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a) I suspect that most of the placements at Winterbourne were commissioned by junior pen-pushers with no knowledge of the front-line services they were commissioning.
Most clinicians will see this occurring in their own patches, too.

b) Winterbourne View was a private provider, where profits came above service quality. Half of all the criticism of Lansley's reforms are about this very issue. Even if you point out that N Staffs was NHS, that does not mitigate the fact that Winterbourne profits were poured into the pockets of shareholders, not into the quality of care for the residents. The residents were merely used as pawns for Castlebeck to maximise profits, while PCTs thought they could off-load their own moral responsibilities with their fees.