Episode 49 · With David Porter · 30 Jul 2026 · 31 min

    Better Care. Better Returns.

    A healthcare private equity investor on why quality and returns are not a trade-off, and what he looks for before backing a provider to scale.

    Featured guest

    David Porter

    Partner, Apposite Capital (healthcare private equity)
    David Porter is a partner at Apposite Capital, a London private equity firm that invests only in healthcare services and life sciences. Trained as a chemist and biochemist, he spent his career in financial services, managing funds and running companies including a bank, before moving into private equity via corporate finance and working alongside Guy Hands at Terra Firma. He started Apposite two decades ago. Half-American, he was raised in Orange County, California.

    Show notes

    David Porter is a partner at Apposite Capital, a London private equity firm that invests only in healthcare services and life sciences. Trained as a chemist, he spent his career in financial services, running funds and companies, before moving into private equity and starting Apposite two decades ago.

    He and Jared get into Apposite's core belief that there is no compromise between strong investor returns and high-quality, ethical healthcare, because quality is what differentiates a provider and wins the people who pay for care. He explains how the firm scales smaller companies by professionalising, automating and digitising everything, improving governance, and growing both organically and through acquisition, using a turnaround in UK home care as the example: a loss-making business that prospered only once its quality, and its regulator scores, were fixed.

    The conversation widens to why healthcare business models rarely export across borders, because reimbursement and health economics differ so much between the UK, US and Europe, and to where David thinks things are heading: quality as the one constant, robotics and AI as the big change, and why he backs automation with real guardrails at a sensible pace, because one bad headline can set a whole category back years.

    Key takeaways

    • There is no compromise between good investor returns and high-quality, ethical healthcare. Quality is the differentiator, because the people who pay for care lean towards the provider they trust.
    • Fix quality first. A loss-making UK home-care and hospital-at-home business only became highly profitable after its regulator scores improved and commissioners stopped treating it as the last resort.
    • Scaling a smaller company means professionalising, automating and digitising everything, tightening governance and internationalising, with a value-creation plan that allows for both organic and acquisitive growth.
    • Transformation runs down every line of the P&L, not just operations. The same digital efficiencies should reach procurement, HR, finance, marketing and customer experience.
    • Disturb your market enough to become a strategic problem for competitors, and you earn extra turns of multiple at exit, because a buyer is then solving a strategic problem, not just a commercial one.
    • Healthcare models rarely export. What works in the UK often fails in the US and vice versa, because reimbursement and health economics differ completely, so test applicability in the biggest market early.
    • Quality is the one constant; robotics and AI are the big change. But adoption is gated by public trust, so one visible failure can set the category back, and the answer is real guardrails at a sensible pace.
    There is no compromise between making good returns for investors and having high-quality, impactful, ethical business practices in healthcare.
    David Porter
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