I have to agree with TC
What matters is the size of an organisation not the territory it covers. A 'national' system would still be tiny - perhaps 150 employees and could save considerable sums
NICE is not a good example of a national organisation but a poor example of a government quango. Look at the medical royal colleges and you will see examples of national standards that are the best in the world - or were until the government replaced them with a quango called PMETB
The charities are to be commended for raising money and for altruism. They are not to be commended for audit or determining how best to medically use the resources because they have sadly failed in that quarter. That again will only come with a national system that is large enough to invest in research