Public and patient participation in health care and health policy in the United Kingdom

Since 1948, the United Kingdom (UK) has operated a National Health Service funded primarily through public taxation where health services are available based on need and free at the point of delivery with limited out-of-pocket copayment. Other European predominantly public taxation funded systems operate, for example, in Sweden, Denmark, Finland and Italy. Domestic policy decisions have been devolved from London and England to Wales, Scotland and Northern Ireland since 1999, although for the latter full devolution did not really occur until 2007. One consequence of devolution has been the growing divergence in policy and practice across the four countries within the United Kingdom. This digest summarizes the evolution of key policies across the United Kingdom and then identifies some of the distinctions between the four different administrations.