The comparisons were inevitable. In one hospital, according to yesterday's papers, there were no waiting lists, and there was ready access to beds, more doctors and nurses, better clinical equipment and aftercare. In the other, long waiting lists, overcrowded wards, long trolley waits even to get a bed. The first hospital was in France; the second in East Kent, England.

These differences might be reasons why the health secretary resisted, for over a year, the idea of sending British patients for operations to continental hospitals with spare capacity. He declared it was "neither sensible nor practicable", but was forced by a ruling of the European Court of Justice to allow British health authorities to sign block contracts with continental hospitals. To his credit, on agreeing to comply with the court, he conceded that Britain had "a huge amount of catching up to do".

Indeed it has. France came top of a World Health Organisation league table of 191 countries in 2000 in terms of equal access, the responsiveness of the service, and the amount people contributed. The UK came 24th. But it is not all bad news. The continent spent too much on health - hence its spare capacity - compared to the UK's massive under-investment, a staggering £267bn compared to the European average over the last three decades. France is cutting back as the UK is making record increases in investment. But it is going to take a decade to turn the corner.

The idea - pushed by both main political parties - that patients should be given a choice of hospitals near their homes is absurd. Of course it is right in principle, but it needs spare capacity, and there will not be any in the UK for the next decade. Iain Duncan Smith had better forget tax cuts if he is serious about making an improvement to public services his first priority. Labour needs to look wider - including restoring the lost 50,000 community beds for longterm care - if it wants to achieve higher hospital efficiency.