They call it, in management speak, "first mover advantage". It's the benefit of getting into a market ahead of the pack, and if you live anywhere in England it's likely that, with £5bn worth of contracts up for grabs, it's happening to a part of the NHS near you. Coalition ministers justify privatisation as a response to a narrative of failure – see, as the latest instalment, Tuesday's report showing nurses too busy to care for their patients. The only option is to bring in the private sector, they suggest: the NHS pound will go further, and state-provided services will be reinvigorated by competition. But where is the evidence? The experience so far, as we saw again this week with the ill-starred NHS 111 telephone helpline, is of over-ambitious bids leading to under-fulfilled contracts.

The increasing scale of the sell-off, according to analysis by the management consultants Bain, now amounts to an arms race. Last weekend the biggest contract so far, for care for older people in Cambridgeshire, went out to tender, although as the pressure to make every part of the NHS a foundation trust has been relieved, the timetable has been extended by a few months.

Leading the charge is Serco. The company that used to be known as the "biggest company you're never heard of", is beginning to be known for all the wrong reasons. Just over a year ago it won a £140m contract to run Suffolk's community services, underbidding the well-regarded local NHS trust by £10m, partly by shedding 137 of the 700 or so jobs in the sector. The number of job losses has since been reduced, along with its projected profits. In January this year it was in trouble for providing false data on its contract to run the NHS 111 service in Cornwall and instructing call handlers to freeze the clock. Earlier this month it was put under investigation, along with G4S, after it emerged it had been charging the Ministry of Justice for (among other oddities) tagging dead people.

The inglorious history of privatising public services moves from failure to disaster, embracing the relatively straightforward – say, the provision of trains that run on time – and the self-evidently challenging – like Atos's work assessment programme, now in special measures. The extent and the nature of the contracts for health services take the challenge to new levels. More than that, the fragmenting entailed in defining contracts works against other vital objectives, like making all the parts of a vast and complex organism work in harmony. It does so just as the whole structure is facing a fractured commissioning process and the most stringent budget constraints. A glance at the first of the new patient approval surveys shows it's not perfect now. But next year looks like a really good time to stay well.