Re: This is not an IT failing
This fiasco preceded the current bunch. The NHS was was (like the schools) "reformed" to create competition instead of cooperation. Each health trust is a mini state. And a health trust in one area may well be running some services, such as Physio or Speech and Language, in another, though maybe not as much as those "reformers" wanted.
N.B. In all public sector fields "Pushing down costs" through competition means that either there are fewer staff or less well paid staff ( or probably both).