The price that Fresenius is paying for Rhoen is impressive and should help push up values in the German hospital market. It will, for instance, make it far easier for a group like hospital and psychiatric group Ameos or Sana, the hospital chain owned by the big private insurers, to float at a decent multiple.More generally, the Four Seasons sale demonstrates that even where prices are as uncertain as the UK local authority market deals can be done if you have a strong management team with a good track record.

It will be interesting to see what happens with the current crop of companies with for sale signs. That includes nursing home group Attendo where IK investment Partners is looking for around €1bn. The problem here is that the scandal engulfing its main nursing home rival Carema won’t go away. That will make an IPO difficult.

Elsewhere, Duke Street is looking for €300-400m for Biomnis, the French reference lab group. Labco which could integrate it easily into its ~french lab network is being touted as a possible buyer. We hear that Alpha Medical, the Czech and Slovak chain owned by Penta is likely to go to Synlab.