IHH Healthcare Berhad (IHH) Earnings Call Transcript & Summary

Ladies and gentlemen, good morning, and welcome to the Second Quarter 2026 Financial Results of IHH Healthcare's Analyst Presentation Conference Call. [Operator Instructions] I must advise you that this conference is being recorded today, 27 of August 2026. I would now like to hand the call over to your first speaker today, Mr. Kelvin Chong from Investor Relations at IHH. Please go ahead, Mr. Chong.

Thank you. Good evening, and thank you for joining us. I'm Kelvin from Investor Relations, and welcome to our second quarter results presentation. With me today are Dr. Prem, sitting in the middle, our Group CEO; Dilip, Group CFO, to my right; Ashok, Group CCO, to Dr. Prem's right. And far-right, we have Evren, Deputy CEO of Strategy and Business Development of Acibadem, our Turkey segment. Result materials are also available for download on the IHH website. We will begin with an opening address by Dr. Prem. Dilip will then present the financial highlights, followed by Ashok who will update on operations across our various markets, with Evren taking on the Turkey, our Acibadem segment. Dr. Prem will then provide the closing remarks, and we will then move into Q&A. With that, I'll turn over the call to Dr. Prem. Dr. Prem, please.

Thank you, Kelvin, for the introduction. Good evening, and thank you all for joining our second quarter 2026 results briefing. We will begin, as usual, with key updates on a group level, followed by results highlights, operational highlights. And lastly, we will open the floor to Q&A. In Q2 2026, on a constant currency basis, revenue and EBITDA grew by 19% and 25%, respectively, demonstrating the strength of our diversified portfolio. PATMI ex EI was up 30% year-on-year. Strong performances were recorded from Malaysia, India and Turkey, all of which has delivered higher revenue intensity and inpatient volumes, whilst maintaining a strict cost discipline. In Singapore, we have been responding to the cyclical shift of patients utilizing public health care by introducing new packages with payers. We are pleased to announce that performance has bottomed out, and we have seen an improvement in occupancy to 51% in Q2 and 55% in July 2026. We will continue to roll out these new packages in the coming months, and we expect volumes to increase. Overall, we remain confident in Singapore's recovery trajectory. On a Group level, EBITDA and PATMI margins continue to be healthy and within our guided range. Our multiyear transformation plans continue to be on track, and we'll share a few details in the next few slides. Given our strong financial performance, we will be declaring an interim dividend of MYR 0.055. We continue to manage our risks effectively by leveraging on our diversified portfolio [ and insights ] to navigate global uncertainties. Overall we remain cautiously optimistic for the remainder of 2026 and are on track to deliver double-digit ROE by 2028. As mentioned, the Board has approved an interim dividend of MYR 0.055 per share for the first half of 2026. This represents a 10% increase compared to the first half 2025 interim dividend. Dividend payout ratio is close to 40% of PATMI, which is well above our dividend policy of 30%. The increase in dividends underscores our continued commitment to deliver sustainable returns to our shareholders whilst managing disciplined capital management approach. Moving on to the key Group updates. This slide was previously shared in our Q1 briefing, so I will not dwell too much on it. Overall I just wish to highlight that we are continuing to execute these initiatives on the slide on all fronts and results are being delivered with the aim of getting us towards a double-digit ROE by 2028. On our transformation plans, we would like to provide some key updates, which have been denoted in boxes with a green font. Our EMR system, which started off in Singapore, has now been implemented in 4 Fortis hospitals in India and will be rolled out to other Fortis and Malaysian hospitals in due course. On the harmonization of our enterprise systems with Oracle solutions, global design workshops are underway and phased country rollouts will commence in Q2 2026, with the first go-live expected in Q2 2027. Overall we remain steadfast in our transformation journey as we continue to unlock synergies, future-proof IHH and catalyze sustainable growth. We continue also to demonstrate strong capital allocation and management at a Group level. Our year-to-date interest expense has been lowered by 8%, following better refinancing rates and a steady progress in deleveraging our balance sheet. Our year-to-date income -- interest income has grown by 24% with improved treasury yield optimization. Group-wide procurement consolidation and centralized sourcing initiatives continues to be on track as we aim for greater economies of scale to lower overheads. Overall we have saved more than USD 200 million in the past 5 years. Our CapEx guidance remains unchanged at MYR 2 billion for the full year -- for this full year. Despite lower CapEx in the last 12 months, we continue to deliver outstanding results. Overall our CapEx will be allocated to projects with the greatest capital efficiencies to maximize growth. That wraps up our key updates on a Group level. I will now pass the time to Dilip to cover the financial section. Dilip?

Good evening to all of you, and welcome to the analyst call. Thank you, Dr. Prem. Building on some of the key points that Dr. Prem had mentioned, in Q2, our core operating performance, which excludes the effect of MFRS 129, recorded MYR 6.9 billion of revenue and a MYR 1.6 billion of EBITDA. PATMI ex EI grew at 30% to MYR 675 million in Q2. On a constant currency basis, revenue and EBITDA grew by 19% and 25%, respectively, demonstrating our strong and resilient growth achieved by our multinational diversified global footprint. Both EBITDA and PATMI margin continues to be healthy and are within our guided range previously. We recorded strong performance from Malaysia, India, Turkey due to higher inpatient volumes and higher revenue intensity whilst maintaining very strict cost discipline. In Singapore, our performance has bottomed out, as we previously had mentioned, as occupancy recovers from Q1 lows, and margin stands at 29%. In July, our utilization has actually gone up to 55%. Recently, we have announced packages with payers, which had contributed to the recovery of inpatient occupancy and increase in daycare cases. For the remainder of 2026, we will continue to focus on driving volume to expedite the growth in Singapore and the recovery thereof. This will include more health partnerships with corporates and payers, with more price-competitive packages. Overall we remain cautiously optimistic on IHH's financial performance for 2026. As always, we focus on the blue box, which illustrates our core operating performance, excluding MFRS, which more truly represents the performance of all our units. We see a 7% and a 14% growth on revenue and EBITDA, respectively, following higher patient volumes and higher intensity. PATMI ex EI grew at 30% for the same period. On a constant currency basis, we had a robust double-digit growth of 19% and 25% of revenue and EBITDA, respectively, again, demonstrating very strong operational performance and growth. For year-to-date basis on 2026, we continue to see a trend of strong core growth, offset by currency translation losses due to the appreciating ringgit. However, on a constant currency basis, revenue and EBITDA grew significantly higher by 17% and 21% on a year-to-date basis, respectively. PATMI ex EI grew by 17% to MYR 1.2 billion for year-to-date 2026. Despite macroeconomic headwinds, our performance remains within our guided range, and we continue to be cautiously optimistic for our performance for the remainder of 2026. We will continue to exercise prudence in our capital expenditures as we execute our brownfield projects and grow our daycare business going forward. This slide shows our financial performance trend on a quarterly basis. While our margins have remained within the guided range, our earnings continue to take an upward trajectory. Revenue and EBITDA ex MFRS 129 has increased 31% and 34%, respectively, between year-to-date '23 to year-to-date '26. In Q2, our core EBITDA margin was at 23%, while our core PATMI margin was at 10%. Looking forward, we continue to maintain our EBITDA margin guidance within 22% to 24%. Overall, on a constant currency basis, the Group achieved a 19% and a 25% growth in revenue and EBITDA, respectively, demonstrating our robust financial performance. As mentioned earlier, we recorded strong performance from Malaysia, India and Turkey, all of which have recorded double-digit growth in revenue, EBITDA on a constant currency basis. Singapore has implemented various strategies to regain volume. As mentioned earlier, recovery is at play and performance has bottomed out with improving utilization. Margins for Singapore stood at 29% following strong cost control. Margin for other countries and IHH Group continue to be within our guided range. Overall we are cautiously optimistic for the rest of 2026. On a year-to-date basis, we saw strong double-digit growth in both revenue and EBITDA on a constant currency basis, growing 17% and 21%, respectively. As Singapore's performance has bottomed out from Q1 lows, the performance gap has narrowed. Year-to-date, revenue is down 5% versus Q1 of 7%. Likewise, year-to-date EBITDA is down 7% versus Q1 of 13%. We remain confident on Singapore's recovery trajectory and the gap will continue to narrow going forward. With that, I will now hand over to Ashok, who will next take us through the key operational highlights. Over to you, Ashok.

Thank you, Dilip, and good afternoon, everyone. Starting with Malaysia. In Malaysia, revenue and EBITDA grew by 15% and 29% on a constant currency basis on the back of higher revenue intensity and greater patient admissions. Overall better utilization at 64% and increased day cases along with greater cost control measures have improved margins to 28%. Despite this, we continue to maintain our guidance in the mid-20s in the long term. While there is growing competition from the peers, we remain confident in IHH Malaysia's growth trajectory. If we take a deeper dive into Malaysia's day cases, revenues and volume increased by double digit in Q2 and year-to-date 2026 daycare revenue has seen an increase of 13% year-on-year growth. Over the past 3 years, daycare revenues have grown by 41%. The strong growth in daycare illustrates our efficient use of CapEx to capitalize on market demand and growth opportunities. We expect daycare revenues and volumes to continue increasing for the remainder of 2026. On to medical tourism. In Q2 2026, foreign patients contributed 14% of Malaysia's revenue. Year-to-date 2026 also at 14% of Malaysia's total revenue in lieu of stronger local growth. Key hospitals like PHKL, PCMC, PHP and GHJ continue to see double-digit growth year-on-year in medical tourism, underpinned by robust industry demand and higher acuity treatments. Overall medical tourism grew by 236% over the past 3 years. Moving forward, medical tourism trends in Malaysia will continue to endure, and we expect to see continuous growth for medical tourism in our Malaysian operations. Moving to Singapore, and I think this, to some extent, has been covered by Dr. Prem and Dilip as well. We have released new price-competitive packages with payers to regain volumes. In Q2, we saw occupancy rising from Q1 lows to 51% and July's utilization is around 55%. This illustrates the effort of our Singapore team to ramp up volumes. Margins stood at 29%, indicating strong cost controls. We will continue to pursue more initiatives to drive our volumes, including more tie-ups with corporates and pushing out more price-competitive packages with our payers. Overall we remain confident in Singapore's recovery trajectory. As mentioned, the slide covers a little bit more on what we've been doing in Singapore. As mentioned, we've been working closely with payers to forge stronger alliances and roll out new packages. Just to share some examples in the last quarter. We have launched new cardiology packages with leading insurers, including Great Eastern, to address the rising cost of cardiology treatments. We've also signed a memorandum of understanding with Allianz Indonesia to drive our volume from Indonesian patients. And we have recently announced the impairment of Mount Elizabeth Royal Square into Prudential's network, expanding patients' access to specialist daycare surgery and endoscopic surgery services. We will also be announcing our latest partnership with AIA in which IHH Singapore hospitals will be part of AIA's facility network. Overall these partnerships highlight our efforts to strengthen our payer relationships and bringing about greater packages for our patients. More packages are expected in the coming months, and we continue to deepen our payer partnership in effort to increase volumes. On another note, we've also further entrenched our clinical leadership by attaining the International Accreditation System for Interventional Oncology services. Being the first hospital in Asia to achieve this significant milestone, it solidifies our position as a regional COE of choice for local and foreign patients that are opting for interventional radiology treatments. Also in IHH Singapore -- also IHH Singapore attained the American Nurses Credentialization Center Pathways to Excellence designations with distinction. We are Singapore's first and only health care service provider to receive this award, which recognizes health care organizations that foster positive practice environments where nurses are empowered to excel professionally and deliver high-quality patient care. With that, I will now pass the time to Evren, who will take us through the operations in Turkey and Europe.

Thank you, Ashok. On our Acibadem vertical, on both reported and constant currency basis, we recorded double-digit revenue and EBITDA growth despite the holidays in May. On a constant currency basis, revenue and EBITDA grew at 44% and 61%, respectively. Occupancy was at 71% and inpatient admissions increased by 15%, despite the addition of 353 new overnight beds from [ Cartal, Kent and Bhinder ] hospitals. At the same time, revenue intensity grew by 22% from more acute patient case mix. EBITDA margin stood steady at 20% in second quarter 2026. Strong cost measures are in place to mitigate the financial impact from the new doctor employment model, which has recently been rolled out in June. As stated previously, we expect a marginal impact to the margins. Despite FX volatility and translation effects, our Turkish and European operations continues to perform well and has contributed significantly to the Group. In second quarter, foreign patient contribution in Turkey operations stand at 12%. Year-to-date 2026, this figure was at 11%. The decline in foreign patient ratio was due to the strong growth in domestic revenues in Turkey. Volumes and revenue for medical tourism continued to increase year-over-year. Year-to-date, foreign patient revenue was at MYR 1.4 billion. Overall, Acibadem's growth continues to be robust from strong local and foreign demand. We remain confident in Turkey's growth and outlook as its economy continues to recover from the shift towards conventional economic policies. Now I'll hand it back to Ashok to cover the remaining slides on our operational highlights.

Thanks, Evren. Moving to India. In India, we remain confident of the growth trajectory. Integration plans in the MSA continue to be on track, and we continue to see positive improvements on our Gleneagles India operations. Overall inpatient admissions and revenue intensity has increased by 14% and 5%, respectively, and occupancy stands at 72%. On a constant currency basis, our India operations recorded double-digit revenue and EBITDA growth of 19% and 15%, respectively. The latest quarter's results were healthy with strong growth in revenue and EBITDA. Excluding ESOP expenses, margins for our India operations would have been at 19%. As the MSA progresses, we remain optimistic in seeing convergence of margins between Otis and Gleneagles through greater clinical and operational synergies. Now to Hong Kong. For Gleneagles Hong Kong, revenue and EBITDA increased by 13% and 52% on a constant currency basis. EBITDA margin reached an all-time high of 19% following higher occupancy levels of 64% and greater inpatient admissions and rising revenue intensity. Our daycare business, we continue to see double-digit growth in both revenue and volumes. Overall we continue to project growth in our overall Hong Kong operations and maintain our guidance of high teens in the long term. Last, our labs. Our labs segment continue to grow with test volumes increasing by 10%. On a constant currency basis, our labs revenue and EBITDA increased by 10% and 13%, respectively. Margin stands at 22% for Q2 2026. We will continue to grow our outreach revenue to diversify our revenue streams and expand the number of tests offered, especially the high-end tests that allow us -- allow the doctors to be -- more informed decisions and improve patient outcomes. With that, we have concluded our operational review, and I will now pass it back to Dr. Prem to wrap up our key takeaways from Q2.

Thank you, Ashok. So very quickly to wrap up things. Firstly, we have achieved resilient growth across Malaysia, India and Turkey. In addition, Singapore continues on its recovery with increased post -- increased occupancy post Q1 lows. Secondly, our multiple transformation initiatives continue to be in play, and this will help productivity and reduce costs in the long run. Lastly, we have declared an interim dividend of MYR 0.055 for the first half of 2026. Our diversified portfolio mitigates single-country risk, and we reaffirm our confidence for double-digit ROE by 2028. With that, we'll now move to the Q&A session. I'll pass this back to Kelvin. Thank you.

Thank you, Dr. Prem. We will first take questions from participants on the call before moving to questions from the webcast. [Operator Instructions] With that, operator, please proceed with the Q&A. Thank you.

[Operator Instructions] And now we're going to take first question on audio line, and it comes from the line of Raghavendra Divekar from Nomura.

Congratulations on a strong set of results. My first question is on the Singapore business. I know you highlighted that you're doing more packages to drive volumes. Are there any concerns about margin erosion from these packages going forward? Or do you think you'll be able to maintain your high 20s margins in Singapore? My second question is on the Fortis business in India. I saw an article which said that IHH plans to increase stake in Fortis to about 51% in the near term. Just wanted to understand if there are any time lines for this expansion. And what sort of ways would we be looking at to increase our stake? Would this include an infusion of the current Gleneagles business into Fortis or would there be other methods also?

Yes. So maybe I can take the first question on the Singapore margin and pass it on to Ashok for the second. See, the Singapore margin, this is something that we've always maintained. What we are really trying to do in the Singapore business is to grow our dollar EBITDA and dollar earnings. There's been a lot of cost control, which has led to increase in the margins, but our focus is clearly on increasing the dollar earnings rather than just increasing the margin alone. So over a longer period of time, my guidance has always been that Singapore margin should be somewhere between 27% to 28% in the longer term. But at this point in time, as I said, the focus is really to drive up volumes and thereby monetizing your cost better and improving your dollar earnings. Ashok?

Yes. I think on India, I think we've said this previously as well, our medium-term, 3 to 5-year horizon, we want to get to 51%. That's been our stated view. In India, you can do this through new capital primary or also through creeping acquisition through a secondary purchase. So I think that really will depend on what the real need for capital is or do we have the ability to buy the stock in the secondary market. I hope that answers the question.

Yes, just to pin down on that, would the infusion of your current Gleneagles India assets into Fortis also be on the table? Or would you be waiting for margins of Gleneagles to come closer to Fortis before that would be a possibility?

So right now, Fortis is managing and operating the asset. I think ultimately at some stage, we would want to see integration complete between Fortis and Gleneagles.

And the question comes from the line of Yen Voo from JPMorgan. We will proceed with the next question, just give us a moment. The question comes line of Selviana Aripin from HSBC.

Maybe I do have a bit of questions around Malaysia operations, medical tourism in particular. I note that it was about 15% of Malaysian revenue in first Q, and it is now 14% in the first half, which actually suggests a little bit of a slowdown in Malaysia. So 2 questions on that. The first one is on Malaysia -- on Indonesian medical tourists, how are we doing on that? Are you seeing a slowdown in 2Q? What are you observing in 3Q so far? And my second question is around Cambodia. Have you been able to grow your Cambodian patient pool in Malaysia?

So on Malaysia, medical tourism remains very strong, right? And you will note that in the past, we've said it was low single digits. With [ Island ], it doubled. And then subsequently, with the more medical tourists coming into our other hospitals in the Klang Valley and Johor, it has continued to grow to 14%, 15%. There will be some seasonal sort of variations. And so 14%, 15%, it doesn't vary very much. We think that it will grow even further from what it is now. And so that's not only from Indonesia, but from other markets as well. Malaysia has now tapped newer markets like Bangladesh and, certainly, Cambodia as well, right? Cambodian patients come to Malaysia, but they also come to Singapore, right? And we've -- I think both countries have got offices now in the country to facilitate medical travel for patients as well. Most notably, we also have patients now coming in from other markets. like Philippines and Bangladesh as well. So these are the countries that we -- so this, I think we'll continue to expect. Malaysia is an extremely conducive country for medical travel. The government has got an agency, the Malaysian Health Travel Council, that helps to promote tourism as well as hospitals in the country. So we are very positive about it. I wouldn't be too worried about the 14% or 15%. It can only go up.

And maybe just to add there, 14% is the revenue contribution, right? But if you look at the absolute dollar number on a year-on-year basis, we've actually grown medical tourism by 15%. It's just that in Q2, we had a very strong local patient volume growth after the Q1 lows because of the festivities, right? So that's why you saw a dip in percentage contribution of revenue. However, the absolute dollar number in terms of medical tourism actually grew.

[Operator Instructions] Now we're going take our next question, and the question comes from the line of Nicole Goh from UBS.

Actually I had a follow-up question on the Singapore margins. I note that, of course, the focus is to grow the dollar EBITDA and the dollar earnings. So just wanted to get a sense, does this mean that in the near term, given that you have introduced packages and all that, that we will likely see a dip in terms of the percentage margins? Or you think that you do have levers to kind of smoothen it a little bit out? And then the second question is also on Malaysia. Likewise, I think the margins are quite high. It's holding up at 28%. Again, going forward with continued, I guess, insurance -- pressure from insurance as well as the potential introduction of [ Mediaca ] in a more -- in a wider manner, would there be then -- would we expect -- would we be expecting a lower margin in the longer term?

Yes. Nicole, so just on Singapore, probably start with Singapore. You answered your own question. As I said, the focus is really on dollar EBITDA growth, right? We are trying to tackle a few things at the same time. One, we are trying to drive volumes up, which means packaging more. And hence, there is certain discounting. On the other hand, we do have the ability to also kind of use some cost levers, which is what we're doing currently in Singapore. So it's a mix and match of everything else. So I think longer term, if you ask me, steady-state margin, somewhere around, I would say, the 27%, 28% is what would be more sustainable in my view, for Singapore. With regards to Malaysia, we spoke about this as well. There's been -- we've worked on various cost initiatives in Malaysia. We've kind of squeezed whatever cost we can in Malaysia, and the volumes have come through in Q2. And that's why you see the margins that you're seeing. Again, longer term, the margin guidance that we've always given to Malaysia is around the 26%, 27% mark, is what we've been giving in terms of guidance for Malaysia.

Sorry, can I just make a very quick follow-up on Singapore? Does it mean that like the packages that you want to introduce, are there significantly more that you want to introduce? Or you're pretty much done and it's just more like tweaking on the surface?

So the packages will continue. As Ashok presented, you would see tomorrow, you'll see this sign up with AIA. We are doing a big launch with AIA in terms of packages and being their preferred partner. So some of those efforts will continue with payers, right? And I said, the focus is really to drive volumes. Because if you drive volumes better, you'd be able to monetize your costs as well better. Some of the costs of running these hospitals are fixed. And as long as they're able to drive volumes, you can monetize your costs better. So that's really what we are aiming to achieve.

Now we're going to take our next question, and the question comes from the line of Amanda Foo from Macquarie.

Congratulations for the strong set of results. If I could have a quick follow-up on your Singapore operations. I noticed that Q-on-Q, your inpatient revenue intensity was still going up despite some of the insurer pressure that you would have undergone. So how should we be looking at this progressing in the coming quarters, especially since we are focusing on more cost-competitive packages? And are we still on track for normalization of Singapore operations by the second half of this year?

Okay. Maybe the first thing I want to say is that intensity is a combination of several things. First is the specialty mix. And as you know, specialties are changing very rapidly across our countries and our hospitals. Many years ago, when cardiology was the big focus, we tended to see cardiology as a dominant specialty in our -- many of our hospitals. But over the years, as we have managed to control some of the risk factors better for cardiology, that has dropped. Today, oncology is rising. And so when you have got patients with cancers, then the treatment tends to be more intensive because there's a wide variety of options for us to treat them with, and they are improving all the time, from chemotherapy to targeted therapies, from routine radiation to proton, right? So there are a number of these things that happen. So that's the first thing that happens. Secondly, how complicated the problems are. Singapore and a few of our other countries as well tend to have more and more complex cases coming to us, especially when medical tourism is rising as well, right? So patients have got problems that have been with them for several months before they come to us in Singapore, and some of the other countries where you see the intensity going up. This is across the board. But in Singapore, it's more pronounced because it is a hub for some of the most complex procedures that we do across our markets. So that's the reason why you see the intensity growth as well.

And on the normalization by second half, can we get a confirmation that it's still on track with, yes, second half?

Yes. So as we said, if you remember, last quarter, we mentioned that Singapore has bottomed out. And as you can see, Q2, it has indeed bottomed out and it's kind of ramping up. So it is in the right direction. It's in the right trajectory, and we expect Singapore to kind of start ramping up. And as I said, I think in July, if you look at the utilization numbers, it's already gone up to 55%. So we are in the right trajectory, and we hope to normalize in the next couple of quarters.

All right. And then secondly, congrats on the PATMI margins. I see that you have reached double digits for the first time in 3 years. I just wanted to find out, right, is this something that we can expect to continue sustainably? And also with the strong momentum from Hong Kong and Acibadem, can we expect dividends to be paid out of these entities? If so, what do you plan to do with these dividends? Yes, that's all for me.

I can probably talk about the PATMI margins and then hand it over to Ashok for the Hong Kong dividend and then turn to Evren for Acibadem. From a PATMI margin perspective, again, we've been doing several initiatives. One is looking at our current debt and our cost of debt and to see how we can rapidly reduce our cost of debt as well as reduce our debt itself. So that's yielded results. As you can see, there's been a drop in our interest expense by 8%. On the other hand, we've also looked at cash, which sits here and there, and optimizing some of the treasury to make the cash sweat better, make it earn. And you can see that we have some other income, which is due to some of these initiatives that we've undertaken across the Group. So yes, I would say, apart from this, the other factor has been the depreciation bit. We are very cautious in terms of capital deployment. And without compromising growth, we've been looking at capital commitment. And you can see that there's been a reduction in CapEx, but not a reduction in growth. So that's something that we are very focused on. And some of these elements have come together to help in expanding the PATMI margin. Ashok, on Hong Kong?

Yes. I think the question on dividend, whether it's from Hong Kong or Acibadem, this basically depends on our overall capital allocation policy. I think we mentioned this earlier as well, we want each of our entities to be capital sufficient so that they can meet their requirements for expansion through greenfield, brownfield CapEx themselves, rather than the funding coming from the Group. So I think that's the basic guiding sort of principle. And I think at the right stage where we think there's excess money sitting in any of our entities, that money can be extracted back to the Group.

And the other thing that I'd also like to point out is Hong Kong for I think for about 6 months now straight, we have been PATMI positive. This is despite having -- it's a [ $10 ] company with HKD 4 billion of shareholder loan and HKD 4 billion of external debt. So despite that, for 6 straight months, we've been PATMI positive, which is very, very encouraging to me.

Can I just quickly follow up? Can we then kind of confirm that for Hong Kong and Acibadem, we're already at an excess cash kind of situation?

No, I think so. I think especially for Hong Kong, like Dilip mentioned, most of the excess cash will go back into any CapEx requirement they have. With Acibadem as well, the plan is basically any excess cash would be used to repay any intercompany loans.

And Hong Kong also has debt, right? So it's better for you to repay the debt rather than keep the cash there. So that's the other thing that we keep doing in terms of looking at paying down the debt levels in Hong Kong as we start generating cash.

Now we'll go and take our next question, and the question comes from the line of Yen Voo from JPMorgan.

Good sets of results there. Congratulations. The first question is with regards to the double-digit ROE that is on track for 2028. Now I just want to back up on the earlier question on increasing the stake to 51% over the next couple of 3 to 5 years. How much of that ROE improvement is expected to come from India? And how do you ensure that additional capital being deployed there is actually ROE-accretive rather than dilutive? That's the first question.