[DrScientist]

Yes and no.

While there are some centralized decisions ( we are paying only for one round of IVF, or this drug isn't good value for money ), most of it is delegated to front line doctors - by the simple mechanism of faced with a fixed time/budget they triage based on medical need.

Note that the UK system is actually a rather odd hybrid of public and private due to historic reasons. It's quite easy to queue jump the waiting for an initial consultant by going private, and then be referred back to the public system for treatment.