Westminster Blog

Ed Miliband left David Cameron on the ropes early on in prime minister’s questions today by probing him about the details of the NHS reorganisation.

The Labour leader pointed out that the number of NHS statutory organisations was growing from 163 to 521 – including “health and wellbeing commitees,” “national commissioning boards”, “clinical networks”, “clinical senates” and so on.

This is not the kind of language Cameron seemed to promise in opposition when he vowed to cut bureaucracy and to end top-down reorganisations of the NHS.

Miliband then pressed home the point that the government has spent £852m making NHS staff redundant, particularly on scrapping the primary care trusts. Would the government be rehiring any of those people, he asked?

Cameron struggled to reply directly, answering only in generalities before saying weakly that Miliband had “an extraordinary vision of how the NHS is run, but it is not the prime minister who hires every person in every organisation in the NHS.”

Maybe not, but the idea of spending nearly £1bn laying staff off – only to recruit them again – has a whiff of the kind of bureaucratic money-wasting that the prime minister supposedly hates.

Cameron came back at Miliband over the savings achievable through the reforms, some £12bn over 10 years, and pointed out that Labour had not made the same promises about ring-fencing NHS spending. Look at Wales, where health spending has been cut under a Labour administration, he said. But Miliband had clearly got under his skin.

The bout was a score-draw, however, because the prime minister then laid into Labour for failing to mention unions or strikes, the big issues dominating the political week – given tomorrow’s big industrial action. No Labour MP had brought up the issue because they were all in the pockets of the unions, Cameron declared. As the session came to a close, he added: “Twenty-six minutes into question time, not a word about strikes, pensions or the need to reform, because they’re paid by the trade unions they can’t talk about this issue.”

It was an effective riposte which neutralised Miliband’s attack.

Nor had Labour brought up the issue of Greece, Cameron said earlier: “He can’t talk about Greece because his plan is to make Britain like Greece.”

It was around that point that the Speaker, John Bercow, intervened to stop the prime minister speaking, saying: “We’re grateful“. Cameron shot him a look of pure anger. Later on Bercow pointedly told the PM that the session was designed to give backbenchers a chance to speak. (“May I remind the House the Prime Minister’s Questions is primarily for backbenchers!“) Again, unhappy faces from Cameron, Osborne and Hague. Relations between the Speaker and the administration are clearly not very sunny right now.

Afterwards a Cam aide told hacks: “We’ll let the looks speak for themselves.”