Ramsay Health Care’s sweetened, final all-cash offer for UK-based Spire Healthcare at £2.50 per share, up 10 pence from its first bid, may not be enough with a few shareholders of the target resisting.

Australia’s largest-private hospitals operator still faces an uphill battle to get its higher offer over the line with Toscafund Asset Management, which owns 5.4 per cent of Spire, and which said Ramsay “continued to undervalue Spire substantially”, The Times newspaper reported.