07 Feb 2024

From The Mission Economy: A Moonshot Guide to Changing Capitalism

Patient Records

Public organizations have increasingly found that outsourcing has not delivered the quality and reliability of services they had expected and has often not been good value for money either. In 2011, for example, the UK government basically gave up on an IT system for patient records in the National Health Service after spending almost £10 billion on it. The causes of the failure were complex, but a decade after the project’s inception in 2002 the private contractor had still not delivered the software.


What became known as the Apollo programme cost the US government 28 billion USD, or 283 billion USD in 2020 dollars.

But cost was not the issue: the point was to get the job done. Indeed, Kennedy was not shy about talking about the expense, explicitly saying in his speech, ‘all this costs us all a good deal of money’ Indeed, the space budget, he argued, was getting higher every year and stood in 1962 at about $5.4 billion a year: ‘a staggering sum, though somewhat less than we pay for cigarettes and cigars every year’. And would it necessarily bring success? No, he was clear that the value for money was completely uncertain: ‘I realize that this is in some measure an act of faith and vision, for we do not now know what benefits await us.’