General Healthcare looks at a plastic surgery buy

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The developments are being closely monitored by Lloyds Banking Group, which assumed hundreds of millions of pounds of commercial loans with Covenant when it took over HBOS last year.

A deal would change the shape of the private medicine industry, since Covenant owns Transform, Britain's biggest cosmetic surgery business, which makes £40 million a year from thousands of patients undertaking breast surgery, liposuction and Botox. Covenant also owns five private hospitals, including a psychiatric unit in Lambeth.

That would fit with General Healthcare's business, which currently has 57 private hospitals, including eight in London under the BMI brand.

It is run by ex-Punch Taverns boss Adrian Fawcett, who today confirmed that the company was shopping for rivals.

He said: "We are looking at all the assets in the market place. The current level of indebtedness means businesses are no longer attractive to their owners.

"There have to be winners and losers. Covenant is one business sold at a large level of debt. It's on the market so it's time for us to look at it."