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    There are fewer places to hide in the private sector, frankly. It is a continuous evidence-based process with audits, contract reviews and outcomes based reviews, with budgets and contracts open to scrutiny at all times. And in the private sector, if you perform poorly you either upskill or you are out. As a patient/service user I welcome that. If I were a poorly performing manager or practitioner I might be a little alarmed. In the public sector I have seen, time after time, rubbish staff remain in post because it is too difficult to shift them, and the only way is up, to get them out of the public eye.

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