Here are the three salient themes to come out of the conference on Emerging Markets.

The real growth will come from operators addressing the mass market. Hospitals for the elite face growing competition. It is taking tertiary care from elite settings into lower cost settings or in building low cost, scaleable outpatient facilities where the real growth and opportunity will come.

We will see massive investment as companies and funds scale up. A single Indonesian hospital chain will add 2,000 beds in 2016. Abraaj is close to its target of $1bn for its global fund for Africa and South East Asia. But adding capacity like this is inherently risky.  The paradox is that it is easier to buy a chain of 12 nursing homes in Germany than to build a dozen in a middle income Emerging Market country from scratch.  The EBITDA multiples for Asian healthcare service groups factor in the opportunity but not the risk.

Thirdly we will continue to see a massive growth in speciality outpatient businesses whether in maternity, dentistry, diabetes or oncology. Such chains are growing fast in India and that process will spread rapidly to other countries.