And who do you suppose...makes the appointments, files the notes , lab results, enters them onto the computer system, ensures letters go out, picks up on patients that have been waiting too long and alerts the teams to make extra provision, ensures patients can be seen in clinics with their notes...or an equivalent electronic record... arranges for repairs and maintenance, printing leaflets and information, ensures staff are trained in key skills by maintining records and organising courses, books agency staff, arranges for staff to be paid, books cover when doctors go off sick, checks they have the qualifications to practice, etc.... NHS pen pushers... of course there is scope for efficiencies and people shoul be treated in appropriate centres... minor ops should be done in satellite clinics for example as should routine physio therapy and the like not in major hospitals... and people should be penalised for wasting A & E time with trivial things not sure how though