Ramsay Santé Q1 FY27 earnings: revenue up 2.9% to €1.2bn, EBITDA up 7.5%
In its Q1 FY27 earnings update for the three months to 30 September 2026, Ramsay Health Care subsidiary Ramsay Santé recorded revenue of €1,232.9m, up 2.9%, and EBITDA of €120.7m, up 7.5%. Ramsay Health Care Limited (ASX: RHC) owns 52.79% of Ramsay Santé, which lodged the update with Euronext, and it was released to the ASX on 6 November 2026.
EBITDA growth outpaced revenue growth, and Ramsay Santé maintained its short and mid-term financial outlook. The EBITDA margin reached 9.8%, against 9.4% a year earlier.
The net result (Group share) remained a loss of €(35.5)m, an improvement on the €(40.1)m loss in the prior corresponding quarter. Revenue rose 2.6% at constant currency exchange rates.
Pascal Roché, CEO of Ramsay Santé
“…This is a positive start to the year, and we remain fully focused on delivering on our strategy.”
The table below sets out the key figures as presented in the update.
| Metric (€ millions) | Q1 FY27 | Q1 FY26 | Change |
|---|---|---|---|
| Revenue | 1,232.9 | 1,198.6 | +2.9% |
| EBITDA | 120.7 | 112.3 | +7.5% |
| EBITDA as a % of revenue | 9.8% | 9.4% | +0.4 pts |
| Net result (Group share) | (35.5) | (40.1) | +4.6 |
| Operating cash flow | (3.3) | (43.5) | +40.2 |
| Net leverage (pre-IFRS) | 5.1x | 5.2x | n/a |
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Operational performance behind the Q1 FY27 result
France and the Nordics
France revenue grew 2.0%, primarily supported by organic volume growth. MSO (medicine, surgery and obstetrics) admissions rose 4.1%, driven by ambulatory care, with one additional business day compared with the prior-year period. French facilities treated approximately 170,000 emergency patients in the quarter.
Two factors partly offset that growth: an adverse mix effect, as day-patient volumes grew faster than inpatient stays, and imaging tariff cuts with an estimated €1m impact. MSO tariffs remained unchanged following the January 2026 revision.
Nordics revenue rose 4.9%, with organic growth of 4.2% on a like-for-like basis at constant exchange rate. Sweden benefited from primary care remuneration for extended care responsibility and the new St Göran contract, which has applied since January 2026 at improved terms.
Capacity also expanded in France, with one new radiotherapy unit opened in the quarter and an additional TEP Scan imaging unit commissioned at the end of the quarter.
Margin drivers
EBITDA increased €8.4m to €120.7m. The update attributes this to resilient organic volume growth, the new St Göran contract (effective 5 January 2026) and strong delivery of performance plan measures, which more than compensated cost inflation. That inflation included the French minimum wage increase of 2.4% on 1 June 2026.
Key operating facts from the quarter:
- Revenue from France (including Italy) was €832.8m, up 1.9%, against €400.1m, up 4.9%, from the Nordic countries.
- The transfer of activities from Clinique Générale Valence was completed.
- 3 maternity transfers/closures in France were completed over the quarter.
- Underlying current operating profit was €9.5m, up €6.1m, against a backdrop of seasonally lower summer activity.
Connecting Care 2030 and what Ramsay Santé’s growth model means for investors
Ramsay Santé describes itself as the European leader in private hospitalisation and primary care. It operates 492 facilities across five countries (France, Sweden, Norway, Denmark and Italy) and welcomes 13 million patients each year.
Its strategic roadmap, Connecting Care 2030, was presented at the Capital Markets Day on 17 September 2026 and is now moving into execution. Management points to day medicine care, imaging, connected care pathways, digital technology and AI, and active portfolio and contract management as the levers for profitable growth.
Day medicine means care delivered without an overnight stay. The update links its development, alongside imaging and coding optimisation, to the revenue development initiatives running during the quarter.
Initial initiatives cited include:
- 4 facilities secured certification renewals.
- A score of 80/100 from an independent third-party body for implementation of Ramsay Santé’s mission objectives.
- A new radiotherapy unit and a PET scanner commissioned during the quarter.
For Ramsay Health Care shareholders, exposure to this business currently sits in the 52.79% stake. The planned distribution of that stake, detailed below, would change how they hold it.
Balance sheet, cash flow and refinancing
Operating cash flow improved by €40m to €(3.3)m, helped by a favourable change in working capital. The prior-year movement was negatively affected by the repayment of French government cash advances, which did not reoccur. Net capex was €41.7m, and cash and cash equivalents were €164.6m at 30 September 2026.
Reported IFRS net financial debt was €3,730m. Restated net debt was €1,788m, compared with €1,867m at 30 September 2025.
Restated net leverage was 5.1x, against 5.2x at September 2025 and 5.3x at September 2024. Leverage at end-September is typically higher than in June, reflecting the normal seasonality of the business.
Refinancing activity during the period included:
- A €1.75bn refinancing closed on 22 July 2026, comprising a €1.55bn Term Loan B priced at E+350bps / 99.0 OID and a €200m revolving credit facility.
- Senior debt maturities extended from 2031 to 2033, with the €100m Euro PP notes maturing in 2028 and 2029 refinanced.
- At HP Dijon-Bourgogne, payment of the €13m option on 20 July 2026 and a new €67.5m Fiducia tranche added on 31 July 2026 over 10 years, providing additional liquidity of €54m.
Total interest expense was €49.5m, against €46.5m a year earlier, with approximately 80% of gross financial debt hedged at the date of the release.
After the period end, on 7 October 2026, the Lyon Court of Appeal handed down a decision favourable to the Group in the Hôpital Privé Jean Mermoz construction dispute. Damages remaining to be received are estimated at approximately €57m, and the opposing parties have lodged an appeal before the Cour de Cassation.
Outlook and what happens next for Ramsay Santé and RHC shareholders
Ramsay Santé maintained its financial outlook:
- FY 2027: revenue growth between 2.0% and 3.0% (excluding FX) and a stable EBITDA margin versus FY 2026.
- FY 2029: revenue growth at c. 3.0% per annum and gradual EBITDA margin improvement.
- Gross capex at approximately 4.0% of revenue on average over the FY 2027 to FY 2029 period.
- Continued deleveraging, targeting net debt/EBITDA (pre-IFRS) below 4.0x.
Stated upcoming events:
- Conference call and live webcast on 6 November 2026, 8:00am CET.
- Ramsay Health Care Limited shareholder General Meeting on 24 November 2026, to approve the distribution.
- Ramsay Santé General Meeting on 4 December 2026, where the Board proposes appointing Frédéric Collet (who would become independent Chairman), Pascal Roché and Alexandra Boleslawski as Directors, with Virginie Banet and Alexandre de Palmas proposed as independent Directors. All appointments are subject to shareholder approval and completion of the distribution.
- Planned in-specie distribution of RHC’s 52.79% stake on 9 December 2026, subject to approval by RHC shareholders and receipt of the required authorisations.
Ramsay Santé has applied for a foreign exempt listing on the ASX and is putting in place arrangements for Ramsay Health Care shareholders to hold their interests through CDIs tradeable on the ASX, subject to all applicable approvals. A CDI would provide equivalent economic exposure and voting entitlement as an ordinary listed share in Ramsay Santé.
The proposed changes aim to establish a majority-independent Board in line with the AFEP-MEDEF Code. On completion of the distribution, the five Directors appointed on RHC’s proposal would step down.
For investors, the quarter pairs EBITDA growth of 7.5% and a maintained outlook with a leverage ratio that improved to 5.1x. The next milestones are the November and December meetings and the planned distribution.
Investors exploring the shareholder decision in more depth can read our detailed coverage of the Ramsay demerger vote, which sets out the 0.25 securities-per-share entitlement, the small shareholder cash option and the independent expert’s conclusion.
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