I think what people lose sight of is that the NHS can be broken down into two constituent parts. The front line staff we see and the administrators who, most of the time, we don't. In my experience it is the latter that cause many of the issues we see with the NHS.
I speak as someone who discovered fairly early in my banking career that I was a better administrator than lender (I could lend money but not get it back!). From that point I strove to be the best I could be and studied and read loads on the subjects of man management and administration. I became, I believe, very good at my job. It therefore annoys me to see very poor management being paid high salaries for doing a bad job and then blaming others.
The NHS is plagued by a top heavy administration structure that has far too high an opinion of its importance. This in turn leads to a lack of finance and thus resources on the customer facing front line. And lets be clear, we are customers of the NHS, not patients, not numbers, not an inconvenience but customers. Were we paying directly we would be demanding and getting a much better service.
I have seen numerous examples where NHS "management" take no responsibility, which is when you earn your high salary, and pass the blame to someone else. Normally that someone else is the customer. In no privately owned service industry would this be possible because it would lead to failure.
Unfortunately there appears to be no politician willing to grasp the nettle and take the difficult but necessary steps to correct this imbalance between front line and backroom. Turkeys do not vote for Christmas, so asking the current management to make cost savings and changes will never result in the cutting numbers, or reducing in seniority, of administration staff and managers. For example one simple cost saving measure would be to re-title 90% of "Managers" as Supervisors and, as a consequence, reduce the salary of the role. This would save tens, possibly hundreds of millions. But of course a senior manager has to have a number of junior "managers" below them to justify their high salary.
I, like many others, was made redundant following an external audit of roles within my building. A similar, all be it costly, independent audit of the NHS could, I believe lead to a huge reallocation of funds from backroom to front line with only a positive impact on service.
The management of the NHS has become a costly, self preserving behemoth that surely one day must be seen for the inefficient waste of money it has become. Until then very little increases in NHS finance will find its way to the front line.
