Witness Seminar marking 25 years of Devolved Health Policy in Scotland : the abolition of the NHS internal market

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Stewart, Ellen and Kelly, Iona, eds. (2024) Witness Seminar marking 25 years of Devolved Health Policy in Scotland : the abolition of the NHS internal market. Centre for Health Policy, University of Strathclyde, Glasgow. (https://doi.org/10.17868/strath.00091573)

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Abstract

2024 marked 25 years since the creation of the Scottish Parliament and the political devolution of significant policy powers to Scotland. A key element of Scottish health policy divergence has been a rejection of competition between providers. In 2004, the Scottish Executive (led by a Labour-Liberal Democrat coalition) abolished the NHS purchaser-provider split which had existed since 1990. This reform abandoned a quasi-market for Scottish healthcare in favour of the unified territorial Health Board structure that still broadly endures. This key early example of Scottish health policy divergence is particularly interesting given that during the same period, the New Labour government in England were turning back towards choice and competition. In May 2024, we brought together key Ministers, NHS leaders and stakeholders from the period for a witness seminar to discuss the operation of the internal market in Scotland’s NHS, the reform process including the intergovernmental dynamics, and to reflect on the achievements and frustrations of Scottish health policy, 25 years on.

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