PMQs review: Cameron rattled by Miliband’s NHS attack

Once again, Cameron struggled to defend the coalition’s health reforms.

Rarely has David Cameron appeared as rattled as he did at today's PMQs. Ed Miliband's decision to lead on the coalition's troubled NHS reforms proved fortuitous as the Prime Minister struggled to offer a coherent defence of his Health Bill.

Asked if he was planning any further amendments, Cameron prattled on about "cutting bureaucracy" and disingenuously claimed that the coalition would prevent "cherry-picking" by the private sector. As is frequently the case, his disregard for detail let him down. Asked if it was true that the NHS would be subject to EU competition law for the first time in its history, the PM appeared either unwilling or unable to answer Miliband's question.

Instead, for the third time in recent months, he selectively quoted from a speech by John Healey in which the shadow health secretary declared that "no one in the House of Commons knows more about the NHS than Andrew Lansley . . . these plans are consistent, coherent and comprehensive. I would expect nothing less from Andrew Lansley."

What Cameron failed to acknowledge is that Healey went on to argue:

They [the Conservatives] believe that competition drives innovation, that price competition brings better value, that profit motivates performance, and that the private sector is better than the public sector. I acknowledge the ambition but I condemn this as the core philosophy being forced into the heart of the NHS. It's wrong for patients. It's wrong for our NHS. It's wrong for Britain.

Miliband, who enjoyed his warmest reception from the Labour benches in months, made easy work of Cameron, but his lengthy questions frequently threatened to turn into speeches. At one point, he reeled off a long list of Labour's achievements on the NHS, a passage that, as Cameron suggested, was remarkably reminiscent of Gordon Brown's machine-gun delivery.

Towards the end, Cameron, visibly angered by the opposition to his reforms from the British Medical Association and Liberal Democrat activists, denounced the BMA as just another "trade union". His willingness to pick a fight with some of the country's most trusted professionals shows how determined he is to push these reforms through. There is no prospect of a forests-style U-turn.

In an attempt to demonstrate that he isn't the only one taking a political gamble, Cameron warned Miliband, whom he humorously referred to as "Son of Roadblock", not to "set his face against reform". Should the coalition's reforms prove unexpectedly popular, it is the Labour leader who will have to change tack. But for now, all the signs are that Cameron is facing a crisis entirely of his own making.

George Eaton is political editor of the New Statesman.

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Who will win the Copeland by-election?

Labour face a tricky task in holding onto the seat. 

What’s the Copeland by-election about? That’s the question that will decide who wins it.

The Conservatives want it to be about the nuclear industry, which is the seat’s biggest employer, and Jeremy Corbyn’s long history of opposition to nuclear power.

Labour want it to be about the difficulties of the NHS in Cumbria in general and the future of West Cumberland Hospital in particular.

Who’s winning? Neither party is confident of victory but both sides think it will be close. That Theresa May has visited is a sign of the confidence in Conservative headquarters that, win or lose, Labour will not increase its majority from the six-point lead it held over the Conservatives in May 2015. (It’s always more instructive to talk about vote share rather than raw numbers, in by-elections in particular.)

But her visit may have been counterproductive. Yes, she is the most popular politician in Britain according to all the polls, but in visiting she has added fuel to the fire of Labour’s message that the Conservatives are keeping an anxious eye on the outcome.

Labour strategists feared that “the oxygen” would come out of the campaign if May used her visit to offer a guarantee about West Cumberland Hospital. Instead, she refused to answer, merely hyping up the issue further.

The party is nervous that opposition to Corbyn is going to supress turnout among their voters, but on the Conservative side, there is considerable irritation that May’s visit has made their task harder, too.

Voters know the difference between a by-election and a general election and my hunch is that people will get they can have a free hit on the health question without risking the future of the nuclear factory. That Corbyn has U-Turned on nuclear power only helps.

I said last week that if I knew what the local paper would look like between now and then I would be able to call the outcome. Today the West Cumbria News & Star leads with Downing Street’s refusal to answer questions about West Cumberland Hospital. All the signs favour Labour. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.