The Sketch: Milburn's a fatal case, warts and all

The Deputy Prime Minister wobbled up to the dispatch box to make a statement about the firefighters. "Talk. Don't walk," he kept saying, aspiring to – and achieving, let it be said – the rhetorical standard of a New York traffic light.

Outside the House, his spin doctor was asked whether they would cross picket lines to get the real fire engines into service. The civil servant in attendance started to say No. "Yes," the spin doctor said. Yes? We know what that means. No.

Let me celebrate diversity by paying tribute to Alan Milburn's accent. The sentence I dream of hearing him deliver in the House is: "Ah ornly horp lorkle vorters gnaw that alder fork will always vort for sorcial ornership."

He pleased us instead with his rousing articulation of the core values of the National Health Service. From his account, it's based on the scale of people's knees not on the size of their warts. That's probably true. People with baby elephant knees and warts like termite mounds go to the back of the queue and wait there until their afflictions move up the list of ministerial priorities. Those who insist he said "needs" and "wallets" have a lot to learn about politics.

Mr Milburn has an impossible task ahead of him. He's got to climb over the backs of a million health workers to get to the door of Number Ten. How will he escape the storm of criticism in ten years' time when it's clear his grand, over-arching, 10-year strategy to reduce health inequalities has failed? By being Home Secretary.

Jenny Tonge made a good point. Your brain has fallen out, I'll wait while you put it back in.

Mr Milburn had been saying that health inequalities had widened over the past 50 years and to prove it, a boy born in Manchester will live ten years less than a boy born in Dorset.

"Isn't he being stupid?" Mrs Tonge asked the House – cries of "woo!" She told us that these morbid statistics are less to do with health care and more the result of housing, education and diet – and the prowling packs of homicidal 12-year-old cannibals that Manchester is so known for.

Mr Milburn is not being stupid however, but cunning. His rhetoric is the forewarning of a massive transfer of public funding from hospitals in the south to hospitals in the north, a sectarian power shift dressed up as pursuit of equality.

Dr Fox did perfectly well, countering each of Mr Milburn's rosy statistics with its nasty opposite. He also produced a critique of the practice of Foundation Hospitals.

Bear with me. To the House, it seems, Minister Milburn talks about patient choice and declares the money will follow the patient. At the same time, however, he tells the chief executives of Primary Care Trusts they'll have five to seven-year bulk contracts, whether patients come to them or not.

You're wilting, be honest. You only have to believe that the two statements are wholly and totally incompatible.

The Tories also managed to point out that there's been a 10 per cent increase in funding already with only 1 per cent increase in outcomes. Money can't buy you love, or public health care, it seems.

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