Incompetent, bureaucratic, greedy, irrelevant, little more than 'parish councils': all these labels have been pinned at various times on the devolved parliaments and assemblies of the UK.
There were high hopes for Cardiff, Holyrood and Belfast, but the new representative bodies have not had an easy ride, and Northern Ireland's Assembly is suspended. All took over responsibility for health. Have the devolved organisations been able to make a difference in this area?
Kirsty Williams, Liberal Democrat chair of the health and social services committee, Welsh Assembly: 'It's been a difficult year, but my committee has been able to make a difference. The average patient in the street would have difficulty recognising that. But we have put in place things like extra free eye tests, and a retinoscopy screening service that we would not have been able to do in England.
'The relationship between civil servants and the Assembly has changed. We have been able to convince civil servants that we are running the show, and that was difficult in the beginning, especially as an opposition member. I have no regrets about devolution.'
Patricia Dawson, director, Scottish Association of Health Councils:
'The Scottish Parliament has delivered on improving scrutiny and accountability. One of the main aims of devolution was being more responsive; the public can now see the Parliament is committed to changing the consultation process, and giving the public more involvement in decisions on proposed service changes.
Health councils are also now in the process - we gave evidence on the Arbuthnott report into how health money is spent - and that's the way it's going to happen, people representing patients will be in there.
'In the old days we never got near a debate. The time that devolution will make a difference to people's health is still a wee way off. But without doubt it is preferable to the system we had before.'
Janis Hughes, Labour member of the Scottish Parliament and former NHS manager and nurse:
'I feel strongly it has made a difference. It has put on the agenda social inclusion and recognising the link between poverty and ill health. Public health was perceived as done by people wearing beards in back rooms, but it has now been brought to the fore, as it should be.
'Opposition parties still complain we are governed by London, but that is not true. We have a Scottish health minister who lives in Scotland, who visits hospitals and healthcare facilities regularly, and who doesn't have to report to an English health minister.
We have got a cross-party group of six MSPs on the Glasgow acute services review, working in a non-party political way; that was unheard of under the rule of Westminster.'
Alan Gilbert, spokesperson, NHS Confederation Northern Ireland:
'We had created a good working relationship with the Assembly. We felt it would bring more local accountability.
We met an all-party committee in February, which demonstrated a real concern about health and social services and a feeling that it was going to grasp the nettle and drive things forward. They identified clearly the areas they wanted to look at, particularly mental health and learning disability. But it was such a short window. They had only just begun to work out a programme when that window closed.'
Mary Scanlon, Conservative member of Scottish Parliament, and member of the health and community care committee:
'In Scotland there was a rather bullying, high-handed and secretive approach by the health boards and trusts in regard to consultation and service reviews. We are trying to create a culture of government, openness, transparency and accountability.
'We are seen on TV questioning health managers, and that sends a clear message to the public: that the old approach will not be acceptable in the future.
'We have also seen Scottish solutions to Scottish problems such as the Scottish Health Technology Assessment Centre.
'I think eventually we will see treatments available in Scotland that are not available in England, and vice versa.'
Robert Skinner, spokesperson, NHS Confederation Wales: 'There's certainly evidence that Assembly members are listening to the debate, looking at health issues seriously, and taking on board what the service is saying. It is still early days and it would be wrong to expect too much.
'The funding problems will take many years to clear, and it's going to take time as far as public health is concerned.
'The difference between the Assembly and the Welsh Office is that the Assembly has a strategic role - in the past decisions were taken elsewhere. Decisions are now being made in Wales, for the people of Wales.'
Going their own way
Scotland: The Scottish Health Technology Assessment Centre will be 'more independent' than its English counterpart, the National Institute for Clinical Excellence, chair Angus Mackay announces in August. In September, the first health legislation is passed - the Mental Health (Public Safety and Appeals) Bill. The Adults with Incapacity Bill is introduced in November.
Wales: The New Labour Assembly leadership develops a reputation for being beholden to Westminster. But in October, Welsh health and social services minister Jane Hutt suggests that Wales should adopt an alternative to primary care trusts, to 'meet Welsh needs'. After Assembly leader Alun Michael is replaced by Rhodri Morgan, Ms Hutt announces a review of the resource allocation system in Wales - a proposal that had been rejected by the pre-Assembly Welsh Office.
Northern Ireland: Sinn Fein's Bairbre de Brun is appointed health minister to the Assembly in December. To address longstanding problems, she announces a 6.6 per cent funding increase, part of which is to tackle winter pressures, and gives the green light to plans to restructure Belfast's maternity services. In March reforms are put on ice as the Assembly is dissolved.
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