There are "striking and troubling differences" in health care between the four countries of the UK, a new report said today.

The Nuffield Trust examined health services in England, Scotland, Wales and Northern Ireland.

The trust - an independent charity that carries out research into health services - found Scotland had the highest rate of spending on the NHS, as well as the highest rates of hospital doctors, GPs and nurses per person.

Scotland also had the highest levels of poor health but, in contrast, the report found the NHS in England spent less, had fewer health staff per head of population, but made better use of its resources with higher activity levels.

The report highlighted some of the differences in health policy between the four countries, with Scotland having introduced free personal care while prescription charges have been abolished in Wales.

Jennifer Dixon, director of the Nuffield Trust, said the marked differences in crude productivity of staff in the three devolved nations when compared to England raised "challenging questions"

Dixon said: "Some of the differences and trends may be because of the historical differences in funding levels, which are not directly related to policies implemented after devolution.

"But some will reflect the different policies pursued by each of the four nations since 1999, in particular the greater pressure put on NHS bodies in England to improve performance in a few key areas such as waiting and efficiency, via targets, strong performance management, public reporting of performance by regulators and financial incentives."

A Scottish Government spokesman said the report was based on data that was "at least three years old and is out of date".

Meanwhile, a spokesman for the Department of Health said: "Devolution allows each country to have the freedom to make decisions about the health needs of their population and to focus on disease prevention, health promotion and health services in a way that is best for their public."