National Health Service Act 1946 National Health Service Act 1946 The National Health Service Act 1946 (c 81) came into effect on 5 July 1948 and created the National Health Service in England and Wales. Though the title 'National Health Service' implies a single health service for the United Kingdom, in reality one NHS was created for England and Wales accountable to the Secretary of State for Health, with a separate NHS created for Scotland accountable to the Secretary of State for Scotland by the passage of the National Health Service (Scotland) Act 1947. Similar health services in Northern Ireland were created by the Northern
National Health Service health service on behalf of another. For example, Northern Ireland has no high-security psychiatric hospitals and depends on hospitals in Great Britain, routinely at Carstairs hospital in Scotland for male patients and Rampton Secure Hospital in England for female patients. Similarly, patients in North Wales use specialist facilities in Manchester and Liverpool which are much closer than facilities in Cardiff, and more routine services at the Countess of Chester Hospital. There have been issues about cross-border payments. Taken together, the four National Health Services in 2015–16 employed around 1.6 million people with a combined budget of £136.7 billion. In 2014