Northern Ireland, the United Kingdom’s only self-governing region, recorded year-on- year the worst statistics on health and poverty. However, it was far from certain that the Unionist government in Belfast would enact the kind of sweeping post-war reform that occurred in England and Wales. The raft of legislation governing health and social care introduced in 1948 was, therefore, the product of conditions and circumstances peculiar to Northern Ireland. The government in Belfast needed to overcome the conservative instincts of Ulster Unionism as well as suspicions regarding Clement Attlee’s Labour administration. Although the process was somewhat blighted by sectarianism, the government of Sir Basil Brooke enacted what amounted to a revolution in health and social care provision.