Well, well well, the Tories are certainly rattled on the NHS. That’s what it looked like at prime minister’s questions today as Cameron shouted at Miliband.

Labour of course ran the NHS as its third policy pledge yesterday and it is turning into the top issue with voters. Ed Miliband chose to use it as his main line of questioning. No wonder David Cameron and his cabinet do nnt like it. And when Cameron does not like something he goes into full Flashman mode, bullying and patronising. It was as if he were still at school asking the decent guy who had crossed him to apologise so that he could humiliate him. Miliband shouted back, but as in all instances of bullying it was horrible to watch.

The lines had clearly been cooked up with the chancellor George Osborne, who could be seen leaning forward enthusiastically and occasionally making suggestions to Cameron. In the whole exchange Cameron barely answered a single question, which showed his contempt.

Miliband is getting cut-through on the charge that Cameron basically was dishonest to the British people about the NHS. Cameron ran a campaign before the general election in 2010 saying that he would not close local accident and emergency departments and maternity units. So, said Miliband, there were 29 of these departments and units he said he would protect, did he manage to protect them?

Cameron did not answer. Instead he said that Miliband had been ‘asked nine times whether he had made the disgraceful remarks about weaponising the NHS’. He then demanded that Miliband ‘apologise for that appalling remark’. You wondered whether Flashman Cameron would cane Miliband if he came up.

Miliband named the units that Cameron had promised to keep open and hadn’t. Cameron shouted again, getting redder in the face all the time that the BBC political correspondent Nick Robinson had said that Miliband told people in private that he wanted to ‘weaponise the NHS’.

Miliband said Cameron had been photographed outside Chase Farm A&E with the local MP saying, ‘Hands off our hospital’. ‘Is the accident and emergency department at Chase Farm open or closed?’, he asked.

Cameron again said Miliband wanted to weaponise the NHS. He wanted to know what Miliband’s motive was for asking these questions. ‘My motive’, declared Miliband, ‘is to rescue the National Health Service from this government’.

Miliband’s killer question though was: ‘Why has new guidance been offered to hospitals making it more difficult to declare a major incident’. Cameron said it was nothing to do with him and the head of the NHS had declared on the radio that there had been no political interference with the new guidelines. It sounded implausible.

And then Cameron brought up Wales where, he said, Labour was failing. He had even set up local Welsh MPs during the course of PMQs to ask about the health service in Wales. Wales and weaponisation – the key defence of Cameron’s handling of the NHS.

And when all else fails: ‘What a useless opposition!’, ‘What a useless shower!’ So prime ministerial. Not.

Dennis Skinner (Bolsover) is always a joy when he stands up to ask a question. He said: ‘If the prime minister can’t apologise about accident and emergency closures maybe he will have a go at the following subjects …’ and he listed foodbanks, zero-hour contracts and payday lending. ‘The truth is’, he said, ‘the prime minister had a record longer than his mate Andy Coulson’ (Cameron’s former spokesman who has just served a prison term). Cameron did not deny this or apologise, but talked about the jobs he had created. Skinner looked furious.

Cameron also did not deny Clive Efford (Eltham)’s point that cuts to state welfare had not gone to paying off the deficit but to funding tax cuts for higher earners. Cameron, said Efford ‘Steals from the rich and gives to the poor’. Cameron’s only response was to ask: ‘When did the Labour party become the welfare party?’

This was a brutal and unedifying prime minister’s questions.

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Sally Gimson is a journalist and Labour councillor in the London borough of Camden. She writes the PMQs on Progress column and tweets @SallyGimson

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