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Something extraordinary happened during Prime Minister's Questions today.

David Cameron was asked a question about the NHS in England and forgot to mention Wales in his reply.

Labour's Natascha Engel complained there were too few GPs and it was no surprise people couldn't get an appointment.

David Cameron said the coalition had increased spending on the NHS, which now had 7,000 more doctors. No cross-border comparison with Wales, prime minister?

I thought initially I had been mistaken and, despite years of training, missed the Welsh angle. But then it happened again, in response to a question about hospital closures from Labour MP Nick Raynsford.

David Cameron said that poor service had to be turned around. He added that the average wait in A and E used to be 77 minutes (under Labour) but was now 30 minutes. Again, no mention of life west of Offa's Dyke.

Labour former cabinet minister Nick Brown had a go, asking about the causes of a projected £2bn deficit for English NHS trusts next year.

Mr Cameron told him the forecasts included efficiency targets - which had been met. After 17 minutes, and three questions about the NHS in England, he prime minister could resist the temptation no longer:

"The great question for the NHS in British politics today, I would argue, is why is it in Wales where Labour are under control (sic) where 8 % cuts have been made in the NHS budget."

Cue mock yawning from Labour MPs.

The prime minister had a final go: "Well, they might be yawning opposite, they're not yawning in Wales because they're stuck on waiting lists waiting for treatment."

The Cameron attacks on Welsh NHS performance have become so routine they are less and less newsworthy. Perhaps the prime minister should change his routine first answer at question time to something along these lines "This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall have further such meetings later today. I shall also be having a go at the Welsh Labour government's handling of the NHS."

It would at least save time.