Since the publication of the Francis Report into the scandal at Mid Staffordshire NHS Trust, David Cameron, against the advice of some Tories, has chosen not to politicise the issue. But at today's PMQs, the first for five weeks, he dramatically changed tack. After Ed Miliband challenged him over the sharp rise in A&E waiting times, Cameron declared:
If anyone wants a reminder of Labour's record on the NHS, they only have to look at the report on Stafford hospital.
His remarks were greeted with loud boos and cries of "shame" from Labour MPs but Tory backbenchers were visibly energised by the intervention (one that bears all the hallmarks of Lynton Crosby). A stunned Miliband replied by accusing Cameron of "a disgraceful slur on the transformation of NHS".
What happened at Stafford was terrible, and both of us talked about that on the day, but what a disgraceful slur on the transformation of the NHS that took place after 1997 and on the doctors and nurses that made it happen.
But in a sign that the Tories intend to make a sustained effort to pin the scandal on Labour, Cameron ended his exchanges with Miliband by declaring that under a Labour government "all the problems that we have at the Stafford hospital will be repeated again." The political war over the NHS just got dirty.
Cameron had earlier responded to Miliband's claim that he was presiding over an NHS "crisis" by referring back to Labour's decision not to pledge to ring-fence health spending at the 2010 election. "His answer is to cut NHS spending when we are investing in it," he declared. This is a strong line for Cameron; the Tories' chaotic reform of the NHS has made it even more important for him to emphasise that the coalition has protected health.
But unfortunately for the PM, it's no longer true (if it ever was). As I noted  yesterday, in his biggest spending commitment since his election, Miliband has pledged that a Labour government would not cut the NHS. Today's exchange was a good example of why. Polls regularly show that health is the most popular  area of spending with voters and Miliband has no intention of finding himself on the wrong side of public opinion on this issue.
Cameron, who has already seen tomorrow's GDP figures (which will reveal whether the UK has suffered its first-ever triple-dip recession), give no hint as to their content or on whether the government would temporarily withdraw from the European Convention on Human Rights in order to enable the deportation of Abu Qatada. But a notable moment came when, in response to a question on benefits, he declared: "I find it extraordinary that heads are shaking opposite. I thought it was the Labour Party, not the welfare party." The line was an echo of what Labour MPs such as Frank Field and Simon Danczuk have said recently and will unsettle those in the party who believe that Labour has allowed itself to be characterised as soft on "benefit cheats". Expect to see it deployed regularly between now and the election.