Take a look at www.nhs.uk. Interesting, isn't it? Not nhs.co.uk, or nhs.org.uk, or nhs.gov.uk. www.nhs.uk. One of the very few websites that is so important as to be just plain "uk".
What does it deliver? "NHS Choices", a website so English that it is a surprise to find links to Northern Ireland, Scotland, and Wales at the bottom.
That is how many policymakers and students of health policy think - and that is why we so often miss the extent of divergence since devolution.
In England, the politics and the debates are dominated by people who do not trust the public sector. There is a strong scepticism about the basic premises of the NHS in England. England is filled with policy experts and private consultants eager to sell managerial and market recipes for the NHS. And it's a seller's market. What is the biggest opposition party, after all? It is the Conservatives. Voters who are disaffected with Labour are offered, above all, a party with a record of doubts about the NHS and interest in increasing private finance and provision.
So for Labour, the English NHS is drinking in the last-chance saloon. If the voters don't like what they get for the current vast spending increases, they will vote against the NHS - first with their feet, and then with their ballots. It explains some flagship Labour policies, such as foundation hospitals and choice. Patients tend to think choice is nice, but there is not much evidence of great public or patient support. And it is, of course, close to irrelevant for many patients with complex problems. Instead, choice, like Independent Sector Treatment Centres, foundation trusts, practice-based commissioning, and private sector commissioning is a tool of public administration. Politicians call it "constructive discomfort." The idea is that even if nobody votes for choice, choice will make the NHS worth voting for.
Those policies do not have much resonance north of the Severn and Wash. They sound uncomfortably Thatcherite, and Thatcher always sounded uncomfortably English in Edinburgh, Belfast and Cardiff.
The public sector and leading professions in Scotland are strong and exert much more influence on debates. Meanwhile, Scottish politics is a clash between the SNP, a Scottish nationalist party with many leftist positions, and Scottish Labour - also leftist, and desperate to prove it is no tool of London Labour. So the hunt is for a distinctively Scottish way to do things, and there is a strong medical elite with ideas that range from undoing trusts to Managed Clinical Networks to the Kerr report on the future shape of services.
On health issues, the SNP is to Labour's left, calling Labour's bluff on issues like keeping the NHS public or investing in public health. So its really distinctive commitments were halting two hospital closures and directly electing the unified health boards that run the Scottish NHS as integrated units. Health policy analysts can carp at both. But they are both distinctively leftist and Scottish, and reflect more faith in democracy and professionals than in markets and management. And a remarkable number of Scottish policymakers have a word for their new world: "fun."
Northern Ireland is a different case altogether. There is always a lot of news out of Northern Ireland, but it is not about health services. Northern Irish people might care about their health services, but their politics are not centred around those issues. Somebody had to run the health services while the politicians argued. So managers and a few professionals faced up to the challenge, and ran health services in a complex environment while keeping their heads down. The result was "permissive managerialism" - so long as managers didn't embarrass ministers, they could deal with their problems as they saw fit. Democratic devolution, though, introduces unpredictability, and so has reorganisation.
Finally, in comparisons, Wales will often turn out to be the most interesting place. That is the case whether you are interested in health politics or constitutional law.
Welsh health policy has followed an interesting trajectory from which all of us can learn. It began with an impressive strategy but weak tactics. The strategy was to focus on "health, not health services." Nobody denies that good housing, education, and community development improve health. The problem is that none of those are the responsibility of the health minister, and that emphasizing the importance of transportation or the environment gives no guidance on the improvement of a bad district general hospital.
The lasting monument of this era was a costly NHS reorganisation and continued failure to address inherited problems. Politicians began to give up. The turnaround took place in the winter of 2004-05. A new minister and a new "strategy" document signalled the new era of tactics without strategy. The idea was to fix the long-unfixed problems of the health services. The problem was that without a strategy, the easiest tactic was to cut. And that proved to be electoral poison, hurting Labour without healing NHS Wales. Now, there is a chance that Wales has re-united tactics and strategy. Maybe it is beginning to find a way to combine a focus on communities and localism - Welsh constants - with a sense of how to define and fix the health services in society.
But those were all Labour policies. Now what? 2007 is all change: the nationalist SNP is governing Scotland; the nationalist Plaid Cymru are in coalition with Labour in Wales; Northern Ireland has devolution in the amazing shape of a partnership between Ian Paisley and Martin McGuinness; and Gordon Brown would like you to know he's not Tony Blair.
But these politicians make history in circumstances not of their own choosing. All must get their advice from somewhere, and must do what it takes to get (re-)elected. So while 2007 gave us politicians who want to change policies, there are constants in the politics. Party rivalries are slow to change, and so are the people who give advice and think up ideas in the different capital cities. So the four trajectories are bending, but they are still divergent.