Our goal is to make the NHS the best health service in the world

Iain Duncan Smith

The Tory spokesman reportedly suggested that more patients should pay for medical treatment.

Dr Fox has been flying around the world talking to doctors, nurses and hospital managers.

And the document, Alternative Prescriptions, sets out details of the funding and organisation of 20 countries' health care systems.

It says social insurance systems used to pay for health in Belgium and Germany are fairer than the fully tax-funded NHS.

'Failing system'

The report compares the NHS to the state-monopoly systems in Eastern Europe before the fall of communism.

But in the foreword Mr Duncan Smith says the ideals behind the NHS are "worth fighting for".

"It is there when you need it, open to all, no matter what your circumstances - no ifs or buts, no small print."

But the Tory leader adds that the NHS is failing to deliver the health care British people want and deserve.

And he argues that Labour's target of matching European average levels of spending on health will fail without reform.

"The problems of the NHS are not just a matter of money. It is the system that is failing."

The Tories have toured Europe looking at other health systems

Mr Duncan Smith writes that "despite increasing taxes by �100bn since they came to office" Labour have "failed to deliver any significant improvement".

"We must have a system based on need not on the ability to pay, but that need should be defined by patients working with doctors, not by politicians," he added.

"Our goal is to make the NHS the best health service in the world.

"We owe it to ourselves to have a modern health service that delivers world-class standards of care.

"We owe it to the professionals in our health service to deliver the world-class standards of healthcare they came into the NHS to provide.

"Above all, we owe it the most vulnerable in our society - to the elderly, the sick and the poor - to renew the promise of the NHS and to make it fit for the century we live in."