Britain's Healthcare Crisis Is Worth £1 Billion

There is something deeply comfortable about a £1 billion takeover of a healthcare company.

Spire Healthcare, Britain's largest private hospital operator, is being bought by Toscafund Asset Management and its partners for around £1.03 billion.1 The group runs 38 hospitals and more than 60 clinics, treating over 1.36 million people in 2025.2

On paper, it is a straightforward investment. In reality, it says something rather depressing about Britain's healthcare system.

The NHS waiting list stood at around 7.3 million in July.3 At the same time, Spire generated 31% of its 2025 revenue from NHS work, alongside 43% from private medical insurance and 21% from self-pay patients.2

That is the uncomfortable business model. A healthcare backlog creates demand. Demand creates revenue.

And revenue makes healthcare infrastructure an increasingly attractive asset for investors.

NHS waiting list (July 2026): 7.3 million · Spire 2025 revenue mix: NHS 31% · Private medical insurance 43% · Self-pay 21% · Adjusted EBITDA (2025): £268.6m · Efficiency savings: £30m

The NHS Creates The Opportunity

This is not an argument that private hospitals are inherently bad.

In fact, they can provide additional capacity exactly where the NHS needs it. Spire says it is already working with the NHS to provide diagnostics and elective surgery, while its 2025 NHS revenue grew strongly.2

But there is a bigger question. Should we really be comfortable with investors benefitting from a problem that millions of patients are experiencing?

When somebody waits months for an operation, that is a healthcare failure.

For a private hospital with an available operating theatre, it can be an opportunity.

That doesn't make the hospital unethical. It makes the incentives worth examining.

And The Incentives Matter

Toscafund is buying a profitable, established healthcare platform. Spire generated £268.6 million in adjusted EBITDA in 2025 and has already delivered £30 million of efficiency savings.2

The investors will want that number to rise - that is how investment works.

But healthcare is not a normal industry. You cannot treat a hospital like a struggling retailer and simply close the least profitable stores.

There are patients attached to those numbers. That is why the question after this takeover should not simply be whether Toscafund can make Spire more profitable.

It should be how.

Will more money go into new hospitals, equipment and staff?

Or will private ownership ultimately prioritise the treatments and locations that generate the strongest financial returns?

The answer may be both. And that is exactly what makes this uncomfortable.

The Irony

Britain desperately needs more investment in healthcare.

Spire is already investing in technology, including AI-enabled MRI systems and surgical robotics, while expanding its network of clinics.

So private capital can clearly bring benefits.

But there is an irony at the centre of this deal.

The NHS needs more capacity. Investors want profitable healthcare assets. And the gap between those two things is where money is being made.

That should make us question where British healthcare is heading.

Because if waiting lists remain high, private healthcare infrastructure will become investable.4

Final Thoughts

Spire may be worth £1 billion today.

But the bigger story is what made that valuation possible in the first place.

A healthcare crisis has created a market, and investors are buying into it.

Footnotes

  1. Reuters, London's Spire Healthcare gets $1.35 billion buyout proposal from Toscafund (opens in a new tab), 14th May 2026.

  2. Spire Healthcare, Annual report and accounts 2025 (opens in a new tab). 2 3 4

  3. NHS England, Busiest summer ever for NHS but A&Es see record numbers within four hours (opens in a new tab), 10th September 2026.

  4. The Guardian, UK’s biggest private hospital firm Spire agrees £1bn takeover by hedge fund (opens in a new tab), 7th September 2026.