News & Updates

In a Financial Times column published on 29 October 2026*, "Private equity grows up ", Robert Armstrong argues that private equity’s current difficulties are about more than bad luck. Returns are lagging public markets, holding periods are longer, fundraising is falling and an evergreen fund has had to gate redemptions. Part of this is cyclical, and part of it reflects the end of cheap money. Underneath both, he sees a long-term shift: an industry that has grown roughly tenfold in two decades is maturing. In his view, private equity at scale is “a different asset class, not a superior one”. He expects it to split the way public equity management did, into low-cost scale providers and high-conviction specialists. Readers of Private Equity in Healthcare and Life Sciences will recognise the argument. Several chapters develop it, with a healthcare lens: - Where returns come from (Chapter 3). We trace how the main driver of LBO returns has changed over time: financial leverage before the GFC, then multiple expansion from 2008 to 2021. Neither lever is available today. What remains is operational and strategic value creation, which requires a clear thesis on what to do with an asset to justify paying a high multiple. - Liquidity becomes optional (Chapters 2 and 4). We cover the rise of secondaries, GP-led continuation funds and evergreen and semi-liquid vehicles for private wealth, including ‘40 Act funds and ELTIF 2.0. We also flag the risk that these structures can create liquidity mismatches in periods of market stress, a risk that has since materialised. - A bifurcated market (outlook). We go a step further than the column. We argue the split is already under way and that liquidity is the dividing line. Large PE-backed platforms are converging on public-market characteristics: faster capital rotation, broader investor access, more responsive pricing and lower fees. Meanwhile, the entrepreneurial lower mid-market (specialist practices, clinics, regional operators) remains anchored in concentrated, relationship-based and illiquid ownership. In that segment, patient capital and hands-on operational work are the point, not a constraint. The open question we pose in the book is whether these developments signal maturity or decadence. The FT’s answer is maturity. Ours is that the answer may differ depending on which half of the industry you look at. * https://www.ft.com/content/b36c5561-b601-48f4-bdbc-9a2227a958fa?shareType=nongift via @FT

On 2 October 2026, France’s Conseil d’État confirmed that Imapole, a Lyon-based medical-imaging company, part of ImaOne group, should be removed from the register of the Ordre des médecins and cannot practise medicine as a corporate entity. The court found that Imapole’s revised articles, financing arrangements and shareholder agreements—especially incentive mechanisms tying doctors’ personal returns to investor outcomes and provisions restricting share disposals—could compromise the professional independence of its physician members, notwithstanding their majority ownership. The case matters because it confronts a long-running feature of French healthcare private equity: since the 1990 liberalisation of sociétés d’exercice libéral (SELs), investors have sought structures that satisfy formal professional-ownership rules while giving capital meaningful economic influence. Private equity has used this route most successfully in medical laboratories, where groups such as Cerba, Inovie and Synlab became heavily consolidated and leveraged platforms; comparable attempts in community pharmacies have met much stronger resistance. Imapole itself illustrates the investment logic. In 2022, Eurazeo’s NovSanté fund—backed by France Assureurs and the Caisse des Dépôts—together with BPIFrance invested more than €50 million to support the expansion of the company and the wider platform now associated with ImaOne. Medical imaging has been attractive to private equity because it combines capital-intensive equipment, recurring diagnostic demand and opportunities for consolidation, with Imapole among the groups leading that wave. But the ruling demonstrates that physician majority ownership alone does not guarantee regulatory compliance. Investor rights, financial incentives and governance arrangements must preserve effective clinical independence. The issue is not confined to France: Germany broadly prohibits direct financial-investor ownership of physician practices and medical care centres, a restriction reaffirmed by the European Court of Justice in December 2024, while many US states apply corporate-practice-of-medicine rules that private equity has often addressed through management-services organisations. For healthcare private equity, Imapole is therefore a reminder that regulatory and professional-ethics constraints can materially shape investment structures, consolidation strategies and the scope for financialisation in clinician-owned practices.

As of October 2026, EQT’s agreed €10.8 billion acquisition of Qiagen illustrates the take-private strategy alongside the ongoing CVC-led bid for Recordati, but the two transactions have different starting points and strategic intentions. Qiagen’s depressed share price, following declining Covid-testing demand and slowing tuberculosis-test sales, created an entry opportunity for a new owner seeking to accelerate investment and redirect resources towards stronger growth opportunities. Recordati, by contrast, is already backed by CVC, which held approximately 46.8% before launching its bid: taking the company private would deepen an existing investment rather than establish a new platform. Its rationale centres on supporting a growing pharmaceutical business’s expansion into rare diseases through licensing and acquisitions, where intensifying competition increasingly requires investment in earlier-stage, riskier assets. Private ownership is intended to provide the stable capital and strategic flexibility needed for that expansion. Qiagen therefore emphasises repositioning after a market reset, while Recordati emphasises extending an established growth strategy. Both reflect the take-private rationale discussed in the chapter: pursuing multi-year investment away from quarterly earnings pressure. But Recordati’s minority-shareholder opposition also highlights the tension over who captures the anticipated upside.

Two pieces from different disciplines document the same gap from opposite ends, and both matter if you invest in, build, or study healthcare AI. The Financial Times ("Medical AI has a proof problem," 18 September 2026) reports Stanford research finding the FDA authorised 258 AI medical devices in 2025, most of which did not require new clinical trials. Only 2.4% were supported by the kind of trial data considered mandatory before a drug reaches patients. That comparison is the point. Device authorisation was never designed to answer the question buyers now need answered, which is whether a tool changes outcomes in a specific institution. Jess Morley of Yale puts it directly in the piece: developers pursue "statistical validation," accuracy rather than clinical efficacy, and the evidence that AI moves patient outcomes is "shockingly poor." A preprint on causal graph neural networks (arXiv 2511.02531) reaches the same gap from the machine learning side. Clinical models degrade across institutions because they learn spurious correlations rather than causal mechanisms. Its fix is architectural, and it warns against "causal-washing," adopting causal language without evidence to support it. That is Morley's complaint one layer down, in the model rather than the dossier. Why this is familiar We develop this tension in chapter 7 of Private Equity in Healthcare and Life Sciences (Wiley, 2026). IBM Watson for Oncology and Babylon Health are usually filed under overreach, but the specific failure was evidentiary: models trained and marketed ahead of proof they generalised beyond the conditions that built them. The economics only became unsustainable once that gap surfaced in deployment. That is why we argue AI's contribution has to be judged against patient outcomes, staff working conditions and shareholder value simultaneously, since risk concentrates wherever gains for one come at another's expense. It is also why our H.E.A.L. framework carries long-term resilience as a dimension of its own, alongside health outcomes, efficiency and access. The FT describes hospitals asked to evaluate tools they cannot see inside, and post-market surveillance consisting of manufacturer reports with no raw data. Those are system-level constraints no single stakeholder can price. The consequence for sponsors is that AI diligence stopping at the technology stack is mispricing risk. Data governance, real-world evidence and generalisation across sites are valuation questions, not compliance ones: the AI maturity assessment we set out in the book. Statistical validation is not clinical proof, and the distance between them is where the losses will sit.

Private Equity in Healthcare and Life Sciences is published by Wiley on 3 August 2026. This companion site hosts the chapter supplements, the practice quizzes, the downloadable LBO model, and the instructor materials.