Polly Toynbee wrote in 2009 (with my emphasis):
There is no doubt that putting some services out to tender has vastly improved certain standards over the years, broken the power of vested interests and brought in competition that has sharpened up results. Just look at how hospital consultants’ waiting lists plummeted when a few Independent Treatment Centres were set up nearby. Suddenly, long waiting lists for hip and cataract operations fell because patients had a choice. The wholescale mass privatisation of a service is rarely needed, but a little gingering up round the edges has an electrifying effect on sleepy outfits. Often, private provision makes sense where small units need to buy in some expertise or back-office work they can’t develop themselves.
Some things have always been private – GPs, for example, the most-loved part of the National Health Service…
The answer is flexibility and practicality; see what works best and keep ideology at bay as far as possible.
Hat tips: Nick Thornsby and Martin Shapland.