My overall view remains that in-house is (should be) best, basically on grounds of continuity, local knowledge ... and response time
Does this assume that the third party provider will not be "in house" (or on site), 'cos this is not always the case.
We provide on site staff who are based at the hospital (and the workshop set-ups, equipment, etc) so long as the hospital (and hence the contract $) are big enough. For those who are not of sufficient size to require full time staff, then we would provide support on a number of days per week dependant on need (this includes provision of PM time obviously).
Do we have to run our business "lean", well yes of course. No room for carrying people in this environment, perform or get lost but that is what enables us to provide a service to our clients which is more economically viable than some of the various in-house groups that we compete with.
It is "dog eat dog" but that's what the private industry is like. If your department's work can be done at less cost than an outside contractor, with the same or better outcomes, then..... watch your back.
