It was a strange prime minister’s questions. The shadow of the attack on the Charlie Hebdo offices in Paris this morning seemed to be the obvious thing to talk about. It was mentioned by both leaders at the beginning of the session, but there were no questions at all from other members of parliament about terrorism, security in the United Kingdom or about this gross violation of freedom of speech. No one dared tear up the script. PMQs locks the House of Commons into a formal dance, which is difficult to disrupt.

Having said that, it was an important domestic subject which dominated the session: the National Health Service. And it was a subject Labour was desperate to air. The party needed to capitalise on the headlines in almost all today’s papers about accident and emergency services around the country in crisis.

Ed Miliband’s attack came hard and strong. David Cameron had promised that there would be no more waiting in accident and emergency, there were huge waiting times and he had failed.

Was it not ‘blindingly obvious’, he said, that closing one in four walk-in centres would increase pressure on accident and emergency departments? Cameron had no answer. ‘It is his politics and they have failed,’ mocked Miliband.

Was it not ‘blindingly obvious’, said the Labour leader, that if you started cutting back on social care that you would end up with pressure on accident and emergency? Cameron waffled on about the Better Care Fund which he said Labour opposed.

Was it not ‘blindingly obvious,’ continued  Miliband, that if you diverted £3bn to a top-down reorganisation that you would increase pressure on accident and emergency?

Cameron got tangled up in the fishing line. His main argument was that the NHS will only get better if the economy gets better and Labour will make it bad by spending too much money. This is how he expressed it: ‘Stick with the people with the long term economic plan not a Labour party which would wreck our economy and wreck the NHS.’

On the other hand, Cameron is very keen to say the government understands there is a crisis in the NHS and is pumping large sums of money into it and employing loads of doctors and nurses from abroad. Well, I am lying – he does not mention the abroad bit, but he did give us tiresomely boring figures about money spent and staff employed. He says Labour’s shadow health secretary Andy Burnham suggested cutting money to the NHS.

And when all else fails, Cameron goes on the offensive and uses abuse, as he did when he had no more answers to Miliband’s policy questions: a BBC political correspondent, said Cameron, had been told by Miliband that Miliband wanted to ‘weaponise the NHS’.

‘The NHS not a weapon,’ roared the prime minister in confected outrage. ‘It is the way we care for the elderly. Perhaps he will deny he said he wanted to weaponise the NHS, a disgusting thing to say.’

Miliband retorted: ‘I’ll tell him what’s disgusting. It’s a prime minister who said people could put their trust in him on the NHS and he has betrayed that trust … It’s a crisis on his watch in the NHS.’

Labour MPs piled in behind Miliband on the NHS. Even Liberal Democrat Martin Horwood (Cheltenham) did so, asking whether the 111 number was not sending people to accident and emergency unnecessarily. Cameron was having none of it, but he is on a sticky wicket. Jamie Reed (Copeland) asked about tents outside accident and emergency departments and said Cameron [in 2007] had promised a bare-knuckle fight on hospitals. Was this what he meant? Chi Onwurah (Newcastle-upon-Tyne Central) said that none of her local hospitals in the north-east had met the government’s scaled-down targets: ‘Does he really imagine we will trust him with our NHS?’

The only human insight on all this was in Cameron’s reply to a question about the health service from Lisa Nandy (Wigan): Cameron admitted that the health secretary Jeremy Hunt had been chased down the corridor by a nurse in Wigan to tell him what she thought about the NHS.

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Sally Gimson is a journalist and councillor in the London borough of Camden. She tweets @SallyGimson