Healthcare

Healthcare in the United Kingdom is a devolved matter and England, Northern Ireland, Scotland and Wales have separate systems with different policies and priorities^[184][185] though the degree of co-operation usually conceals the difference from cross-border users of the services. The four systems provide public healthcare to all UK permanent residents that is free at the point of need and paid for from general taxation. A much smaller private medical system also exists. Various regulatory bodies are organised on a UK-wide basis such as the General Medical Council, the Nursing and Midwifery Council and non-governmental-based (e.g. Royal Colleges). Across the UK, there is a large number of medical schools and dental schools, and a considerable establishment for training nurses and professions allied to medicine.

Healthcare in England is mainly provided by the National Health Service which today covers just England though originally it covered England and Wales. It was set up by the National Health Service Act 1946 that came into effect on 5 July 1948. The Department of Health exists to improve the health and wellbeing of people in England,^[186] and the Secretary of State for Health is answerable to the UK Parliament for the its work and for the work of the NHS. England's NHS is one of the largest cohesive organisations of any type in the world employing over 1.3 million people.^[187] Public sector healthcare delivery consists of primary (general practice), secondary (district general hospital) and tertiary (teaching hospital) levels of service. There is considerable interaction and cross-flow between the various levels. The National Institute for Health and Clinical Excellence, or NICE, advises on whether drugs or treatments should be provided by the NHS in England and Wales.

Healthcare in Scotland is mainly provided by NHS Scotland, Scotland's public healthcare system. The service was founded by the National Health Service (Scotland) Act 1947 (later repealed by the National Health Service (Scotland) Act 1978) that took effect on 5 July 1948 to coincide with the launch of the NHS in England and Wales. However, even prior to 1948, half of Scotland's landmass was already covered by state funded healthcare, provided by the Highlands and Islands Medical Service.^[188] In 2006, NHS Scotland employed around 158,000 staff including more than 47,500 nurses, midwives and health visitors and over 3,800 consultants. In addition, there were also more than 12,000 doctors, family practitioners and allied health professionals, including dentists, opticians and community pharmacists, who operate as independent contractors providing a range of services within the NHS in return for fees and allowances.^[189] The Cabinet Secretary for Health and Wellbeing is responsible to the Scottish Parliament for the work of NHS Scotland.

Healthcare in Wales is mainly provided by NHS Wales. Originally formed as part of the same NHS structure created by the National Health Service Act 1946, power over the NHS in Wales was transferred to the Secretary of State for Wales in 1969.^[190] In turn, responsibility for NHS Wales was passed to the Welsh Assembly and Executive under devolution in 1999. NHS Wales provides public healthcare in Wales and employs some 90,000 staff, making it Wales’ biggest employer.^[191] The Minister for Health and Social Services is the person within the Welsh Assembly Government who holds cabinet responsibilities for both health and social care in Wales.

Healthcare in Northern Ireland is mainly provided by the Department of Health, Social Services and Public Safety.