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There's your problem - trying to change the world from the offset. No wonder it goes wrong, and is manna from heaven for the legal teams......
What is so wrong with saying "Yes; we want it to cover the NHS eventually (so it needs to be scaleable) but, bearing that in mind, let's start with a small pilot scheme."?
Or is it really that the big providers want to sign the billion-pound contract, knowing that they'll cash in to a huge extent, regardless of the outcome?
Which is why I said it must be ideology or corruption as to why so much of this work is contracted out rather than the government build up its own capacity which would expand its economies of scale and economies of scope.