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The larger any organisation gets the less efficient it becomes in my view. The amount of money being paid to agency staff who are willing to cover at the moment must run into millions.
Agencies in London are offering up to £86 per hour for night shifts doctors, take it at £80 for a 12 hour shift, £960.
If you are unlucky enough to be in hospital at the moment, then you are being seen by someone who's there for the money, the next shift you may well see a different doctor with different ideas to your problems.
Its a bit like taking your car into a garage and having 2 or 3 different mechanics working on your car, its sure to go tits up. :0)