My daughter is a fully qualified nurse and studying further for a Masters Degree. The admin problem is a 'top heavy' big issue but also the proper people to fit in to these kinda organisational posts is as big an issue - there are lotsa people in there who can hardly manage their own household activities, let alone managing people and budgets. Many of them are totally unsuitable for the work that they are supposed to be doing for various reasons and, in some cases, they are also in conflict with other NHS staff due to stressful situs, creating tension, poor integration with staff etc. Also gotta mention the wastage issue, which is managed at all well. The lack of requisite funding is still an issue but there are certainly other improvements to the service that could by a govt with the clout and ethics to do it! That UK govt is not currently evident!