It’s often worse than this. Most hospitals have administrators (not doctors) that oversee budgets for departments. Often it is allocated to additional or flexible staffing. Any capital expenditure is rarely discussed, although the lead consultant in a department can have input (depending on structure). It seems to be more about the patient’s perception of their care than what will improve treatment. State/ training hospitals can be a little better. In private often there’s more of what isn’t needed (water features in the hallway or fancy sofas) and not enough of what is needed - like beds and xray equipment.
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