That is so what happens when employment description inflated "Accounts Executives" (clerks) get to operate bureaucratic systems using their own initiative.
The cross border aspect is because of devolution, but the reality is that NHS Trusts constantly bill each other for work carried out on patients from another trust's area. I suppose that it keeps office workers and managers in work.
Did anyone notice the DNA study showing that the Romans, Danes and Saxons didn't actually wipe out the English only to be stopped by the Celtic nations. http://www.bbc.co.uk/news/science-environment-31905764