That's a great question.
When you're setting up one of these projects, the government is choosing what the contract terms should be and whether or not to enter into one of these. You can build whatever accountability mechanisms you want into these contracts. In general the thing people are not trying to do is tell people exactly how to deliver the services. The idea is to give them some flexibility as long as they can achieve results. But in terms of provisions for protecting populations against bad outcomes, there is no reason why you can't build your traditional provisions into these projects, if that's a priority for you.