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In some countries, the private sector has played a significant role in the provision of medical services, including hospital services, over many years. The extent of state involvement in health insurance and direct service delivery differs significantly from country to country. The following sources concentrate on the UK experience, where government has dominated health provision since the end of the Second World War through the National Health Service (NHS). For a variety of reasons, reform of the healthcare sector in the UK has been politically controversial and has taken place under a range of different policy initiatives. Some of these have been driven by performance improvement, some by the pursuit of additional capacity (particularly with clinical care in the hospitals sector) and some as a result of a major programme of asset renewal.
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