The organization of the national health service in the United Kingdom has been under constant review and revision since its inception after the Second World War. Central government spends £35,894 million each year on the Health Service and it is the country's largest employer. Total health expenditure in the United Kingdom accounts for 6.1% of the Gross Domestic Product. This apparently compares unfavorably with 12.4% total health expenditure in the United States.States. However the public health expenditure is identical in the two countries, 5.2%, and this figure is similar in most developed countries including Australia, Denmark, Spain and Switzerland. The overall regional administration of the Health Service in England (Scotland, Wales and Northern Ireland have slightly different organizations) is well established, although the names of the different strata of administration change from time to time. The Secretary of State for Health oversees the Department of Health including the National Health Service Management Executive. Under this Management Executive are 14 Regional Health Authorities covering 100% of the total population.There are within the London area several Special Health Authorities set up in the past because of the particular expertise which they provided. These are under review and will almost certainly lose their special status in the future because of the improvements and increase in services nationwide. The Regional Health Authorities have under their care 177 District Health Authorities and 90 Family Health Service Authorities.They do not manage the National Health Service Trusts—a new development which allows hospitals and other organizations within the Health Service to work autonomously to provide NHS services.