Tony Blair and Michael Howard have fired the first shots in what is likely to be a major battleground of the next election - the National Health Service.
The Tories want independent hospitals to be able to do NHS work
The clashes came as they unveiled their respective plans for healthcare.
At prime minister's questions Mr Blair said the Tories were offering a "right to charge" not "a right to choose".
Mr Howard said Tory policies could "make waiting lists a thing of the past" - adding that Labour's policies would just lead to more bureaucracy.
He contrasted that with the "Conservative vision of an end to centralisation and targets, real freedom for doctors and nurses, and a real right to choose for patients".
Liberal Democrat leader Charles Kennedy, meanwhile, said what people wanted was high quality public services near their homes rather than "a false debate about choice".
Mr Blair used a speech at a London hospital to promise a "new generation" of "personalised" public services.
With the government's five-year plan for the NHS being published on Thursday, the Tories have also fleshed out the details of their "Right to Choose" healthcare plans.
Shadow health secretary Andrew Lansley told BBC News Online: "The most visible aspect of the right to choose is proposing to give patients who need planned hospital operations unrestricted choice of where they go across the country."
Lansley denies the subsidy will deprive the NHS of funds
The government is currently pledged to allowing patients treatment at a choice of four or five hospitals.
Leaks suggest ministers plan to extend that to unrestricted choice.
But unveiling his party's plans, Mr Howard said Labour had tried and failed to improve the NHS.
'End to waiting lists'
The Tories are promising doctors more freedom, with all hospitals made foundation trusts with greater flexibility to borrow and invest money.
They also want to give people with long-term diseases control over how their conditions are managed.
And private hospitals could take on NHS work if they can meet the health service's standards and prices.
"Our approach will mean that, at last, we can make waiting lists in this country a thing of the past," said Mr Howard.
Blair may alarm some unions with his choice agenda
Perhaps the most controversial aspect of the Tory package is to allow patients to use half the cost of their NHS operation to be treated in a private hospital instead.
The Tories insist this idea, previously called "patients' passports", will free up extra capacity in the NHS without depriving the health service of funds.
Labour is already claiming the plans would take £1bn out of the NHS to help those who can pay, without producing more operations.
And Lib Dem spokesman Paul Burstow branded the Tory plans "unfair, unworkable and uncosted" and said Labour had created an NHS for the "pushy and the articulate".
In his speech, the prime minister insisted extra investment and reforms under Labour had brought real improvements, including falling waiting times and dramatic falls in the "big killer" diseases.
Mr Blair said: "With growing capacity in our public services,
we can now accelerate reform.
"We have the opportunity to develop a new generation of personalised
services, where equity and excellence go hand in hand - services shaped by the
needs of those who use them, services with more choice extended to everyone and
not just those that can afford to pay.
"Services personal to each and fair to all. This is the battleground for the
future of our public services."
Mr Blair said he believed in choice based on people's equal status as a citizen and not on the basis of their wealth - which he termed "choice for the few".
And, in what will be seen as a pitch to the middle classes, he said it was a coalition of "the decent and the disadvantaged" that got Labour into power in 1997.
The prime minister's comments will alarm some Labour MPs and union bosses, with Unison chief Dave Prentis warning that public service workers would not be impressed if reform was code for privatisation.