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

  • Use of consulting rooms £22 per hour, discounted to £19.80 for direct debit
  • Spire employed medical secretary based at Spire Montefiore Hospital: £26.41 per hour
  • Spire employed medical secretary based at home: £24.00 per hour
  • Office rental: £26 per square metre per month

“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 Oulton Hall, Leeds. The total cost of the events in 2022 were approximately £6,463 and £20,338 respectively.
  • In 2023, the conferences were held in June at M Restaurant in London and in November at The Midland Hotel, Manchester. The total cost of the events in 2023 were approximately £2,931 and £20,389 respectively.
  • On Monday, 27 November 2023, MAC Christmas dinner and meeting, total cost of £1,927.45, 17 attendees (14 consultants).

In 2019, Spire Healthcare held a series of five dinners with 70 consultants from across five 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, 2022 and 2023.

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:

  • Football hospitality: April 2015 £57 per head
  • Cricket hospitality: April 2015 £90 per head
  • Cricket hospitality: July 2015 £25 per head
  • Cricket hospitality: August 2015 £35 per head
  • Cricket hospitality: July 2017 £45 per head
  • Cricket hospitality: August 2018 £90 per head
  • Cricket hospitality: April 2019 £50 per head
  • Cricket hospitality: July 2019 £90 per head
  • Cricket hospitality: June 2021 £90 per head
  • Football hospitality: February - May 2022 £150 per head
  • Cricket hospitality: June 2022 £90 per head
  • Football hospitality: February - May 2023 £150 per head
  • Cricket hospitality: June 2023 £90 per head
  • Football hospitality: February - May 2024 £150 per head
  • Football hospitality: February – May 2024, 12 consultants and 8 staff at £150 per head

The hospital has four debentures for Brighton & Hove Albion FC that are used by consultants and staff. The face value of each of these debentures is £150 per month.

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:

  • Candice Davis: indirectly holds a 2.08% share in Montefiore House Limited, which owns Montefiore Hospital
  • Shuaib Karmani: indirectly holds a 2.08% share in Montefiore House Limited, which owns Montefiore Hospital
  • Antonio Perello Sancho: 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 or as follows:

  • Mr Pakarian is currently Chair of the Medical Advisory Committee at The Montefiore 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) £500 for each annual medical appraisal undertaken for a doctor designating to Spire for the purposes of revalidation; and (iii) £200 per hour for the preparation of an independent report (up to a maximum of £500 per report) upon request by the Medical Director or Chief Medical Officer.
  • Sunil Sharma attends and provides advice to the Hospital Infection Control Committee for a fee of £13,770 per annum
  • Timothy Chevassut and Tim Corbett attend and provide advice to the Hospital Blood Transfusion Committee for a fee of £8,700 per annum each.
  • Mr Hatrick held the position of Medical Director for The Montefiore Hospital until June 30 2023, for a fee of £10,200 and within the role he provided advice to the hospital senior leadership team, had oversight for the medical committee and chaired the medical committee meetings.

    Mr Hatrick held the position of Chair of the Medical Advisory Committee at The Montefiore Hospital, between July 2023 and December 2023. Their role was to provide senior professional advice to the Hospital Director and Director of Clinical Services in order to support effective medical governance and oversight. They were paid £14,000 per annum for this role and was also entitled to receive the following fees for the provision of additional ad hoc services: (i) £750 for chairing a Professional Review Committee; (ii) £500 for each annual medical appraisal undertaken for a doctor designating to Spire for the purposes of revalidation; and (iii) £200 per hour for the preparation of an independent report (up to a maximum of £500 per report) upon request by the Medical Director or Chief Medical Officer.

  • Dr Antonio Perello Sancho, Consultant Anaesthetist provides anaesthetic support to the hospital pre-assessment clinic. The role requires clinic support and advice for patients when required. Role is paid at an hourly rate of £250.
  • Dr Stuart Cairns holds the interim position of Consultant Endoscopy Lead for The Montefiore Hospital, to assist with the JAG accreditation and ongoing endoscopy service, for a fee of £150 per hour spent performing these duties.