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Government of any political colour has a problem. A private sector senior manager who is paid bonuses solely for 'increasing shareholder value' will not be playing a game. Buying in a cheaper clinical service from a multinational company, last week known only for mending your computer will probably lead to misunderstandings. The PCT owns the pitch but the private provider holds the bat and ball. The PCTs have been known to exaggerate the fineness of their ground and have issued contracts based on (mis)understandings rather than firm and enforceable specifications. Where the company finds that the ground is not as described, and cannot wriggle out of the contract ,’Can't play, won't play’ becomes the order of the day.
It would look even worse for government if the private providers were publicly given the boot for not 'playing the game' so, of course, the DH will want to ‘give existing providers an opportunity to improve before others get a look-in’ - at least until after the next election.