Re: I work in the NHS
Having worked for both hospitals and for IT suppliers to the NHS across a lot of different NHS England hospitals, there is a huge variation in how IT services are delivered and their professionalism.
The best I've seen are in-house staff who were reasonably well looked after and had down-to-earth managers with reasonable IT and management skills (many originally trained in the armed forces). The worst I've see are where
a) IT services are outsourced to a very big blue company who won't react until they have a purchase order
b) outsourced to tiny local companies with insufficient resources to handle anything but the normal day-to-day 'my pc won't boot' fault and find it difficult to retain skilled staff.
c) in-house staff are badly managed by maniacal leadership who are only concerned in advancing up the ladder and think that staff motivation has a 1:1 link with how loud they can shout.
Unfortunately in my experience, there are a lot of very competent and dedicated indians (small i) being lead by incompetent chiefs. I have seen first hand that once you are in the NHS, it is a job for life unless you actually kill someone and where the only way to 'get rid' of someone useless is to promote them.