I read the following question from Baroness (Jane) Campbell and answer from Professor Peter Beresford recently, in the context of independent living. It seemed to me that Peter answered quite brilliantly the “why?” of user-led service delivery as part of the market in public sector provision. I’ve thus reproduced the edited relevant parts of the question and answer below.
Question (Baroness (Jane) Campbell of Surbiton): So it is not all about the money, but money is tight. Do you think that there are any specific changes to Government policy that could better meet the [aim of independent living] without increased funding?
Answer (Peter Beresford): I noticed today [that when] the Government are thinking about introducing competition, then there is immediate mention of the private sector.
[W]e have several sectors here and the most exciting, emerging and radical sector for me is the user-led sector.
Yet, despite the evidence we have from research of the value that that sector can contribute in all sorts of senses as an employer, as a service provider and commissioner, user-led organisations are still not really getting any kind of equality in terms of opportunities to be part of the market, to develop the unique capacities they have to match the rights and needs of disabled people and, of course, to take on the task, which they have always been very skilled at, of recruiting disabled people to employment and to new roles and tasks in our society.
I would hope – and this picks up on what [has been] said about providers – that there could be a real emphasis in reality on a market that is equally open to user-led providers and local providers and where an emphasis is placed on people having opportunities and increased life chances through the employment that they can offer as well as perhaps the better services that they can offer.
If there is one thing we have learnt lately – I think we have learnt the lesson; even the money people tell us the same – it is that we cannot really just go to the most unconstrained approaches to funding private sector organisations if we are really concerned with securing the rights and needs of service users too.
I am not making the point that I know some people make, which I think is a very unhelpful and arbitrary point, that profit and meeting need are just incompatible. That takes us nowhere.
What I think does take us somewhere is recognising the very real contribution that a diverse market would have. That must mean a much bigger role, supported by Government at central and local level, for user-led organisations and services.
arbitrary constant 
You are so right on the point of a diverse market.
Think fo the three wise monkeys in reverse: they would be listening, seeing and communicating.
The first thing that requires to happen, is for people to LISTEN.
Then we need to take the blinkers off, and see that if the right help is not given at the right time, we are further disabling those who are already struggling.
The communication is vital: If you are struggling with your benefits payments and keeping warm, it only causes annoyance and frustration when someone brings you a rocking horse. (With the kindly advice:”It will take you mind off your problems and give you something to do!”)
And timing is vital.
If you have a plane to catch at 11.a.m.,and the taxi does not arrive to take you to the airport until 11.30.a.m., you have been further disabled.
There is a real struggle with this in systems: the help has been sent: what are you complaining about?
The appropriate assistance at the appropriate time will promote a diverse market, which is fully inclusive and full of potential.
I wait and wonder.
How many can see, hear and communicate effectively?.