Grasping the nettle of middle management roadblocks

In affa sair's Facebook page a member opined that the whole NHS system was broken. Another member had been moved up the priority list after he had contacted his local Councillor and MSP and not to do with his medical need.  Whilst glad to accept this he still thought it unfair.  Other folk  thought it down to money.  I thought it would be good to continue this debate in a more open forum.

You know, I'm not sure more money is the answer. It's certainly not the only answer. The NHS is so behind the times with I.T. systems and their procedures are terribly inefficient. It's the old story of too much middle management who get a great deal of money for very little outcome.

There is so little regard for the patient in the ranks of the middle managers. Budgets and targets are their priority supposedly to make the service more efficient cheaper to run. In fact the opposite happens.
There seems to be a lot of personal infighting with managers working against each other in power grabbing attempts. Not only is there scant regard for the patient in these ranks but also for the staff members under their charge.  It seems middle management are causing roadblocks to all new ideas which might affect their cosy positions.
Of course there is always good mixed in with the bad but unfortunately the bad are winning and are not going to give up their prize easily.
The people on the front line are not valued as they should be.  They are paid peanuts, so as the old adage goes, "you pays peanuts you get monkeys!"  Changing where the considerable NHS funding goes might go some way to helping the service look after the patient as it was supposed to.  Is it right that managers with no medical expertise should be at the top of the earnings scale?  No.  The playing field needs to be levelled.  Give more money to the bottom front line level and you will get folk who care more about their work and do a bit more for the patient and each other.  The Managers should try pulling their staff along with them rather than pushing.
I remember watching a TV programme many year ago where an industrial Knight of the realm was charged with making a hospital more efficient by putting his proven private sector policies into practice.  He was met with roadblocks all the way.  Folk trying to hold on to their little empires and people from all levels of the workforce refusing to change.  A sad state of affairs that hasn't gotten any better.
Nowadays, not even the politicians who are supposed to control Health Boards, have any power or are unwilling to force the Boards to make necessary changes to their services.
But, who should be in charge.
Is it right that Politicians should have the final say on how your local health services are run, or, should people with the medical expertise decide on how best to spend their allocation of public money?
Should local Health Boards have more people from every walk of life on their panels or should it be left to the more well-off in society who have no real need of public health services to decide what's best for the populace?
Should the current obsession with targets and the large section of staff used to police them continue?  How else can we see if our money is being spent on the right priority?
I'd love to know if you agree with my comments or are upset by them and think I'm talking out of a place where the sun don't shine!
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