Compliance with CMA Order 2014

In October 2014, the Competition and Markets Authority (the "CMA") published the Private Healthcare Market Investigation Order 2014 (the "Order") following its investigation into the private healthcare industry. The Order imposed requirements on private hospital operators to disclose certain information in relation to referring clinicians (as defined by the Order) for the benefit of patients. Full details about the investigation and the Order can be found on the CMA web page. The information provided by Spire Healthcare below is required by the Order.

"Higher value" services

The services provided at Spire Harpenden Hospital to referring clinicians and the amounts charged by Spire for those services are set out below:

  • Use of consulting rooms: £19 per hour
  • Medical secretarial services: £19 per hour

“Low value” services

The following “low-value” services are also provided to referring clinicians with practising privileges at this hospital:

  • General services to ensure clinical safety (eg in-house training, chaperones)
  • Operational services such as patient bookings/admissions (including online booking and payment for consultations), access to a virtual consultation solution, administrative services and billing, and insurance/indemnity cover in respect of NHS patients
  • General marketing support, including production of consultant directories, promotional activities, web profiles etc
  • Basic workplace amenities such as teas/coffees/refreshments, subsidised meals, car parking, stationery

Corporate hospitality events for referring clinicians

Spire group Medical Advisory Committee (MAC) Chairs conferences

Spire group Medical Advisory Committee (MAC) Chairs conferences are held twice a year, focusing on clinical safety and governance issues. MAC Chairs from all of Spire’s hospitals are invited to attend, with their partners, and are joined by members of Spire’s senior management.

  • In 2017, the conferences were held in Berlin and Aylesbury and the total cost of the events was approximately £85,000 and £25,000 respectively.
  • In 2018, a conference was held in Berlin and the total cost of the event was approximately £88,000.
  • In 2019, the conferences were held in Lisbon and Aylesbury and the total cost of the events was approximately £95,000 and £28,400. MAC Chairs were also invited to attend the Spire Healthcare Senior Management Conference in Birmingham in June 2019 (8 MAC Chairs attended at a cost of £845 per head).
  • No conferences were held in 2020.
  • In 2021, conferences were held virtually via Zoom as well as face to face in Aylesbury. The total cost of the events in 2021 was approximately £2,120 and £19,300 respectively. 
  • In 2022, the conferences were held in May at Spire’s head office in London and in November at Oulten Hall, Leeds. The total cost of the events in 2022 were approximately £6,463 and £20,338 respectively.

In 2019, Spire Healthcare held a series of 5 dinners with 70 consultants from across 5 Spire hospitals for the purpose of meeting various members of the Spire Executive team and listening to and engaging with consultants. The cost of the dinners ranged from £60 to £80 per head. No dinners were held in 2020, 2021 and 2022.

The MAC dates for 2022 are:

  • Monday 28 February
  • Tuesday 10 May
  • Wednesday 17 August
  • Thursday 24 November

MAC meetings in 2021 were held via Zoom - there was no hospitality involved as all meetings were conducted online.

The MAC dates for 2021 were:

  •  Monday 15 February
  •  Wednesday 12 May
  •  Thursday 19 August
  •  Monday 15 November

The Annual General Meeting was held via Zoom on Wednesday 26 May and was followed by dinner for the Medical Advisory Committee members who attended at a local restaurant at £35 per head.

The MAC dates for 2020 were:

  • Thursday 6 February
  • Wednesday 13 May
  • Friday 7 August
  • Monday 16 November

Quarterly MAC Meetings at £15 per person.

Corporate hospitality events

Corporate hospitality events held by the hospital at no charge to referring clinicians are set out below, together with the cost of providing such events:

  • West Ham v Watford 10.02.2018 = Free of charge (part of the Spire London East sponsorship)
  • England v Ireland Rugby 17.03.2018 = £1068 per person
  • Wimbledon 02.07.2018 = £948 per person
  • Consultant and Partners Party 30.03.19 = £72 per person
  • Practice Manager Pamper Evening 03.04.19 = Free of charge
  • Henley Regatta 03.07.19 = £625 per person
  • Consultant Faculty Dinner 06.06.19 = £59 per person
  • Go Karting Event with Dinner 19.09.19 = £73 per person
  • Theatre Trip with Dinner 25.11.19 = £118.78 per person 
  • Medical Secretaries Dinner 11.12.19 = £50.58 per person

Clinician financial interests in Spire Healthcare

Private hospital operators are required to disclose details of referring clinicians practising at their facilities, who have a share or financial interest in those facilities or any equipment used there. Some clinicians may own shares in Spire Healthcare Group plc, which were acquired either at the admission price or through trading on the main market of the London Stock Exchange. Where a referring clinician has an individual web page profile on this hospital website, relevant shares and/or financial interests are disclosed there. For referring clinicians who do not have an individual profile, their shares and/or financial interests are shown below:

  • Mark Sandler holds less than 0.1% of the shares in Spire Healthcare Group plc

Clinician advisory services to Spire Healthcare

Private hospital operators are required to disclose details of certain paid services provided by referring clinicians to private hospitals operators in addition to exercising practising privileges at that hospital. This information can be found on the referring clinician’s individual web page profile on this hospital website.

  • Harish Parmar is a Specialist Consultant Orthopaedic Advisor to Spire’s Group Medical Director and is paid £10,000 per annum for this role.
  • Mr Harish Parmar is Chair of the Medical Advisory Committee at Spire Harpenden Hospital. Their role is to provide senior professional advice to the Hospital Director and Director of Clinical Services in order to support effective medical governance and oversight. They are paid £14,000 per annum for this role and are also entitled to receive the following fees for the provision of additional ad hoc services: (i) £750 for chairing a Professional Review Committee; (ii) £200 per hour for attendance at regulatory or other national body meeting (capped at £500); (iii) £500 for each annual medical appraisal undertaken for a doctor designating to Spire for the purposes of revalidation; (iv) £1,000 per annum for undertaking the role of governance lead in addition to MAC Chair; and (v) £200 per hour for the preparation of an independent report (up to a maximum of £500 per report unless otherwise agreed due to complexity) upon request by the Medical Director or Chief Medical Officer.
  • Dr Ratna Makker and Dr Savita Marathe, have been appointed as pre-operative lead anaesthetists to run and improve pre-operative assessment clinics at the hospital. Duties include weekly anaesthetic support services for patients undergoing pre assessment at the Hospital.  Dr Makker and Dr Marathe are paid £200 per hour to provide these services to the hospital.
  • Dr Dev Acharya, Consultant Anaesthetist chairs the quarterly ERU and Resus Committee Meeting and is paid £1,200 per year to provide this service to the hospital.
  • Dr Hala Kandil, Consultant Microbiologist, supports Spire Harpenden Hospital in the delivery of a robust infection prevention and control programme for which she is paid £3,000 per annum.