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Devolution hits the NHS

Devolution has created four different NHS systems in Britain - breeding envy among patients - health experts says.

Gill Morgan, Chief Executive of the NHS Confederation, said patients in the UK's four nations are receiving different services, driven by different philosophies.

However, patient groups said this is leading to envy among patients, who wonder why they are not receiving the same healthcare benefits as those across the border.

"All we can say is that patients are experiencing different systems, each one has its advantages and we will have to wait to see what happens," said Ms Morgan.

Douglas Smallwood, Chief Executive of Diabetes UK, said: "We must ensure that politics does not stand in the way of people with diabetes receiving good care, regardless of where they live. Each of the UK's nations must learn from one another's NHS systems to ensure effective care is in place across the country."

He added: "Each of the four NHS systems has its strengths. For example, in Scotland, there is a lot of flexibility around where healthcare professionals work to allow them to be most useful to patients. In England we are seeing real opportunities in commissioning, and trailblazers Wales and Northern Ireland have led the improvement of social services across the UK.

"Diabetes UK has been key in highlighting clinical needs for people with diabetes in each nation, for example by setting out the problems they encounter with their healthcare.

"Ultimately, we want good care for each person with diabetes across the board. Increasing postcode lottery concerns need to be tackled to ensure that everyone has access to good care and choice from the NHS."

Diabetes UK

Your comments: (Terms and conditions apply)

"The NHS needs a radical evolutionary approach. The culture of dependency needs to change if we are to get the best out of this service" - V Henry, London
"Yes! Many patients are feeling disgruntled about having to pay for prescriptions when our neighbours in the UK are not. Also there is much bitterness about the lack of mental health facilities and social care for the elderly in our area, particularly in relation to what is provided - often free of charge - in Scotland. And I don't blame them. As England contains the vast majority of taxpayers in the UK it appears wrong to pay for Welsh and Scottish patients to be given free treatment when we don't receive it ourselves. There is a lot of poverty in our area - despite being cited as  "prosperous" by the government - with very low pay and home insecurity, lack of affordable housing, high divorce rates, pressures of juggling sometimes two and three jobs to pay for high cost homes and one of the highest teenage pregnancy rates in the UK - and resentment is high. I personally had to manage caring for my elderly mother with dementia with very little input by the social services, as we had no money. Care was restricted to one day centre place a week as we are poorly paid as a family and could not afford to pay for more. It is galling to realise that if we lived in Scotland, this type of care would have been more readily available and her personal care would have been provided free! She sadly died three months ago but I am now over stressed, in poor health and my career has suffered.  AND I have to pay for my prescriptions" - Name and address supplied