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Political devolution of the UK's health services

Three Acts of Parliament were passed in 1998, which established devolved legislatures in Scotland, Northern Ireland and Wales. Powers transferred to the Scottish Parliament and Welsh Assembly on 1 July 1999, and to the Northern Ireland Assembly on 2 December 1999.

The devolved administrations adopted different attitudes towards choice and competition in the health care sector and devolution provided a natural experiment across the UK over the following decade.

While England would place a greater emphasis on patient choice and the use of provider competition, Scotland, Wales and Northern Ireland would reject this approach.


Bevan G, Mays N, Connolly S.
Funding and performance of healthcare systems in the four countries of the UK before and after devolution.
Nuffield Trust; 2010.