Surely a large part of the problem with government decisions – and the frequent U-turns – is that some chap is put in charge of, say, the Department of Health, without having a clue about hospitals, doctors, nurses, general practice, dentistry, pharmacology, general health workers, community care, medical training, etc. etc. and feels obliged to make changes and make his (usually his) mark. Furthermore, most of them are London-centred where things are not always done in a way that is appropriate for the rest of the country. Then after off-loading the bee in the bonnet, said chap then moves on to a completely different department and makes his mark there.
No one takes the rap for bad decisions and the long-suffering public is left with the cost/inefficiency/bad service/no service – whatever – before another set of radical changes is introduced by another equally ignorant chap in charge.