Abstract
The provision of services by private contractors in the National Health Service rather than by direct labour is not a recent phenomenon. Certain services, eg. the erection and repair of buildings, have been performed by contractors in the majority of health authorities. In some instances, catering and domestic services have been performed by outside contractors for a number of years (although this has been the case only in a very small minority of hospitals). What is novel is a policy which says health authorities must invite companies to tender competitively against their own in‐house services, and choose the tender which is the least costly.

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