Ok so without pen pushers who is going to do all the management?
Oh right yes, Doris and Betty the cleaners can just clean aimlessly all day, that's a really nice shiny floor you have there Betty but the bogs are minging.
And how are Kate and Adam the nurses going to know which patients they are allocated to? What there is a patient in for Dialysis, um, he's deid, who was his nurse?
Oh no here's one, who is going to send out all the appointment letters? What no administrators to do it? Yes the Urologist is expected to send out his own appointment letters, wow what a great use of his time, can he see any patients, nope he is too busy telling them when to arrive for appointments.
Taking it back into Software, how many development team leaders actually get a chance to write code? Mine is too busy planning and allocating work to have written code since he got the job. In fact he's so busy doing that, that the allocating of support calls has been delegated to me and line management of lower grade staff on the support team to someone else so he can focus on planning and allocation of the new development work.
As for the tea trolley, there is a machine about 25m from the front door of the office, we are expected to use our recommended 5 minute break per hour away from our VDU's for stuff like that.