The parties’ general election manifestos show just how different health policy in England has become from that in Wales.

The manifestos, of course, are talking about the English NHS. Superficially, England and Wales seem to share some objectives, such as improved access to care, protecting investment in the NHS, and spending money wisely. But the latest eye-catching ideas from England seem to have little to do with Wales.

The three main parties all agree on the key issue for England – how to drive up the performance of the NHS. Their shared recipe has three ingredients: help NHS workers take over and run their own services; encourage a range of provision; and give people lots more information on how well local services are performing.

This is as far from the debate in Wales as would be discussion about the merits of SATs in schools, or the transport infrastructure around the Olympic stadium.

Our ingredients for driving up performance include getting the public sector to work together, encouraging clinical networks and benchmarking, and a strong steer from the centre.

Contrast this with English Labour, where all the talk now is of getting good performers to take over the poorer ones, enshrining patient rights in legislation, and making primary care available from “8 ‘til late”.

The difference is startling, as is the consensus amongst the main parties in England.

None of this difference need matter, of course, and actually it might be a good thing to experiment with different approaches and see which works best. A moment of quiet reflection, however, might reveal a paradox: how can we be proposing two so completely different approaches to improving the NHS – to achieving essentially the same goals? One might wonder whether anyone actually knows which approach is best, or whether we are not all going with our gut instincts and the herd?

Surely not.

Written by Professor Marcus Longley, Director, WIHSC