An unhealthy business: major healthcare companies use tax havens to avoid millions in UK tax
While in public they have been presenting themselves as the future of the NHS, a Corporate Watch investigation into the accounts and finances of five of the major private healthcare companies has found widespread use of tax havens,* including the British Virgin Islands, Luxembourg, Jersey, Guernsey and the Cayman Islands, and tax avoidance schemes Barclays or Vodafone accountants would be proud of.
- Spire Healthcare, the UK's second largest private healthcare company, is channelling £65m a year through a Luxembourg subsidiary of Cinven, its private equity owner, almost wiping out its taxable UK earnings.
- Care UK, which operates NHS treatment centres, walk-in centres and mental health services across England, is reducing its tax liability by routing £8m a year in interest payments on loan notes issued in the Channel Islands.
- Circle Health, the self-styled “social enterprise” that became the first private company to take over the management of an NHS hospital, is owned by companies and investment funds registered in the British Virgin Islands, Jersey and the Cayman Islands.
- Ramsay Health Care, the company with the greatest number of healthcare provision contracts in the NHS, has used a subsidiary in the Cayman Islands to finance the purchase of a French health company for its Australian parent company.
- General Healthcare Group, the biggest private hospital group in the UK, has registered the ownership of its hospitals through subsidiaries in the British Virgin Islands, potentially avoiding stamp duty when its owners come to sell.
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Much of the money appears to be routed through the Channel Islands stock exchange and other subsidiaries registered in Guernsey, avoiding withholding tax by using the “quoted Eurobond exemption” (see the Care UK section), but as their accounts are not publicly accessible, and as Spire would not show them to Corporate Watch, it is difficult to know in exactly how this is happening.
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