Michael Howard has attacked the government's failure to extend choice in the National Health Service.

Speaking at prime minister's questions, the Conservative leader said NHS patients should have a greater choice of hospitals.

Tony Blair said that was why the government was expanding capacity and introducing more patient choice.

But Howard said plans put forward by health ministers would only allow limited choice after waits of six months.

"Under our plans, patients will have the right to choose whichever hospital they want to go to, within the NHS and free of charge," he said.

"Isn't that a real right to choose, isn't that what patients should have?"

The prime minister said he was delighted "to join battle" on the issue and argued that there could be no choice without extra capacity in the NHS.

He said the Conservative "patient passport" policy would only benefit the few who could pay half of the cost of their operation, while taking money out of the NHS

"What a typical Tory proposal," said Blair.

"First of all it only goes to the few who can afford to pay 50 per cent of their operation.

"Secondly it is to help people go out of the National Health Service not stay in it.

"And thirdly it takes money from the National Health Service.

"And that is the difference between us and them. We want the National Health Service better, he wants to wreck it."

Free choice

But Howard insisted the choice he was proposing would be offered within the NHS and free of charge.

He said the government had forced 300,000 people into the private sector.

"We are not going to force anyone out of the National Health Service, we are going to give people choice in the National Health Service," pledged the Tory leader.

Howard said choice would lead to improvements in levels of care.

"In every other area choice drives up standards. Why does the prime minister say health should be a no go area for choice?" he asked.

Blair said the NHS had been in a worse state when the Tories were in power.

"If he wants the debate to be, between now and election day, who cares for Britain's National Health Service, let him come on and have it," the prime minister added.