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PMQs review: Miliband beats Cameron with detail again

But the Labour leader's new approach is subject to diminishing returns.

Detail, detail, detail. Ed Miliband has found a winning approach and intends to stick to it. Today's subject of choice was NHS bureaucracy."There are 163 stautory organisations in the NHS at the moment," the Labour leader noted. "how many will be left after the government's top-down reforms?" David Cameron, not a details man, was stumped, leaving Miliband to answer his own question: "561 ... is this what he meant by a bonfire of the quangos?" It was further evidence of the Labour leader's new focus on wasteful public spending.

The session continued in this vein, with Miliband asking the PM a series of technical questions on redundancy costs in the health service and Cameron struggling to answer. The government had spent £852m on making staff redundant, would it now be rehiring any of these people? It was a strong line of attack from Miliband, not least because many Tories will privately agree with it. The PM, in danger of suffering a third consecutive defeat, eventually erupted with a fury rarely seen in recent weeks.

"He can't talk about strikes because he's in the pocket on the unions," cried Cameron. "He can't talk about Greece because his plan is to make Britain like Greece." And then, the most telling rebuke: "He has to talk about the micro because he can't talk about the macro." Cameron was cut off in full flight by the Speaker ("We're grateful," John Bercow quipped, prompting Cameron to shoot him a look of pure fury), but he had made his point.

It was a criticism that at last some on the Labour benches will agree with. With Greece on the brink and the country facing the largest industrial action for decades, the opposition leader chose to ask an obscure question about health service reform. Few voters, you sense, believe that the Prime Minister should spend his time immersed in the detail of NHS bureaucracy.

Miliband can still mark today down as a win but his approach appears to be subject to diminishing returns.