Fewer than half of people in Wales realise the NHS is the responsibility of the Welsh government, according to a poll commissioned by BBC Wales.
Forty eight per cent knew Welsh ministers are in charge, while 43% think it is the UK government’s job.
There was a better understanding of education, with 61% correctly saying Welsh ministers were responsible and 31% the UK government.
The poll marks 15 years since the Queen opened the assembly in 1999.
Throughout this week BBC Wales is looking at 15 years since devolution – throwing a spotlight on different aspects of it each day.
The findings on health will throw a new light on the political row between the UK and Welsh governments over standards in the Welsh NHS.
Earlier this year David Cameron said care was so poor in some Welsh hospitals that Offa’s Dyke was a “line between life and death”.
The Welsh government maintains its overall budget has been cut by the UK government, and it is dealing with rising demand for services.
It also argues that outcomes for some health treatments are better in Wales than England.
When the poll asked about policing, 42% wrongly thought the Welsh government had control, with 50% saying the UK government.
There have been calls for policing to be devolved to Wales, with a recent cross-party inquiry into devolution suggesting powers over the four Welsh police forces should be handed to the Welsh government.
Overall, the poll found that just 34% of people felt that devolution had led to an improvement in the way Wales is governed, with 46% saying it had “not made much difference”.
And 31% said the south-east of Wales had seen the greatest benefits, with just 4% citing north Wales and 1% mid Wales.‘Confusion’
Prof Roger Scully from Cardiff University’s Wales Governance Centre said: “The figures are not great in terms of public understanding of who is responsible for what.
“I think that it does show there is still a lot of confusion amongst people about exactly where the line for responsibility comes between London and Cardiff Bay in terms of governance.
“We do see thing are rather better in terms of education, and I think that what that suggests is where devolution actually touches people’s lives – perhaps whether they have children, grand-children or relatives in school, where they see an actual difference with the way thing are done in England, then people become more aware of it.”
He added: “Beyond that, people have some general sense that there is a devolved government in Wales, there is a government in London, but exactly who does what and why, I think the details of that largely elude them.”
Prof Scully added there was some evidence people became “re-educated” about devolved policies during assembly election campaigns.
ICM Research interviewed a random sample of 1004 adults aged 18+ by telephone on 22nd May – 1st June 2014. Interviews were conducted across Wales and the results have been weighted to the profile of all Welsh adults. ICM is a member of the British Polling Council and abides by its rules.
There are different methods of covert rationing for different Regions of the Health Services. Reducing inequalities (in Wales) comes ahead of raising standards (in England). Choice is integral to the English Health services, but Wales has chosen to limit choice to reduce expenditure between regions (The Money follows the patient in Choose and Book), and feels that this will reduce inequalities. It does for those without the means to make a choice, or to game the system, (most people) and can be interpreted as “Lowest Common Denominator” medicine. It explains (to a large extent) why doctors themselves try to avoid Wales rural areas to live and work, and have a family in. Since some the public can still afford to buy private care or purchase insurance, perversely, the Welsh policy could be seen as increasing inequalities. The lack of awareness does not say much for the AMs or the CHCs in their engagement with the average person. More awareness of Education is explained by the fact that those affected remain alive. Dead people let down by the Welsh Health Service don’t vote..
Standards in Scotland compared to England are assessed by The Economist: Devolved NHS in Scotland – The Economist 2004
and the Death rates in Wales are questioned: Call to look into death rates Wales