Devolution of the NHS

Health policy in the various parts of the United Kingdom is beginning to diverge, so there are opportunities to learn from the differences. Most of the rest of our site is about England, so this page concentrates on the smaller countries.

Studies of the effect of devolution on health policy:

Scott L. Greer, currently at the University of Michigan, writes and speaks a lot about policies in the different parts of the UK – and succeeds in making the subject entertaining. He also brings interesting perspectives from both Europe and the USA.

The Nuffield Trust have done some work on values in the NHS across the borders and on Funding and performance of health care systems in the four countries of the UK

The Devolution and Health Project based at The Constitution Unit, UCL carried out a two-year programme of research into effective scrutiny at all levels of government in the UK from 2002-4.

Devolution and Social Care: Are There Four Systems of Social Care in the United Kingdom? Derek Birrell 2007

SHA conference – Vive La Difference – September 2007

Basic facts:

England Northern Ireland Scotland Wales
Population (2005) 50.431,000 1,724,000 5,094,000 2,958,000
Life Expectancy 2005 76.9 (m) 81.2 (f) 76.0 (m) 80.8 (f) 74.2 (m) 79.3(f) 76.3 (m) 80.7 (f)
NHS organisation Marketisation – development of purchaser provider split and introduction of more providers and more choice and competition Civil service. Health and social care combined Unified health systems combining hospitals and community services. Central and regional planning. Greater emphasis on public health. NHS aligned with local authorities. Purchaser/provider split now abolished

Competition or collaboration? A comparison of health services in the UK  WW Holland 2010

Devolution and Social Care: Are There Four Systems of Social Care in the United Kingdom?