Dr Bateman's primary concern

Dr Bateman, the founder and boss of Primary Health Care, the country's leading medical centre provider, and his wife Belinda had splashed out nearly $1 million for the yearling Foxwedge at the Inglis Easter Yearling Sale.

Satin Shoes provided another chance for the Batemans in the same race. Hopes were high for the pair as Sydney's racing elite gathered at Rosehill Gardens for the country's premier race for two-year-olds.

But when the 1200-metre race with a $3.5 million purse was run, the pair had come up short. Foxwedge, a hefty colt, was edged out of the way by the eventual winner 400 metres out from the post and was seventh. Satin Shoes was ninth.

The Batemans also invested significantly in bloodstock in recent years with mares such as Georgette Silk.

"We are happy with what we have got and we buy them to breed, and that is why we are buying at the top of the market," Dr Bateman told Thoroughbred News in March.

Investors in Primary Health Care may be excused for pondering the similarities - a top-of-the-market purchase and a case of what might have been. Once the market darling of the health sector, Primary is under renewed scrutiny as a $900 million debt refinancing looms next year, slowing growth prospects, asset sales and buyout speculation.

As the first ructions of the global financial crisis took hold in late 2007, Primary prevailed in a drawn-out $2.7 billion battle for Symbion Health to expand its footprint and diversify earnings away from its mainstay medical centre business.

Primary was humming. It was a growth stock, profiting handsomely from the federal government's billion dollar health spending in its one-stop bulk-billing medical centres.

But with the Symbion deal, expanding its pathology and radiology businesses, Primary's debt ballooned to $2.3 billion. Synergies and savings of about $100 million were pencilled in to extract value from the deal. Investors coughed up more than $1 billion in early 2008 to finance the deal.

Then the crisis hit. In its wake, healthcare stocks are no longer viewed as a defensive sector with steady profit growth. Governments have been cutting funding for services outside hospitals.

Until then Primary had regularly delivered. A growth stock compounding impressively year over year kept shareholders happy while Bateman undoubtedly created a model that allows more patients to get access to bulk billing.

The only ones grumbling regularly were doctors, who sold their practices to Primary and had to work long hours to meet targets to earn the guaranteed salaries of up to $200,000 a year. "He's a tough bastard," one investor said.

From its beginnings on Sydney's northern beaches, Bateman turned Primary into a key player in the trillion-dollar health industry.

His is a story of a north shore upbringing, of the grandson of a NSW Labor minister, following his father's footsteps into medical school at Sydney University, before becoming an entrepreneurial GP, and appearing in the BRW Rich List with an estimated fortune of $300 million.

But just as he was forced to list the company when Westpac called in a loan on his rural properties in the 1990s, Bateman, now just months shy of his 70th birthday, faces a fresh round of talks with his banks.

The Symbion deal appears to have been the crucial point. Synergies proved tough to achieve. Governments began tightening spending. And the company's stock sagged as growth options, government cuts and debt chatter weighed on it.

While its share price nearly touched $10 in 2007, it fell to $2.82 earlier this year. It is now $3.48.

Bateman himself has also been selling down his shares over recent years, paring his stake to below 8 per cent and opening up the company's share register.

In March Primary trimmed its full-year guidance for the third time in less than a year, cutting it to

$320 million to $330 million a year the initial guidance was $360 million a year.

Primary's debt position has been no secret, but also weighing on the stock had been the government's looming budget and cuts to spending. Primary has been viewed in some circles as one of the losers of the federal budget.

A new funding agreement with the government, cutting its pathology bill by $550 million over five years, has removed some uncertainty from Primary stock, given it was less than had been feared. Changes to mental health funding will also reduce support to GPs.

With its growth prospects slowing, investors have begun taking a different view of Primary stock.

Chatter about potential corporate activity emerged late last year, featuring private equity. But the bruising battle for Symbion has also provided the allure of a possible rematch between Bateman and then Symbion boss Robert Cooke, who sparred openly before Primary prevailed.

Some analysts see speculation in the financial press about private equity interest as a carrot to potential suitors to make an offer.

Still, private equity has looked over Australian health assets before. In fact KKR missed out on the private hospital operator Healthscope last year. Pacific Equity Partners is also believed to have looked at Primary last year.

On one hand, a slowing growth profile and improved funding conditions speak in favour of private equity interest. But there are questions over whether private equity would have the appetite for another health industry investment given CVC Asia-Pacific is struggling with I-Med's debt burden.

Then Primary's announcement of a potential sale of its Health Communication Network raised eyebrows. Analysts expect a sale to attract $300 million, with proceeds used to pay down debt. But some have questioned the rationale, particularly given a move to more e-commerce.

What is clear is that Primary is at a crucial juncture. Primary is a family affair for Ed Bateman. His three sons work there one has been touted as a future boss.

Bateman's looming 70th birthday combined with his reduced stake and chatter about corporate activity provide a ready mix of issues needing to be played out for the family's future in the business.