Patient Choice?

A saga of inefficiency labelled as choice:
A problem with a creaky shoulder becomes more acute so eventually hubby makes an appointment to see a doctor. He waits a week for an appointment, very willingly, because he wants to see a particular doctor for whom he has a great deal of respect but who happens to be on holiday. Doctor looks at shoulder and discusses options, deciding eventually to refer for physiotherapy. Hubby comes home expecting an appointment to arrive soon.
Letter arrives some days later from the local PCT with a series of instructions from which we eventually deduce that he needs to ring the musculoskeletal assessment unit, and use the password on the letter to arrange an appointment. Hubby telephones, gives the password and is told that there's at least a 3 week waiting period and he will receive an appointment in due course by post.
Why oh why couldn't they just make the appointment there and then even if it is 3 or 4 weeks in advance? Or, why not the old system of an appointment card arriving and it being his responsibility to keep or change the appointment as appropriate? Where is the efficiency gain in this system I ask?
Rant over. It's a lovely sunny morning and I'm going to make the most of the day before going to spend an evening enjoying the company of fellow Lib Dems and supporters tonight.