Unlike in the US where private companies step in to fill the gap left by a welfare state never having really been built, in the UK, private companies deliver previously public services. The services remain free at the point of use (with the exception of dentistry), but many are run by private companies. The performance of the companies running these services is monitored by the body that would have originally provided the service themselves – national and local government, local NHS structures and so on. The process of outsourcing, of paying private companies to carry out the work of public services, accelerated in the 1980s with the introduction of ‘compulsory competitive tendering’. This legislation placed a requirement on public sector organisations to tender all contracts for service delivery, meaning that anyone could bid for them. The contract was awarded to the company that would provide the service the most cheaply. This duty was relaxed slightly in 1997 but by then outsourcing was established as the new normal. Now, £284 billion per year is spent buying goods and services from external suppliers. This is about a third of all of public expenditure21 and 13% of GDP.22