I have no expertise when it comes to NHS services and funding arrangements. That said its easy to “extrapolate” your experience elsewhere into circumstances like these. Perhaps this is the only way to manage out-of-hours GP services (though I doubt it). It does however seem another case where an almost ideological, governmental commitment to “out sourcing”, by way of “procurement”, champions getting the service delivery right in the first place. The danger of having a few, large contractors primarily chosen on price is a foreseeable one. This is a theme we know all too well after 10 or more years of “consultation” concerning similar proposals for the Justice system. What is more anybody who has looked at it dispassionately seems to see this as a likely disaster. We will be reentering into these discussions in the New Year
This example may well not collapse like the recent West Coast rail franchise, but it is another warning sign. Time for a bit of applied thinking.