Any doctor or nurse will tell you about the importance of a good bedside manner. If a physician has a kind, friendly, understanding attitude it will help patients to recover more quickly.
Justin Ash, the boss of private healthcare group Spire, has decided to extend this philosophy into the boardroom.
As we walk around one of the group’s hospitals in Nottingham he continually stops to greet staff and ask about their day. Nurses, surgeons and lab technicians are all in line for smiles and handshakes. ‘It’s all about the staff,’ Ash says. ‘That is what drives our business.’
Boss of private healthcare group Spire, Justin Ash, says private healthcare will never replace the NHS
He says he tries to visit at least one of Spire’s 39 hospitals every week. Business is booming and the scrutiny on his segment of the health industry is growing. Increased National Health Service waiting lists and strike action by hospital staff are fuelling fears about the future of healthcare in the UK.
Some worry that the private sector could lead to an American-style health system with its horror stories of eye-watering bills and very expensive health insurance plans.
As the boss of Britain’s biggest private hospital operator – a FTSE250 company with a valuation edging close to £1billion – you would expect Ash to be rubbing his hands at the prospect. But he flatly rules out his support for an American-style model in Britain.
‘I’ve met with many big US healthcare companies and I tell them it won’t work here,’ he says. ‘And it’s because we are all proud of the NHS. Myself included.’
Ash argues that the public and private healthcare sectors can support each other as they have already done in the past.
‘Our buildings can be put to the service of the NHS,’ he says. ‘But there are patients here that aren’t using the NHS so someone else can.
‘We also have lots of staff who join us from the NHS. And others who go and join the NHS after working with us.’
Ash says the NHS frequently relies on Spire’s services, but he adds that the firm is ‘not dependent’ on simply creaming off excess demand. ‘Some of our hospitals do almost nothing for the NHS, but for some it can be as much as 50 per cent of their business,’ he says.
Spire’s ability to support the health service came to the fore during the pandemic when it was called upon to perform surgical procedures on NHS patients because wards in public hospitals were filled with those hit by Covid.
Ash estimates that the number of NHS patients who were treated by Spire during the crisis ran into ‘hundreds of thousands’.
He described a growing demand for private healthcare. ‘NHS waiting lists are definitely a part of it,’ he says. Patients are increasingly turning to private providers so they can be seen faster.
Ash, 59, does not seem out of place on the wards. With an approachable manner and rolled-up shirt sleeves, the bespectacled boss would not stand out among a group of GPs or consultants. So it is a surprise to learn that he is not from a medical background.
A politics graduate from the University of Leeds, he served as an officer in the British Army in West Germany towards the end of the Cold War.
Ash is not originally from a medical background and served as an officer in the British Army
He had a passion for politics and later worked on both sides of the Atlantic – for US Democratic congressman Stephen Solarz of New York and former UK Labour deputy leader Roy Hattersley.
Unusually he then chose to pursue a career in private enterprise, crisscrossing several industries. After five years at US management consultant giant Bain & Co, he spent over a decade in the food and drink sector including stints at booze maker Allied Domecq and then as the UK manager of fastfood chain KFC.
He moved into the health sector in 2004 when he was made managing director of Lloyds Pharmacy. He stayed for four years, then served as head of dentist chain Oasis until 2017 when it was bought by Bupa. He arrived at Spire as chief executive later that year.
Ash helped to steady the ship after the hospital group was hit with a £37million compensation claim by victims of disgraced breast surgeon Ian Paterson. The firm had to shell out more than £27million.
In 2021, he was forced to deal with the fallout of an attempted £1.4billion takeover swoop on Spire by Australian rival Ramsay Health Care. The management of both sides agreed the tie-up in July of that year, but it abruptly collapsed later that month after a rebellion by several major investors, including its second-largest shareholder Toscafund, which meant approval fell short of the 75 per cent threshold.
But under his tenure things seem to have improved with the group raking in more and more cash as demand continues to grow.
Shareholders were buoyed by Spire’s most recent results – for the six months to the end of June – when strikes by NHS doctors and nurses resulted in the firm’s profits rocketing to £20.3million from just £3million in the previous year.
The convenience of private healthcare, Ash believes, is likely to become even more appealing to the public.
He says: ‘The average age of our patients is about 50. So many of them will still be working and will need to be seen by a GP at a time that fits into their lives.’
Ash points out that demand for private insurance, from both individuals and companies, has jumped as strains on the NHS leave many people concerned about their ability to receive timely medical treatment.
This has ramifications beyond the NHS and could play a vital role in solving the productivity crisis.
For employers, access to care is critical if they want to avoid staff being struck down by illness or injury for extended periods.
‘We’ve got some companies that employ engineers and want them treated straight away for things like back pain or knee problems,’ Ash says.
He adds that the firm is also seeing increased demand for private GP services as patients struggle to book NHS appointments. There is also rising demand for complex surgical procedures such as those dealing with spinal injuries and heart issues.
Ash with some of his staff at the Spire Nottingham Hospital
Despite claims that private healthcare draws away many of the best workers from the NHS, he argues that companies like Spire help to stem the brain drain which has seen many UK doctors and nurses being lured to countries like Australia for higher wages and a reduced workload.
Ash says some consultants he meets have adopted an equal balance between working for Spire and the NHS, which he claims keeps them looking after patients in Britain rather than resorting to going abroad.
‘Some of these people will have been with the NHS for 20 years,’ he says. ‘And rather than going to Australia, they will keep serving patients for another 20 years with us.’
As someone with a strong political background, Ash is not shy about highlighting areas of healthcare which politicians need to give more attention in order to help boost Britain’s economy. Chief among them is occupational health – medical services often offered by companies to promote the wellbeing of their workers.
Ash says the Government should implement ‘tax incentives’ for occupational health to alleviate the rise in long-term sickness that many say has been hampering Britain’s post-pandemic recovery.
‘We have a productivity issue,’ he says. ‘So there needs to be a political consensus that occupational health is the way forward.’
What he wants most is for MPs to allow the private sector to help the NHS, rather than replace it. He adds: ‘I strongly believe we can contribute to the workforce of the healthcare system because ultimately we are part of that system.’
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