End of an era for South African private hospital giant

Over the past few years, Life Healthcare has reshaped its business to transition back to a purely Southern African healthcare and diagnostics focus, divesting from many of its international businesses.

The latest sale, completed in 2025, was Life Molecular Imaging (LMI), an integrated radiopharmaceutical company that was sold to US-based Lantheus for around R13.9 billion.

In the five years prior, Life Healthcare also disposed of its other major international operations, including Scanmed in Poland in 2021 and Alliance Medical Group in 2024.

This strategy appears to be paying off for the private hospital giant, which released its interim results for the six months through March 2026 on Thursday, 28 May.

These results showed that Life Healthcare made revenue of R12.42 billion, up 2.4% from the prior year. Its normalised EBITDA grew by 5.2% to R1.96 billion. 

Life Healthcare also reported a profit after tax of R828 million, a significant recovery from the R2.16 billion loss it reported for the first half of its 2025 financial year.

The company also reported positive basic earnings per share of 52.8 cents for the first half of 2026, a bounce-back from the basic loss of 155.2 cents it made the year before.

The losses in H1 FY25 were due to a R2.92 billion fair value adjustment and a R303 million charge related to Life Healthcare’s sale of LMI, rather than poor operational performance.

The arrangement that led to the fair value adjustment was settled in the first half of 2026 and saw Life Healthcare pay Piramal, the group it originally acquired LMI from in 2018, R2.43 billion.

With this liability now settled and LMI disposed of, Life Healthcare’s normalised earnings per share increased by 8.4% to 53.1 cents.

This strong performance came despite a significant blow in the first half of Life Healthcare’s 2026 financial year – one of its funders was placed under curatorship, reducing the group’s revenue by R130 million.

This also affected its paid patient days (PPD), which declined by 0.4%. Without the impact of the curatorship, PPD would have increased by 0.4%.

Focusing on Southern Africa

With LMI’s disposal complete, Life Healthcare can now refocus its operations on Southern Africa, with the group having big plans for the region.

Life Healthcare originally expanded internationally through acquisitions and partnerships, but has taken the past few years to consolidate its operations and refocus on its Southern African operations.

Over the past five years, Life Healthcare has systematically exited its European and international businesses, with the aim of streamlining its focus.

In 2021, it began with the sale of its Polish healthcare operation, Scanmed, which was concluded in March that year for a total cash consideration of R733 million.

Next was Alliance Medical Group, which provided diagnostic imaging services across the United Kingdom, Italy, Ireland, and other parts of Europe, in January 2024.

This deal generated R10.2 billion in net cash proceeds, which allowed Life Healthcare to deeply deleverage its balance sheet and reward shareholders with an R8.8 billion special dividend.

The latest sale was LMI, its radiopharmaceutical business, which was a highly complex transaction that was finally concluded in the 2025 financial year. 

Life Healthcare originally acquired LMI from Piramal in 2018, which gave rise to a pre-existing arrangement. 

Under this deal, it was set that once LMI’s cumulative management EBITDA position turns positive, Piramal would earn 50% of management EBITDA in any given year up to 30 June 2028, up to a maximum cumulative amount of $200 million (around R3.29 billion).

The deal further stated that, in the event of a sale, net proceeds from the disposal are added to management EBITDA when calculating any liability due to Piramal in any given year.

Therefore, the time to pay came in 2025, which resulted in a R2.92 billion charge for Life Healthcare.

Similar to its Piramal liability, LMI’s management incentive scheme liability was also remeasured upon the sale of the business, resulting in a R303 million charge in 2025.

While it came with some pain, the LMI sale is now completed, and Life Healthcare can reinvest and expand into its main market, Southern Africa, with big plans already underway.

Now, 100% of the group’s non-current operating assets, which total roughly R13.98 billion, are located exclusively in Southern Africa. Its operations span across South Africa, Botswana and Namibia.

As Life Healthcare has been exiting some of its international operations, it has raised proceeds that have been reinvested in Southern Africa.

For example, the group has been making a strategic push into non-acute imaging services, which started with the acquisition of East Coast Radiology in the 2022 financial year.

This was followed by the acquisition of TheraMed Nuclear in 2023 and a KwaZulu-Natal-based imaging practice in 2024.

Now, in its 2026 financial year, Life Healthcare reported that it is actively opening PET-CT sites.

To further aid its ambitions, the group has partnered with AXIM to construct two cyclotrons in South Africa, which are set to begin commercial radiopharmaceutical production later this year.

Life Healthcare also wants to grow its hospital network in South Africa, with the construction of a new 140-bed Life Paarl Valley Hospital already in progress and set to open in the 2027 financial year.

This sale triggered large non-trading fair value accounting adjustments.