With trees, baubles and tinsel, Christmas hasn’t arrived so much as kicked in the door of the usually quiet Dublin city centre hotel lounge where Medihive chief executive and former Facebook Ireland boss Gareth Lambe has agreed to meet me.
Festive elevator muzak threatens to overwhelm the voice recorder on the table in front of us. All of this less than two weeks after Halloween.
Lambe has been busy since he departed Facebook owner Meta in 2022 after 10 years, most of it spent at the helm of the tech giant’s Irish unit.
“I planned it for a long time,” he says of his decision to step down. “I gave them a lot of notice and I took over a year off – a year and four months.”
RM Block
Still, the transition must have been difficult.
“I was really looking forward to it, but it turns out you can’t just switch the cogs off from working. I probably got a bit impatient for a while. I can tell you, my wife got impatient with me being in the house.”
We’re growing our business at 25 per cent year on year, but at the highest gross margins in the industry because of our platform efficiencies
Small wonder he found it difficult to switch off. Lambe describes his more than 15-year executive career in the tech sector – first at PigsBack.com and then PayPal, before heading up Facebook’s European headquarters in Dublin – as a “rollercoaster” of “crazy hours, travelling a lot, with a lot of responsibilities”.
During his tenure at Facebook Ireland, the social media giant expanded its Irish headcount from 300 to 3,000, with an additional 6,000 or so contractors. Political controversies, data protection breaches and fines, and a global pandemic were just some of the major issues Lambe and Meta’s executive team at large had to navigate during that time.
Since his departure, Meta has waded deeper into controversy, particularly on the other side of the Atlantic where Facebook co-founder and chief executive Mark Zuckerberg has, along with the other Big Tech barons, backed US president Donald Trump’s second term. Lambe said it was jarring to see Zuck’s appearance at Trump’s inauguration last January.
“I think it’s safe to say it gave us a bit of the ick when we saw Zuckerberg, Bezos and all these guys kind of cosy up to Trump,” he says. “But I think, as ever with this, there’s a kind of nuance to it.”
The subtlety, he says, is that Zuckerberg is a “progressive liberal” and a Democrat voter, “but where he falls into the Maga camp is on freedom of speech”.
It’s not all purely “ideological”, Lambe concedes. “The bit that probably is a bit more opportunistic is that they like the way Trump is training his guns on Europe and the regulation, and putting pressure on them, saying that they’re targeting [US companies]. That is opportunistic and helpful to them.”
Happily for him, Lambe isn’t paid to sweat the details of Big Tech and its many moving parts any more.
After his brief sabbatical, he re-emerged on the public radar in September 2023 as the new chief executive of medical technology company Medihive. Earlier that year, the company made headlines, raising €7 million in a funding round led by US-Australian medical device giant ResMed that valued the business at a reported €62 million.
It was a natural choice for Lambe, who says he was keen to join a growth-stage company. “I didn’t want to go back to the bootstrapped start-up,” he says. “But I also didn’t want something [like a] big multinational. So, it hit the right note for me.”
Covid bulldozed through many sacred cows about what can and can’t be done online
— Gareth Lambe
There are two planks to the Medihive business, the first and better-known of which is the telemedicine platform Webdoctor. The second element, which Lambe describes as the “core” of the company’s business, is the software services it provides to other companies indluding ResMed, Axa Health and the pharmacy group Phoenix.
“It’s the technology around delivering clinical experiences to patients and doctors,” he explains, in areas such as waiting-list management, patient workflows and scheduling.
“That side of the business is going very well,” says Lambe. “Globally, there’s been huge growth [within health technology] in what they call provider operations – the front and back-end administrative side of delivering services. That’s our wheelhouse.”
Lambe isn’t exaggerating the subsector’s growth. A recent Silicon Valley Bank report indicated that provider operations companies have raised $5.5 billion globally so far this year, with another $3 billion or so expected by the end of 2025. It now accounts for about 44 per cent of overall health-tech investment, up from about 19 per cent four years ago, according to the report.
Against this backdrop, Medihive has hit “very important financial milestones” recently, Lambe says. “We’re growing our business at 25 per cent year on year, but at the highest gross margins in the industry because of our platform efficiencies. And we are profitable this year, which is really important.”
Combined with another €5 million Medihive raised earlier this year, it means the business has “good optionality” heading into 2026, according to Lambe. That could be important for a company looking to grow through acquisition, something that is very much on the cards, he admits. But if there’s anything specific in the pipeline, he isn’t showing his hand just yet.
“We’re at an inflection point now with the revenue milestones we’ve hit and the profitability,” he says. “We are currently looking at our options for step-changing the business, whether that’s taking in new investment, M&A etc.”
Medihive’s software business has an international reach. Webdoctor’s customer base, on the other hand, is “predominantly” Irish, Lambe says. He believes there remains “huge runway” for growth domestically, and “even in time, through other jurisdictions, more likely through M&A”.
On the home front, Lambe sees Webdoctor as filling an important gap in the Irish healthcare system, specifically the chronic and worsening shortage of general practitioners. As a one-for-one replacement for GP consultations, telemedicine has its limitations and also its sceptics.
There are still “some suboptimal telemedicine operators out there, not just in Ireland, but abroad”, with whom Lambe says he “wouldn’t be proud to work”. But scepticism in the technology has waned. Covid “bulldozed through many sacred cows about what can and can’t be done online”, he says.
Trust is key for companies operating in the space, and the fact that Webdoctor has the highest Trustpilot score of any of its rivals is something Lambe and the company are keen to highlight.
The score is really a “proxy” for the overall quality of its telehealth service, Lambe argues, the first pillar of which is the quality of the doctors it works with. Despite the dearth of GPs in the Republic, “we still refuse four out of every five doctors we interview”, he says, “and we see them showing up in other practices and online players”.
Medihive has invested heavily in its technology to provide same-day services to patients, which happens in 80 per cent of cases, Lambe says. The other 20 per cent are served within one day, “with no wait time”.
[ GP visits decline as patients embrace telemedicineOpens in new window ]
Still, there are limitations. “We’re not the same as bricks and mortar,” Lambe says. “We don’t offer as full a service. We do offer about 80 per cent of what you can get in a normal GP practice. When the business was launched 10 years ago, that was maybe 50 per cent, so that’s improving all the time through technology, home diagnostic kits, things like that.”
Webdoctor, he says, has now taken “a million consultations off a creaking system” in which “a lot of people can’t get a GP at all”.
Like the thorny question of social media platform regulation, there are no silver bullets when it comes to solving the perma-crisis in Ireland’s healthcare system, Lambe believes, but he recognises that the “public’s patience is running out” rapidly.
“I suppose, being closer to this, what I’m seeing are the huge benefits and progress we can get from embracing technology,” he says. “Embracing technology doesn’t mean a reduction in quality or service if done right.”
If Webdoctor, and Medihive more broadly, are examples of that potential, doubts remain over whether his former employer can deliver on quality.
Public perception of Big Tech has been deteriorating drastically in recent years as the large platforms struggle to address issues such as misinformation, privacy concerns and child protection, to name just a few. A poll conducted by US think tank the Brookings Institution in 2023 found plunging levels of faith in tech giants such as Facebook, Amazon and Google, “at least partially due to perceptions of how tech companies use and secure private information from individuals”.
Lambe says public opinion of Big Tech has gone through “a few changes” over the years. “In the early days of your Metas and Googles, it was incredibly exciting,” he recalls. “Then there was this period of massive hostility, I would say, from particular media and politicians, [and] by implication, the public.
“I think it’s coming around a bit now, whereby I think people are sort of finding new things to be worried about.”
That includes artificial intelligence (AI) and the rise of the “deepfake” and its impact on the sophistication of disinformation disseminated on social media, about which Lambe is quite concerned. “I think young people are more attuned to it,” he says. “It’s actually older people who are less attuned to it ... But either way, I don’t know how we’re going to get around it.
[ We should all be worried by deep fake technologyOpens in new window ]
“There’s going to be an ask, I think, of tech companies to mark or signal if something is AI. I don’t know that that’s ever going to be 100 per cent achievable.”
Somewhere within this matrix of EU regulation, tech and Maga sits Ireland and its highly exposed economy. Looking beyond the next three years of Trump, Lambe – a former president of the American Chamber of Commerce Ireland – says there is a troubling trend emerging.
“I do think Irish influence in the US and Washington is unquestionably diminishing,” he says. “That’s demographics as well as politics. So, it might mean that we need to change our approach a little bit, not rely on friendship and be a little more functional and even transactional.”
Regardless of who takes the White House or Congress over the next few years, the lasting impact of the Trump era will be this “slightly more transactional, tit-for-tat” approach to US foreign and trade policy, Lambe thinks, “because I think Americans of all political persuasions are seeing that there are some results from it”.
[ Irish influence in the US is waning, says new report from influential think-tankOpens in new window ]
It’s less about Ireland specifically and more about the deteriorating relationship between the US and the EU, he says. The perception is that US technology is being “targeted” by European regulation.
“I do think we need to be careful there,” Lambe says, before adding: “I want to be clear, I am happy and proud that Europe is taking a lead on regulation of Big Tech, but it can’t be at the expense of innovation.”
CV
Name: Gareth Lambe
Age: 52
Position: Chief executive, Medihive
Lives: Monkstown, Dublin
Hobbies: Sports junkie, especially football and rugby, but most sports really. I love watching, attending and playing
Family: His wife, Deirdre McKnight, is a solicitor and they have three teenage children, Conor, Aisling and Emma
Something you might expect: “I like to invest in Irish start-ups; it’s business and pleasure in one”
Something that might surprise: “I am co-owner of ThreeState gym in Monkstown, with professional rugby player Andrew Porter and dietitian Josh Percival”
