David Cameron yesterday claimed the Welsh border had been turned into a dividing "line of life and death" after a report raised fresh concerns about growing NHS waiting lists in Wales.
As 8,000 people in Gloucestershire continued their battle to be treated by the English NHS and not the Welsh, Mr Cameron made a strongly worded attack on Labour's record on health in Wales.
Yesterday campaigners in the Wye Valley said a new report which showed Welsh patients waited 170 days for a knee operation compared to 70 days in England, showed exactly why they didn't want to be forced to use Welsh hospitals. Hours later the Prime Minister inflamed the row between London and Cardiff Bay with his speech to the Welsh Conservatives' conference in Llangollen.
"Doctors and nurses are being woefully let down by Labour," he said. "Patients are waiting weeks and weeks for vital heart scans. One in seven people in Wales is on an NHS waiting list.
"A Cancer Drugs Fund in England – but not here. I tell you – when Offa's Dyke becomes the line between life and death, we are witnessing a national scandal."
Earlier in the day, Health Secretary Jeremy Hunt claimed the Welsh NHS was "sleepwalking to a Mid Staffs tragedy''.
Patients living along the border have been battling with the authorities since 30,000 English residents were told last year they could only access the Welsh NHS.
A three-year joint study by the Nuffield Trust and the Health Foundation assessed the quality of patient care in all four countries since devolution and found the gap between England and the rest of the UK has narrowed.
But England performs marginally better in a number of areas, including amenable mortality rates, life expectancy and ambulance response times.
Wales has free prescriptions but longer waiting times for diagnostic tests.
Patients such as Wye Valley art gallery owner Mariana Robinson, who wanted to be treated in Bristol for her pancreatic problems, have highlighted the growing row over waiting times.
The row could also impact on Beachley Barracks, home of 1 Rifles, because although the army base is technically in England, the local GP practice is registered in Wales. Last week the Government claimed that waiting lists were so long in Wales that the MoD had to transfer soldiers to English hospitals for treatment.
The lobbying group Action4OurCare is meeting with GPs on the border after NHS lawyers said the transferred patients should expect exactly the same standards of care as the rest of England. It could mean two computers.
"We understand the Nuffield Trust report highlighted longer waiting times and we do not think English resident patients should have to adhere to these times just because their GP is registered in Wales," said founder Pam Plummer. "The actual treatment you get may not be any different, but people should not have to wait 18 months for a hip operation when they can get it in much less time in England."
The Nuffield study found the four countries practically doubled the amount spent on health care but only Wales has cut the budget by 1 per cent because of austerity measures.
Andy McKeon, senior policy fellow at the Nuffield Trust, said: "Our study period coincided with the biggest sustained injection of cash the four health systems have ever seen, so it's perhaps unsurprising that staff numbers have increased and performance has improved.
"But what is interesting is that, despite hotly contested policy differences in structure, targets, competition, patient choice and the use of non-NHS providers, no one country is emerging as a consistent front-runner on health system performance."
But he warned: "Wales's lengthening waiting times should set alarm bells ringing among policy makers when considering its possible impacts."
First Minister Carwyn Jones told BBC Radio 4's Today programme: "We have been at the end of some pretty vitriolic political attacks over the last few weeks over the Welsh NHS and the report shows that those attacks were unfounded. Yes, there are challenges and of course we notice what's happening with regard to diagnostic waiting times and other waiting times in other areas. But we also take heart from the fact that cancer waiting times are better than in England, we have more nurses per head than England, life expectancy has improved, we don't have a tablet tax – people don't pay for their prescriptions in Wales – and our cancer survival rate has increased."