Not Just the NHS
do you know how many fax communictaions are involved in a football transfer?
if the FIFA fax line goes down on deadline day, the deadline gets extended.
On the subject of the NHS, the system is broken, there is not enough cash in the right places and the wrong things are centralised and pushed to the edge. THere have been numerous attempts to remove the middle managment an beurocratics, but somehow regional and national and sub-national structures make there way back.
The current money wories in the NHS can be traced to the (finaly) former health secretary's Health and Social Care Act 2012, that formed the current funding system of the NHS, that sees these non-medical non-accountabale bodies known as CCGs get to choose where everyone in their area gets certain things done and by who, this frequently entails private companies who pay there less qualified staff considerably less than the NHS and get to deliver services from the NHS buildings.