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I worked in the NHS for 36 years. The annual financial system was a nightmare which occupied many many hours of management time in trying to make the best of an unworkable system - time that could have been much better spent on productive activities. The capital budget was the worst - approval of bids often came too late to purchase the item in question leading to either an underspend or panic buying of lower priority items which could be obtained in the time available. Eventually spending was so tight that my centre was allowed to submit bids for no more than 5 capital items per annum, regardless of the true need. Colleagues who had worked in the private sector could not believe the financial rules that they had to operate under and were clear that the private sector could not function with these arrangements.