Shares in Spire Healthcare, the UK's largest private hospital operator, surged nearly 50% on Thursday after its second-largest shareholder, hedge fund Toscafund, proposed a £1bn buyout. The board has backed the non-binding proposal worth 250p per share, sending the stock to 221p from a five-year low of 142p in March.
Toscafund's Offer
Toscafund, founded by Martin Hughes—known as “the Rottweiler” for his aggressive approach—has until 11 June to make a firm offer under UK takeover rules. The activist investor previously took TalkTalk private in a £1.1bn deal in 2021. Spire's board said it would unanimously recommend the offer if a firm bid is tabled.
Company Background
Spire operates 38 private hospitals and over 60 clinics across England, Wales, and Scotland, serving 1.36 million patients in 2025. It was founded in 2007 through the acquisition of 25 Bupa hospitals and floated in 2014. The company has since expanded, building new hospitals in Manchester and Nottingham.
Just under a third of Spire's revenue comes from NHS work, such as hip and knee operations. On Thursday, the company noted that over 85% of NHS commissioning for the new financial year has been agreed, indicating strong growth in the first quarter. Private patient revenues have also grown, particularly from self-pay patients.
Previous Takeover Attempts
This is not the first takeover attempt for Spire. In 2021, a £1bn offer from Australia's Ramsay Healthcare at the same 250p per share was accepted by the board but rejected by shareholders. Earlier this year, talks with private equity firms Bridgepoint and Triton collapsed when Triton pulled out in March.
Spire's largest shareholder is Mediclinic, a global private healthcare group holding just under 30% of the company. Peel Hunt analyst Miles Dixon said the board remains confident in its standalone strategy, adding that the deal is likely to go through given the offer from the second-largest holder.
Industry Context
The proposed buyout comes amid concerns about privatisation of the NHS. Health Secretary Wes Streeting has defended the growing use of the private sector. In a related move, NHS landlord Assura was bought by Primary Health Properties last August in a £1.8bn deal after a battle with US private equity firm KKR.
Spire said it has made significant progress in strengthening care quality, diversifying revenue streams, and driving efficiencies in recent years.
