Westminster blog

In his second answer at prime minister’s questions today, David Cameron asked a question of Ed Miliband:

As we are being kept here to vote on the publication of the NHS risk register, why don’t you ask a question about that?

It seemed like a strange tactic. Why would the prime minister, who has been ordered by the information commissioner to publish the document detailing the potential risks of his NHS bill, want to bring up the fact that he is refusing to comply? Surely this was a subject on which Labour, not the government, holds the upper hand?

Only after the prime minister had put the challenge several times did we find out why he was so keen to talk about it. 

I have here Labour’s briefing notes for this afternoon’s debate. There is an excellent section on why you don’t publish risk registers. It says ‘Andy Burnham blocked the publication of the department of health’s risk register in September 2009.’

Ramping up the anger, Cameron shouted:

They are revealed as a bunch of opportunists not fit for opposition and not fit for running a government.

It would have been a devastating put-down – if Ed Miliband had raised the risk register in the first place. As it was, it was an effective debating tactic, but risks looking on the outside like a strange distraction from the substance of the debate, which is more about the health reforms themselves.

The problem for Cameron is that countering accusations of “You’re ruining the health service” with “You didn’t publish a risk register” is hardly an effective tactic. Far better, surely, for the prime minister to keep plugging his point about Labour refusing to back the government position of ring-fencing health spending.

Ed Miliband had a couple of good lines. His counter to Cameron’s risk register attack was particularly effective:

I will match our record on the NHS against his any day of the week.

It worked because it is what the country generally thinks, as shown by the latest polls on which party voters trust to protect the service.

But the Labour leader is at risk of overplaying his hand. Some journalists thought afterwards his argument that this is “the government’s poll tax” was his best. The problem is that as and when NHS services start to be affected (more probably because of the savings the service has to make over the next few years than anything to do with the bill), it will be a much slower and more gradual change than the poll tax.

Some Tories have made the point: “Ed Miliband is going to look pretty stupid in six months’ time when the NHS is still here and working.”