Tony Blair has been attacked on the number of managers in the health service.

Iain Duncan Smith demanded to know "why there were more managers than beds in the NHS?".

The Tory leader said Labour had failed to cut bureaucracy in line with its 1997 manifesto pledge. "The NHS now has 210,000 but fewer than 200,000 beds so he has failed," said Duncan Smith.

"Will he now confirm that half the extra money that he has put into healthcare has not gone into improving care for patients?"

Blair said that the government had increased the number of beds and delivered an upbeat assessment of the NHS under his stewardship.

"They have increased in the last year for the first time," said Blair. "If he is saying that good management is not important, it is important."

"If we look at the quality of healthcare...I do indeed think it is improving," said Blair.

"Now virtually every single indicator is moving in the right direction and that is precisely extra investment we are putting into the health service that he opposes."

The Tory leader was not impressed. "With all that nonsense it is no wonder he is sponsored by the Fantasy Channel," he said in reference to Labour's donation from top-shelf publisher Richard Desmond.

Duncan Smith also called on the prime minister to say whether the public would see any improvements in the NHS as a result of the extra spending.

He said: "Could he tell us now whether or not we will get European standards of healthcare for European levels of spending by the next election - a simple yes or no?"

Blair said that extra government investment was improving standards. "We have set out precisely the targets we will achieve by the next election," said Blair.

"When he talks about the numbers of beds and waiting within the health service let us just remember that the last Conservative government cut the number of beds by 60,000 during the last parliament, waiting lists went up by 400,000."