Private healthcare company BUPA said its underlying profits rose 19 per cent to a record £429 million in 2007, a year which saw the group sell off its UK hospitals as it repositioned its focus and expanded its operations abroad.

Reporting her last financial results as chief executive, Val Gooding said the medium to long-term prospects for the business were strong but that profits for 2008 were likely to be lower because of the investment needed for a string of recent acquisitions and the exit from the Irish insurance market.

Revenues from continuing operations rose 11 per cent to £4.24 billion, compared to £3.82 billion last year, partly due to growth in its UK insurance business, which saw the total number of customers rise by 5 per cent to nearly 4.2 million. Underlying customer numbers increased by seven per cent to nearly 8 million.

Ms Gooding hands over to finance director Ray King in May after almost ten years at the group's helm.

Arguably, her most significant achievement has been overseeing the transformation of the group from an almost entirely UK-based operation to one which now takes more than a third of its revenue from overseas. By next year, if the planned merger of its Australian health insurance business with BMF, the country's second biggest player, goes through, overseas revenue could account for nearly 50 per cent.

Last year also saw a number of major acquisitions in Australia, New Zealand, Spain and the US in both care homes and insurance markets, although a number of analysts question whether they overpaid for acquisitions in general.

Analysts point out that with the uptake of private medical insurance (PMI) in the UK falling at an average 0.5 per cent year on year, a move to international markets seems wise. So far BUPA has managed to buck the trend but they question how long this can last.

It has also been questioned whether BUPA is positioning itself to be in the right space in the future to bid to manage parts of the NHS if government policy moves in that direction. Already the group has made inroads towards working with the public sector, including the acquisition of Health Dialog, a telephone-based counselling service which works with public health providers to keep down the cost of spending - a system which has been successful in the US.

A market source said: "Today’s results are good but with rising premiums, the tightening of belts in recessionary times and waiting times on the NHS falling, BUPA and the private health care sector are facing testing times. There is also a move towards self-insuring with people questioning whether spending £1,000 to £2,000 a year on private healthcare is worth it.”

Last year, UK insurance accounted for 45 per cent of the group's revenues and a third of its underlying profits.

The division, which includes BUPA Wellness and BUPA Health Assurance, grew revenues by 3 per cent to £1.9 billion, while profits increased by £9.1 million to £115.6 million.

As a provident, BUPA does not have shareholders and profits are ploughed back into the business.

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