VERDICT: a much more effective, less disappointing performance from Labour. Shadow health secretary John Healey scored with his Office for Budget Responsibility's increased inflation forecast figures making NHS funding a real-terms cut of 0.25%, which forced Health Secretary Andrew Lansley into sophistry and evasiveness.

Lansley continued with his method of repeatingly emphasising one response (this month, it was “Labour wanted to cut NHS spending”) - this tactic is predictable, untailored and will soon run out of steam.

Unsurprisingly, the national media pick-ups of Health Policy Insight's reporting of No 10 & 11 Downing Street concerns about Lansley's plans got air. Lansley's responding "don't always believe what you read in the papers" line requires a jauntier, thicker-skinned performer.

There was comedy, too, with vertically-challenged Speaker Bercow slapping down first his favourite enemy Minister Simon Burns for over-long answers, and then in the interests of balance, having a go at shadow health secretary John Healey for over-long questions. Healey will not be much bothered: he had to make his technical point, and he did.

A selection of questions - roughly transcribed and not verbatim - follows.

...

Q: whather any impact assessment done for effect of White Paper reform on services, linkage and PCT planning?

Paul Burstow: Health and wellbeing boards will integrate care (and uses a lame joke about a "save the PCT; don't trust the GP" slogan)

Liz Kendall: Given your plan to abolish PCTs and hand £80 billion to consortia that don’t yet exist, will you publish details of financial assurance scheme and also show how you will ensure accountability to Parliament?

PB: Labour making an interesting choice in aligning theirselves with interest of PCTs not patients and the White Paper will deliver outcomes and quality.

Q about GP commissioning consortia pathfinders

Secretary of State (SoS): I’m delighted with the response. Some pathfinder applications are coterminous with their local authority; others are based round a defined population size or based on acute trusts.

Ben Bradshaw: What effect will reforms have on acute trust waiting times?

SoS: I think it will be good.

BB: So why do RCGP President Dr Clare Gerada, the BMA and the Treasury and No 10 all question them? The latter two are so concerned they’ve got Oliver Letwin involved!

SoS: What a surprise that the minister in charge of government policy (Letwin) is looking at policy! (SoS then quotes from the RCGP White Paper response – you know, the one produced prior to Clare Gerada being in charge).

David Miliband: Is the SoS aware that in the eight years of a GP’s training, not one hour is spent learning about management?

SoS: Commissioning is not management, and consortia will be able to buy management support.

Johnathan Lord: We have no good comparative data on medics' performance - how will we collect some usefully and unbureaucratically?

Simon Burns: We need easily-understandable unbiased information, and we’re studying consultation responses, but it’s about empowering patients with information to enable their choice of the best-quality services.

Q: on the acute specialist childrens’ tariff

SoS: We have agreed the top-up payment for specialised children’s services at 60% over tariff, and the number of procedures carried out under tariff will be extended in 2012.

Q: Reorganisation of employment arrangements for community staff ex-of ALW PCT: some going to an FT, others to local authority.

Paul Burstow: You should be grateful for integration

Q: Would appealing a PCT’s commissioning decisions be an issue for national commissioning board?

SoS: Yes it will be after 2012. John Reid allowed politicisation of PCT priorities, and that is why I'm doing the White Paper’s changes.

Q: On savings on management costs in PCTs – will this benefit my constituents?

Simon Burns: cutting management costs by 45% and creating new consortia will allow us to strip out costly top-down bureaucracy present now and will benefit every MP in England's constituents.

Q: 100 jobs going in my constituency: can Minister guarantee frontline services are going to be protected?

SB: Only by efficiency savings and ridding of bureaucracy can we invest in front-line services. Labour left us in a mess.

Q: (following up Health Minister Simon Burns stats on reduction in diagnostic waits from 1.8 weeks in may to 1.7 last set) Do you expect them to stay down?

SB: I refer you to the Secretary of State’s earlier answer

John Healey: We welcome SoS’s change of mind on NHS childrens' tariff. Inflation forecast in latest Office for Budget Responsibility (OBR) report (p.83) predict that inflation increase will outstrip the rise in NHS funding, so it’s a real-terms cut.

SoS Lansley: We did not change our mind on specialist children’s tariff, York review was instigated by Labour government, and we have now reviewed its recommendations. NHS revenue is rising in real terms.

Healey: These OBR figures mean the NHS will get an annual 0.25% decrease in funding, which has been confirmed by the Haouse Of Commons Library. No wonder the PM is rattled. Can SoS confirm that the coalition government’s promise is being broken?

SoS Lansley: I do not accept that. The comprehensive spending review laid out how our promise was being met; and it’s a good thing we didn't listen to Labour advice to cut the NHS budget.

John Mann: if an acute reconfiguration is decisively rejected by a local population, who will listen?

SoS: Only our government gave the four tests for reconfiguration.

Q: Picking up earlier point on inflation and OBR figures, how does SoS define inflation?

SoS: What I said earlier was completely accurate.

Q: Will waiting times for inpatient acute increase or decrease next year?

SoS: they will respond positively to GP commissioning