The demographics have changed, but they take that into account in terms of how they handle and manage care.

There's a lot of thinking and work that goes on to cover working out the changing needs of your population that has to be handled by any well managed healthcare service.

In the NHS specifically I am aware that they also have change management procedures that exist to try and understand how to provide continuous improvement as needs and situation change.

That's not to say things are perfect, by any stretch of the imagination. For example the NHS still has a big blindspot when it comes to tech. Most people aren't willing to take the effective pay-cut of being a techie and working in the NHS, a lot of people inside the service don't really respect people with tech skills and there's still a bit of a holdover of not paying much for anyone that isn't a doctor.

That's not to say the situation remains static, some doctors for example are slowly accumulating tech skills as a result, so what will probably happen is that success for a tech person in the NHS is going to require a prerequisite medical degree, at least in the near term.

Which though I don't think it's the best strategy, I can't also argue it's a terrible one to expect people who provide tech services into the NHS have a reasonably high level of domain knowledge.

This is a large institution with a substantial mandate, we should expect to pay a reasonable amount proportional to what it provides us. The fact that it's substantially cheaper than other healthcare services while still providing a very high quality of care leads me to believe that it's doing a pretty good job meeting that mandate.

So I don't think blindly questioning it without taking such things into account is helpful, nor do I think that pointing to costs as being "too high" are helpful without considering what is happening and why they are being paid for in the first place. Chesterton's fence and all that, it's not enough to just cut costs, you have to ask what doing so gains you. There are too many social programs which we cut because "spending less is good" without asking if the spending actually gives us a positive return as a society.

One common complaint from doctors (at least, in the U.S.) is the need to hover over a laptop all the time that takes time away from talking to the patient. A big problem as I've heard of a number of doctors retiring early because they don't feel as though they are even treating patients anymore, they are slaves to a console. (And these are not old doctors nearing retirement anyway.)

Personally, I think we've become a little too tech obsessed in thinking every problem can be solved with IT. Digitizing records only feeds a surveillance state anyway and can be dangerous (for other, obvious, reasons).

Well, doctors are mainly hovering over a laptop to justify their treatment plan to insurance companies anyway. They were not implemented because someone thought they would improve quality of care.