It is so unfortunately, what happens is that for any given department, there is the manager on the ground, plus the heads of department, various health chiefs not attached to the hospital, whitehall propper and the health secratary him or herself issuing directives completely seperate from one another. So you got maybe... 8 or 9 managers all giving out extra paperwork (often repeating other sections recomendations) all adding up. So to deal with this, the NHS has to have that many pen pushers in the background just to deal with the system... Even the government in PMQ's (Prime ministers Questions) has had to acknoledge it (although they tried like buggery not to).
The railways is the one place that I can honestly say that a quango has sorted it all out, yes there are still delays, but not nearly as bad as it was. There are actually more trains on the rails, the costs of operating on the railways has been reduced.
Is it still a mess? Well yes it is, but, its a hell of a lot less messy then it once was, and its still getting better. Primarily because of the training and recruiting of managers that actually know what they're doing as aposed to the old boys club where it isn't what you know, just who you know (as it is in the NHS and many other areas of public service).
