It's the same as buying any other sort of goods and services. Do you think the NHS makes its own paperclips and grows its own potatoes? No, the private sector really is massively more efficient, for two absolutely crucial reasons: 1) there are actually many sellers with interchangeable products and 2) paperwork and catering aren't actually core to the NHS mission.
If 1 and 2 aren't true, if there are a limited number of sellers of the service, and the service is core to the mission, then outsourcing will certainly fail.
The majority of government outsourcing deals are ideology or to hide the numbers.
Take PFI, if I offered to take over the rest of your mortgage on your house. But you had to pay me equivalent of the mortgage payment for 100years and you had to buy my services for any cleaning or maintenance of your house for the 100year term - then even though you were now mortgage free (ie. you had reduced your deficit) - you would be mad to take the deal.
If however your only interest was being able to claim that you had reduced your deficit going into the next election - and it wasn't your money anyway - you might look at it differently
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It's the same as buying any other sort of goods and services. Do you think the NHS makes its own paperclips and grows its own potatoes? No, the private sector really is massively more efficient, for two absolutely crucial reasons: 1) there are actually many sellers with interchangeable products and 2) paperwork and catering aren't actually core to the NHS mission.
If 1 and 2 aren't true, if there are a limited number of sellers of the service, and the service is core to the mission, then outsourcing will certainly fail.
The majority of government outsourcing deals are ideology or to hide the numbers.
Take PFI, if I offered to take over the rest of your mortgage on your house. But you had to pay me equivalent of the mortgage payment for 100years and you had to buy my services for any cleaning or maintenance of your house for the 100year term - then even though you were now mortgage free (ie. you had reduced your deficit) - you would be mad to take the deal.
If however your only interest was being able to claim that you had reduced your deficit going into the next election - and it wasn't your money anyway - you might look at it differently