NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland. It operates 14 territorial NHS Boards across Scotland, seven special non-geographic health boards and NHS Health Scotland. At the founding of the National Health Service in the United Kingdom, three separate institutions were created in Scotland, England and Wales and Northern Ireland. The NHS in Scotland was accountable to the Secretary of State for Scotland rather than the Secretary of State for Health as in England and Wales. Prior to 1948, a publicly funded healthcare system, the Highlands and Islands Medical Service, had been established in Scotland in 1913, recognising the geographical and demographic challenges of delivering healthcare in that region.