The Sketch: Simon Carr

When you brush the cobwebs off Erskine May, the holy writ of parliamentary practice, you find that MPs are forbidden to quote from newspapers on the floor of the House. Stupid book. No wonder it's ignored. As Matthew Parris pointed out, newspapers used to report what happened in parliament: now parliament reports what happens in newspapers.

Iain Duncan Smith took up the Evening Standard story of the blood-encrusted 94-year-old grandmother who spent two days on a trolley in Accident and Emergency. He wondered whether the Prime Minister would care to apologise to the old lady? The Prime Minister replied that the newspaper report was strongly disputed by the hospital, that the Tories were to blame, and that things were going to change.

In the ensuing hubbub, he demonstrated a mastery of parliament by dropping his voice to be heard. "Rather than trying to denigrate everything, let him applaud, for once, people working to deliver excellent standards of care."

This leitmotif will run for months, I fear. Smith castigates Blair for failing to apologise; Blair castigates Smith for failing to pay tribute. I'm sick of it already.

"Paying tribute" is the last refuge of the ministerial scoundrel, as we know, so we can say that the exchange was a score draw. That is, a win for Mr Duncan Smith.

The letter from the old lady's grandson is a belter. It winded the Government; you can't howl down a speaker quoting direct evidence such as this: "She had not been washed. She was still wearing blood-soaked socks and had congealed blood under her fingernails." (Cries of "disgraceful!" from both sides of the House, for opposite reasons.)

Mr Blair is one step ahead (that's not enough steps). He can diagnose the Tory strategy but doesn't disable it. "The reason he wants to run down the NHS is to make the political case to get rid of it." There may be a few operations that go wrong, he admitted, but "the vast majority" found standards to be "excellent".

Even the Prime Minister's abilities in the arts of sincerity can't carry that one off. There are 100,000 people from the past five years who don't believe it – mainly because they're dead, killed by the bug that lives in unwashed, unswept wards.

Then you hear him say: "They kept her in a medical assessment unit. Perfectly properly." The unit turned out to be a chair in a corner of A&E which had been reclassified as a Medical Assessment Unit.

We must all want to believe the Prime Minister – his ratings remain high as a kite, after all. But how difficult it is when you listen to him.

In response to another question, he said Britain's educational achievements were outstanding. Compared to what? Now that black families are sending their children back to Africa and Jamaica to be educated? But of course, Mr Blair wants to put the money in and Mr Smith wants to take the money out. For the first time, that sounds like rather a brilliant idea.

As Mr Blair pointed out (helpfully, for I hadn't realised this was the policy), the Tories were offering tax cuts so people could buy their own health insurance. Who wouldn't buy a health insurance policy for themselves and their family, if the Government paid for it? How persuasive can a man be? Even when he disagrees with what he's saying we can't help warming to it.

Simoncarr75@hotmail.com