"We really don't know why the term 'healthcare commissioning architecture' has become so closely associated with this reform. Architecture would give us the belief that detailed blueprints were being followed as is in the design of a building, a methodology that has scientific merit. When it comes to the Secretary of State’s healthcare reform there has been no blueprint detailed enough to prevent the chaos having been played out over the last year across the NHS commissioning and provider side with more to follow we suspect. So perhaps the illusion of architecture has been used to give us a false sense of reassurance." Tony Riley, Healthcare Commissioning Architecture. The UK Health Bill translated and implemented (Health Solutions Partnership, 2011)
Architecture is known for creating illusions (also known as visions), but (as Baudrillard pointed) out the ability to create illusions can also generate self-delusion. (Jean Baudrillard, Architektur: Wahrheit oder Radikalität? 1999) (Selected quotes in English). See also Mimi Yiu, Virtually Transparent Structures (2003).
Another well-known paradox of architecture is the conflict between architecting for the real world (complete with conflict and compromise) and architecting for a fantasy "theme park" world in which there is no place for conflict and compromise. In a 1997 book on Disney, this is called the Architecture of Reassurance. (This was also the title of a short film released in 2000.)
An implication of Riley's remark is that senior people within the NHS are paying lip-service to architecture as a substitute for actually doing any proper architecture. If this is true, it would explain the apparent reluctance to expose organizational designs for public and professional scrutiny. But I for one don't find this very reassuring.