It's not hard to find diagrams like the ones above, the Internet is littered with examples of just how overly complicated the NHS' management structure and bureaucracy has become. It shouldn't take several textbooks and a few years of intense study to understand the way in which a health care system works (or does not as the case may be), the fact that the NHS is so hard to understand implies that it is a disorganised shambles with no clear chain of command. It should be so much easier to comprehend, but the government keep reforming, making things more complicated and shambolic.
The market argument is a complicated one, even a bottom up market would probably be more inefficient and bureaucratic than a well run state run system. However one can guarantee that a top down state run market system will be ridiculously inefficient and cumbersome. The diagrams above the the government 'newspeak' sum up the stupidity of the current process. Even people at the top are starting to see the light, and about bloody time too, it's just a shame that our moronic leaders like Tony Blair cared more for their own wallets than the nation's health. The lack of a clear chain of command means that the system is also incredibly dangerous as no one ever takes any responsibility when things go wrong.
The sad thing is that there appears little that we can do as cogs in our great 'democracy' to affect change in this regard. Labour copied all the flawed ideas of the Conservatives and then put them into practice from 1997 to this day, the Conservative would carry a lot of them on if reelected, while the Lib Dems never seem to oppose anything much with any vigour. The current economic situation and the future NHS spending cuts mean that we can expect to see front line services hit hard, while I am sure that the spending on bureaucracy, managers, PCT numpties, new incomprehensible reform strategies, management consultants, quangos et aliter would not be affected much.
It makes my blood boil. So much corrupt and cynical politics dressed up in nothing more than glossy bullshit. In the current financial climate it is a disgrace that money should be wasted in such a wanton manner. If I want to buy a load of bread the most efficient way to buy it is not to pass the money to the shopkeeper via four organisations and decide upon which loaf to buy by employing a cohort of idiots who then hire a group of management consultants to make the expensive decision for them, I haven't even started talking about how this NHS-style system would go about getting my loaf home; if I need a loaf of bread I'd go to the shop and buy it myself.