In general, a bureaucratic system is one in which normal market forces have been systematically suppressed. In such an environment, there tends to be a sea of (relative) mediocrity, sometimes punctuated by little islands of excellence. Further, the islands of excellence tend to be randomly distributed. They do not correlate with much of anything.
When government provides a service, such as health care or education, variation tends to be random. There is no market mechanism to weed out bad performance or reward good performance.