We need new thinking about the operating environment we currently frame as a 'marketplace'. We need a courageous, informed articulation of what is happening now, and the start of the thinking that can move us towards a method of effective working, both for quality of care and the health of our finances.
About a decade ago, many companies in the UK pushed their customer service centres offshore to new call centres located far away - often in India or the Philippines. The aim was to save money because the captains of industry bought into the idea that distance was dead - work in call centres can be performed anywhere by anyone.
How did a British university get to the stage of inspiring such anger and contempt from someone like Geoffrey Robertson, the man who organised war-crimes trials in Sierra Leone, that he would be prepared to spend days of his time working unpaid, dealing with petty academic administrators, instead of making the big bucks in Strasbourg?
Imagine what would happen to Britain if the Home Secretary had the power to expel anyone from the country "without assigning any reason." Then imagine what it would be like now if the power had always existed: no dissenting voices left, no debate; anyone in a minority either too intimidated to speak out or already deported.
It stands to reason that the most effective IT outsourcing relationships are built on a foundation of commonality. It's one reason why the importance of having compatible values should not be underestimated. For this reason, a willingness on both sides to view the relationship as a 'partnership' and not simply a 'contract' is key.