This is the problem. The "if you can get it" translates to "if your company has a huge request-for-tender team dedicated to shmoozing your way into these kinds of contracts".

Add to it the whole tech-health ecosystem is scorched earth after countless clueless contractors have blown their way through it (earning the tens of millions of pounds and so on in the process), it's not a great environment for trust, innovation, or making your way through everything to a real-world-usable result.