HBI Deals+Insights / Interviews

“We want to be a strong and collaborative healthcare partner for the UK Government” — in conversation with Viren Shetty, Narayana Health

British private equity firm Bridgepoint recently sold Practice Plus Group (PPG), the UK’s fifth largest for profit hospital group by revenue, to Indian healthcare giant Narayana Health for around €215 million.

The deal includes PPG’s secondary care business only and excludes its Integrated Urgent Care operations, such as NHS 111 contact centres and out of hours GP services, as well as its Health in Justice division.

The acquisition marks Narayana Health’s entry into the UK healthcare market, where demand for surgical procedures, particularly in the private sector, is expected to grow in the coming years.

HBI spoke with Viren Shetty, Executive Vice Chairman at Narayana Health, about the rationale behind the deal, the group’s strategy for the UK, and how it approaches international expansion and healthcare investment across markets including India and the UK.

 

HBI: What conditions influenced Narayana Health’s decision to enter the UK market, and why was PPG the target?

Viren Shetty: The UK is a market we have been observing from a distance for a long time. Dr Devi Prasad Shetty, Narayana Health’s Founder and Chairman, has been invited multiple times by Parliament and the Ministry of Health to advise on efficient healthcare systems.

Over the years, private equity investors have entered and exited UK hospital systems. We were frequently approached by bankers regarding potential opportunities; however, at that stage, we did not yet have the conviction or operational readiness to pursue them. Our prior attempts to run hospitals in Malaysia and Kenya taught us the importance of operating in stable environments, and we have since applied those lessons when evaluating newer geographies. So when the opportunity arose, we felt the timing was right. With our experience lowering costs and running highly efficient systems, we believed we could acquire and scale a UK healthcare system.

As for why PPG, when we analysed the healthcare groups available, it was the one most closely aligned with our ethos and how Narayana Health operates in India. Their model focuses on high-volume, low-cost care for the average consumer rather than positioning itself as an exclusive, low-volume, high-end provider. This is highly synergistic with our approach of lowering healthcare costs and making it more accessible to larger number of patients.

HBI: Are there specific segments in the UK healthcare landscape that Narayana Health is particularly interested in?

Shetty: In India, Narayana Health is primarily a high-volume procedure and tertiary surgery focused institution. That is what we are globally recognised for and where we believe our strongest capabilities lie.

Preventive care, diagnostics and wellness are areas we offer, but they represent a much smaller part of our operations. Around 90% of our work in India and the Cayman Islands is based on procedures and surgeries, both short stay and long stay. That is where our primary focus will remain.

HBI: How does the UK’s public–private partnership landscape align with Narayana Health’s strategy?

Shetty: PPG works largely with the NHS, with about 97% of its patients coming through that channel. That proportion is likely to remain quite high for a long time.

As we enter the market, we want to be seen as a strong and collaborative partner for the government. We believe we can help address several challenges currently facing the system, particularly waiting lists and workforce shortages. As a low-cost, high-volume provider, we also want to be seen as a solution to lowering total healthcare spend.

HBI: Do you foresee further acquisitions or partnerships in the UK following the PPG acquisition?

Shetty: Yes, although we have only just begun. There is a significant amount of work to do within the hospitals we already have. For example, we are replacing the entire technology stack with our in-house hospital operating system, and we are integrating various systems and teams across PPG network.

This integration work will probably keep us busy for the next two years. That said, we are also keeping an eye on the market for smaller hospital groups that could be added to the network.

HBI: How do India and the UK compare in terms of healthcare investments?

Shetty: They are obviously very different. If I compare them from the perspective of market size and depth, India is significantly larger, more dynamic and has an enormous untapped market. Roughly 60% of the population is not yet adequately served by regulated healthcare systems, so there is tremendous room for growth.

From an investment standpoint, the UK has a larger percentage of foreign investors investing in private healthcare. And there is tremendous scope for increasing the participation of private healthcare as part of the government’s mandate to lower healthcare spending.

Overall, both markets are hungry for growth, but they operate under very different conditions.

HBI: Where do you see the most significant growth opportunities in Indian healthcare today, and what should foreign investors consider before entering such a large and complex market?

Shetty: India is almost a blank slate in many ways. The market is enormous and still significantly underserved, with strong demand across the entire healthcare spectrum. Because of that, it can be difficult to narrow the focus. At Narayana Health, we have invested in insurance, clinics, pharmacies, healthcare technology, analytics, AI tools, hospitals, diagnostic centres, preventive care and workplace wellness. Many Indian providers and international investors are also expanding in these areas.

For foreign investors, investing for the long run is critical. India is vast, and building deep expertise takes years. When we entered the UK, we did not expect to generate massive returns within five years and exit our investment. Our approach to international investments is long-term, measured in decades. Investors entering India should adopt the same mindset. It is a market where opportunities will continue to exist for many generations of investors.

HBI: You are speaking at the “Investing in the UK and Ireland” session at HBI 2026. What can audiences expect to take away from the discussion?

Shetty: I will share the perspective of an organisation coming from a developing market that operates in a very high-growth, dynamic environment.

From that viewpoint, the UK can appear more regulated and slower moving. An interesting question is why a company like ours would move from such a dynamic environment to a much more structured and regulated one. That contrast will shape much of the discussion.

 

Viren Shetty will be speaking at HBI 2026 panel “Investing in the UK & Ireland” on March 24 in Paris. The session will also feature Sebastian James (Group CEO, Veonet Group), Tony Romero (CEO, Cygnet Health Care), Jawad Khan (CFO & Chief Strategy Officer, Circle Health Group), Sharon Lamb (Partner, McDermott, Will and Schulte).

We would welcome your thoughts on this story. Email your views to Rakshitha Narasimhan or call 0207 183 3779.