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PMQs review: Miliband's finest performance

The Labour leader finally found his voice today.

Does Ed Miliband, like Tony Blair and David Cameron, perform best when his back is against the wall? On the basis of today's PMQs, the answer is yes. This was the Labour leader's finest performance for months. Rarely has he sounded so passionate and authentic on the economy. He tore into Cameron and George Osborne ("a byword for self-satisfied smug complacency") with cathartic force and the Prime Minister was visibly unnerved.

And why wouldn't he be? The economy is shrinking, unemployment is heading towards three million and the national debt has reached £1 trillion. Yet as recently as June 2010, Osborne was promising a "a steady and sustained economic recovery, with low inflation and falling unemployment". Cameron reeled off a litany of traditional excuses ("the overhang of the debt and the deficit", "higher food and fuel prices", "the crisis in the eurozone") but was unable to rebut the central charge that his policies have only made things worse. He accused Miliband of failing to take responsibility for Labour's "mess" but soon he will be forced to take responsibility for his own.

Some will question why Miliband chose to split his questions - the final three were on the NHS - when he had Cameron on the ropes. But it was the right decision. The NHS, which, lest we forget, employs 1.4 million people, is once again becoming a headache for the coalition and Miliband seized an opportunity to heighten the pain. Noting that the Prime Minister had boasted last September that his reforms were supported by GPs and nurses, the Labour leader asked him to provide "an update on the support for his bill from the medical profession."

With the British Medical Association, the Royal College of GPs, the Royal College of Nursing, the Royal College of Midwives and the Chartered Society of Physiotherapy all now calling for the bill to be dropped, Cameron could only cite the support of a lone GP in Doncaster. "What is good for Doncaster, is good for the rest of the country," he declared in a farcical riff.

The reality, as Miliband said, is that 98 per cent of GPs want the bill withdrawn. Once again denouncing Cameron's "arrogance" (a charge that has clearly been focus-grouped), he urged the PM to keep at least one promise and put an end to this "top-down reorganisation". Cameron, visibly beaten, scorned Labour for caving into the "trade unions" but he may yet regret picking a fight with the most powerful of them all.