NHS managers are more likely to have qualifications in management than managers in the private sector. Unlike the private sector, there is no single bottom-line that forgives incompetence in all other respects, there is a torrent of government directives to be worked through on a daily basis, to determine what must be adhered to, and that which can be safely ignored.
Old wards can be remarkably inefficient - for example one may just have the option of having the heat on or off, with little option for modification. Secondly, capital budgets may be available when day-to-day expenditure is actually more vital to the survival of the organisation. Those same capital budgets can be forced on the encumbents even if they don't want them - lumbnering them with public-private longterm costs that have been rejected at a local level etc.
The system has many faults, there are incompetent, demoralised managers - unsurprising in a system that cannot fail, but that is only one of many problems. Having said all that, the waste in private hospitals, makes anything I have seen in an NHS hospital look like chickenfeed.