Not for the first time, SRCL in the south west of England are facing scrutiny after the Competition Commission has provisionally found that the company’s purchase of EcoWaste South West might lead to a substantial lessening of competition.

Previous history in the south has proven that the Competition Commission can and does delay, and to some lesser extent sharps, the sale and acquisition of smaller waste management companies though in reality the wise can manipulate the deal to achieve the primary aim without too much problem.

But is it wise? Going against the ruling – or is it just advice – of the Competition commission seems to be a marginal issue with little comeback except in the most extreme of cases.

And on the other side of the coin, what is the evidence that there is, or will be, any adverse impact from a lack of competition whether that is actual or perceived? Bigger means more efficient, though actually that could be difficult to measure and even more difficult to demonstrate. But bigger also means more resilient, which is a key performance criterion upon which to select a provider.

Price is perhaps the greatest concern for a cash-strapped NHS. There is no evidence that merger and acquisition increases prices though it is right to monitor this. However, that is not the purpose of the Competition Commission, who focus on forward-looking predictions of what might happen. Post-facto, they are nowhere to be seen, so if their best guess is wrong the value of their intervention has been worthless.

Of course, prices may rise when manipulated by a behemoth but also when services are provided by a smaller local or regional provider struggling to survive in a geographically small catchment with limited commercial opportunities and ever-increasing costs.

Perhaps the Competition Commission has a role and indeed that role might be strengthened to prevent companies sidestepping a CC ruling, but ultimately the customer should decide.