Is the NHS being ripped off or is it lack of ownership?

Many years ago, whilst working in a large teaching hospital, I enquired about the cost of office renovation work that was being done in the department that I was working in. The job involved splitting an office into two by putting in a partition wall and adding a door. I  was having some renovations done at the same time so I was aware of the cost of materials (which I estimated to be in the region of £300) together with the labour charges (2 men for 3 days which would have been around £600). So, I was shocked when I heard that the actual cost to the NHS and you, the taxpayer, was £10,000! When I asked the manager who signed this off how it could possibly be that much I was told that there was a complex tendering process that applied to contractual work within the NHS. I asked the manager (who was a nurse by background and had no experience of building) how this could be justified and was told that there was an operating procedure in place and that this had been followed. This was clearly not right, but there were two sides to the problem, a manager without the experience to fight for a better deal and a contracter who had learned to play the game and take advantage of the tax-payer.
Unfortunately this abuse of the system still exists and in my opinion results in the loss of significant amounts of money which, if there was ownership, would be saved. The NHS is not one organisation, it is lots of smaller organisations stuck together and the budgets for the hospitals are controlled by Clinical Commissioning groups quite often with block contracts over 3-5 years. Significant cost saving programmes are available but these would put individual components of the NHS at risk (even if they could provide better care) as many hospitals are already running over budget and cannot compete with private companies that could do it cheaper. The only way we can get around this is for central support to help support transition to a leaner organisation that has…ownership!