The blueprint for Britain's National Health Service was drawn up in Scotland. Early in the 20th century a sense of nationalism had secured a health administration in Scotland, separate from that for the rest of Britain and able to set its own course. By 1913, the Highlands and islands had the first comprehensive state medical service in Britain. In the Depression of the 1930s, there was already a powerful consensus in Scotland, supported by a medical profession with a long established tradition of public service, that free and comprehensive medical services must be extended across the whole country. A plan for Scotland, published in 1936, became the basis of the schemes for the National Health Services established north and south of the border in 1948. The author shows that in Scotland the plan, as originally conceived, was accepted in full and by consensus. In setting up the NHS for England and Wales, important concessions were made to overcome the resistance of powerful interest groups and an English medical profession less committed to public service. As a result, two distinct forms of the National Health Service were established in the UK, each with its own character and ethos.