic growth driven almost across the board from each and every business, which is pleasing to see. Whilst that is great, we still have many areas that we feel that we can improve. So we fully expect to continue on the journey of consistent growth in this particular area.
As I talked about previously, you can see Indian hospitals is up and has rebounded and the operational changes that we said that we would make have started to take effect. I don't think that that's a full effect that you're seeing yet in the quarter. So we expect that to mature as we go through the year. And we've got a little bit more immaturity that will come into the system because over the course of the next few days, we've got a 300 bed facility that is being opened. I think it goes fully operational on Monday with a soft opening.
So good luck to our Indian team with with that new opening. One of the Romanian hospitals, the Polaris hospital, which is in Cluj, doing really, really well. It's become the biggest robotic hospital in Romania with the highest number of operations. And, obviously, that's just a facility that's only been open a a couple of years, so congratulations to them. In the figures here, you'll see that we had a long standing sort of position with Hungary where we were going to exit and we fully executed that in Q2.
That drops our membership down a little bit, but we still have growth in membership. I mentioned in my commentary that it's a little bit subdued. That's mainly due to the kind of political political situations and the delays with EU funds being deployed in some of our markets. So people are a little bit hesitant, but we fully expect that to to start to flow through as we go through the course of the year and as we go through 2026. So even though those those headwinds are are are coming at us, we're navigating it well and and and still performing at a high level, and I don't expect that to to change. We fully consolidated CitiFit. This was the acquisition that we mentioned in in in q one. That's come straight into our network, and the biggest synergy you get from that, of course, is that your member base that was going to a third party provider now is going to your own provider.
So that's that's fully starting to show in our numbers. So the team did well to put that in place. Look at the growth. It's very consistent. Look at the margin.
It's improving. Look at the membership. It's been adjusted down. But as I said, I expect a little bit more membership growth to come through in Q3 and beyond. And then in terms of revenue growth for the division, it's it's pretty strong across the board.
You've got the 21%, as I say, 13% for India in local local currency, 5% in euros, and and other areas do doing well. And then we've got a pretty consistent payer mix, and and it's a it's a healthy one. So that's positive for us. And then if we go to diagnostics, very encouraging for diagnostics. I think what you can see here is the building of some momentum.
Part of that momentum is coming from the fee for service area, which is exactly what we would want to see. The Synlab acquisition has has come into the business. We've started with our our our synergies and started to execute, and some of those have have been done. There'll be others that will will take will take effect over the course of the next few quarters. So that's very positive for us.
And, of course, it's had a a big impact in terms of the number of tests that we do. So our overall test volumes have have increased quite well. Germany, revenue growth, as we talked about, is is fairly subdued, but, really, the reform, you know, the reforms that came towards us, I would say the team are navigating that well. They are quite challenging. We've got to do more efficiency and put more things in place, but the team have done well.
So that's good to see. Ukraine, strong growth driven by public pay and our ability to be able to also do fee for service with some of the customers that come and upsell and do other products. So that's worked quite well. And a couple of couple of important developments from a genetics perspective. As you can see here that liquid biopsy portfolio has they're doing some clinical research that has gone well and looking for clinical validation of that.
And the first phases of that have been done have been really well received by the medical community. So we we look to see that develop over coming quarters and years to see and see how we can increase our exposure in that particular area. And we've integrated our our technology with with Element Biosciences, which gives us extended distribution capability, which again, we're quite excited about and looking to see how that will develop over coming quarters. If you look at the division's revenue, up 16%, very, very positive. If you look at the margin, we've got increasing margin, very positive, quite a big increase in the lab tests.
No significant change really in the mid teens. And I'll hand over to Anand now really to talk you through some of the financial numbers in detail.
Thank you, John, and good morning, everyone. So I would say, pleasing to report another strong set of numbers from us and a continuation of the trend of prior periods. So to remind you of the themes that I think are important. So one, double digit organic growth. So done that consistently now for a while.
Number two is margin expansion across all profit measures. And pleasingly, not just EBITDA and EBITDA, which we speak about a lot, but actually now you can see that it's coming through in net profit and EBIT as well. I'll take good cash numbers and debt leverage in line with our prior guidance, which we've given, and I'll talk a little bit about the expectation for the end of the year. And finally, we're on track, as we've said before, to beat our 2025 targets that we've set previously. So in terms of going into a little bit more detail on that, so you can see that revenues in total were 597,000,000.
John's touched on that. Overall growth is 17.1 with the just under 14% of the total growth being organic, which is pleasing. The EBIT numbers, I'll just touch on now as well. So EBIT up 96% year on year for just under 42,000,000, and material margin expansion of about two eighty basis points to 7% and net profit tripling as well. So we normally have always spoken about EBITDA and EBITDA in the past, but actually as we see improved capacity utilization flow through all lines of our p and l, naturally, our EBIT and net profit improves, which gives us good soundings for for the future.
So so that's pleasing. In terms of other things to note, I'd say, our net cash position was good. I'll talk about that in a later slide and up year on year, and our earnings per share tripled to €12.7 cents in the quarter. And the final point to note from a cash flow perspective is that we did pay the dividend of €05 per share, turning to just under €23,000,000 in Q2. If you look at Healthcare Services, John's touched on this.
So the pleasing thing for me, a lot of organic growth, as John said, of 15.6%. And broadly split, 8.7% is price with the balance being volume. And you'll see on the next slide that actually on diagnostics, we've had good volume growth as well. So pleased to see that actually we can expand our pricing as well as generate volumes through our network. EBITDA of 53,500,000.0 with margin expansion materially from a rate perspective.
So what you can see in health care and diagnostics, again, a continuation of prior quarters in terms of margin expansion. But obviously, the health care numbers you've seen this quarter are lot stronger. So, you know, healthcare is up 73%, whereas diagnostics is up one and a half percent. So still strong numbers. And what you can see, if you talk about the hospitals, for example, you can see that in q one, we had the loss making immature hospitals contributing $3,900,000 of negative EBITDA.
That's going in the right direction in Q2, so that's a $2,700,000 impact now. But as those mature through their maturity curve, we expect them to, if they got to zero, add on another 0.70.7% EBITDA margin within healthcare. So still room to grow, but as John said, there'll be new hospitals opening one in this quarter that will kind of bring the number down again. The pleasing thing I think to note is as we fill our capacity and all the infrastructure that we've built in the prior quarters, although there's still room to go in terms of what we can do, our medical ratios come down naturally. So medical ratios, you know, improving by about 2% year on year in the quarter.
In terms of diagnostics, I would say strong growth again. So again, organic growth of just under 10% with the majority of it being volume with the price being about 3.5% of the growth. Again, strong numbers across EBITDA and EBITDA. What we did have in the quarter, which we'll talk about later, is obviously the Synlab acquisition. So we added on circa 27 labs and 92 drawing points, so that adds to our non financial KPIs in terms of number of facilities.
As there were challenges in Germany around, obviously, the public pay model, then clearly, I think the team has done a good job in terms of improving fee for service business, not just in Germany, but across the rest of the countries that were in diagnostics as well. And again, just to reiterate what I said earlier in terms of good price and volume growth from diagnostics as well as health care. In terms of cash and other financial metrics, so leverage at 3.6 times in q two. You know, we've guided to that in the past, and we've also guided to the fact that we'll be nearer three by the end of the year, and we stand by that. And, obviously, in terms of the other material thing to note is as we did the two acquisitions in q two this year, we've increased our net debt by a 178,200,000.0.
Remember, we bought those two acquisitions because we expected it to be revenue accretive and margin rate accretive from this year. We still expect that to be the case. In terms of the effective tax rate, 28%, so that's pretty much in line with q one. And I've provided earlier that actually the range for this year will be between 26% to 30%, so nothing different there. And from a net cash operating perspective, up year on year as a consequence of the margin expansion impacting our profit numbers flowing through into cash.
And finally, I think on this slide, I'll just talk about ROIC. So I think, you know, if you remember our q four statement, you know, ROIC was 6.7%. We said that that'd be kind of as we fill the infrastructure and as we get improving margins, we'd see an uptick in our ROIC numbers, and we're pleasingly seeing that this year reasonably quickly. So at the end of q two, we're at 9.3%. We know there's still some way to go, but we expect to be double digit by the end of the year.
In terms of CapEx and other investments, I think in terms of total CapEx spend in Q2, broadly the same as Q1, so we spent €27,000,000 which is 4.5% of Q2 revenue. However, we previously guided that our CapEx spend this year will be between 5.5% to 6%. So clearly, CapEx will be backloaded into H2, so back to your models. The other thing in terms of space, I would say, so currently, at 970,000 square meters. In the quarter, we added on 55,000 square meters of space, and that's probably around the two acquisitions that we've made.
It's 26 gyms and the Synlab acquisition, which are basically 27 labs. And nice to blood drawing points. And finally, from a targets perspective, I mentioned at the start, you know, and Frederic said this last time and John's saying it now. And I'm saying the same thing again in terms of we will exceed these targets. So our revenue will be in excess of 2,200,000,000.0.
Our adjusted organic EBITDA will be in excess of 350,000,000. The numbers the other profit measures quoted on the bottom right, we will exceed those as it stands today, and leverage will drop from below 3.6 to a number below 3.5 and closer to three by year end. So before I hand over to John, just to summarize what I said at the start. So double digit organic growth, margin expansion across all profit measures, but pleasingly in EBIT and net profit, good improvement in EPS and ROIC, strong cash and on track to exceed our targets. Thank you. John?
Thank you, Anad. So q two for us has been a a really good quarter. You've got continued strong growth, both organic and a bit of acquisition coming through. Margin expansion, very, very positive for us, which is good good to see. We're filling up our our facilities, still adding square square meters, but filling up our facilities as customers start to use us and more importantly, as customers come back.
Immature hospitals, we are seeing progress. There's more to do, but but that journey is progressing well. And we fully expect the the trend to continue going forward. Leverage, as we've said a few times on this call already, it's a temporary position for us. So that will start to come in line as we go through the year.
And the the momentum is is strong enough to achieve, I think, our 23 to 25 targets. So very pleased, very grateful to all of the people in the organization that have worked very hard to achieve this. So thank you very much for all that you all that you do. And I suppose the sound bite in terms of how do we sum up the quarter and our place currently is that we're in a a a strong position with a strong platform with good opportunities as we go forward. So we're excited to see what happens in q three q three and q four and beyond. Thank you.
Next question comes from Julia Angeli Strand from Handelsbanken. Please go ahead.
Hi, good morning. Thank you for taking my question. And I have two questions. And my first one is on Germany and the pricing reform. And I know you talked about this before and that you would know more in July.
So I'm wondering how do you expect the pricing reform to impact operations going forward? And how should we look at the potential of ongoing efficiency initiatives? Yeah.
Do want to
No. No.
I'll take it. So so, you know, the German reforms were, you know, quite harsh. I think if you if you go back in time and history when the they were first muted, there was quite a lot of worry, fear, and trepidation about, you know, what could this what could this do to our numbers that literally, from our perspective, you know, you can't answer till you get into the journey. But, you know, there's two sides to reform. There's the, you know, adapting to the the actual reform and sort of responding as an operating unit.
And then the second side is that any reform has opportunities for the players that can navigate that well. So far, you know, we're we're only two quarters in, and I think to really see the full effect of it, it it it really is a a whole 12 journey because of the way that the German system works in terms of the the the quarterly adjustments. But so far, the sound bite from us is that our team in Germany are doing a good job in terms of navigating the navigating the challenges. They are generating efficiency. They've got more to do, and we will continue to press on on that journey.
But most reforms are designed to cut off the tail. You know? They're designed to cut off some of the smaller players that maybe haven't got the the most efficient systems and therefore can't adapt to the the pricing that they put in place. That will happen in the market. The tail will get cut off.
As the tail gets cut off, these the suppliers that are are left that are able to provide the services will get the work that used to go to the tail. So we we fully expect that those trends to be seen as we as we go as we go forward. You know, we can't quite see them see them yet, but it's early days in terms of the progression. But our sound bite in terms of where are we versus the initial the initial trepidation that some people would have had is that, actually, the team are navigating it, managing it well, but still have some work to do to be able to complete the journey.
Okay. Understand. Thank you. And just a follow-up on that. Is the reform in line with you expected so far? Or is it worse or possibly better?
I don't want to tempt fate, really. But, you know, in terms of the our modeling of the financial situation when it first happened, it was quite extreme. If you then look at our current numbers versus that extreme position, then we're as I said before, we're navigating it well.
Okay. Okay. And then to my last question. So regarding the subdued member growth, is this a short term fluctuation? Or could this be indicative of a broader trend? Is there anything you could elaborate on there?
I see it very much as a short term trend. You know, the the beauty of the the scale that we have is that we can see the employer trends, and we see when they start to slow down putting extra employees on and when they start to speed up in putting employees on. So, you know, we get our growth really from two main areas. One is brand new business, people that haven't had a relationship with us before, and the other side is the organic growth that comes from an employer that's already with us, putting extra employees on. I think with the political situation of the world, political situation in in Poland Poland, Romania, and with the delay of some of the deployment of some of the EU funds, you've just seen a little bit more hesitance and caution from some of the employers, and that organic growth isn't as strong as it was before.
But we've had that for quite a period of time. And if you look at our numbers, our numbers have still been pretty strong. So we have an ability through our new business and through our pricing to be able to navigate these things, and I fully expect the EU funds to be deployed. I expect the political situation to calm down a little bit and people get more used to it as it as always happens, and then the employment market to be buoyant again. And whenever that's buoyant, we we are strong.
So we're not in a bad place at all. We're in a very, very good place. It's just there's a little bit of hesitance, and and that's, you know, cooked in a little bit to the the present numbers. But if you look at the present numbers, they're still very, very good.
Next question comes from Matthias Watsson from SEB.
Matthias Watsson from SEB. I have three questions, I think. First one I'll take them one by one. First one relates to India. So the sort of key driver for the return to the strong growth in the quarter.
If you could describe maybe the market climate a little bit, is it business as usual now in India? And any general sort of growth outlook for the second half is very much appreciated as well? That's the first one.
Yeah. Okay. So I I think in the in the conversations that we had post the the q q one call, we were, you know, very open with everybody in terms of the situation in in India. One, we were subdued in q one. Two, it was a little bit surprising to us.
There were some kinda factors in terms of the election. There were some factors in terms of medical tourism, in terms of the government not issuing the visas for people to be able to come come through. And as we honestly said, there was a few operational own goals in in some of our strong marketing techniques that we'd used historically where we'd thought we'd modernized a bit and we could change the mix, and it didn't really work. The good news for us is the, you know, the election's gone, and there's no signs of any drag from that. The medical tourism and the visas are now being issued, and we are sort of back to normal in terms of the volumes.
But, of course, we didn't have a 100% of that in q two because it took a bit of time for that to filter through. And the operational own goals that we scored, we've we've and and, you know, we've we've made our defense a little bit better, and the the team have adapted well. And and that's the one where I said in my commentary that, you know, you don't get the full effect of that in the in the quarter. So we we expect and we we see so far in in July a strengthening of our position. Market conditions, well, that is quite strong, I have to say, because there a there are some of our competitors that are also in our markets considering to do IPO, which makes them a little bit more focused on some of their activities and some of their recruitment activities.
But the local team are very strong in the the areas that we operate. You know, they're very well established. We have have good good reputation with the doctors that we have and and good systems and good equipment for them. So we we're we're in a a good place, but we we expect to see it improve as we go through q three in terms of the as we, you know, repair some of the things that we've done. So better for us q two, should be a little bit better for us in in q three, and we'll see where we go by q four.
Thanks. Very clear answer. Then the next question. I mean, seeing the first sales figure for C2C FinLab for the group looks quite good, I think. Could you disclose if you're satisfied with what you've seen in terms of growth so far?
And perhaps also talk a little bit about the margin contribution from them to at this stage as it stands right now and the scope to sort of lift margins going forward? That's the second one.
Yeah. So so I'll I'll take this one if that's alright, John. So, yeah, look, we've kind of integrated the businesses, as you can imagine, in q two. So remember, I think one was on the first of April, and the the second one was on the April 6. So yeah.
In in terms of what we've seen so far and what we've captured into the numbers, there's no surprises in terms of what we expected from synergies or revenues, I would say. Obviously, things are always slightly a little bit different. But actually, terms of do we still expect, as I said earlier, you know, full year margin accretion and full year revenue accretion as a consequence of those businesses? Absolutely. We have seen margin accretion in q one in q two, sorry, most definitely as a consequence of doing it, but probably not as much as we would have expected.
But I think some of some of that will happen in the second half of the year. So so we're pleased with the businesses and what they're generating at the moment. And we still have got the same expectations that we had before with regards to the profitability of the businesses.
Sounds very encouraging. The last one relates to the margin. So the EBITDA margin up by a significant two percentage points year over year here in the first half. Is it likely that this trajectory continues in the second half? Or are comps getting gradually a bit tougher?
And should we consider the opening here in July as well? Because it looks like a significant Yeah. Also. Just a few words there, maybe if you could help.
No. I agree. So look. I I think, you know, John framed it well. So, you know, q one was strong and q two was stronger.
So say if I had to pick, and I know you want margin rates for the rest of the year, then then I'd pick something in the middle in terms of your models for one sort of better phrase if I was being prudent. But no. No. We'll carry on doing what we're doing, which is focusing on optimizing our facilities and stuff. But yeah.
I think I I'd say, you know, q two probably a surprise to you guys in terms of margin rate expansion versus q one. But, yeah, if you pick a number somewhere in the middle, it's probably right. But but, obviously, we'll try and beat those ones. The the other thing sorry. Just sorry.
The other thing, Matthijs, just to remind everyone of, is remember in q three last year, we had the impairment write off. Yeah. So the q three numbers will probably look a bit odd from an EBIT level anyway, year on year anyway, because we had a 16,400,000 write off sorry, write off impairment of the two businesses, the fertility businesses and German Dental. So the year on year is a little bit odd for next quarter.
Thanks. That's very helpful. Sorry for squeezing in one more, but maybe a few reflections on elections that were taking place during the quarter and the impact on the market environment.
Yeah. I I I think I think for from us, you know, politics is politics. So, yeah, time will tell in terms of how it how it really it really plays out. But I don't think the political situation from our our business perspective currently will, you know, influence or change change our course. In fact, there may be some good opportunity that actually come comes out of it.
You know, the the Romanian change is perfectly okay in terms of the environment for us, in terms of pro European, etcetera. And the Polish position is is kinda shaking down right now currently with the reshuffle that happened yesterday. So I think that's that's an interesting change in terms of the health minister. But, again, I think, from our perspective, we're we're not sitting here with any major reaction from from the changes that we've seen.
Thank you so much.
Next question comes from Christopher Lilleborg from DNB Carnegie.
Four questions from me. I'll also take them one by one maybe. First, you mentioned that the acquisition actually benefited a bit here to margin in the quarter. Is it possible to quantify how much they contributed to earnings? And whether that was mainly one of the acquisitions or both of them?
Yeah. Yeah. So so we're we're not willing we're not gonna quantify that. It was more in the grand scheme of things. Think, let's be honest, in terms of the quarter, the the overall underlying business did super well versus versus any acquisitions that we did.
So yeah. Look. I I mentioned it was positive from a margin rate perspective, positive from a revenue and EBIT perspective. But in the grand scheme of things, it's the overall medical business that contributed the largest to our performance.
Okay. And when it comes to the Synlab synergies, what's the timing of of this? Yeah.
I I think we you know, some some are already there in terms of of things that that that we've done. I think you'll see more in three and more in q four, and and then it will start to settle down. So, you know, the next two quarters are quite key for us in terms of implementing some of that change. But, you know, from our perspective, the team are on it, very focused, very clear, and know what to do, so they should be executed.
Will you have some some one off costs related to to that restructuring here in the third and fourth quarter?
There there might be. There might be, but I wouldn't expect it to be dramatically material. So, usually, when you do these things, there are there there were some, for example, with CityFit, but they're they're not, you know, they're not dramatic dramatic for us, so it should be okay.
And then the third question relates to the minority line and the fact that that one is is positive. Is all of that India or some other explanation for that?
Yes. So so the majority of our minority interests are are India. There's small bits and bobs, which is, yeah, less than 2% of the total. But but India is our material minority interest at the moment. No material change quarter on quarter.
I think the only change is driven by FX changes in the quarter, but nothing else has moved.
Okay. And then my final question, this effect dilution from new hospitals. Do you expect that €2,700,000 negative to be smaller end of the year or larger because of the new openings?
Yes. I think we've got to a bit careful about this one because I remember talking in Q4, we said, actually, you know, it's going to improve through the year. Then, obviously, you saw the q one numbers spike due to the challenges that we had in India. So, look, I think we've we've fixed the own goals, as John said, and any other external factors that had that were there out there that kind of resolved themselves. So look.
We'll we'll go in the right direction, but, you know, we will add on another hospital that will be negative from a margin perspective. But, look, I will say the same thing again. Over time, it will get better. We're hopeful the next two quarters will be stronger.
Okay. Thank you.
Next question comes from Philip Eckengrain from ABGSC. I
just want to go back to the subdued growth in members. Did did you say anything about which markets or or was that kind of overall in the different markets you operate?
No. Mainly from a well, actually both, but, you know, the the the big member growth position or the big membership business we have is in Poland. You know? And I I would know you know, we we've put that line in so that, you know, people are aware that some of the organic growth isn't the strongest history, but I I wouldn't overcook this in terms of our ability to navigate it. These some of these trends have been there for a while.
And, you know, if you actually look at the strength of our Polish operations, our Polish operations have been good. So there's there's also a bigger positive side to come through, which is whilst these trends are there, it does subdue us a little bit, but it will you know, eventually, the organic side of life will will will come come back stronger again. And we've seen these trends. If you go back in history, you had these periods where it it dies down for a period of time because of usually the economy or or some uncertainty, and then it starts to mature again. So from our perspective, it's it's there.
We're navigating it, but it's not something we're we're worried about at this stage. But it it's mentioned because Hungary will disappear, and therefore, there's a smaller base. And when the smaller base is, there's a little bit more volatility.
Sounds reasonable. Thank you. And then a final short question from my side here. The privately paid business seems to have had strong momentum in all markets, and you mentioned Germany here. Could you elaborate a bit on that?
Is that a result of the changes in the German market or any other reasons for that, please?
Sorry, we missed the first couple of words that you said. Which line?
Right. So the the privately paid business, yeah, in in diagnostics. So the private pay in diagnostics. Yep.
Yeah. So so so I'll I'll start with that one if that's okay. So listen. In a in in Germany, clearly, given that there has been tightness around public pay, then the team have done a good job on trying to expand our private offering. So if you look across diagnostics, full stop, and including Germany, there has been a growth in our fee for service model, as we call it.
So that that helps us offset some of the shortfalls that we've had in terms of price in the public pay sector. So that that's helping us, actually. So previously, you know, we've said that actually we'll consolidate Germany and make sure that we kind of still, you know, grow it in the right way. So you've seen that actually in q two, you know, revenue growth of 1%. You could argue that it's a little bit better underlying because of movement of Easter.
But then after that, our margins are flat as well. So we have seen pleasing movement in fee for service, not just in all of diagnostics, but in Germany as well to an extent.
Sounds good. Thank you. That was all for me.
Next question comes from James Vane Tempest from Jefferies. Please go ahead.
Yes, hi. Thanks for taking my questions. John, maybe just a question on your first impressions. I know, obviously, you've been at the company for fifteen years or so, but in nearly three months in as CEO, I guess, in your new role, what are your more nuanced observations about the business seeing it from a different perspective? And then my second question is the company has always given this sort of midterm guidance.
And obviously we're coming up to 25. When do you think would be a natural point having sort of looked at the business from a new perspective when we can get an update? And what's your sort of initial thoughts on philosophy? Are we likely to get one year? Or do you still think you know, two, three, or even five years?
Because know sometimes the company's given two or three year guidance. So any kind of first sort of initial thoughts around those would be really helpful. Thank you.
Yeah. Sure. First impressions, well, you know, part of the business is very new to me in terms of the detail, but not new to me in terms of the you know, of being aware of of of things that we do. You know, lots of opportunity for us to improve things, lots of opportunity for us to grow. Very excited in terms of what can happen as we as we go forward.
You know, we're in this planning and organizing phase for us to evolve things more. There's not gonna be dramatic change, but I think we can evolve things more and as we do that, make improvements. So but, you know, if you want a sound bite, it's I'm very excited by what I see. In in terms of the the guidance, we're very aware that we've gotta give new guidance. We haven't actually completed the guidance that we gave we we gave already.
So we're we kinda wanna get to the base count of Mount Mount Everest before we actually say where are we gonna go next on the journey and the climb. So I think you'll expect something from us either the end of the year or the beginning at the beginning of next year. That's the kind of range that we we we've discussed so far. Whether it's one, two, three years, again, we we we haven't haven't confirmed that. We're at the beginnings of the of the discussions.
It won't be five. Five, you know, basically, is a a little bit too long in in terms of time frame. But, you know, we would definitely, as we get towards the back end of the year, be very clear about either here's the numbers or here's when it's gonna appear.
That's great. Thanks very much.
No problem.
Next question comes from Bram from Bering.
Hello. Most of my questions have already been touched on, but I'd like to go back to yeah. You slow, you lose. But I wanted to go back to talking about the employment environment in two of your big countries, Romania and Poland. I'm fairly clear why companies would be hesitant to add workers in Romania. But could you just maybe walk me through a little bit on what would be causing hiring head hesitancy in Poland?
Yeah. I'll ask a question after that.
I I I think I've mentioned it before. You know, the the the world political position is at stages throughout this year has been a little bit unclear in terms of the American president making certain statements that unsettle people. You've then got, obviously, the elections that were happening in in Poland, and that always creates people to just hold back for a period of time and looking for that to settle down. And then you've had, as I say, the e EU funds, which Poland are always very good in terms of deploying and using. They've been a little bit slower in in in terms of being being deployed.
You know, we mentioned this in our statement just to make people aware, but it's probably also very important to clearly lay out that these trends in terms of the hesitancy have been there for, yeah, a few quarters. And if you look at our performance over those quarters, we are still strong. So they're there. They do create a headwind for us, but it doesn't stop us moving moving forward. And at some stage, as I said earlier, these will be turning from a headwind into a tailwind, which then we will see the advantage of.
So it's it's normal cycles. You know, if we go I've been, you know, with the business fifteen years. I've seen the cycles of the organic growth drop for a period of time, and then I've seen the the the cycles when the organic growth goes like a rocket, and it and it's great. And I think we'll we'll mature out of this because we've we've got much more stability from a political position that that appears to start to have been navigated. The EU funds will will start to roll and come, and confidence will build.
So we very, very much see this as a temporary position, but we're mentioning it really because we're making a significant change on the membership base with the Hungary exit. And as your your base gets smaller, volatility is seen, and we're just pointing it out. So we're just putting it so that there's no surprises as we as we go forward. You know, our membership growth in q three is a little bit better than than q two or is expected to be. So, you know, I'm just as you say, we're mentioning it for context. No panic from our perspective.
Clear. The other question was regarding you've been very kind in giving us numbers on losses stemming from being mature units. So part A of this question is you have a new 300 bed unit opening very soon. How much how many more openings will you have over the next twelve months?
We from in India, we have we have one more opening scheduled, which will be early early twenty six.
So that that would be we're pretty
And then
So that that week we Sorry, sir.
I'll let
you know. Will be it for that will be it for now. Correct?
I I I wouldn't say that with us. You know, from from our perspective, you know, we're always planning and always looking. All I can say today is as with regards to our current plans and the current position, the the next hospital in terms of a self built position is scheduled for q one next year, and there's nothing currently in the pipeline. But, you know, opportunities come at us very fast. We can move very fast.
So, yeah, I wouldn't rule it out, but that's the current position.
Okay. Thank you very much. No problem. Part b would be, again, in the context of this, know, EBITDA loss coming from immature hospitals. By how much would this new opening later this month increase those losses in terms of the third quarter?
I'm not going to ask you by how much how the rest will improve, but by how much would a new unit just off the up cut number, how much would it increase the losses from the immatures?
As you can expect, that's quite sensitive information with that our competitors would love to have from us in terms of not only the losses, but also the pace that we move through those losses. So it's not something that we actually disclose.
Fair enough. Thank you very much.
Thank you.
There are no more questions at this time. So I hand the conference back to the speakers for any written questions and closing comments.
Just checking to see if there's any any written questions that we've got time to answer.
Yeah. So touch on one or two of them, I think. So that's the bottom one. What was the price growth within diagnostics segment
3.5.
Segment in CE? So I think if if you look at our webcast report, think in total diagnostics, we're saying price was three and a half within all the areas. So I think that answers that question. Germany is 50% diagnostics. So, yeah, you could kinda calculate the balance from that.
I don't think we've been specific price growth by sector country before. We're We're not adjusting your midterm targets. Think John's already answered that question in terms of we we will say we're beating our targets. We've said that before, but we're not gonna give further guidance apart from uncertain profit lines, which I've said earlier. So that's answered.
In terms of sports, was our revenue growth in q two mainly driven by price or volume? Combination of both in all honesty. I would say so remember when I looked at when I talked about overall health care services, we said of the 15 odd percent, you know, 8% was about price and 7% was volume, and that's consistent with ambulatory and sports, which is our biggest sector. And and then m and a strategy, do you wanna talk about that one, John?
Yeah. I think that, you know, from our perspective, when it comes to m and a's, we're constantly looking at at our pipeline. So even though our current ratio is high, that doesn't mean to say we stopped the work because we fully expect to be able to bring that down relatively quickly. So the work doesn't stop. We've got lots of opportunities.
We're evaluating different things. And as and when we feel it's the the right situation with something that's highly synergistic accretive to us, we will we will press the button and and and execute it. So I I would expect us to do things as we go as we go forward.
I'm sorry. Just reading the final question. Do we expect wage hikes in Poland from 2025 to negatively affect margins in health care services? Look. I think there's always inflationary costs for maybe wage rises or something else.
But as a business, we work hard to up try and offset this through either pricing or being more efficient in the way we operate our business. So, you know, we've given guidance for this year. We're confident in our guidance number, and that assumes any potential impact of either macro factors from a political perspective or, let's say, weight inflation factors.
Yeah. Great. I I think that covers all all the questions that that's been been written. So thank you everybody for joining the call. Just in summary, it's been a really good quarter for us.
We're very pleased. We're very grateful to all of the people in the organization for everything they've done to to help us achieve these results. So thank you very much to them. And the soundbite for last quarter was that we were strong. The soundbite for this quarter is that we are stronger and the outlook for us remains very positive.
So we look forward to talking to you in Q3. Thank you very much.