Structure of the Private Hospital Market

Six main private hospital organisations

The private hospital market in the UK is dominated by six organisations: the NHS and five private hospital groups: BMI Healthcare, BUPA, Nuffield Hospitals, Capio Healthcare UK and HCA International. There are a little under 300 private hospitals and private patient units (PPUs) in NHS Trust Hospitals. These six organisations account for over 80% of them. The actual numbers, based on the current CareHealth Directory of Private Hospitals, are shown in the chart below:

Although there are significantly more NHS Trust private patient units than hospitals belonging to any one of the main private hospital groups, NHS units tend to have smaller numbers of beds, typically 10 or 12. These are dedicated private patient wards which are part of large district hospitals.

The hospitals operated by the private groups, on the other hand, are generally stand-alone hospitals, typically with 40 or 50 beds, all of them for private patients. The consequence is that the larger private groups have more private beds in total than the NHS Trust private patient units. There are approximately 11,200 private beds in UK hospitals. The chart below shows the percentage of private beds belonging to the six main organisations.

HCA International is distinctive in that it is only independent group to have hospitals in central London and these are much larger on average than the hospitals owned by other groups.

Two of the private hospital groups have charitable status: BUPA (which stands for British United Provident Association) and Nuffield Hospitals.

BMI Healthcare is part of General Healthcare, a private company recently purchased by BC Partners, a UK venture capital group.

Capio Healthcare UK is part of a Swedish company (Capio AB), which acquired the UK listed company Community Hospitals Group in 2001 and subsequently rebranded the hospitals. BUPA sparked the acquisitions process by making an agreed bid for CHG in April 2000. The bid was referred to the Competition Commission, which ruled that it should not be permitted unless BUPA separated its insurance and hospital arms, which the company was unwilling to do.

Capio AB arranged a sale and leaseback of CHG hospitals for £250m in 2002 which repaid the company most of the cost of buying the group in the first place. Capio states that it is a knowledge based industry rather than a property company.

HCA International is a subsidiary of HCA Inc of the US.

Smaller groups and independents

In addition to the six main organisations described above, there are approximately 40 smaller groups and independent private hospitals. Two other groups have substantial operations, although none has more than 2% of hospitals by number.

Abbey Hospitals has six smaller hospitals, mainly in the north of England.

The remaining independent hospitals include some of the best known private hospitals, such as the Cromwell Hospital. This category also includes several hospitals run by charities and religious organisations.