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I am not an Accountant but, AIUI, even if supplies are VAT-exempt it is still necessary to register for VAT once the threshold is reached. Even if not necessary, you may still wish to register voluntarily.
An Accountant is required.
in OP's context of the supply of private medical services, those are exempt supplies, and therefore it is unlikely the Ltd would cross the VAT threshold as exempt does not count towards the Vat turnover total, plus: If all your supplies are exempt, you will not be able to register for VAT.
Insurance is also an exempt item @bookworm105 and whilst some insurers sell both insurance and non-insurance products/services there are certainly some companies only sell insurance and yet they are VAT registered... a former client wanted all costs inclusive of VAT because they couldn't recover any at all but they do have a UK VAT number. Obv these are complex organisations with service and SPV entities but surprised by the comment, its similar that the service companies dont have to charge VAT to the insurance company because they have fully authority and so counts as insurance activities.
the reason for insurance companies being registered are complex and beyond the need for answering OP's question.