34Spire Healthcare Annual Review 2010Chief Financial Officer's statementSpire Healthcare produced another year of strong revenue and profit growth with total revenue of £643 million, an increase of 3.7% over 2009. ""

35drive operating efficiencies, particularly within labour and procurement through local monitoring of KPIs and active contract management. This allowed us to continue to manage a reduction in corporate overheads as a percentage of revenue . Capital investment for the year was £50.6 million, including acquisitions totalling £6.1 million. Cash generated for the year was £170.3 million. Cash at bank and in hand at 2010 year end was £59.6 million The financial statements on pages 39 to 73 report the results of the business. The table below includes highlights of these statements.Spire Healthcare produced another year of strong revenue and profit growth with total revenue of £643 million, an increase of 3.7% over 2009. This converted into a 10.5% improvement in EBITDAR (pre-exceptional items), up from £153.6 million in 2009 to £169.8 million in 2010.Key financial highlights for the full year. Revenue grew by £23 million. This was partly a result of continued growth in out-patient and diagnostic activities through further investment in our diagnostic capability and an increase in the average revenue per discharge. This increased Spire's EBITDAR (pre-exceptional items) margin from 24.8% in 2009 to 26.4%. Other factors contributed to this improvement; for example, we continued to Group results2010 full year£m2009 full year£mGrowth%Revenue643.0620.03.7%EBITDAR (pre-exceptional items)169.8153.610.5%EBITDAR margin %26.4%24.8%To improve year-on-year comparability in measuring operating performance, our primary measure is EBITDAR (earnings before interest, tax, depreciation, amortisation and hospital property rentals).Group revenue and profit before interest and tax2010*£m2009£mGrowth%Revenue643.0620.03.7Group EBITDAR (pre-exceptional items)169.8153.610.5Rent(1.4)(3.2)Group EBITDA (pre-exceptional items)168.4150.412.0Integration and rebranding(0.4)(1.0)Reorganisation and set-up costs(1.1)(3.5)Corporate restructuring and refinancing1.6(0.5)Depreciation(45.8)(41.0)Profit/(loss) on disposal assets(0.0)(0.4)Profit before interest and tax122.7104.018.0*Full income statement is presented on page 43.