I would suspect that it's because the primary mission of the NHS is to provide jobs for bureaucrats, any healthcare we happen to get is just a side effect. Same with the MoD and submarines.
Even the most incompetent bureaucrat doesn't actively want to do a bad job. And I'm pretty sure that it doesn't say "we exist to provide jobs, with healthcare as a side effect" anywhere in the NHS charter.
Gov't IT projects suck because the RFP process is the most waterfall thing in existence, meaning the project is doomed from the start. And it goes downhill from there, with absurd amounts of politics and turf-protecting on all sides.
Well you could never say it outright, could you? But consider that the last government increased the number of nurses by 10% yet doubled the number of managers. Other than shuffling paper back and forth amongst each other, what do they do?
It's a truism that a bureaucracy always seeks to expand itself. They could all be brilliant at it, but the problem is a) it takes time and b) isn't actually necessary oh and c) they are all paid a fortune to do it, including their gold-plated pensions.
Well, it's not hard to convince me that large bureaucratic organizations turn into a mess.
But the same thing happens in private industry, too. Constantly. And nobody would ever label a private bureaucratic mess as "there to provide jobs first and turn a profit second". That was my bone of contention with your post, you're mistaking generic incompetence for something more perverse.
"primary mission of the NHS is to provide jobs for bureaucrats"
That might be the case for the bureaucrats in the NHS (of which there are too many) but I'm pretty sure that most of the actual front line staff are there to help patients.
I am not sure that I can fully answer what the root cause is, but most of the delays are due to the various levels of approval that take forever. In addition, they are very concerned with patient information security, and have various process to work through in regards to that.
