Wales, Health and the General Election: What you need to know
Ask anyone what their top three concerns are in the General Election and I bet you health would be among the answers nine out of ten times.
In the past, the government we elect in Westminster would decide how 'bread and butter' issues like health and education would be run across the UK.
But if you live in Wales, Scotland or Northern Ireland things have changed since 1999.
It's confusing. Even people who are paid to know these things are often baffled by who's responsible for what and who funds it.
So here are my four "Things You Need To Know" about Wales, the NHS and this general election.
These are worth remembering every time you hear or read about "The NHS"
1. A 'National' Health Service doesn't exist
Let me explain. If we take the word 'National' to mean the four countries that make up the UK then no single NHS covers all four countries.
There are four National Health Services in four nations, run by four governments of different parties. So as of today....
Wales - Welsh Government (Labour)
England - Coalition Government (Conservatives/Liberal Democrats)
Scotland - Scottish Government (SNP)
N Ireland - Northern Ireland Executive (Multi-Party)
All four share basic principles - such as being free to use. But devolution means each NHS is run differently.
In England for example there is competitive tendering for services. That doesn't exist in Wales.
2. The Assembly election matters more than the General Election...
That's if your concern is the day to day running of the Welsh NHS.
If you're interested in your local hospital, waiting times and other matters then an election for a Westminster Government will have little impact.
The Secretary of State for Health in Westminster cannot tell the Welsh Health Minister what to do. He can't say how services should be run and where to spend money.
They can disagree, even argue but technically both are equal (although one gets to sit in a national cabinet and the other doesn't.)
So the next Assembly Election will decide who runs the NHS in Wales, not the General Election.
3. But the General Election does matter for Wales...
At this point it can get confusing. Despite each country running their own health system, what happens in the English NHS impacts on the rest of the country. It's all down to money. Broadly it goes like this...
Westminster still decides how much Welsh ministers have to spend on public services. The so called 'Block Grant.'
When money is increased or decreased in departments in Westminster (like health) it has a direct knock on effect for how much the Welsh Government has to spend.
So when national politicians say they'll spend X billion on the English NHS - it mean's Wales will get more money. Equally if there's a cut Wales gets less.
Still following?
One last point here. Although Westminster tells Cardiff Bay how much money it has to spend, it's down to Welsh Government ministers where they spend it.
So if more money is spent on the English NHS, the Welsh government will get extra cash.
However it's up to the Welsh Government to decide if that extra money goes on the Welsh NHS. If, for example, it decides schools were a bigger priority it can be spent there.
4. This will hardly ever be explained to you
Maybe there's an assumption that the electorate knows the difference, but evidence suggests otherwise.
Last year a poll found 43% of people in Wales believe it's the UK government's job to run the Welsh NHS. It's a depressing statistic and maybe we in the media need to explain the situation better to voters.
Politicians know the NHS matters to voters, regardless of devolution. They will use this election explain what they would do in future. However the public need to be more aware of who runs what, and where power lies.