Background: The Act on Patients Rights should ensure that people should have equal access to health services of good quality, regardless of age, gender, economy and place of residence. Several studies show that there are variations in the allocation of health care, both among the regional health authorities and among health enterprises within the regional health authorities. To ensure a consistent practice and harmonization of prioritizing, priority guidelines are developed. They include a description of medical conditions, with a recommendation of an allocation of patients with or without a legal right to treatment and also a medically maximum waiting time. Priority regulation allows the use of medical duration of discretion, but we have little knowledge of what are the reasons for prioritization decisions. Purpose: The purpose of this study is to examine how the health authorities by specialists make their decisions on the allocation of the health care and whether patients have access to treatment according to priority regulation criteria. Material: The study is based on data from the fields of general medicine, substance abuse and mental health care in a health authority. Information of prioritization practice was obtained from six specialists from various disciplines and four department heads as well as data of waiting time and proportion of patients with prioritized health care from the Norwegian Patient Register. Methods: The collection of data is done through qualitative, structured interviews and retrospective quantitative analysis of data from the Norwegian Patient Register. Results: The interviews indicated that there was no systematic practice of prioritization in the selected areas of healthcare. Priority Regulation criteria of cost effectiveness is not used in the assessment of referrals. Both the regional health authorities and health enterprises have a high proportion of patients with prioritized health care, and the fields of mental health and substance abuse have a right share of close to 100% also in 1’st tertial of 2010. Conclusion: The findings indicate that the priority regulations and priority guidelines are implemented to a limited extent in the local health authority, and priority decisions are mainly based on clinical discretion.