What makes you say that? It works very well in other parts of the world. A governing panel from "the Ministry" (to whom the contractor reports) holds sway at every hospital. Contractors are held to account, and even penalised when they fail in some regard.
In our own area of concern, faulty equipment has to be dealt with within a specified (short) period (or else, again, deductions are imposed).
There is often a specific programme of equipment to be renewed during the contract period, and other such good stuff as that.
There is a fixed budget, and standards are enforced. It sure makes a change from "business as usual" and "lessons will be learned"!
