Europe in general has a fetish with subcontracting IT to the point where only the contractor’s can do it. Sometimes it’s the contractors’s contractor’s contractor who is the only one who can do anything.
in the short term this does not matter, because the company stays profitable, but long term this is resulting in a system in which no one has complete ownership and responsibility of their systems, which makes doing changes and innovating nearly impossible.
For instance, when I worked in US govt, best as I could tell all the real work was done by contractors and the govt employees sat around on their asses all day.
Headquartered in Switzerland, its German office was mainly just Product managers writing requirements. Most of them would do endless paper work and all technical work is outsourced to multiple contractors. One of the requirements of the Product managers was to handle all these contractors so that things run smoothly. Many of the product managers had PhD degrees or Masters doing this nonsense. Finally the wonder why the cost of their products are so high.
I have noticed that it is better in the United States where a lot of medical companies have a lot of in house technical experience.