Competitiveness does not equate with caring and quality. Both go out of the window when the tick box, micro managing ethos is adopted to meet targets and efficiency savings, all in the name of competition.
The rhetoric of competition and choice has not won the hearts and minds of the professionals and other staff who provide healthcare. Arguably it has alienated many of them and led to the loss of something that cannot be bought, which is commitment to the organisation and its mission. Management has clearly been incapable of reinspiring staff in some places, perhaps many places, and no amount of regulation can recreate the vital spark. So what is the point in persisting with an approach which has pathway to failure written all over it?