I’ve worked in private companies for about 40 years.
They have been far from efficient or well run although you get pockets of things being done properly for period. The only difference is the money runs out after a while if they are not making a profit.
Look at Carrilleon, a private company spending public money, went down for billions and billions, I don’t think they’ve even got to the bottom of it.
Private or public, it’s the British way to run things chaotically, politically and inefficiently by often putting the wrong type of people in key positions.
Anybody thinking privatisation will somehow transform our health service into a panacea of efficiency is just wishful thinking, the Tories only want it for ideological reasons rather than making it better.
Carillion wasn't well run, they cooked the books and hid their debt, which loads of people apparently realised before they went into liquidation, they were broke long before this. They also had the wrong business model which was inevitably going to come back and bite them, which it did. They're similar to Interserve, those two are probably the worst "large" construction companies I've come up against as a sub-contractor. I mean against too, as when working for them, you have to actually cover/ remind yourself that they're working against you, as your PC, when they should be working with you.
The Carillion example is a good one though, they relied heavily on government/public sector contracts, which was a bit nieve during a recession recovery, headed by a Tory government known for shafting the public sector. They also took on all the risk, which is extremely naive when working for a client who does not know what they're doing. This coupled with their model of ******* off (bankrupting/ shafting) subcontractors, effectively left them with crap work, for a crap client, with a subcontractor base (nearly all of their work was sub-contracted) who either massively overcharged (insurance against Carillion) or would not work for them.
They Carillion/ Interserve had all risk contracts, yet took on subcontractors who would not/ cannot do all risk, it's not how construction works. You cant price low, take all the risk, assume subbies will absorb those risks (which they're contractually not obliged to do) and then shaft the same subby with under and late payment. Word gets around, and inevitably a company which 100% relies on subcontractors has nobody who will work for them for a fair price, with a fair contract. Towards the end, when they asked us to price work for them I would always stipulate settlement of the outstanding debt, before I even sent any e-mails related to the job they wanted us to tender for, then any new jobs our terms were payment up front. This partially worked and we were getting our outstanding debt back, at a low trickle, it was the only way to trickle that money back.
In the end Carillion went down owing me about 50k I think (better than the 80k it was), and Interserve still owe about 30k which has been going on about 7 years, although they're still sort of going somehow. I won't price Interserve work "normally" now though, last job for them was at James Cook, the new secure treatment section, the whole job was a joke, and took about 6 months to get paid all of it.
Everyone knew what Carillion were all about or, or learned this between 2008 and 2015, the only ones who didn't were new sub-contractors, new to the industry or those scrapping for any sort of work after the recession (this was plenty of companies mind, we were the same in 2010/11).
Oh I didn't say it would work (running it all private, but as a publicly owned company), as it relies on a competent client/government, which we currently don't have (we've had 13 years of bad, who dug a big hole), and won't have for 2/3rds of the time (going historically). It could work under Labour, if they got competent people in, to look after it, but I'm not sure I would even want to take that risk, as it's coupled with the risk of losing to the Tories. It could (and should) really work, but I'm not really saying it would.
It doesn't mean the private aspect is wrong, it means we have a control problem. I think some smaller sections of it (to start) could maybe run private but mainly needs to be on the low-risk, easier areas (not construction), and areas where budgets can be forecast more easily. It's certainly not easy, but controlling that sort of budget never is. It also doesn't mean we can't make big changes, to streamline things, pre A&E/ GP Triage, bring back walk in centres for minor injuries, not suitable for A&E, pharmacies taking on more responsibility etc. I imagine some things need breaking down, to take the load away, dealing with smaller, should make it easier, but some areas need better integration, like between the NHS and social care, as they're so reliant on each other, and one can sink the other.