Ramsay Générale de Santé SA (GDS) Earnings Call Transcript & Summary

Okay. Welcome, everybody, and thanks for those being here attending in this room. Welcome, everybody, for those attending online for this Capital Market Day for Ramsay Sante, a new chapter for this company, a new chapter of profitable growth and medical excellence. So through this morning and with a site visit, 4 objective I would like to share with you, our objective that we are going to discuss with the following agenda. First, what makes Ramsay Sante unique as a company in Europe. Secondly, we would like to frame with you -- we are going to frame with you the market in which we operate. We will be pleased to unveil today to you our next chapter for the next year, a new strategic plan called Connecting Care 2030. And finally, with no surprise, we will do an update on the financial performance as of today and what are our guidelines for the future. Today, I will have the pleasure to present alongside Clement Lafaix, our Group CFO; with Jerome Brice, who is our CEO for France, with Dr. Britta Wallgren, who is our CEO for Sweden; and with Dr. Margareta Danelius, who is our Chief Medical Officer for Europe. And in order to share with you, to discuss with you, to explain to you this first objective, we have built the following agenda. I will start with a global introduction regarding Ramsay Sante, then important certainly to look forward regarding once again the market in which we operate in the next year. We will have a financial overview once again with Clement. I will be pleased to share with you the guidelines, the 5 pillars of the strategy that we have built in the last year with 600 manager, once again called Connecting Care 2030. After a break, we will go through the medical excellence for our group in Europe, what makes us unique regarding medical excellence. And of course, because of the size, the importance of footprint, both in France and in Sweden, we will have a deeper look to these 2 countries, regulation, footprint, what do we do, how do we want to roll out Connecting Care 2030 in these 2 countries. And finally, we will do some closing remarks and commitment guidance, I would say, with Clement. There will be time for Q&A, and we'll be very pleased for those of you who have been registering to do tomorrow 2 site visits, primary care, which is a walking distance from here and later, one of a big flagship medicine surgery obstetric, MSO as we serve in our industry in the left bank of Paris called des Peupliers, The popular, if I'm right, in English. So talking about introduction of Ramsay Sante. Let's share the context and to some extent, the importance of today. On February 20, as part of the strategic decision to simplify its portfolio to focus on Australia, Ramsay Health Care announced its intention to propose to distribute the Ramsay share to their shareholder. The same day, Credit Agricole Assurances reiterated its long-term commitment shareholder regarding Ramsay Sante, its confidence on the strategy, the team and the potential of the company. July 22 was an important day as we have been successfully completed the refinancing of our debt, and Clement will take us through that, maturity, simplification, et cetera. Today, once again, our strategic road map for the next chapter of profitable growth. October 2026, the demerger booklet of Ramsay Health Care will be provided in a nutshell to the Australian Financial Authority as well as the court approval. November, we will release our first Q1 results. Just to remind that as of today, our results are June. So we will release our first 3 months results as well during the Ramsay Health Care General Meeting in Sydney, Ramsay Health Care will ask the shareholder to approve the demerger. Would it be the case? The implementation of the demerger will take place afterwards and then, let's say, new year, the new areas, the new chapter for our group. So to be a bit more precise, what has been announced by Ramsay Health Care on February 20 and what will be the impact will the demerger take place regarding the shareholder. As of today, just to remind everybody, if I may, the current ownership structure, Ramsay Health Care owns nearly 53% of the capital of the company, whereas Credit Agricole Assurances owns 40%. And this has been the case since 2014. We've got an individual shareholder, Dr. Attia, owning nearly 7%. And as of today, our current free float is 1%. Would the demerger take place at day plus 1 and assuming that the Ramsay Health Care shareholder, they keep their respective Ramsay Sante share, de facto, the floating will come from 1% to 54%. And once again, that being happening regarding Australian, Asian shareholder, we have been -- we are building with Ramsay Health Care, we have been building a specific tool, a CDI, a CHESS Depositary Interests. So long story short, Ramsay Sante will be too listed on the Sydney Stock Market, easing thus, I would say, any transaction, et cetera, that could happen. Beyond, I would say, what will happen on day plus 1, regarding the Board, undoubtedly, the governance will change, and it will change to respect the best practice of the profession and compliant with the French Afep-MEDEF Code, which means that the new Board, there will be independent directors, independent directors that will constitute the majority of the Board. The Chair of the Board will be independent. The Chair of the Audit Committee will be independent. As to the new member of the Board, they will be appointed through a very rigorous selection process. Now that being said, let's summarize what is Ramsay Sante as of today. If I were to use 4 words, I will use pan-European, market-leading, diversified and integrated. Let's build a bit on these 4 words. Pan-European. As you can see on the left on this slide, we operate in 5 countries through, by the way, the Ramsay Sante brand for France, so Capio brand for Denmark and Sweden, and the Volvat brand for Norway. A couple of figures. As of today, we are taking care of 13 million of patients every year, out of which over 1 million are pure digital patients. Beyond that, these patients are taken care in 491 to be very precise, facilities in Europe, a strong footprint in MSO, a strong footprint in primary care, a strong footprint in mental health, et cetera. We will come back to this. We've got 1,000 operating rooms in Europe. Beyond that, we are working with roughly 10,000 doctors, non-salaried in France, salaried in Sweden, for example, non-salaried in Norway, et cetera. Pan-European, we were saying. Market-leading position. undoubtedly, and we will come to this with further detail with Jerome and Britta, we are the #1 healthcare player in France. We are the #1 by far healthcare player in Sweden, #1 in Denmark, #2 in Norway. We've got only 1 hospital in Italy, but very good medical quality and very strong, by the way, economic performance. We were saying diversified. Diversified on the right of this slide as in the last year, the part of the out of France revenue has grown and represents now 33% of the total revenue. Diversification too, because on the bottom right of this slide, MSO represents still a large part of the activity. But that being said, it's a bit a mistake to say that because between medicine, surgery, obstetric, emergency department, dialysis, et cetera, the variety of activity makes a stronger diversification. And as you can see, it has been one of the key developments of the last years, primary care now in Europe represents around EUR 700 million of turnover, a big, big part and growing part of our activity with mental health, with imaging and so forth and integrated because, as you can imagine, we are going to talk about the patient pathway and how we answer to the patient needs. Going back to a bit the key dates of the history of Ramsay Sante. We've got a long-standing legacy of market leadership transformation of growth. Ramsay Sante was created in France roughly 40 years ago for the older in the room as I am, I would say, a daughter of the former Generale des Eaux. Capio was created in '94 in Gothenburg, West of Sweden. A couple of key other dates. We're saying the merger, the entrance in the capital of Ramsay Health Care and Credit Agricole Assurances took place on October 1, 2014. If you look later at a key date in November 2018, Ramsay -- former Ramsay Sante acquired Capio in order to extend, to diversify and to begin the integration. 2018, we were saying then on the road, we have done 2 midsized acquisition, GHP in 2022 to reinforce our footprint in Sweden, 24 facilities, 23 in Sweden, 1 in Denmark. And in 2023 (sic) [ 2024 ] , we entered the fragmented over EUR 30 billion primary care market in France by taking the former Cosem. Now very pleased today once again to share with you our next plan up to 2030 Connecting Care. And just I can tell looking at the growth figure between 2018 and 2026 from EUR 2.2 billion to EUR 5.4 billion. So what makes Ramsay Sante Group unique? Seven reasons. Seven reasons we are going to elaborate in due course during, I would say, the next moment. A couple of words, compelling European market, leading healthcare platform of scale with systemic relevance in 4 countries, truly integrated care offering anchored in medical excellence, a partner of choice and that's critical for patients, payers, doctors and of course, our team. We are at the forefront of digi-physical care and AI innovation, and we want to do more. We've got a solid financial performance with a clear strategy and milestone in spite of a constrained tariff environment, and we are an experienced management team. So let's try to illustrate in a couple of facts, I would say, each of these reasons. The first one, the market in which we operate. The markets are supported with favorable demographic with very good visibility and high barriers to entry. There are many facts around that. If we go on the left side, you know many of them, aging population, prevalence of chronic diseases. I will come back to this later. Therapeutic innovation are pushing, I would say, of the demand and we can foresee. And if we look at the 4 key countries in which we operate on the right of the slide, very easy to remember, if I may, in the last 10 years, the healthcare expenditures in average has grown at 3.2% per year. In the next 5 years, we expect 3.3% per year. Now the bottom of this slide is really important. Not only we've got very good visibility and a strong and growing demand, but we operate in a sector with high barriers to entry. What do we mean by that? In France, you cannot do anything without an authorization delivered, registered in the 5-year plan of any regional health agency. You cannot do without. Beyond that, you need to have a significant level of certification to operate as well, by definition, in order to be in this sector, you need medical expertise, you need the medical resource. There is a real know-how in investment. And finally, because there are very, very specific regulation, you need to have a regulatory expertise. So first reason, compelling market in which we operate. Second reason, the scale, the systemic relevance of Ramsay Sante in its country. Once again, we are #1 healthcare figure, Sweden, France, Norway, #2 in Denmark, sorry, #2 in Norway. A couple of figures. There are many, but trying to share with you some according to what is important. In France, the private sector, which plays a key role. We've got a 21% market share in medicine, surgery, obstetric. In Sweden, primary care, we are the leader with 1 million of Swedish patients listed in all primary care. Primary care, if I may, is the organization of GP in towns. I would say, once again, 10% market share, we are the leader and at the same time, opportunity to keep on developing. We are the leading -- as an example, in France, leading national expertise in cardiology. South of Paris, we've got one hospital, the larger one for cardiac MRI in Europe, in the top 15 in the world for implantation, is that the right word in English of aortic valves as an example. And another example of a systemic relevance, we were sharing the number of patient visits per year, which has grown from 9 million to 13 million in the last 5 years. In France, 67 million inhabitants, as you know, if whatever the type of hospital, public, private, nonprofit, religious, or market share in surgery, we are taking care of 1 French person out of 8, 1 French person out of 8. Another example of being a trusted partner for the government, the complexity, the importance of what we do in France, we've got 350 oncology authorization. And I would like to end this presentation of maybe too many figures by one according to us, which is really important, an acid test of our strategy in the last year. As we have been sharing, our strategy has been to build integrated pathway. And out of this 13 million patients, 20% are coming from internal referrals from one activity to another in order to ease the patient pathway. We'll come back to this. That's very important, and we want to build on that. Another reason why we consider being unique, we have become a mission-driven company in 2022, a very specific French status. It does not change. It does not change at all on focus on profitability and value creation. Rather, it serves as external recognition of principle that has been always in our DNA, medical excellence, taking care of our own people, respecting the environment, et cetera, et cetera. This is -- it has always been central, and you can see example, I would say, on this slide regarding Ramsay Sante. And all these topics are key driver of sustainable profitable growth. Moreover, our commitment as a mission-driven company are audited every year and the Chairman of the Audit Committee is Mrs. Magali Chesse. Another reason that makes us consider having built differentiating competitive advantage is this integrated pathway. To be a bit more detail, it means that in these 4 key countries, I'm sorry not to talk about Italy, but France, Sweden, Norway and Denmark, we are a player. We are delivering care in prevention, in primary care, imaging in radiology in 3 countries out of the 4. We are a key player, of course, with 250 hospitals being medicine, surgery, obstetric, being full care rehabilitation after a stroke, for example, we've got dedicated hospital to recover after a stroke. We are a key player in mental health in all the country, and we are more and more developing at home taking care, including in palliative care. Britta will give us example where we are very developed with a fantastic medical excellence in Sweden. And finally, we are working around this with digi-physical solution. So why do we consider it makes sense to have been working on this integrated pathway -- because once again, the patient suffering more and more from chronic disease with more and more specialized doctor, et cetera, they do need a horizontal coordination of a pathway. It reduces the time, it's better in terms of delay and there is a continuity of care. It's better for employee and doctors, of course, to be able to take care of a patient to follow up the patient in the pathway for the payer because we are reducing the access to time. And of course, it promotes access to healthcare to all. And it avoid us, in any case, to be disrupted by any other, I would say, player. I've been talking already quite a lot regarding a footprint in the various countries. We are not just an addition of country. I mean, if we have chosen to be in this country, it's because of the medical excellence, the role we play and being a pan-European player, we are relentlessly leveraging our best practice from one country to another. Our mantra is Sharing is Caring or another way is stealing with pride. What does it mean? It means that in the last year, we have been entering from scratch the primary care market in Denmark, in France, developing in Norway because we have been leveraging our unique expertise of managing primary care center in Sweden as well very proud, and Britta will come back to this. In Stockholm, we are managing a fantastic flagship called St Goran, St. Goran maternity ward has been opened a couple of years ago, over 3,000 babies now every year with the support, the expertise of the French team as well, the French and Danish team are working together in order to expand our imaging footprint. But maybe more importantly, in terms of being working as a team together, as the clinical networks that we are building between a specialist and a Chief Medical Officer will come with many more detail how we are better from a patient and efficiency standpoint through, I would say, these clinical networks. Another reason we have to be and we are a partner of choice for patients, payers, doctors and employees. We are going to deep dive a bit on these 4 topics with a specific focus and employee on the next slide. Patient in our industry as in the service world, NPS, the Net Promoter Score has become, I would say, the level of measurement from a patient experience. Very, very pleased to share with you that in France, we have been improving in the last years and that as of today, we are at 74%. Once again, Margareta, our Chief Medical Officer, will share with you how do we rank, what means the 74% on a worldwide basis. In Sweden, very, very good. So NPS with 69. Same you will see later, Norway, Denmark, Italy. Regarding our payer, we are entrusted partner with our payer. We play a key role as we're saying, being in oncology, accessibility, emergency department. We try -- we will share with you some facts, I would say, on all this working side-by-side with the payer with, by the way, many cooperation with public hospital and et cetera. And being in France, being in all the country in which we operate, we are seen as a partner for public authority. We'll give you some facts about this. And regarding employee and doctors, regarding employees, our engagement score has improved in the last year, reaching a best-in-class 87% in Sweden, a good 65% in France, and we cannot see a correlation between the engagement score, the quality of care we deliver and the decrease regarding the turnover rate of the team. We were saying focusing about the team, of course, those who delivers the care that's more than critical. We are a people business. And if we were once again to have some keywords, we would say we need to Attract, we need to Develop, we need to Lead and we need to Care. As to Attract, maybe to take 2 points, I would say on this. The first one in Sweden, we are the #1 employer seen by all the nurse community in Sweden, #3 for doctor. In France, we are proud to say that we've got 6% of our total workforce with disability, which is, as you know, a commitment versus the French law. Regarding Develop, as an example, we've got -- we have trained in the last 3 years, 2.5 years, to be precise, more than 5,000 of our team members regarding AI. As well, we are working a lot with junior doctor. As to the lead with the management of this company, all the management, all the CEO of all the facility. Every year, we've got over 300 of our top manager, which are trained through specific Ramsay Sante group leadership program. And finally, putting our people at the heart of everything we do. As an example, in France, we're the first company to have a work-life agreement signed with all the trade unions in order to take care of those who are delivering the care. We were saying to a trusted voice among payers, policymakers and healthcare leader. That's critical, obviously. A couple of points to try to share that with you. First, we do contribute to the future of healthcare delivery beyond the fact, as an example, to take care of 1 French people out of 8 regarding surgery. We've got close to 1 million of French people in a 30-plus emergency department with a 20-minute average time before seeing a doctor, whereas the average on the French market is 2 hours and half -- 2 hours and 30 minutes. We've got a Ramsay Sante Foundation, which in the last year, we have been incubating key start-up in health prevention, close to 200 in the last 6 years as well with this foundation, we've got 6 million of people, France, and 9, every country who have -- to which we are proposing prevention programs, et cetera, et cetera. We have been -- it was a long time ago and yesterday, we have been at the forefront of the pandemic response. In France, half of the COVID patients in resuscitation beds were taken at Ramsay Sante, whereas our market share is 21%. The team has done an exceptional job, I would say, by creating in less than 6 weeks over 370 additional resuscitation beds as well many, many COVID patients have been taken in St. Goran. And finally, being a core pillar of the healthcare system, a couple of figures. In France, 60% of our facility are in underdeveloped medical area as such, recognized by the French state. As well in France, 20% of the patients we are taking care are patients with low-income revenue of the French person listening, the CMU say, so 4 million of poorest people. And regarding our university hospital in St. Goran, the students we are taking care every year. Britta will share with us many more details. Another reason that we consider makes us unique, the fifth one is being at the forefront of digi-physical care and AI innovation. And this is for the patients. This is for the team, for the management, and this is for the doctors, I would say. Regarding the patient, we have been the first one in France to create an online admission tool already 10 years ago, Ramsay Sante, which as of today, more than half of the patient, they do everything online. They are booking the day of the surgery, the type of room if they consider, they will need a taxi when getting out, et cetera. So it's a real tool, I would say, in order to ease the access, by the way, it's a tool to increase the revenue cycle management. As to Capio Go in Sweden, we've got fantastic tool in order to take care of the patient through workflow, referrals and including prevention program that we push to the patients. Management, Ramsay Companion is an internal AI tool that has been built as an umbrella of the best, I would say, classical AI we know we use, and we are leveraging on that in order to do medical content. And finally, regarding employee doctor, we are working with a lot. The list is not exhausted. We are working with a lot of start-ups in France, in Europe. And net-net, as you know, the Nordic country are more digitalized. So great, great deliveries from our team in the Nordic, Sweden, Norway, Denmark regarding start-up and once again, transfer of best practice, Tandem as an example, being one as a speech to text rollout in primary care in Sweden, and we begin to roll out to in France. There was, by the way, an announcement 2 days ago on that. Another reason, what we consider differentiators going back to figures, solid financial performance in the last 2 years. On the left side, the revenue has grown, if I were to work through rounded figures from EUR 5 billion to EUR 5.3 billion, which is a growth year-on-year of 3.9%, quite well balanced this growth, as you can see, because the 3.9% is 4.3% in the Nordic country and 3.8% in France. On the top of the slide, you will like the like-for-like growth, excluding the FX effect, which has been 2.5%, 2.3% in the last 2 years. Now moving to the EBITDA on the right side. There is a first way to read the figure, and I will propose a second way that we consider more accurate. The first one is to note that the EBITDA has grown from EUR 611 million to EUR 638 million. But that being said, post-COVID, the French state for all hospital in France, public, private, whatever, have put in place a very specific system called the French Revenue Guarantee System and a couple of inflation grants, and as of today, in the last year, the specific grants put in place post-COVID were 0.0, whereas they were still EUR 60 million 2 years ago. So excluding these grants, it cannot go below, I would say, by definition, excluding this grant or margin, the EBITDA margin has increased from 11.1% to 11.9%. Now all this we have been sharing with you has led to the result -- a couple of results on the slide regarding the strategy we are just getting out called Yes We Care 2025. As we can see on the right, beyond the financial figure, huge increase in the number of patient visits, and we will see later where do they come from, on what type of segment, specialty we have been building for the future. Increased by 50% in the last 4 years -- 5 years, sorry, of the digital consultation, undoubtedly a enabler for the future and a demand from the patient. So website visit has been increasing by -- has been doubling. You may be surprised that we talk about website visit. Well, patients suffering from chronic disease, a patient becoming more and more a consumer in our industry. We are proud of what we deliver and being proud once again -- we propose we try to build a pathway for him to reduce the delay, et cetera, and creating, I would say, some loyalty is very important and explaining what we can do. And finally, and it's not by random that we'll close by this imaging volumes increase, namely 41% in the last year because France, this is a figure mainly for France. France is still underserved regarding imaging equipment, all type of imaging equipment. So there is an unmet patient needs, a very still interesting segment to -- from an efficiency and economic standpoint. Imaging is at the crossroad today and even more tomorrow of any diagnosis assessment for a patient. So as we will see, we've got 113 imaging equipment in France and a number of volume has increased by 41%. So as a consequence of this and -- now moving, and we will detail later with a specific session with strategy. The next year strategy going -- moving forward to 2030 is going to unlock the full potential of this integrated care with some acceleration with, I would say, some specific focus. So we want to ensure active portfolio and contract management. Please accept the words, we will detail later what it means. We want to strengthen integrated and accessible healthcare offering. We will embrace the digital transformation of healthcare delivery still certainly at the beginning. More than ever, we will continue to focus on cost initiatives, and we will accelerate additional profitable growth through new revenue stream. Connecting Care 2030, we are going to share with you with more detail what it means, what is a consequence and with a further look, I would say, in France and Sweden. So finally, and we are a people business. So once again, pleased to share with you the management, the ExCo team in Europe of the group. Everybody is here today and people would be very pleased to have a discussion with you for those by definition attending here in the room at any break. That being said, it's certainly very important to do some deep dive, 10 minutes regarding the market or forecast of the market in which we operate in Europe. So what about the healthcare market as a whole? The first slide is to illustrate that there are very -- if we step back, there are very, very few industry where we can anticipate with some accuracy, we think what will be the need, the demand in the next 5, 10, if not 20 years. Really, in our industry, we've got so many key and foreseeable drivers that we can say that as of today, we say that in the last 4 years, healthcare expenditure in France and Sweden used to represent, as you can see on this slide, in the 70s, roughly 5% of the GDP. Last year, 11% roughly in France, Sweden, net-net around the same in Norway, Denmark. Whatever the study you may look like in the next 5 years, healthcare expenses will grow faster than the growth of the GDP. It will not go without asking some question, undoubtedly, but this is a real asset of growth for it to know that there will be more and more need and to remember, at the same time, very high barriers to entry. What is driving that? Aging population, obviously. Aging population, as you can see on this slide, the number of people that are going to be over 60 years old is going to grow very rapidly. It was roughly 41 million people in 2020. It will be 48 million in 2030. Why insisting on the people over 60 years old? Because as you can see on the right of this slide, they represent half of the healthcare expenditure, and it will -- as a percentage, it will increase. And we are very well positioned to answer the need of these people as we are the leader in cardiology, in oncology, in dialysis, in orthopedics, et cetera, et cetera. So we will take care of a growing number of people because of the aging population. Another key reason is chronic disease. In France, as you may know, as an example, there are 31 diseases, cancer, insulin-dependent diabetes 1, et cetera, that are considered as a chronic disease. Roughly 16%, 1-6% of the French people are suffering from a chronic disease. It represents already 66% of the total expenditure of healthcare in France, and this percentage is growing, plus once again, the importance to be accessible, integrated and to build pathway. So an expected rise of the chronic disease. And on the right of the slide, we are an amazing industry with a lot of passion because we know that tomorrow, we will take care better than today of the patient, being through medical, I would say, innovation being in surgery, drugs, et cetera, but to the way of delivering the care. So innovation is a fantastic driver of this industry. And innovation means that the demand is increasing. Maybe two examples very different and very cautiously on the first one versus 20 years ago, some cancer become chronic disease, not all of them, unfortunately. Another positive example on that side, hip prosthesis. On a daily basis, we are taking care in all country of patients 90, 92 years old to do a surgery on hip prosthesis. 30 years ago, it was not the case, it was not the case. So all this innovation and diffusion and with an increase, I would say, standard living, people are more and more taking care with once again innovation. So these are key drivers. There are many other regarding an expanding demand. Another one on the left side of the expanding demand in all the country in which we operate, the waiting list are increasing, being to see a GP in towns, being sometimes to have access of a surgery. This is the figure for the global market. For example, in France, in the last 5 years, having an appointment with an ENT doctor, an otolaryngologist, an ENT doctor was an average 37 days, now it is 2 months in average in France to meet with a specialized ENT. Sweden is facing as overall in the country, an increase in the waiting list of patients, which is front page of the Swedish newspaper every day. And on the contrary, versus this increase in waiting list, you could ask, yes, but what about the ability that you have or the whole industry to take care in the future on this patient needs expectation. Good news. Good news versus some figures 5, 7 years ago, the number of doctor graduates now is increasing in all the country in which we operate. Another point to share with you regarding the strong market fundamental for the next 5, if not 10 years, is that as we're saying more and more, the patient is comparing. The patient wants to look where he's going to. If the waiting time is too long, he won't hesitate more and more to change, I would say, his choice where you want to go, where you want to have a surgery, et cetera, et cetera, it becomes, to some extent, a kind of consumer. It is as it is. And versus, I would say, this change in the patient expectation, our answer is agility, flexibility and to be digitalized. We have been already in this pathway. Connecting Care 2030 is going to take us to the next step regarding this pathway. And another point, which is very important regarding the market fundamental and the roles, what is our footprint as private operator in each and every country? Let's take 2 key countries, if I may, French and Sweden. In France, 36% of all the hospitals are private. And if you take only surgery in France, more than half of surgery is delivered in the private hospital. It is the legacy of the 1945, I would say, decision and history. So surgery in France is mainly done in private hospital, 40%, 4-0 in France of the chemo session are done in private hospital. And by the way, we are the #1 on that. In Sweden, regarding primary care, the organization of GP in towns, more than half of the primary care patients are taking care by private provider. Once again, we are the leader. If we look to -- regarding, I would say, our own coverage on all this, as you know, and we will see later, we are the #1 player. So what it means regarding the role of the private hospital, and let's talk a couple of seconds regarding France. We all know that France is facing to be polite, quite a complex economic situation. So on the bottom right of this slide, you will have, we think, very important figures. Private hospital in France represent 25% of the total beds or let's call it, capacity. We are doing 35%, 36% of all the activity in France, whereas for the French state, the payer, the French tax, we are representing only 18% of the total cost with, in average, a better quality. So long story short, the private hospital in France, they are part of the solution regarding the challenge of the French economy. And as to Sweden, as you can see, as we've just said, more than half of the primary care private whereas for the Swedish taxes, any citizen, they represent only "38%" of the total. So this is, first, we are operating with one of a fantastic market where we see a foreseeable demand for many drivers that we can predict. And we do consider that a differentiating factor make us very well positioned in order to answer to this future unmet or, let's say, patient needs. Now we are going to move -- I'm sure you have been waiting for that too, to figures with Clement.

Thank you, Pascal. Good morning, good afternoon, everyone. Maybe before going through the next few slides that cover our historical financial performance, I would like you to keep 3 important facts in mind. First, our revenue growth has remained resilient, predominantly volume-driven. Two, underlying profitability has continuously increased over time despite a constrained tariff environment; and three, operational execution has provided us a solid financial position, solid foundations for our next phase of growth. Let me now set the context in which this performance was delivered. As outlined by Pascal, we are supported by powerful and structural tailwinds that are here to stay. Healthcare demand is growing in all our geographies. And that's a very important point. However, we operate in a constrained tariff environment where tariffs have lagged inflation over time. And as outlined, temporary grants that were here to offset missing volumes post-COVID or specific inflation has now been totally discontinued. Against this backdrop, the last 2 years are the perfect proof point on how our strategy has enabled us to grow profitably, to diversify our revenue streams, to build a more integrated platform and to develop our activities in the right segments. The key achievements over the last 2 years have been, first, in France, the acquisition of ex-Cosem primary care centers in June 2024, the opening of 11 Medipsy mental health centers and the rollout of 25 new imaging equipment over the last 3 years. In the Nordics and specifically in Sweden, we have been awarded the contract to operate St. Goran Hospital for the next 8 years, plus 4 optional years under better tariff conditions versus the previous one. And importantly, this growth was supported by effective performance actions driving further productivity. I will have the occasion to come back to this today, but performance in our industry is the engine that converts growth into higher margin. Here are the key figures that I would like you to retain. First of all, our revenue have reached EUR 5.4 billion in FY '26, growing 3.9% on average every year over the last 2 years. Scale matters. And as you can see on this pie chart, we are now well diversified both in terms of geographies and specialties. Our EBITDA margin reached 11.9% in FY '26, EUR 638 million, out of which 70% is coming from France, 30% for the Nordics. Before diving further into figures, I would like to remind one important point. France and Nordics, they share a lot of similarities, and operate obviously in the same group, but they do not share exactly the same earning model. One major difference is the revenue base. In France, more than 80% is regulated by the French state with tariffs typically revised once a year, and Jerome will have the opportunity to come back on the French funding system later today. Increasingly, we generate hospitality revenues that are nonregulated and directly get from patients. And we also re-invoice to the French Social Security, specific medical purchases at no margin, representing approximately 8%, as you can see here, of our revenue base in France that mechanically contributes to dilute our margin percentage calculation. In the Nordics, our funding model, it's much more diversified with basically 3 main segments. First of all, primary care in Sweden, 136 primary care centers operated under a capitation model with a fixed fee per listed patients. St. Goran Hospital under a long-term contract agreement with the region of Stockholm, and Britta will have the opportunity to explain how essential our role is here is in St. Goran, and specialty care in all our Nordic countries that are regulated under different kind of contracts and especially in Sweden, funded by 21 different regions. The second difference is the cost base. Personnel cost, obviously, is the main cost driver in both geographies. but it's not directly comparable between France and Nordics because the medical model is not exactly the same. In France, most of our doctors, they are self-employed, consultant doctors. Therefore, the cost is not reflected in the cost base. Whereas by contrast in the Nordics, most of the doctors are employed, driving personnel costs, as you can see here, representing 65% of our revenue base. With that in mind, let me now deep dive into our recent historical trading performance. Our growth, as I mentioned, has been resilient, 3.9% on average per year over the last 2 years, well diversified and increasingly diversified by geography, 4.3% in the Nordics, 3.8% in France and by specialty. By specialty, as you can see in this bridge, MSO remains the main growth driver over the last 2 years. But the other segments such as primary care, imaging, geriatrics, are growing at a faster pace. So back to MSO, 2.7% increase on average, driven in France by higher volumes, 2.5% on average, partly offset by a continuous switch from full hospitalization to ambulatory care. In the Nordics, MSO growth has been fueled notably by the new St. Goran contract under better tariff conditions, so with higher revenues over the last 6 months. The transition was successful in Jan 2026. Primary Care increased by more than EUR 150 million over the last few years, driven in France by the acquisition of the ex-Cosem primary care centers and in the Nordics by both increasing in the patient base, but also better tariff support from the regions in this area. Geriatric cares have benefited from the strong demand in this segment and fueling this specific business line in Sweden by more than EUR 20 million additional revenues. And finally, Imaging is growing by more than 4% a year, it reflects our ability to roll out new equipment to secure new authorization in this segment, as you know, which is a very interesting segment because strong demand and but also a good profitability. Let me now further comment our historical revenue performance, but on an organic versus M&A versus FX perspective. Organic revenues has remained resilient, 2.4% on average over the last 2 years, whereas we operate in a tariff constrained environment, notably in France. In France, tariff increase has remained modest, 0.5% in March '25, 0% in Jan '26, and no restitution of the prudential coefficient neither in December '24 nor December '25. As a reminder, prudential coefficient is a retention that is made upfront by the French state, 0.7% that may be released afterwards, depending whether the national expenditures met or not the total targeting envelope. So no restitution means a tariff decrease of 0.7%. However, on the positive side, we also benefited in June 2024 from a 2.17% increase when a specific coefficient called CICE coefficient was canceled. It was coefficient specific to private sector, now canceled. So now fully secured in the tariff base. And more importantly, since this date, now every variation in tariffs that we observed has been similar between public and private players, reflecting a principle of equality of treatment that we advocated and that was agreed at this time with the French government. So organic growth has been resilient in France, MSO driven, organic and volume driven; In the Nordics, sustained by a strong demand of care and St. Goran new agreements. So we were able through this growth to translate sustainable demand of care into tangible volume growth. M&A, I mentioned it. It mainly reflects the acquisition of the ex-Cosem primary care center, but also a couple of bolt-on acquisitions done in the Nordics. FX has improved over time, thanks to the appreciation of the Swedish currency against the euro. Let me now zoom in our EBITDA margin that was sustained by this growth converted into tangible margin improvement, thanks to higher efficiency and productivity. In FY '26, our EBITDA was at EUR 638 million, 11.9%, increasing by 0.8 percentage points over 2 years. And this margin improvement has been powered by all geographies. In France, 0.6% increase in percentage points in 2 years, if we exclude the temporary grants that has been phased out. That's an important point to remind. And in the Nordics, 1.1 percentage point increase over 2 years, notably fueled by a new contract St. Goran transition in Jan 2026, so with a 6-month effect, but more to come in FY '27. Again, tariffs have lagged inflation over time. And if we were able to increase profitability, thanks to good conversion of this growth into tangible operating leverage and additional performance actions, and I will come back to this point. Importantly, in this environment, performance, operational excellence makes the difference to navigate a challenging tariff environment. So let me come back to this performance plan. As you can see here, they are made of different streams, new revenue streams, segments, new strategic focus, such as enhanced hospitality revenues, but also cost-cutting actions in every region, in every function, both administrative, but also medical. Cost-cutting means leveraging our scale. It means aligning our internal best practices. It means benchmarking each other and developing internally a true culture of performance. Over the last year, FY '26, we estimate these actions delivered EUR 80 million of additional EBITDA. It's not one-off. They are structural actions and impacts that are now embedded into our operating model. It's a tangible proof point on how we were able to convert operational performance and excellence into tangible financial results, and we will not stop there. We already identified new actions to come that will bear fruit in the future. Let me now highlight a couple of actions that were successful that delivered tangible results of the past and where we believe, again, we can do more. In France, we have multiplied by 7 over the last 5 years, the day medicines specific revenues, out of which plus 30% increase over the last 12 months. It's accretive to our margins and at the same time, fully aligned with public payer expectations. Again, we can -- we believe we can still accelerate in this area. On the cost side, we reduced by 72% the temporary staff cost over the last 2 years by more efficiency and productivity, but also prioritizing on permanent staff recruitment. In the Nordic, a couple of examples as well. In the primary care segment, we reduced by 13%, the ratio of pharmaceutical costs and revenues, thanks to the use of geriatrics and the alignment, the rollout of the best practices across the whole network. We also optimized our orthopedics sourcing, thanks to reduction of the number of reference of implant references, so then enabling to increase the volume per reference and therefore, decrease the price per reference. Again, we will deliver more. We monitor these plans. We have a specific monitoring of all of these actions to make sure that they are converting into tangible EBITDA and cash flow delivery. In parallel, our capital expenditures have remained, as you can see here, fairly stable, around EUR 200 million every year over the last 3 years, focusing on high-value segments to ensure profitable growth, to ensure the continuity of our operations and also AI and digital investments. In addition to our maintenance regulatory CapEx representing roughly 2.9% of our revenue on average, we have focused our development CapEx capabilities to the areas where we see a strong demand, where we see a clear strategic focus, of course, obviously, where we see higher return. It includes notably CapEx to continue to optimize our MSO portfolio, and Jerome and Pascal will come back to a few examples later, notably in Valence, 25 new equipment in imaging, but also CapEx in medical innovation, including surgical robots, including AI-assisted tools, including specific digital medical care delivery to increase the patient access, improve the patient access, but also the operational performance. And Margareta will have the occasion to explain how critical these investments are to maintain and further improve our medical quality. Let me now how -- have a look on how our revenue combined with higher EBITDA margin converted into robust cash flows, combined with disciplined allocation of our capital enabled us to reduce the leverage over the last few years from 4.9x in June '24 to 4.7x in June '26. As you can see in this bridge, we benefited from positive working capital variations, thanks to an improvement of our DSO receivables in France, notably, but also from the onetime effect of a factoring program that we implemented recently, which is now recurring and will be reconducted on a recurring basis. Again, reminding in our industry, working capital is a cash resource with DSO from patients, PHI, social security being shorter than our DPOs. We also benefited from a one-off specific opportunistic transaction regarding our real estate, the sale and leaseback operation that has been performed in June 2026, generating EUR 45 million of additional cash, therefore, reducing net debt and improving the leverage. Let me now show you how we reinforced our balance sheet. June 2026, we finalized successfully our refinancing of EUR 1.75 billion senior debt package cov-lite, including EUR 200 million of RCF lines. This operation was supported by both existing lenders, but also new lenders and our banking partners. This senior debt package now fully accommodate with the contemplated transaction distribution of our shares by our shareholder, Ramsay Health Care. We also extended our maturities from 2031 to 2033, so by 2 years, providing higher flexibility to deliver our strategic ambitions. We re-conducted our ESG sustainability-linked package behind this debt that now covers approximately more than 85% of our gross debt, enabling to reduce our financing costs. And we profited also from this operation to simplify our balance sheet structures with the refinancing of EUR 100 million of Euro PP -- former Euro PP notes. Overall, this operation enables to provide higher flexibility and reinforce our capital structure. On the balance sheet again, let me now have a word on our real estate. Our real estate portfolio at the end of June 2026 is valued at approximately EUR 1.5 billion, quasi-exclusively in France, 42 facilities. As you can see here, it represents roughly 21% of the square meters that we operate, 380,000 square meters. And if we zoom on the location, as you can see, more than half of it or roughly half of it is located in prime areas, Paris, Paris region, Lyon, or Lille. Owning high qualitative real estate is a key asset for the group. It provides higher flexibility on the operating leverage. It provides also opportunities to secure financing at attractive conditions, EUR 350 million at the end of June, including real estate financial lease, mortgage loan, Fiducie Surete, what we call Fiducie Surete in French, is security trust mechanism. So again, this is a key asset enabling to increase the flexibility and reinforce our balance sheet structure as well. As a conclusion, as you have seen in this presentation, we have been able to deliver a resilient broad-based growth. We intensified our performance actions and we will continue to do so, thanks notably to an embedded culture of performance and innovation and paving the way, of course, to a future profitable growth going forward. In the same time, we continued to invest selectively in our platform. We deleveraged the company, and we reinforced our balance sheet structure. So altogether, this provides a solid foundation from which to execute our Connecting Care 2030 strategy and move confidently into our next phase of development that Pascal will now detail in the next section. I thank you for your attention.

Okay. Thanks, Clement. So just to summarize, resilient and solid result, a stronger balance sheet, paving the way for the future profitable growth for this company. So talking now about the strategy, we have been sharing with you before at least the name and the 5 pillars. So now to give you more content, more flesh, I would say, versus as of today, just a flavor. This strategy undoubtedly is part, I would say, of the continuity of the last 10 years. If we just rewind a bit. The plan we had launched in 2015 called -- Let's Do It 2020 was undoubtedly regarding the diversification to scale into a European group [tick]. In 2021, we have launched a Yes We Care 2025 plan in order to create a robust platform being more integrated, more diversified with digi-physical solution, [tick]. And now we do want to unlock this full potential. We want to work on very specific action we are going to take you through in order to open the new chapter of good medical excellence, best-in-class medical excellence and profitable growth for Ramsay Sante. So just coming back on the left side, we have seen already some of the figures, but a different angle regarding where we are. You certainly remember that in the last 4 years, if we go on the left on this slide, we have said we are pan-European, more diversified, leading position and more integrated. And as a consequence, as you have seen, the percentage of turnover outside of France has grown from 19% to now 1/3. As a consequence, the footprint in MSO in France in a constrained tariff environment as a percentage has decreased. As a consequence, in the specific PHI segments in Sweden, where 15% of Swedish citizen do have an insurance, and it is a growing number. We are the leader. We are around 30% market share. We have been multiplying by 3 our footprint, and we will keep on. Britta will come back to this. And once again, and very importantly, our number of patients is not fueled by internal referrals. And talking about the number of patients, we have been saying before that the patients in the last year has grown from 9 million to 13 million. But where does this growth has been coming from? In fact, it does not stem from the inpatient. The future of this industry is outpatient. We are very proud, of course, to take care of inpatient patients if they do need, of course, this type of care. However, outpatient is critical. And as you can see on the second bucket, I would say, on this slide, in the dark blue, the growing patient, 3 million has come from outpatient imaging, primary care, day hospital, mental health, et cetera, as well. As you certainly remember, our number of digital patients has been growing a lot. So in the continuity of this where we are, what we want to be, how we are going to deliver and how we are going to build -- to keep on building sustainable competitive advantage, 5 pillars we are going to detail one by one with further detail, of course, when talking about Sweden and France. The first one is ensure active portfolio and contract management for the profitability. The second one is strengthen integrated and accessible health care offering to capture the growth. The third one is to embrace the digital transformation, ongoing accelerating of the health care delivery efficiency for the patient. The fourth one is to continue to focus on cost initiatives. Clement has shared with us the EUR 80 million delivered last year, obviously, for the profitability. And finally, and very importantly, both for profit and undoubtedly efficiency and for the patient, accelerate additional profitable growth through new revenue stream. All this more than ever embedded in our ambition or DNA that we once again reiterate more than ever, quality care at every step for everyone, more than ever our ambition. And in order to deliver this 5 pillar, in order to respect this plan, we think -- we do think that we do need to leverage 7 capabilities, and they are all linked one between the other. Medical excellence, we will have a specific session with the Chief Medical Officer, people, of course, data and AI, an enabler, a strategy, a fantastic opportunity in our industry, brand and reputation, customer centricity, putting patients at the heart of care, sustainability. We want to keep on building on sustainable deliveries. And finally, the word IT infrastructure encompass a lot of topic in order to build once again to be risk safe and to look forward. So these 5 pillars, let's give you some content. The first one in order to work on the efficiency and the patient is ensuring active portfolio and contract management. What do we mean? If we go on the left side of this, in the whole, in Europe, we've got 491 once again facility. The MSO network in France, we will keep on. We will accelerate the network rationalization, the refocus of medical offering and the active transfer and the potential closure. So as you know, we have been clusterizing our business in the -- since the last 10 years. Jerome will take us through a very concrete example. And more than ever, we want to optimize the facility network, transfer some activity in the close by activity in an industry where in a given place, -- the more you do volume, the better in average of quality, the more efficient you are, the more you can reinvest. And just to share an example that will take place in 10 days, October 1, to be precise, in Valence. As of today, Valence is a town south of France between Lyon and Marseille. We've got, as of today, 3 facilities very, very close by. We will transfer one of the activity and the team for 1 facility in the other 2. Net-net, we are going to close one of the facility, and we will deliver through that a better EBITDA performance. We will go back to this. On the other side, and it's more impacting, I would say, potential on the Nordic country, we do a lot of activities through contract management. Britta will explain us the regulation and our footprint in this in Sweden. It has been already said 8 plus 4 years, 12 years to manage since January 2026, very proud to have won once again this RFP, St Goran and only 6 months as of today in our accounts once again with better tariff terms. So it is a contract management. We have done a ramp-up of a new maternity. We are going to enhance once again the high quality of our deliveries, and we expect in the next year up to 2030, 30,000 additional patients to be taken care. The second point, which is, I would say, versus the patient and the growth, strengthen integrated and accessible health care offering in Connecting Care 2030. We want to keep on growing on where there is unmet patient needs and where we can deliver a good profitability. As such, and Clement has been already a bit touching base on this. In the last 2 years, over 20 authorization and net-net MRI scan have been opened in France. We are going to keep on more than ever doing that. We will take some additional example with Jerome. And regarding primary care, I'm on the right of that slide, in Sweden, we are the leader in primary care. It's still very fragmented. We have only "10% market share" in the last year, the team has done a very good job by increasing the number of listed patients. We are best-in-class regarding the medical outcome and the experience measured patient outcome, and we plan to keep on growing in a market that we consider is considered by specialist company to keep on growing at a 4% CAGR every year in the next year up to 2030. That's regarding accessible health care offering. Regarding the further driving development of integrated care chain, I would say that has been once again the logic of the last year. We want to increase. We want to keep on working on that. On the left slide, it is maybe a better, more detailed example regarding the entry point of the patient through the health care system. So sometimes the patient enter directly through an MSO facility through a needy MSO and this patient if she needs to go to a primary care GP. So we can refer to the close by primary care that now we have in many, many countries once again as well getting out of imaging, I would say, activity, 62% to be precise, of people having an imaging activity in one of our department, they will need -- there will be something, let's call it something. They will need a nearby GP consultation, surgery, whatever. So we are integrating this care as well, getting out of MSO hospital taking care at home of the patient, many times all patients, but not always, St Goran is a great example of proposing our elderly and mobility activity in the Stockholm region. And all this with digital approach, continuity of care in order to take care of the patient what he or she needs. And as a consequence of that, we have been saying that as of today, 20% of our patients last year have been taken care through internal referrals. We plan to increase this figure in the next year. And in order to do that, one, I would say, 2 of the key initiatives, these 5 pillars are very correlated one with the other is to keep on embracing the digital transformation of health care delivery. We are convinced that we -- all the industry needs to accelerate. We are convinced that we are already well positioned. We are convinced that the best practice sharing is a necessity, and we are trying once again versus all the manager, all the team to promote internally this sharing is caring. And we are working more and more with some specific start-up. We are testing to proof of concept. It is in the middle of the slide with leading labs, leading labs, for example, in Aquitaine in France, South of France, close to the Spanish border. We've got many large hospitals, et cetera, we've got dedicated team testing, I would say, somewhere to take care of the patient with a digital solution. If it works, of course, we've got this ability through our innovation hub and our culture to roll out rapidly where it makes sense from a patient and economic standpoint. Focus on cost initiatives. Clement has shared some initiatives Jerome and Britta will share. Once again, that's critical for the profitability. We anticipate a constrained tariff environment. We want to be resilient. We want to be able to navigate and we will navigate through that. A couple of examples, procurement optimization in France, 10 years ago, we used to have roughly 300,000 references on the shelf being hip prosthesis, drug, implants, et cetera, eye implant offers. We are now below 100,000. We are going to keep on improving the occupancy rate of operating theater. That's critical in order to amortize the fixed cost. As you can imagine, an operating theater, it's quite -- to be best-in-class, quite a cost. Jerome will share with us later what has been our delivery in the last year and how we plan to keep on increasing. Overhead reduction, we are going to keep on working on how to improve, to do better with less and how we can work on the nonmedical staff in order to increase the productivity with various tools. Maybe just an anecdote, an example, in 3 weeks, we are going to move our headquarter from the north of Paris to another place outside of Paris, dividing by more than 2 the cost of our HQ. Medical staff efficiency big decrease in temporary staff over 60% in the last 2 years, and that's not a one-off. That's a structural improvement that is not done. And once again, there are other stones to be turned in order to keep on doing that. And let's call it, workflow optimization relentlessly in order to work on all the dimensions. So key focus once again on the cost initiatives. And we want to enter new revenue stream addressing patients' needs. There are many, in fact. Let's start, by the way, by Sweden on the right of this slide. Through a current subsidiary in Sweden, we are about to address a growing need. There are over 3 million of Swedish people salaried and the company in which they are working, they want to promote for the employees, preventive packages. Something we do see, by the way, in many countries in Europe. We are very well positioned with current or team in order, I would say, to capture this growing need. As well, to stay on Sweden one second, the private health insurance on which we are already the leader. We've got a strong expertise to discuss with the local insurer in order to capture market share versus the increasing waiting list. In France, just 2 examples regarding needs of the patient unmet and profitable growth. We want to expand and we will expand our home-based care, which is something on which France is lagging. And as well, as we know, France, we are very, very far behind many other countries in Europe regarding taking care of some mental health issue, mental health patients through day care. We have been already expanding in the last 2 years. We will increase this expansion in the next year. So to summarize, Connecting Care 2030, we would like you to remember our ambition, quality care at every step for everyone, quality of care, patient safety, Choosing Wisely and give us a couple of minutes with Margareta to detail what means and where we are on Choosing Wisely, international collaboration through clinical networks, innovation, research and training. Our DNA to keep on recruiting the best doctor, the patient and looking forward. So that being said, I think if I'm right, we are a bit in advance, by the way, regarding timing, which is quite rare. I propose I'm looking -- I think we can do a break by now, and we will reconvene at 10:55. Am I right saying that? Yes. So thanks a lot. And I propose, of course, for those attending in this room to share a coffee and to come back at 10:55. Merci. [Break]

Welcome back from the break, everyone. I hope you had some good interaction, and welcome back to you online as well. I hope you find something good to do during the break as well. I am very happy to present to you something that lies very, very close to my heart, that is medical excellence. Medical excellence is actually the core of our business. Medical excellence is what gives a good outcome for our patients, and that is what will make them trust us, come back to us and stay with us. This is not only true for the patients, but medical excellence is also what will make us win tenders, what will make health authorities trust us with contracts and what would make Public Health Care insurers trust us as a partner. For doctors and staff, medical excellence is also of huge importance. They want to be in places where they have the resources and the environment to perform their best. Furthermore, medical excellence is what brings quality and quality is what is bringing productivity, and that is what will lead to the long-term financial outcome. To do the right thing with the right patient at the right moment and nothing more, that is what brings productivity and quality. So medical excellence is an important strategic driver for long-term success. We can look at medical quality from many different perspectives, and one of them is evaluation from external bodies. We have in France, the HAS, the Haute Autorite de la Sante, which will give accreditations to hospital. This is done every fourth year by a peer review. And you can see that we -- why is this? Yes. Sorry for that. I didn't recognize the numbers. Yes. No, you can see on this slide. Sorry to confuse you. You can see on this slide that our Ramsay Sante hospitals have a higher degree of accreditation, both compared with other private hospitals and with the public hospitals. I think an external evaluation that is maybe more influential, and that is the one that is very much talked about by health care professionals and health care providers, that is the ranking done by the French magazine Le Point every year. This is not a ranking of health care providers, but it's a ranking of hospitals and procedures. And you can see here on the slide that among more than 1,000 hospitals in France, actually 15 of our Ramsay Sante hospitals are among the top 50 hospitals. So this is the external evaluation of quality, but now we go to the maybe opposite perspective, the patient's perspective, the patient satisfaction. We want the patients to be happy with their contact with us and to feel confident with us. Again, this is what will give loyalty. This is what will make them stay with us and make them come back to us. But we actually know that a high patient satisfaction also affects the medical outcome because it will make the patient more compliant to the treatment, and it will make the patient more engaged in his or her own health care. I think Pascal passed briefly through these numbers of NPS. Patient satisfaction can be measured in many, many different ways, but one of them is the NPS, Net Promoter Score. This is used in many different businesses, but in health care, a number from 25 and above is considered to be very good. And you can see here that in all the Ramsay Sante countries, we are far above that number. Moving on from this to the medical outcomes. I think that both Britta and Jerome will dive a little deeper into what different services we have, but I have picked out 4 examples of this. But first, I want to quote Voltaire. [Foreign language] The art of medicine consists of amusing the patient while nature cures the disease. This was probably true in the 18th century when Voltaire said it. But since antibiotics and anesthesia came to medicine, there has been huge advances that really makes medicine give a difference for medical quality, for health quality for the individual patients and for society. So what I want to share with you, that 4 examples. And on the top left, you see the myocardial infarctions. Myocardial infarctions that means a heart attack. That means that you -- the heart does not get enough oxygen to pump. The outcome after a heart attack is highly dependent on how quickly you get care and exactly what care you get. And here, you can see that in the Ramsay Sante hospitals in France, the mortality rate after myocardial infarction is significantly lower than the average in France. Moving one step down, we look at breast cancer surgery in Sweden. This is a survey on small breast cancers that are screen detected often before the woman feels any symptoms. And those are almost 100% curable, but they can be curable in different ways. The traditional way is to remove the breast, but we today know that many of these women can actually keep their breast with the same curability rate. The Swedish breast cancer register has a target of 85% of the women with this type of cancers that should be able to keep their breast. In Sweden, Capio Sweden, we achieved 90% -- 95% of the women. But it's not enough to only measure medical quality in the hospital. Something happens with the patients also after the hospital stay and to make sure that we are really doing good quality, we have to follow the patient and see what happens after. And top right, you can see the results on surgery for gastrointestinal hernia in France. And the slide shows the readmission rate. This means all the patients that got a good surgery and got -- went home after the surgery, but a certain number of them will come back to need to have to redo the surgery. And you can see that this readmission rate is lower in our hospitals compared to others. Another really long-term result that I think is very valid because it's really into the quality of life for the patient, not only for the surgeon who has done well, but actually that this affects the patient. And this is the follow-up of the quality of life after hip replacement 1 year after the surgery. So that is quite a long time, but these results are really sustainable 1 year after. And you can see in the Capio Sweden orthopedic units, the surgery leads to a higher quality of life compared to other hospitals, which also means that not only the surgery was good, but also the rehabilitation. My role as a Chief Medical Officer in Ramsay Sante is to make sure that we are always on top of medical excellence. And medical excellence is not something that you achieve and then you stay there and keep doing the same. We know that society is changing a lot. Pascal mentioned the different trends. We know that our possibilities to cure and to bring health are getting bigger and bigger, but at the same time, the demands and the wishes from both patients and society are growing. Therefore, research is a very important strategical driver for us. We know also that units that are engaged in research, they are much quicker and proner to adapt new methods, new treatments, new interventions, new innovations. And that is not only true in their own field of research, it's true like a cultural thing that if you're into research, you are also prone to adapt and change. 1 out of 5 physicians in Ramsay Sante are engaged in research. We have more than 1,000 publications in scientific magazines every year. And for the last 5 years, more than 10,000 of our patients have been engaged in more than 700 clinical studies. So research really strengthens our quality of care today, but it will also attract a new generation of health care providers. Innovation is another important field, and that sort of overlaps the research, but it's not really the same thing. Innovation often addresses the how we do things, not the what. We do the same thing, but we do it in a different way that brings higher quality and higher efficiency. Sometimes it is only a behavioral change and maybe the word only is not really good because behavioral change is what is one of the hardest things to do. But often, it also includes innovation, the use of new technique. And I will here show you 3 examples of this. First, robotic surgery. Robotic surgery means that we can do surgery with a much, much higher precision than the traditional way. And that means that the tissue around is less damaged that will mean a quicker healing and a shorter rehabilitation. This is used widely in cancer surgery, but we are now in Ramsay Sante also doing pilots in other fields, for example, even joint replacement. Pulse field ablation is also a wonderful new technique. It's a treatment against something that is called atrial fibrillation. And atrial fibrillation means that the heart instead of pumping steadily, solidly, strongly like this, it flickers, which makes a much less strong heart, much less efficient. And it also gives a risk for blood clots forming in this flickering in heart and going away giving stroke and infarctions. With pulse field ablation, you can treat and cure the electrical pathways that have gone wrong in the heart. Traditionally, this is done by heat or cold, burning or freezing in the heart, which again brings a lot of damage around the place where you should cure. But when you do it with purely electrical impulses, you can do it with much higher precision. My third example is digital health care or virtual health care. And that means giving the possibility for patients to meet us through chat and through video. Five years ago, this was really controversial. But today, we know that all medical consultations that do not include a physical examination, they can actually be done online. And that makes the availability for the patients much, much higher, and it also gives the opportunity for our doctors to work in a much efficient way and also save their time for the patients that really, really need the physical contact. In Sweden, in Scandinavia, this is so much used now. So we no longer talk about digital health care. I think we hardly say digi-physical health care. It's so natural that digital tools are part of any patient pathway. In France, we are also using this more and more, and we are also trying in new fields, for example, into mental health, where this technique helps us to move mental health care from inpatient to outpatient. So these types of innovation, they add to improved quality and productivity, but also to achieve sustainability for health care. Problems with the slide. Clinical networks. Being a multinational health care provider is really a great opportunity. We can learn from each other. We know that medical excellence and medical science does not have borders. It is global. But we know that we can learn from each other by seeing how we do things differently, for example, by adapting to our health care systems that are different in different countries. This helps us step -- take one step aside and look at our own services and see how we can do them differently. We can also add knowledge. And what we do in Ramsay Sante is that we make professional meet over the countries within the specialties also to help executive committee and management with knowledge that is important for strategic decisions. And I will help you with -- I will give you 4 examples from the clinical networks that we had during the previous year. The first one is in sports medicine, and that takes the base that many of our orthopedic clinics are highly specialized and have collaboration with elite sportsmen, the first clinic, Artro clinic in Sweden, Nimi in Norway. I can give you the example from the Olympics in Paris, we had actually 80 of the athletes coming for medical interventions at our clinics before the games and 24 of them won medals. So I think we did something we did good. In this clinical network, we -- they looked at the very specific competencies for different types of sports that we have all through our countries and made a business plan on how we can use this competence so that it is available in all the countries and therefore, attract these athletes everywhere. And that also attracts the lay sportsmen. They want to be in the same clinics as the athletes. The obesity network got a question from the Executive Committee, and that is how do we handle all these new medications and all these new pharma that can help obesity, which is one a big, big challenge and a big, big opportunity globally. And they did a big mapping and they did deep dive into research and science and came back with a very, very good suggestion on how to work with patients with obesity very, very broadly through all our businesses, addressing this group, picking them up, offering them the best services and where to use pharma. But what was maybe a little surprising for us was also they said, keep the bariatric surgery right now. It will still have a place in medicine. And I think those of you that go to the site visit this afternoon, we will hear a little more about that. We had 2 more clinical networks, ophthalmology and anesthesiology, and they did more of a classical benchmarking looking at what we do where. And they also came to the conclusion that we should join the global movement that is called Choosing Wisely. And that is actually looking very carefully at all the procedures we do to try to identify tests, imaging, small things that are not actually necessary for the quality outcome and remove that, thus giving a more efficient pathway for the patients and for us. Prevention is maybe the most effective type of health care because it prevents the disease from coming in the first place, and we work with that on many different levels. The first one is the Prevent2Care program in France, where we, through the Ramsay Foundation support start-ups in prevention and help them with expertise and mentoring and to try their products in real world. And that makes us also be frontline and see what is coming. The Prevent2Care also participated in the French prevention week. But we also use -- work with prevention in clinical care. And here is an example of hypertension, how we treat high blood pressure in primary care in Sweden. Pascal mentioned the capitation system, and Britta will come back to that. But in the Swedish health care system, it's actually very, very good to keep your patient healthy. Of course, in every health care system that is good for the patient. But in the capitation system, reducing the blood pressure for our patients and preventing heart infarction, more serious and more costly things that is actually good for all in the long run. So finally, I don't think you can talk about the future without talking about AI. And of course, this is something that is important in Ramsay Sante as well.

Yes, that's right. One good example is mammography screening in Sweden. Mammography screening is that women are called in certain intervals to get the mammography screening to detect early breast cancers. Traditionally, these images are looked at by 2 doctors. And we did a big scientific study led by Karin Dembrower at Capio St Goran's Hospital, where one of these doctors were exchanged to AI. And we showed that by doing this, 12% more early cancers were detected, and that was not the only benefit. 13% of the false-positive were not seen. So we reduced that level a lot. And also 26% of the women -- 26% less of the women had to come back for new imaging. This was -- really got a lot of attention. It was published in The Lancet, and the BMG and Karin Dembrower was the keynote speaker on many international conferences. But best of all, I think, is that we could immediately turn it from a scientific study to clinical everyday practice. Big data is also something that is very important, and we are investing in health care platforms where we can collect data, transform it into knowledge and use it for our strategical planning and for better medical excellence in the future. So I would say all through these teams about medical excellence, they have one thing in common, and that is that they lead to quality, quality lead to productivity, and that will also give the good financial outcome. So medical excellence is not a destination. It is a journey, and we are very well profiled to lead that journey. And with that, I leave over to Jerome to introduce our services.

Hello, everyone. Thanks, Margareta. Delighted to be with you in order to present you a few slides on the French businesses, once again, one of the core business of Ramsay Sante. I will go -- I will take you through, in fact, of a journey that the implementation of -- during the last couple of years on all the actions that we have launched with the team in order to navigate in a challenging environment, in order to reshape the French activities and locations, as mentioned by Pascal, to adjust our organization to the new trends and as well in order to be ready to accelerate on the implementation of the new strategic plan. Three ideas I will develop in the following slide. The first one is that we are operating, but we are as well positioned in a regulated market, French one, with having as a headwind, the tariff and as a tailwind, the growing volume demands. Second idea is that most of our past and future performance and efficiency measures improvement will be, in fact, done through levers that we control ourselves. Third point is that the next 5-year strategic plan could be seen mostly as the acceleration of the existing strategic plan with the right balanced approach between continuation of all the actions we have launched, especially in terms of efficiency and improvement measures and as well fueling the next growth levers that we have identified. Now first, let's discuss about a quick snapshot on the market where we are operating in. As you can see on this slide, we are operating, in fact, in 5 different sectors. First one being MSO, and I will not come back on the breakdown of the activity in France, full care rehabilitation, mental health, imaging and primary care. When you read this slide, you will see that there is a total market size for all of these sectors. Then second, the market size related for the private operators and after market concentration or market share for the private operators. The main comments on those slides are the following. First one is that when you look at our positioning in those specific sectors, you see that, in fact, we have a leading position. And being in a leading position is quite important in order to play an active role in the next 5 years and evolution of those markets. Second thing as well is quite important from a dynamic or performance standpoint, size matters a lot. The second comment is that when you look at the addressable market, okay, first, talking about the first 4 verticals, you will see that the global addressable market for private operators is roughly EUR 30 billion. So that's the market we can address. Then after, and that's a specific point, primary care. Primary Care, as you know, for France is a new market. It's a new area. It's a new activity that we have developed in the last 5 years. Now, thanks to the previous strategic plan, thanks to as well a nice support from Sweden given their expertise, given their size on this sector. At the end, it's a market that can represent up to EUR 39 billion or EUR 40 billion total. It's a market where it's a bit more difficult to see what is public, what is private. But we can consider that most of this market could be seen as private, given the fact that we are talking about independent doctors doing consultation flows. So at the end, please keep in mind that there is a EUR 70 billion addressable market for us. And at the end as well, what is important is that we can consider that we are the #1 health care provider or service provider in France, globally speaking. And that's quite important when we think about our strategy, which is indeed developing care pathway integrated care. Now let's talk about the overall implementation, overall regulation around that. Everyone has his own view on it, but I believe that most of you will consider that France is a super highly regulated market. It's true. It's true. I will not deny it. It's true, but I think it's a very good thing. It's a very good thing because at the end, in fact, when we have the size of Ramsay Sante in France, when we have the diversity of activity in France, when we have the footprint that we have in France, in fact, it's a super strong protection being in a regulated market. It could be seen at a very nice high barrier to entry. It goes, of course, alongside other expertise that we have like making sure that we master quality processes in our clinics that we master as well or that we entertain correctly an experienced team and that we work alongside our doctors' community. But all that together, I mean, in fact, that being in a regulated market is something that could be seen as very good and very important for us. Now how this market is organized and how -- what is the dynamics around that? First, at national level, direction are given by both the National Health Ministry; second, by National Administrative Bodies, and they are in-charge of things like pricing strategy or defining what is the care quality audit that they want to impose to each and every care player and hospital on our case. Second is that there is as well an organization at regional level. This organization at the regional level is mostly organized around 17 health regional agencies. And they are in-charge among plenty of other things of one topic, which is quite important and has been mentioned by Pascal, which is the authorization processes. And please keep in mind that we need authorization to operate in our clinics. If we don't have an imaging authorization, we can't develop imaging business, okay? So we need authorization. And that's why we have more than 1,000 different authorization to cover all the spectrum of care that we want to address in each and every facility that we have in France. Now let's talk about the funding system. That's a slide with plenty of information, and I will help you going through that. As I would say, as a synthesis, as a summary, I could say that, in fact, funding in France is massive. It's growing, but it's not enough. Why it's massive? When you look at the left part of the slide, you will see that ONDAM, which, in fact, is a French wording to say -- to talk about the health care national budget in France. ONDAM is at EUR 274 billion. It covers the total health care services and markets. Within that, once again, we have EUR 70 billion of addressable market for us. Second comment on what is growing. When you look in the middle, you will see that there is a CAGR over the last period, roughly between '19 and '26 of 4.5% CAGR in average, 4.5%. So it's growing. It's growing clearly. Let's talk about the way the budget, in fact, is allocated and is built because that's why at the end, it's not enough. The way the budget for health care is done, first, it's completely a mirror of the French state budget in terms of process, in terms of organization, which means, in fact, that it's a process lasting over a year between the initial assumptions that are taken or the macroeconomic assumptions that are taken to define the budget and then after the implementation on real life and on our cases, for example, on tariff. And which means that during this 1 year, if you have volatility of some of the macroeconomic assumptions, there is no chance to be completely reflected in the final implementation of the budget, and it's the case for inflation. And we have in the past a severe misalignment between the initial assumption retain or the inflation level and what is inside the tariff at the end. Another point that has been already mentioned by Pascal in the tariff is that you will -- you'll see that year after year that you still have a significant discrepancies between the tariff provided to the public and the tariff provided to the private sector. And such discrepancy can go to -- up to 80% plus of gap when looking at some specific care, 80% plus. Then why do I say it's underfunded? We'll talk about that later on in specific to the private sector. But first, please have a look at just the white rectangle on the left part as an example. Here, it's written that, in fact, the public hospital deficit has widened during the last 6 years from '19 to '25 from EUR 0.6 billion deficit to EUR 2.5 billion deficit. And that's a nice example, unfortunately, of the fact it's underfunded or it's not enough funded. Now let's move to the revenue breakdown for the top private sectors where it's coming from. As I said, it's a regulated market. So obviously, we are mostly paid by public administration. And that's what we see on this chart. The main payer for us by far is the private health insurance -- public, sorry, health insurance in France, what we call, Caisse Nationale d'Assurance Maladie. What it gives us? It gives us, in fact, very secured payment, no risk of not being paid. It gives us as well short payment delays. We are paid in less than a month globally speaking. That's very important. Now the remaining part is private payment. Those private payments can be mostly splitted into 2 equal parts, one part being a patient out of pocket. The other one being private insurance payment. And in France, it's called Mutuelles. Mutuelles, in fact, is a private health insurance that are strongly linked with administrative French bodies, okay? So if I see this graph a bit differently now, what is, in fact, the level of revenues that are regulated, that are managed in a way directly or indirectly by the French administration and the French state. We go up to 90% to 95% when we add up what is paid by the public health insurance and when we add up as well what is controlled or regulated and paid by the mutual. If we move to the next slide, sorry, a bit more specific on the evolution of the tariff, the evolution of the inflation and the main driver around that. First, an explanation on the slide. You have 3 graphs. The first one, which is really the tariff evolution year after year during the period '19 to '26. The second one, which is the national inflation index, okay, that's a national inflation index. And the third one, which is really the national volumes covering everything. So it's both outpatient, inpatient. What we can see on those graphs. First thing, maybe a technical point. 2021, we see -- you see a white rectangle 6.2% stating Segur effect. The French government has decided in 2021 to massively increase nurses salaries, mostly nurses salary -- or salaries of people in the employees in the hospital. And to do that, they have decided to do that as a recognition for COVID as a fact that there were not enough paid in the past, et cetera. And they forced both public and private to increase those salary. To do that, they have add up 6.2% to the tariff in '21 to finance it. At the end, please keep in mind that for Ramsay Sante, it's a net net zero approach in terms of margin. We have not saved money. We have not paid more. Excluding this topic, you will see that, in fact, when you look at the 2 first graph, tariff versus inflation that each and every year, you are underfinanced. Our tariff does not reflect inflation each and every year. And keep in mind that given the budget is done, you need to look at year-end for the tariff and year-end minus 1 for the inflation to have a direct link. Last comment on this slide, national volume. National volume is growing. As said by Pascal, it's a kind of a mega trend. We have chronical diseases. We have more and more care to deliver to the patients. So it's growing. So we have a strong underlying trend from this topic. As a summary on this slide, I believe we can say that national volumes is clearly the tailwinds or national and growth volume is clearly the tailwinds where dry tariff is the headwinds. Now after those few slides on the global market, the global dynamics in France, let's see, in fact, what are the kind of -- or the kind of player, the kind of health care operators that can, in fact, benefit or that can benefit the more from this current environment and in order to capture the volume demand. I can simplify, and it has been said by Clement and Pascal, size matters. We need to be big. We need to be sizable. We need to be diversified. It's quite important in the French environment in order to address and to capture this growing demand. Two things on those -- on this slide. The first one is when you look at the left, you see once again a certain number of figures. They are all showing, in fact, that we have built in the past decades or years, significant barrier to entries. We already have 350 Oncology authorization. We have more than 100 numbers of dialysis stations, et cetera, et cetera. It's all strong barrier to entries. I would just comment one specific figure, which is a 91% certification average. This 91% from a technical standpoint first, it has been already started to be explained by Margareta, a technical standpoint is the 9% remaining doesn't mean that we are not certified, okay? So it means that we are certified under a certain number of conditions that we need to fulfill in the coming months. Usually, it's processes that we need to adapt to the latest regulation and that has not been updated quickly enough. It's processes that we need to adjust given the organization of the clinic, et cetera, et cetera. Nothing major things that we need indeed to address in order to make sure that we deliver the right set of care to the patients and that we are working in close relationship with doctors for them to deliver the right diagnosis or the right fact. But it's -- I think the 91% is a very, very, very strong recognition of the work done by employees, nurses and by doctors on the quality of the work or the offer that is made towards the patients. Now on the right side, once again, size matters. Size matter, globally speaking, we mentioned it earlier. Size matter as well at local level. We don't ship a patient from Marseille to Lille. We don't move a doctor from Lille to Marseille. So we need to look at local level as well. And what you see on this chart is that, in fact, we have a very strong market share in at local level, Lille, Paris, Lyon, Toulouse, for example. And at the end, it means that we can be considered as the main alternative or even the only alternative versus the public hospital offerings. And if you want just to make one deep dive, look at the Lille region, 82% market share for private. If you don't want to go in public, you have to go on the Ramsay Sante in Lille. Next slide, a deep dive on our activities. Once again, looking at the same kind of split between -- that I have presented earlier. Globally speaking, please keep in mind one thing that we have an integrated care approach, integrated care approach. Now when we look at the competition or when we look at our colleagues, we see that most of health care operators could be leader, could be strong in one vertical, could be strong in one vertical. We are unfortunately not strong in one vertical. We are strong in several verticals at the same time. And that's super important when we look at integrated care operating model. Now looking a bit more in the details. You see that we are leader in orthopedics, ophthalmology, cardiac surgery, oncology, dialysis. We have a leading position in rehabilitation. We have a leading position in mental health. We are #1 in imaging, and we are #1 as well in primary care. All that goes with 2 things. First, recurring investment, as mentioned by Clement on the long run. Second, the fact that we invest on innovation, we invest on state-of-the-art tools and equipment in order to make sure that we deliver what needs to be delivered for patients and doctors. And just a few examples of that, 29 robots, orthopedics, urology, covering different kind of care. Over 900 operating theaters, state-of-the-art, no condition on those operating theaters, by the way, in terms of certification and over 140 imaging equipment. Now let's talk of something which for me is even more important than what I just mentioned earlier of verticals leading in each vertical, et cetera. It's once again back to the integrated care platform model. We have developed in the past years, a model of not looking at hospital by hospital separately, but really looking at it at the regional level in order to make sure we can benefit from the size effect in a way. It's not something that others can replicate easily because we need to have the size in each and every region where we implement this kind of organization. What does it bring? It brings first economy of scale by definition. It brings ability to share capacities. It brings ability to share expertise to coordinate teams, to strengthen some of our activities, to do the right allocation of resources. And at the end, please keep in mind, in fact, that once again, all that is done first as let's not talk about a hospital separately from the other. It's done as building an integrated care operating system in a way with the objective to enhance patient outcome to enhance capital allocation and to make sure that we allocate -- or we have the right efficiency measures in place. And we have a nice example of that, which is the Lille cluster. The Lille cluster, what we've done in the last 10 years is, in fact, strengthening our activity, gathering them in the same location, making sure that we share the expertise, removing what we believe is noncore, relocation of some of the specialties in one dedicated area. All that, in fact, has been done through a 10-year period and has been done, thanks to the ability to discuss both with all our employees and with our doctors as well because the doctors should be part of it -- should be part of it. What the underlying message behind this slide as well is that when we try to execute such a plan on a 10-year basis, once again, we do it only with the people and with team. And we believe we have a talented team. I think Pascal mentioned it, health care is a people business. We need people to be put -- you need employees to put in front of patients or to manage patient or to help patients. We need employees as well to work with doctors. We can't escape that. So we need to manage our workforce clearly. That's what we are doing. A few figures first. Over 28,000 employees, more than 80% being medical trained staff. And we make sure that they are trained at the appropriate level. We want them to make -- to be at the state-of-the-art in terms of procedures, in terms of medical knowledge. Doctors, 7,000 independent doctors. quite a nice community. On top, we can add more than 750 salaried doctors, mostly rehabilitation and for our primary care businesses. 11 years average doctor tenure. They are not here just popping up for a few years, they are here for the long term, quite important. And therefore, we have built a number of conference calls, video meetings, et cetera, in order to exchange with them on visions that we have, views, difficulties, ambitions, projects, quite important. We strongly believe that we need them, they need us as well. Two figures. 86% doctors recommendation for -- to their relative to go on Ramsay Sante facilities it's 4% missing. It's already 96% -- sorry, 65% engagement score for employees, and it's growing. I would say that on top of those 2 very nice figures, we can even say that it's showing the recognition of the team on our strategy and on the fact we can leverage or use them or they can be helpful to develop and to implement the next strategic plan. Having said that, why do we believe that we have the right to win in France? Why we have the direction to a path to success for the next couple of years? 6 reasons. First one, largest integrated network in France. We mentioned it, we said it, et cetera. It's already existing. It will be -- we will continue to develop it. It's of paramount importance, as I said, size matters. Second, new care pathway because we believe that's the new trend and because we believe that we have already built the foundation to continue working in this direction and be part of the next health care revolution in this direction. Third, digital first. Digitalization is everywhere. Digitalization and AI has already started, as mentioned by -- on some examples by Margareta, both from an administrative standpoint and operating standpoint. Fourth, quality of care, it's part of our DNA. I will not come back on the 91%, which I think is the foundation on which we can build the next evolution of quality of care. Operating excellence as well part of our DNA. We have a holistic 360% -- 360-degree performance plan mindset in our DNA that we have already started to implement and that we will continue all the action. Public affairs, we have a unique positioning. We have a unique positioning. It gives us a voice, Pascal started to mention it. It gives us a voice to explain our difficulties to explain what we believe are the next 5 years, the next 10 years view on the health care services, our opportunities as well and our ambition. At the end, I would say that we have the right to win, in fact, because we have understood that in order to succeed, we will need to execute correctly or properly the underlying action plan behind those 6 reasons. And we have demonstrated in past years that tangible assets -- tangible results in this direction. A few comments. First one, evolution of the health care services. Health care services, as mentioned by Pascal, moves from inpatient to outpatient. We believe it will move to a care pathway very quickly. Just one example, chronical diseases. The patient will not come every time in the hospital. So we need to find new care pathway in order to integrate that. That's what we have started to build. That's what we will continue to build. We will connect or we'll do the connection between our services within our hospital. We will do the connection between our hospital within the cluster. We will do the connection between our cluster within the territories managed by the health regional agencies in order indeed to have this vision of increasing with better care for the patient. And that's why we have invested in primary care. That's why we invested in imaging. That's why we have invested in mental health day clinics. That's why, in fact, we have as well invested in digital tools to make sure that we have the appropriate framework to work in this direction. Second focus, operational excellences. Operational excellence, the mindset is the following. We need to be pragmatic. We need to be agile to make sure that we are following any kind of trends in front of us or any kind of difficulties in front of us. Therefore, the strategy or the mindset is we standardize when it matters, and we remain local where it counts. Another way to look at it is that we need to focus on or we want to focus on action plan on improvement where, in fact, we control the levers. We control the way easier to manage. Three examples of what we've done in the past to explain as well that we are well in-charge of the next plan and the continuous improvement plan that we are working on. First one, occupancy rate for operating theater, plus 5 points in 1 year, right allocation of resources. We make -- we are careful of the allocation of resources. Second thing, working efficiency, minus 62% of temporary staff in 2 years. We have a kind of a toolbox in order to manage scarcity of resources. Procurement excellence, 88% of purchases made under the framework of a national contract, 8% reduction of SG&A cost in our clinics. We control our cost. We look at our cost. And as well, we leverage our size. And we will continue to do that with the doctors through the Choosing Wisely approach once again, which is the right care for the right patient at the right moment. We believe it can help us as well to optimize our procurement, for example. Next focus, Pascal mentioned it, portfolio reshuffling. I would broaden the view. It's not only portfolio reshuffling as some can consider is to -- it's a way to adjust the services or the activities within each and every clinic or location in order to make sure that we follow the ongoing trends in the health care services. And here, we use the full scope of actions possible or yes, or operations possible, rationalization, refocusing, merger, transfer, whatever the kind of action that can be possible, we assess it in order to see if it answers best to the situation. Now there is one transversal mindset, which is quite important. We never do that without prior long discussion with both regional agencies and local political authorities, public authorities. Why? Because we believe that, in fact, we need to look at the care offering for the patient, and we should maintain this care offering globally speaking, at the appropriate level and usually defined by the health regional agency. Last focus on digital. Digital first, it's everywhere. It's part of our DNA now, both for operating processes and administrative processes, of course. Two mindsets. We don't look at technology, just new technology just for the beauty of the new technology. We look at the new technology as a way to enhance our existing processes as well to bring to the next level of efficiency and quality, our internal processes. Once again, both administrative and medical. Second topic is that it's a holistic view that we're looking at. We're not looking at cost driver. We are as well looking at quality enhancement. It's super important to look at the way to enhance the data that we have in our tools to make sure that the quality is the right one. At the end, especially when you talk about medical data, it will be used by nurses and doctors to assess to define to be more specific on diagnosis and as well for revenues. We need to look how it can help our revenues. It's visible that we have such analysis or such assessment in all different kind of family of processes that are presented on the left part. On the right part, you see a specific example on the electronic medical records for the patient, which is where, in fact, we gather all the data, all the information needed for nurses, all the medical staff, globally speaking, at the time where the patient is in one of our locations. And why do we need to have a strong to have a stable EMR? Why do we need to have a standardized EMR as well? It's because, in fact, it's written on this slide as we need it, in fact, to support our care pathway strategy. We need it to support a high level of quality of data that once again are needed by our doctors to assess correctly the situation and do the right diagnosis. We need it as well because it will help or smooth the journey of the patient within our location. And we need it as well because at some point, we are delivering a care, and we need to make sure that the invoice is exactly in line with the care we are providing. After those few focuses, as a wrap-up, we have built, we have created with the team a dynamics, in fact, that should be seen as the first step of the connecting care strategic plan that are currently -- that we will implement. Going through the 5 pillars of this strategic plan again. First one, ensure portfolio management. We have medical projects in each and every of our clusters. We have already started to implement them. We need to continue. We need to accelerate when needed. Second, strengthening our care pathway. We have care pathway here and there. Now we need to make sure that each and every cluster will develop care pathway, leveraging on what is already existing, both nationally and internationally when talking about with other countries. Third, embrace the revolution on digitalization and AI, of course, as I said earlier, on processes, but as well to support our new care pathway, especially [indiscernible] hospital. Fourth, continuation of the performance plan. Of course, once again, 360 degree view, which means everywhere, everyone, every day, all line of cost, all line of revenues, all processes. Last one, accelerate towards innovative solution, new solution, new care pathway, new revenue stream. And I will mention just one thing, which is the evolution towards virtual hospital. What is virtual hospital just in a very simple sentence. Once again, when we said that care pathway is going outside of the hospital more and more outside first of the -- from outpatient -- from inpatient to outpatient and then to care pathway. We need as well to offer care pathway to our patient that will, in fact, involve being at home and being in our primary care. And therefore, being less and less maybe in the hospital. That's what we call virtual hospital. And I will end up on the fact that the team is committed, as I said. The team knows how to execute the plan. The team has already executed the previous plan and the previous performance and efficiency measures that we have designed with them. And therefore, I will come back on the final -- coming back, sorry, on the ideas I just mentioned at the beginning, regulation is something which could be seen as very important for us because it's a high level, high barrier to entry. And we know how to navigate within this environment. Second is that we need to focus, and we have already do so on performance improvement using levers that we control, and we have shown nice example on operating room occupancy rate or the [indiscernible] evolution. And the next 5-year plan is really mostly a continuation or an acceleration of the previous one, adjusted obviously to the current situation and with a balanced approach between what needs to be continued and how to fuel the next growth lever. Thanks a lot. And now I leave the floor to Britta.

Thank you, Jerome. Are you still awake. You know that research says that attention span is 45 minutes at the most. Our kids, their only attention span is maybe 2 minutes. So I ask you to stand up and sit down, so you are ready for Sweden. And you who are online, please stand up and sit down too. Yes. I'm happy to have the opportunity to deep dive on Sweden. The first couple of slides will be on the health care system and the conditions for private providers. And then I will go into Capio what we are and where we are heading. See if I can get the slides going here. So the first slide is on the health care market, and it's a big market in Sweden as well with a high proportion of GDP spent on health care. The proportion of private health insurance is growing. It's more limited than in France, but it's growing, and it's totally separate from the public system. So either into public funding or into the PHI system. The reason why I mention this already now is because it's a tailwind for us with growing queues and people that are not satisfied with the public system, they invest and their companies invest in private health insurance. But the majority of our business is, of course, being a partner to the public system. And on the mid-bar, you see where we are able to operate, 86% of the publicly funded health care in Sweden is provided by the public, but 14% of this huge amount of money is outsourced to private players. The vast majority in primary care, but also in specialist care. And at the bottom, you see our market share. We have a good position, and we have a competitive edge, I would say, that I will come back to being the only provider on the full care continuum. So that was about the money spent on Swedish Healthcare. How are we organized? We're a tiny country compared to France, 10 million inhabitants. Nevertheless, we have 21 health care systems. We have 21 regions and healthcare is funded on a regional level and we have a regional taxation. Hence, it's fully tax funded. Everybody is covered, but it's very decentralized. So we -- even if we have a national legislation on care choice in primary care, we have 21 different rulebooks for how this is defined in the different regions. And healthcare, when it's decentralized and we have 21 regions, health care is not totally evenly spread. They are differently good at organizing health care and private provision is -- it is outsourced to private providers to a different extent in different regions. Hence, we have growing queues in Sweden, as you see to the right from you, and it's unevenly spread. And this is a good tailwind for us as a private provider as we -- in specialist care, it's cheaper than the region's provisions, and we are more efficient, and we can help regions shorten their queues. And healthcare in all countries are stratified. We have different care levels. The most expensive level is the university hospital level. Then you have the emergency hospitals, then you have specialized clinics and smaller hospitals and the primary care. Primary care in Sweden is kind of -- if you are used to go to a GP, primary care is a broader setting in Sweden. It's a team-based organization where you have both GPs, you have specialized nurses, both on children care and maternity care. You have physical therapists, you have psychologists, you have dietitians. So it's much more team-based than a traditional GP setting. And if you go from the top to the bottom, the cost of care is, of course, most expensive at the top. Very limited of that is outsourced. The only emergency hospital operated by a private provider is our St Goran Hospital. That's the only outsourced hospital in Sweden. But a lot of the specialist care and primary care is outsourced, and that's where we are able to operate. But it's also thinking about where the future is heading with a lot more day surgery day cases. We are very well positioned for the future as the vast majority of the business I am running or we are running in Sweden is outpatient care. So this is -- the high volume is where the private providers are present and for the regions to outsource care to private providers. Of the publicly funded health care, the 14% outsourced, there are 2 routes to outsource. One is the EU legislation called LOU, which is that you tender contract. Those -- the other path is a Swedish legislation called LOV, and that's more than like the French system authorization. It's a care choice system. In the first one, in the tender ones, the regions set they define the volume we're going to take care, of what we're going to do and for a time frame. We also know what indexes we will have. In the LOV setting, as it's more of an authorization, there is no set time frame. We don't have a volume guarantee, but it's more flexible because it can be reiterated with the region. So it's more innovative in some ways. And to the right, you see the PHI market is, of course, totally different, and we can have both capitation models, fee-for-service models, other types of risk sharing depending on how mature the local insurance company is. And we spend a lot of time in developing health care and make them understand prevention and preventive care models that I will come back to. The 2 ways of procuring health care, the LOV and the LOU and how are they used? I said the biggest market for private providers in Sweden is primary care. We have a national legislation of care choice. So it's procured through authorization and care choice, open for all providers. Both private and public have the same reimbursement in primary care. That's the only area where we have the same reimbursement. And it's developing more and more towards a capitated reimbursement that we -- per listed patient that we can attract to our care centers, we get a fixed amount of money. It depends on what age group, if you have a lot of diseases, et cetera, but it's really a capitated system where it, as Margareta said, it's -- you make value and more -- it's less costly to work with prevention and not have to take care of a disease instead of working more upstream, you could say. So -- and that creates a lot of room for innovative care and how we take care of our chronic patients to make them stable in their chronic disease and not deteriorating, getting that heart infarction, stroke, et cetera. And in the blue, you have -- or in the green, you have the specialist care that is more unevenly spread between the regions, how much they have outsourced. Of course, a lot of the outsourcing is where a lot of people live, Stockholm, Gothenburg and Malmo, the big cities. And the regions can choose if they want to create a care choice, an authorization system or to tender a contract. They can, for instance, like in Stockholm tender pediatric care, just take some sort of -- some level of the care and tender that or you can have a broader variety of care and tender for queue shortening, for instance. But it's a limited time frame. The region defines what kind of care we are going to deliver. So those are the 2 differences between the way the regions procure between primary care and specialist care. Okay, have you understood the Swedish health care system perfectly now. Ready for Capio? And in short, you can say that we are the biggest and the best. So now I can go home. Now that we have the largest health care network. And you see we have a national coverage. 50% of the population in Sweden live in either Stockholm, Gothenburg or Malmo, Hence, we have a high density of clinics where the population is. And we are an important and respected player. After those 3 regions that I mentioned, we are #4. Before -- the fourth region in size as a health care employer. We employ 15,000 employees. And we are really seen as a thought leader in a lot of development and a good partner to the regions. in helping them develop them. And I will come back more on [indiscernible] then, but that has been really a way to show the regions lead the way and they get help that, oh, if Capital can do it, then we should do it as well. As I mentioned, we are in the full care continuum. What do I mean by that? You remember the care levels, but it's also the way not only what you do or it's also how you do it. So we are in digital care. We are in mobile care, hence, hospital at home. We are in primary care. We are in specialist care, including rehabilitation and geriatrics. And as I mentioned, we run the only privately operated emergency hospital in Sweden. We also have a special business area that we call Capio partner. It's here in green, and that's our commercial customer business area. They handle -- that's where we handle all the business relationship with insurance companies and other companies. And then the care is provided, of course, by our -- the blue business areas, but all the contracts are handled there to be able to scale. The biggest business area is primary care, Proximity with 5,000 employees. Why are we not regionally organized? Why have we organized ourselves in this way? It's because we think you get good at what you do a lot of -- and we use this organization a lot to benchmark best practice, steal with pride, et cetera, that Pascal mentioned. But of course, we have a close collaboration regionally with internal referrals working on integrated care that I will come back on. So this is our platform that we have in Sweden today. And what are the unique capabilities that lead to success? And I will -- the coming slides will give you this proof if you don't believe me, but I will take you through the capabilities going clockwise, starting with what I just showed, the large integrated network. That's, of course, the base of being successful in integrating care and develop health care for the future. And then the second is best-in-class quality of care. As you heard Margareta said, quality attracts both patients and staff. And quality drives productivity to do the right thing with the right patient at the right time and not more. We have heard it several times, but that's really key, and that's why I love working with health care and managing health care even if I'm a trained doctor and did 20 years of clinical practice, but this is unique, that it's much cheaper to have high quality than to have poor quality. And of course, we are a service business and quality is not developed behind my desk. It's in the meeting with the staff, the doctor, the team and the patient. So having a great employee value proposition is key. And we don't have demographies, not only tailwind for volume, it's also that we are less people that are going to take care of more people in the future. So we have to attract staff and engage them. And engaged staff are twice as productive as satisfied staff. So then you can realize if you have unsatisfied staff, how productive they are. So to take care of your workforce is really key to be successful going forward. And we are at the forefront of digitalization. We are a pioneer in integrating digital and physical care, as Margareta mentioned. And to set the scene a bit, I think that the Nordics are quite ahead in digitalization in all kinds of industry. And I think that Sweden is ahead of the southern part of Europe and Capio is leading that transformation of health care in Sweden. We also have excellency in tenders and integrating businesses. When you win a tender, you take over the contract, you have to integrate the staff in your culture, and we also use that skill when we do acquisitions. And I will come back on the big acquisition we did a couple of years ago, but to have an integrated platform, not only for our patients, but to embrace the culture for all our staff. And last but not least, we live in a political landscape and to have a strong public affairs and be seen as the thought leader is extremely important for us to be able to help the regions and politicians to set the right things for the future. And I think we are seen as a very important and respected player in public affairs in Sweden. I'm also sitting, we are on the board for the Enterprise Association, et cetera. Giving you some proof of what I just said, Pascal mentioned that we just won -- we won the tender of St. Goran and the flagship of private health care in Sweden, I would say. It's very close to my heart. I spent 25 years in that hospital of my life. So I think I spent more nights in that hospital than any other place in the world. And after doing clinical practice, I spent the last 8 years there -- until 10 years ago when I entered this position as the CEO of the hospital. And it's the flagship of private provision, but it's also extremely good for our brand and for international and national benchmarking within our group. We are also associated with Karolinska Institutet in research. You heard Margareta talk about Karin Dembrower's research in mammography screening and that we implemented that right away. Normally, it takes 17 years from a research publication until you have it integrated in -- implemented in clinical practice, but we have a much more innovative mindset and culture in this hospital that also spreads to the rest of our businesses. And we can show the public that we operate this hospital 20% less -- it costs the region of Stockholm 20% less than their own hospitals and still we do it with a healthy profitability. And as Clement said, we have stable contract conditions for the coming 12 years, 8 year plus 4 year and -- so we are looking to develop emergency health care even further. The latest acknowledgment we got was last month where we got the label Antibiotic Smart Hospital, the first one in Sweden. And that's extremely important for the future, how we use our antibiotics to not get resistant bacteria, et cetera. So it's really a sustainability issue. So to have that stamp is something that will both save a lot of lives, but also to be guidance for the rest of the group. As said that we are good at integration. And Pascal mentioned the acquisition of GHP. 23 clinics were integrated to our Swedish operations into the 2 business areas, orthopedics and specialist care. And it was a very strategic acquisition because we wanted -- as we wanted to build on integrated care, we needed to expand our platform, which was in specialty care, which we had a lot of primary care in Skane and Gothenburg, but less specialty care. And with this acquisition, we got specialty care in those regions. But we also got more -- we expanded our specialty portfolio with cardiology, expanded in gastroenterology, et cetera. So we really created a much better network for integrated care, but also to capture the PHI volumes, which have increased the revenues fivefold after the acquisition. And we also set the base for the future in occupational health as we, with the acquisition, got a small digital occupational health provider included. So -- and we promised a lot of synergies to Pascal. We delivered ahead of time. And we got a lot of clinical expertise and really the culture has been growing together, and we have a lot of capabilities to grow this integrated care into the future. And I would -- I said that I would come back to what's being on the forefront in digitalization. And Magaretta said that we almost not talk about digital care because for us, it's all physical care, and it depends on -- we say digital when possible and physical when needed. So we really start with the patient needs and then define what kind of care do we want to provide in a capitated model in primary care, something can really be done by the patients themselves by thorough guidance in self-care. We can do it chat-based. We can do it by video or it's a physical visit or an emergency visit, all integrated in our seamless interface that you see the Capio app that you see to the right. And all our units have a digital front door. But we also had, as already heard, the Capio Go, which is fully digital, but we can seamlessly network patients that we thought we could take care of digitally, but into the facilities. So it's a network of digital physical care that we have created. Digitalization, though, is not just the way we interact with people or our patients. It's so much more. It's accessibility, it's how we really create an efficient health care system. So apart from making it easier to be a patient, not only having contact, but be able to manage your own disease and be empowered. It's also about making it easy to be a manager to make decisions based on information that is not from last month, you have real-time information in your dashboards and even predictive information. Okay, we have an occupancy rate of 86% right now, 3 patients will go home. How can I plan? So it's really making life as a manager much easier. But also for our staff, I said that there will be a staff shortage with the demography going forward. And of course, we need our staff or want our staff to spend as much time and free up time to be with patients instead of behind the computer. And we try to do that with better tools. You have already heard about AI and mammography, but we have the biggest base of Ambient Scribe, Tandem, more than 1,500 doctors using Ambient Scribe instead of dictation and then the medical secretary writing it. We have automated recording of our vital parameters instead of taking the blood pressure right into the electronic medical record, it goes right into the record. And that both saves time, that it's also much more patient safety. Those are just some examples on how we can do, but of course, a lot of admin support. And to your right, you see the effects of all those things that we have tried to accomplish the last couple of years, the fivefold increase in digital contact, or 275% is in digital contact, but also the share of digital contacts of all the contacts. So I've tried to give you a glimpse of where we are, and I'm extremely proud of the achievements we have done in the previous strategy period. Yes, we care and of our trademark of quality and productivity, and continuous improvement. And we will continue the successful journey in our new strategy, Connecting Care 2030. To guide you -- it's a global strategy, but of course, with local adaptations, as you heard Jerome previously. But for Sweden, if I give you some example, the first pillar about portfolio management, that will be to ensure strong performance at St Goran with a new contract with better conditions, but of course, to continue our journey of continuous improvements and productivity. Second pillar about integrated care to strengthen the use of our expanded network of clinics. And we have -- we are on a good track, but still a lot to do in truly integrated care, one contact and then we are responsible for your health. That's our new mantra to guide the patient in the health care system and with internal referrals, with guidance. The third pillar is about transformation to embrace the sustainable transformation of health care delivery. We all know the challenges we have in the Western world with the demography, where less people are going to take care of more people and less people are going to support more people. And we are going from a reactive physical, doctor-focused health care into preventive, proactive team-based digi-physical world, and we will continue that journey, and even do more things with hospital at home, more day surgery. Today, 30% of all the hips and knees implants, they go home the same day. Operated in the morning, you go home. When I left medical school, you were hospitalized for at least 10 days. So it's a tremendous development that we will continue to work on this to drive the transformation. The fourth pillar is about productivity and cost control, and we will continue to choosing wisely, both medically, but also administratively to have AI-supported scheduling, both for patients and staff to work continuously with our shortening of average length of stay, the day surgery expansion, as I mentioned, but also I think Pascal or [indiscernible] was showed what we have done with procurement by aligning that we only use a few high-quality implants. We are continuously working on procurement optimization within the group and have a great help also of the rest of the group. And last but not least, we are, as you have seen, very closely related to the regions, and we are working with new revenue streams. So the last pillar is to accelerate our nonpublic funding to develop more relationship with the private health insurers, but also to reinvent occupational health. Also other companies than health care would have a workforce shortage in the future with demography to help the companies keep their staff healthy by using our knowledge base that we have in health care. That's a new way of expanding and not waiting for people to get a disease, but to really work preventive back together with their employers. So that's very -- I'm very thrilled about this angle of our -- the use of our capacity going forward. So we have achieved a lot, but there is still a lot of development to drive in health care.

Thank you, Britta. So it's no time for me and then for Pascal to conclude this presentation. Looking ahead, we are pursuing a clear growth ambition. Ramsay Sante has built a unique position to benefit from a compelling European health care market, benefiting from dynamic and supportive demographic trends, aging population and increasingly prevalence of chronic disease. But it's not growth for the sake of growth that we are after. It's about to create long-term growth, sustainable growth, lasting value for all our stakeholders, leveraging our unique integrated platform. So for that, we will build on the core, and we will further develop new segments, high-value segments, scaling up primary care in Sweden, accelerating in imaging and in mental health in France and continuing to develop new complementary businesses, PHI, occupational health notably. So over the last few years, we have demonstrated capability and agility to navigate in a constrained tariff environment. And we will have to demonstrate and we will demonstrate going forward a discipline and agility to adapt our mix to adapt our resource allocation to a continued evolving price context. Let me now zoom in the identified levers that will enable to drive profitability up in the future. First of all, continued optimization of our portfolio of clinics with a better utilization of our capacities, building a leaner and more efficient network. Second of all, accelerate performance actions in every country, driving higher productivity concretely, as Pascal said, we will turn every stone in every facility. And finally, accelerated on digital transformation to unlock efficiencies and to simplify patient administration. As you have seen in this presentation in several examples, our proven track record in terms of efficiency actions, combined with a truly ingrained culture of performance and innovation give us confidence in the ability to pursue this ambition. We will also increase our cash flows, thanks to operational and financial disciplines using the following levers: stable and optimized real estate policy, so continuity optimizing our footprint and engaging in opportunistic lease negotiations, streamlined financing costs through notably an active hedging policy through the continuity of our ESG sustainability-linked mechanism, adjusting the margin, therefore, reducing the financial cost, but also improved our financing mix. Three, capital allocation, disciplined capital allocation. So we will continue to be highly selective in our investment policy to prepare profitable growth. And last, improve working cap requirements with further efforts on DSO and improvements in our processes. In the end, as you can see here on this slide, here is the equation on how we will continue to deleverage the company. So again, first, we sustained revenue growth, thanks to our unique integrated health care platform, strengthening the core and diversifying our activities in new segments that are high margin, high profitability. Second point, which is important, we see a gradual margin improvement, thanks to higher performance actions and efforts in terms of cost discipline. Third, we maintain and we will maintain a disciplined capital allocation. And then we will improve and continue to improve our working cap requirements. So behind all these levers, we have clear and measurable financial objectives that we will monitor regularly. And all combined, they will contribute to our continued deleveraging plan. So I will now hand over to Pascal, who will present and unveil to you these financial objectives and conclude this presentation. I thank you for your attention.

Okay. Thanks a lot, Clement, and thanks for your attention. It has been quite a long day for those of you online, quite a long evening, if not night, I would say. So what are the guidance we are sharing for you today regarding the next year and the next 3 years? Guidance around revenue growth, reported EBITDA, gross CapEx as a percentage of revenue and deleveraging. First, revenue growth. For the year that has already started, just to remind once again our accounts at June to June, we anticipate as we plan to deliver between 2% and 3% of revenue growth in the coming year. Now if we look at the next 3 year on the CAGR approach, it would be in average 3% in the next 3 years. Regarding the EBITDA margin, which is, as of today, 11.9%, our guidelines or guidance is a stable margin this year and then a gradual margin improvement. Growth CapEx with a strict capital allocation as we have tried to explain to you, we plan a 4% of revenue on average over the period. And as to the deleveraging with last month of June, we end up at 4.7x, so measured as a net debt versus EBITDA, the continued deleveraging to target below 4x. So this is the guidance we are sharing with you today. And before opening the session for the Q&A, 6 points we would like, if possible, I would say, you to remind. First, we are really operating in a business in which the demand is ahead of us, increasing with strong drivers of this potential. Secondly, we are very well positioned in all the countries in which we operate and beyond Sweden and France, same in Norway, Denmark, in Italy in order to capture this growth in each and every market, thanks to a diversification and integrated. Third point, we are -- we always need to improve when you take care of 13 million of patients, but our medical outcome are best-in-class as measured by external, I would say, agencies. Fourthly, we are pleased to share with you today a plan which is not once again out of the blue. We are taking the solid foundation that the team has built in the last year. We are going to unlock the potential. We are going to adapt, but we are really confident in our ability to deliver this plan. This plan, undoubtedly, in what we anticipate to be still a constrained tariff environment mean that we will keep on focusing on our demonstration of efficiency for the future. And finally, with where we start today, with the guidance we are sharing with you, we consider we are in a solid financial performance that we will keep on improving versus the KPI, the guidance we have just been sharing with you before. So thanks a lot. We do recognize it was quite long, but we wanted to try to explain to you, I hope, with pride and patient what we are, what we want to be. So now there is a session for Q&A. We have received already quite a number online of questions. But if you don't mind, if everybody agrees, maybe if there are first question in the room, we'll be very pleased with the team to answer to your question. If not, we will go to questions that we have already received online.

I have a couple of questions. I'm [ David Sano ] from [ Kepler Cheuvreux ]. First, I would like to come back to your objective, short and midterm. Regarding just the revenue growth, how do you -- do you include M&A? Or is it just organic? And can you have -- can you provide us the split between volume and price just to understand the dynamics? Secondly, regarding your objective to deleverage, if I'm right, you never say that you could dispose your property asset. So is it an option for you? And regarding the value of the property asset, what is the implied cap rate of this portfolio? Who is the auditor? And are you the full owner of this portfolio? And the last one...

I should have noted because I'm not sure I'm going to...

Okay. And the last one is very short is regarding the presidential election next year in France. So how do you expect the budget to be for France next year? I know it's not an easy question.

Okay. I'm going to try to give you with the team, by the way, some guidelines and that's some figure. I'm sure you will understand, we don't disclose. I would say regarding the revenue growth that today, we have planned to be 3% in average every year. In the next 3 years, M&A, we are not slave to growth for growth strategy as we have tried to demonstrate. We are already the #1 in each and every country. So M&A is not, I would say, big M&A on the road at all. I would say in some very specific segment e.g., Primary Care in Sweden, would it be a bolt-on acquisition respecting our financial and medical threshold, why not? But net-net, the message, if I may, out of the 3% revenue growth, don't expect, I would say, a driver being M&A. Now between the delta volume versus delta price and not to disclose everything, but I really would like to share with you that we have been cautious regarding the tariff environment for France, very cautious. So let's put it away. We consider, and I think the past has proven it, and I hope the strategy that volume -- capturing volume on selected segments will be a key driver of the growth. Your second question, as far as I remember, was deleveraging, I'm right?

Yes, deleveraging [indiscernible]

Yes. I mean, regarding deleveraging, and I will hand over to Clement don't hesitate. We plan to have a continued deleveraging to be below 4x. As Clement has explained, the first driver of the deleveraging will be the margin improvement. Margin improvement going back to your point, driven by the volume growth, which in many segments are amortizing the fixed cost. As an example, the increase in the occupation rate on the theater is a critical driver of a margin improvement. Moreover, as you have seen, we have been investing in the past, and we want to develop on unmet patient needs, e.g. imaging, e.g. day hospital, et cetera, primary care in which the economics are better. So this deleveraging will come with this margin improvement in regarding the real estate and maybe to hand over to Clement, we could be opportunistic, but nothing else. So net-net, stability, but please, Clement and going back to the value.

Yes, to complement, the deleveraging strategy is the result of a combination of different levers from revenue growth, from margin improvement, disciplined capital allocation and working capital improvement. So that's not a single, of course, measure behind this. It's a combination of multiple levers. And back to your question on the real estate. So we do not disclose on the cap rate behind our real estate value, but we believe it's a market standard cap rate according to the location of our real estate, again, we are locating in prime location, more than half of the portfolio that we own is based in Paris, Paris region in France, but also Lille & Lyon. Regarding -- I'm sure I'm skipping what, I'm sure you will come back. Regarding the presidential election. I'm sure you will be surprised if I were today to give you personal feelings or whatever. Now that being said, what is important, of course, and that was, I would say, a key driver and will be still a key driver of being diversified. Would we be only in one vertical, in one country in an industry in which we are very dependent, to be honest, of an external decision being price, being authorization, we could be at risk undoubtedly. So net-net, I've got, of course, no idea regarding the outcome of the presidential election. But what we have built, we think, is a platform which is, I'm sure is in English, but waterproof, let's say, resilient whatever the outcome of the political elections. Of course, we are going to advocate for the whole system regarding what we think should be a fair remuneration for health care in France. We are going to keep on advocating and starting with myself in France for a multiyear agreement. As Britta explained, we've got ambition in some of our activity in Sweden to expand in other region, under your control elderly on mobility, et cetera. But net-net, whatever the political outcomes, and I have no idea, of course, I think we have built a platform in order to be resilient and to navigate through whatever the results. I'm sure I forgot one of your question.

[indiscernible]

Yes, it's mostly at 100%...

Yes, [indiscernible] that's correct, quite exclusively.

Yes. Thanks for your question.

Why don't you disclose the cap rate while you said it's in line with the market? Sorry.

No, no. As of today, I mean, I'm going to disappoint you. As of today, we don't disclose the cap rate. But it's really aligned with the market. Let's look forward. We are hearing your question, but we don't disclose it. Any other question in the room? Yes, please.

[indiscernible] BNP. One question regarding your -- the economics of your activities in France. Can you share with us [indiscernible] some of them are super profitable, some loss-making between MSO, primary care and so on?

Okay. We don't disclose, of course, I would say, EBITDA, et cetera, facility by facility. Undoubtedly, there could be some difference according to the type of specialty, according to the region, to be honest to you. Now we don't look for, I would say, having the same profitability, whatever the type of specialty location, et cetera. What is important is undoubtedly, if we take the primary care, primary care in average could be seen in France as a lower profitability, but it's very CapEx light, as you can imagine and beyond. We consider it to be an entry point in the market. That being said, whatever is the facility in each and every country, the challenge sometimes we can face regarding the results are operational mainly. And as I think the team, starting with Britta and Jerome have explained, we are working one-on-one in each facility regarding medical excellence and profitability. Now undoubtedly, through the example Jerome has given regarding Valence through sometimes network optimization also first or what we have done in Lille in the last year with a huge reorganization of our activity, closing one facility. It's what we are calling to network optimization sometimes. But we don't disclose, I would say, of course, facility or specialty by specialty. Any other question?

This is Raphael Ganet from ODDO. I was wondering if you could share with us your view on the impact of an improvement of 1 point of rate of occupancy of a surgery theater, for example. What's the target by 2030?

Okay. I'm very cowardly going to hand over to Jerome.

Good question, if I may. So what is the impact? So I'm not sure we'll disclose the guidance in detail by point presentation. Now the impact of 1 point, the idea behind why we're looking at optimizing the occupancy rate is that when we look at plus 1, plus 2 points, we believe we'll do it at almost the same organization. And therefore, we will have, of course, a bit of procurement, a bit of specific fixed cost that will be a bit variabilized, but most of it will be a net gain. So that's the idea behind of having this 1 point or 2-point increase. What we can complement is undoubtedly 1 or 2 points as a real impact versus other industry, you certainly know. What is a bit more complex in our industry is that you've got threshold of norms. What I mean, if we take, for example, a maternity delivery in France, when you go from 999 babies per year to 1,001, so being over the 1,000 threshold, you need one additional midwife, et cetera, so the fixed costs are increasing. So it's a bit more complex than just saying that, but net-net, it does have an important impact, and we do plan to increase the occupancy rate.

Still on the revenues, one more question about the different margin per specialty. Would it be possible to have a kind of graduation between primary care, between ophthalmology, imaging? Is it possible to have an idea of what are the more profitable or with high return on capital by specialty and to match it with what you want to develop on? That would be the first question on revenues. And the second one, I'm curious about your view of the public reaction. There is a lot of move around the GHP on the public sphere. Do you think that it could have an impact on your market position and the way you could get the inflow of patients?