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**Hugh** · 08-07-2020, 13:55

Quote:

Originally Posted by nomadking

If Boris is responsible for the whole of the UK, how come Sturgeon keeps announcing different rules?

Scotland had its OWN separate pandemic plans. Link from 2011. Just as in the US, it is the State Governors that set and announce any rules. The individual states run their OWN health systems. Scotland is responsible for NHS Scotland.

That’s a very simplistic view - the Federal Government has a huge input re funding, regulations, and resources.

https://www.ncbi.nlm.nih.gov/books/NBK218212/

Quote:

Federal

The federal government plays a large role in the public health system in the country. It surveys the population's health status and health needs, sets policies and standards, passes laws and regulations, supports biomedical and health services research, helps finance and sometimes delivers personal health services, provides technical assistance and resources to state and local health systems, provides protection against international health threats, and supports international efforts toward global health. The federal government does all of these mainly through two delegated powers: the power to regulate interstate commerce and the power to tax and spend for the general welfare.

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Overall, federal activities fall into two major categories: those that are conducted directly by the federal government—assessment, policy-making, resources development, knowledge transfer, financing, and some delivery of personal health care—and those that are contracted by the federal government to states, localities, and private organizations—the majority of direct service programs. (Hanlon and Pickett, 1984)

The major portion of the federal government's health business is conducted through contracts and grants to states, localities, and private providers and organizations. The federal government acts through financing intergovernmental and interorganizational contracts to encourage various public health initiatives, convening participants around an issue, coordinating activities, and developing state and local provider contracts. In return for federal funds, states, localities, and private organizations must follow the federal standards and policies set in the contract. Thus in many programs, the federal government takes an oversight, policy-setting, and technical assistance role, rather than a direct provider role.

Federal contracts can take the form of seed money for researching and developing new programs, such as Community Mental Health Centers, or they can be support for ongoing activities, such as the Early Periodic Screening, Detection, and Treatment Program. Contracts can be made with agencies to operate specific public health programs or to support general agency activities.