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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Inside a shaken city: "I just want to be anywhere that’s not Manchester”

The morning after the bombing of the Manchester Arena has left the city's residents jumpy.

On Tuesday morning, the streets in Manchester city centre were eerily silent.

The commuter hub of Victoria Station - which backs onto the arena - was closed as police combed the area for clues, and despite Mayor Andy Burnham’s line of "business as usual", it looked like people were staying away.

Manchester Arena is the second largest indoor concert venue in Europe. With a capacity crowd of 18,000, on Monday night the venue was packed with young people from around the country - at least 22 of whom will never come home. At around 10.33pm, a suicide bomber detonated his device near the exit. Among the dead was an eight-year-old girl. Many more victims remain in hospital. 

Those Mancunians who were not alerted by the sirens woke to the news of their city's worst terrorist attack. Still, as the day went on, the city’s hubbub soon returned and, by lunchtime, there were shoppers and workers milling around Exchange Square and the town hall.

Tourists snapped images of the Albert Square building in the sunshine, and some even asked police for photographs like any other day.

But throughout the morning there were rumours and speculation about further incidents - the Arndale Centre was closed for a period after 11.40am while swathes of police descended, shutting off the main city centre thoroughfare of Market Street.

Corporation Street - closed off at Exchange Square - was at the centre of the city’s IRA blast. A postbox which survived the 1996 bombing stood in the foreground while officers stood guard, police tape fluttering around cordoned-off spaces.

It’s true that the streets of Manchester have known horror before, but not like this.

I spoke to students Beth and Melissa who were in the bustling centre when they saw people running from two different directions.

They vanished and ducked into River Island, when an alert came over the tannoy, and a staff member herded them through the back door onto the street.

“There were so many police stood outside the Arndale, it was so frightening,” Melissa told me.

“We thought it will be fine, it’ll be safe after last night. There were police everywhere walking in, and we felt like it would be fine.”

Beth said that they had planned a day of shopping, and weren’t put off by the attack.

“We heard about the arena this morning but we decided to come into the city, we were watching it all these morning, but you can’t let this stop you.”

They remembered the 1996 Arndale bombing, but added: “we were too young to really understand”.

And even now they’re older, they still did not really understand what had happened to the city.

“Theres nowhere to go, where’s safe? I just want to go home,” Melissa said. “I just want to be anywhere that’s not Manchester.”

Manchester has seen this sort of thing before - but so long ago that the stunned city dwellers are at a loss. In a city which feels under siege, no one is quite sure how anyone can keep us safe from an unknown threat

“We saw armed police on the streets - there were loads just then," Melissa said. "I trust them to keep us safe.”

But other observers were less comforted by the sign of firearms.

Ben, who I encountered standing outside an office block on Corporation Street watching the police, was not too forthcoming, except to say “They don’t know what they’re looking for, do they?” as I passed.

The spirit of the city is often invoked, and ahead of a vigil tonight in Albert Square, there will be solidarity and strength from the capital of the North.

But the community values which Mancunians hold dear are shaken to the core by what has happened here.

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