As for overheads – once again – find some facts.
Okay, I can walk into any supermarket and pick up a pack of ibuprofen for 20p. I know for a fact that my local hospital pays much more for them, and on top of that has to pay a fiver for ‘pharmacy’ costs. Even I can see an overhead there.
I don’t think the issue is NHX vs private. I think the issue is NHS managers and successive governments just being a) plain lazy and just signing any deal and b) just not having the knowledge to come up with requirements that could in anyway shape or form be watertight enough for companies.
happens time and time again (see most government IT projects). They get the soundbyte out. Some shoddy requirements, companies bid then the requirements change and it’s kerching, that’ll be £1 billion please to change it.
As you said, TJ earlier, you want better managers in the NHS – you’ll have to (in theory) pay good money for good managers so costs go up.