A £1bn bid to create Britain’s biggest private hospitals group is facing opposition from some of the largest investors in Spire Healthcare.

Sky News has learnt that some City institutions intend to reject a recommended 240p-a-share offer for Spire from Ramsay Health Care of Australia.

A successful bid would unite Spire’s 39 UK hospitals with Ramsay’s 37 under common ownership, making the combined group bigger than rival BMI Hospitals.

Spire’s board, led by newly appointed chairman Sir Ian Cheshire, sought to justify its recommendation by pointing to a near-25% premium to Tuesday’s closing share price and a 55.8% premium to the price on March 5 – the day before Ramsay’s initial approach.

However, several institutional shareholders in Spire are said to be stunned at the recommendation and believe that the company’s freehold property portfolio alone could be worth £1bn.

They are thought to want to push for offers valuing Spire at closer to 400p-a-share – nearly 70% higher than the recommended bid.

A fairness opinion was provided to Spire’s board by the investment banks Goldman Sachs and JP Morgan Cazenove – for which they are expected to be paid a multimillion pound fee.

One City source said that the pent-up demand in waiting lists caused by the coronavirus pandemic’s impact on hospital capacity meant that Spire had “five years of earnings growth to look forward to”.

Directors of Spire are now expected to come under pressure from leading shareholders to launch a formal auction of the company.

Mediclinic, a South African group which owns 29.9% of Spire, gave its endorsement to the 240p-a-share bid, although one insider said that that stance had been heavily influenced by its need for cash.

No other shareholders provided irrevocable acceptances despite being briefed on the offer ahead of its formal announcement.

Spire’s leading shareholders include Aberforth, Fidelity, Schroders and Toscafund.

None of the investors approached by Sky News on Wednesday would comment.

One person close to the company defended the level of the bid and said it represented a fair outcome for shareholders.

The looming row between Spire and some of its leading shareholders comes at a sensitive time, owing to the number of FTSE-250 companies being targeted by private equity and overseas bidders.

In recent weeks alone, John Laing, the infrastructure group, has agreed to be taken over by KKR, the buyout giant, and healthcare provider Vectura recommended an offer from Carlyle.

Equiniti, Sanne and Elementis, all of which are FTSE-250 constituents, have also attracted bid interest.

Spire declined to comment.

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