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Michael Moore's new documentary is more tightly focussed than its world conquering predecessor Fahrenheit 911 and much the better for it. Where the last film took a blunderbuss to the entire Bush administration, Sicko eviscerates the American healthcare system, saving its sharpest tools for the insurance companies that hold the power of life and death over so many American citizens. It's enough to make you get down on your knees and thank the ghost of Aneurin Bevan for the NHS.

As a filmmaker, Moore is perhaps not held in such high regard as he used to be, partly thanks to a succession of campaigns attacking the accuracy of his polemic, and partly because, well, he's just a bit irritating. As with any Moore film, Sicko is a mixed bag: the genuinely shocking fights for space against the saccharine and sentimental, brilliant agitprop vies with self indulgence, cheap gags crowd up against monstrous injustice.

"POLITICAL GELIGNITE"

On the whole though, it works. Sicko has been criticised for painting Europe as a neverland of perfect healthcare, where no-one has to wait and every hospital is a pristine palace. But if even half of the stuff about American HMOs in the movie is true, the NHS and its equivalents do indeed appear utopian by comparison. There's plenty here to be outraged about - the lumber worker who was offered the choice of saving his index finger for $60,000 or his ring finger for $12,000; the insurance company that refused to pay for a major operation because the patient once had a yeast infection, the doctors whose job it is to deny care and drugs wherever possible, and so on. Moore's commentary can grate, but his most brilliant prank - escorting a group of 911 workers to Cuba for free healthcare - manages to be political gelignite and intensely moving at the same time. Highly recommended.

Sicko is out in the UK on 26th October 2007.