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Why are NHS managers like this, hmm lets see:

Real world CEO: I need you to make sure you get output up to 10,000 widgets
Real world Director: Widgets are not a popular product, we would be better to make 2000 widgets and 8000 wodgets.
Real World CEO: Ok, lets discuss this at products comittee and make a decision.

NHS CEO: I need you to get production up to 10,000 widgets
NHS Director: We need more wodgets than widgets. If we do more widegts we can't do any wodgets and patients need wodgets.
NHS CEO: Listen the SHA are very concerned about our widgets, not our wodgets - so make more widgets, ok. I am concerned about your performance and so are the NEDs.
NHS Director to staff: make widgets quicker NOW.
NHS Staff: There is no point making more widgets, it doesn't actually help patients.
NHS Director: I am concenred about your performance and attitude. I want an Widget improvement action plan and a monitoring sub-comittee set up.

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