Healthcare is traditionally seen as fairly recession-proof. That is most unlikely to be the case this time round.

Sure, there will be some sectors which are going to be almost completely bomb-proof. It is no coincidence that diagnostics is the sector of both Biomnis, bought by Duke Street last week, and FutureLab, close to being bought by Mid Europa. 

But many private hospitals rely heavily on cash payments by individuals. That is the case for half the revenue of the big hospital chains in Finland and Greece. Of the two, Finland may be the worst hit; its public sector hospitals may not be brilliant, but they are great deal better than those in Greece. 

But it doesn't end there. One analyst I talked to reckons that for two of the big Greek hospital groups 'discretionary spend' makes up 20% of sales. By that he means consumers lashing out for plastic surgery or extra frills, like a private suite. 

The real danger is that the big quoted Greek groups will dash into Romania and Turkey to make up for any drop in income. Cross-border hospital acquisitions are notoriously tricky to pull off successfully!

But recession should help in other markets. It should present the big German chains with another chance to buy public sector hospitals, as their owners, the Laender and cities, decide to sell. After all, pay is expected to rise 5% next year whilst income tax drops. 

It should also help outsourcers, like Carema and Attendo in Sweden, and Medone and Esperi in Finland. In particular, it should accelerate the transfer of the care of the elderly to the private sector.