Health is high on assembly election agenda
When it comes to the debate on health in this election, there is one key difference.
Previously, rows over the Welsh NHS have revolved around how money should be spent.
Whether it was the introduction of universal free prescriptions - or the availability of cancer drugs - key decisions were being made at a time of record health spending.
But now the landscape is very different - in 2011 the key theme is cuts.
Each party is having to come up with a palatable way of saving money.
Financial pressure is already being felt on the front line of the health service, according to Jackie Wilding, a nurse from Powys.
"I've seen nurses who have been in tears, because they are short in numbers and staffing levels are very minimal," she said.
Jackie has over 30 years' experience in nursing, and is particularly concerned by recent developments.
"I was a Parkinson's nurse specialist where I was undertaking a case load of a 100-120 people; I know that there are staff and Parkinson's nurses through the whole of Wales who are now taking case loads of between 230 and 500," she said.
The Conservatives are the only party which has pledged to protect health spending in line with inflation over the next four years.
Their spokesman, Nick Ramsay, defends the policy - despite meaning much deeper cuts would have to be made in other departments.
"It is a bold pledge, but it is a pledge we have to make because the NHS is so important to people in Wales," he said.
The party is also promising a cancer drugs fund for Wales, but would re-introduce a means-tested prescription charge of £5.
"We fully believe in the Welsh Conservatives in properly and well resourced NHS," says Mr Ramsay.
"That's why we've made that commitment and that's what we're going to stick to."
The other main parties have heavily criticised the Conservative policy.
Helen Mary Jones from Plaid Cymru describes the pledge as a 'pie-in-the-sky' commitment.
"If you 100% ring fence the health budget, you have to make massive cuts," she says.
"A 25% cut perhaps in social services, 20 odd percent in schools, in housing - things like housing and social services have a huge effect on people's health."
Plaid's manifesto says they would save - by cutting NHS middle managers - by 10%, and renegotiate the contracts of doctors and dentists.
They have also promised to maintain current district general hospitals in Wales - a pledge they have challenged other parties to match.
The debate over where - and when - patients receive treatment is also central to this election.
After improvements in waiting times for treatment over the last five years, performance on the 26 week target has declined in the last 12 months.
According to Dr Andrew Dearden, who chairs the British Medical Association's Welsh Council, it is another casualty of cutbacks.
"Probably the biggest change I've seen is the lengthening of waiting times," he explains.
"Both to be seen in outpatients, sometimes to be admitted for treatment, but also just for simple investigations.
"Sometimes we're seeing the length of time between when I feel when someone needs a test and actually getting the scan done - that is getting longer."
'Problems in orthopaedics'
For Labour, Edwina Hart, who served as health minister for the last four years, accepts there have been problems with waiting times but says they are being addressed.
"We have had specific problems in orthopaedics which I have recognised," says Ms Hart.
"But I think everybody realises about the problems in orthopaedics.
"We're an ageing population - we're having more referrals.
"We have looked at capacity and allocated further resources in that area - but that's going to be an on-going pressure area."
Labour's manifesto pledges to maintain free prescriptions and introduce health checks for the over 50s.
When it comes to savings - they say they will try to reclaim the £70-85m of "wasted resources" currently spent in A&E to treat the misuse of alcohol.
Waste is also a key theme in the Liberal Democrat manifesto - they are promising a new Office for Health Spending to monitor efficiency.
They are also promising to save money by helping prevent hospital admission, according to Lib Dem Veronica German.
"Keeping people out of hospital means that there is more space for those people who need those treatments,' she says.
"At the moment far too many people are going in through A&E - we want those people to be seen to outside, in their community - put up alternative methods for them to be treated."
The party want to end the current ban on private finance in the Welsh NHS - and while accepting some services may have to move - make greater use of small hospitals for 24 hour care.
Whoever wins power on 5 May - they face a stern challenge in shaping the future of the Welsh NHS - deciding where the cuts should come will be the key.