Ed Miliband asks "micro" questions on health as David Cameron accuses him of ducking the big issue of the strikes

By Jonathan Isaby
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2pm update:

CCHQ has rebutted Miliband central asertions from today's PMQs abotu the detail of NHS reforms, issugin the following statement:

"Ed Miliband is absolutely wrong to say that there will be 521 statutory bodies.  We will abolish 151 Primary Care Trusts, and 10 Strategic Health Authorities.  They will be replaced by clinical commissioning groups - of which we don't know how many there will be yet - and one NHS Commissioning Board.  There will be no other new statutory organisations.  We are also halving the number of national arm's length bodies.

"On the cost of redundancy, we are clear that we need to reduce NHS running costs by 45%. Some of this will involve redundancies amongst managers, most of which are voluntary. Already, since the election there are 4,000 fewer managers - unlike under Labour, when the number of managers in the NHS increased at 6 times the rate of the number of nurses. These cuts in bureaucracy will release £5 billion gross savings over the Spending Review period."

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Ed Miliband came to PMQs this week seeking to score points against the Government on the NHS - not  a subject that seemed especially topical, with David Cameron being at his strongest when he made the point that the Labour leader was scared or raising questions about the strikes on account of Labour being so reliant on the unions for funds.

The Labour leader's opening gambit was to ask whether the number of statutory organisations in the NHS - currently 163, he said - would increase or decrease after the current re-organisation. Cameron didn't have a direct answer, but noted that strategic health authorities and PCTs would go - and delighted in saying that former Labour health minister Lord Darzi is backing the Government's health reforms.

Miliband said the figure would go up from 163 to 521 with the creation of such bodies as pathfinder consortia, shadow commissioning groups, a national commissioning board, clinical networks and clinical senates. "Is that what he meant by a bonfire of the quangos?" But Cameron insisted that there would be a saving of £5 billion through reductions in bureaucracy and that since the Coalition government took over, doctor numbers have gone up and bureaucracy has gone down.

Miliband then queried much the Government would spend on making NHS staff redundant. Cameron said he accepted that there were costs as well as benefits in reducing bureaucracy: there would be a £1.4 billion cost, but over £5 billion would be saved over a Parliament and £12.3 billion over a decade.

Twice Miliband then asked whether NHS staff being made redundant would be rehired at new quangos to do their old jobs. Cameron did not make such a promise, not least because it is not the Prime Minister who hires every person in the NHS. In any case, he said, this government is investing in the NHS and providing the necessary resources, with the support of the likes of the Royal College of Physicians, Lord Darzi and Tony Blair.

Milband's final bite of the cherry was to suggest that "the whole country" has heard how Cameron can't promise that staff won't be rehired to do their old jobs, concluding with the question: "What is he doing to the NHS?"

Cameron was fired up for his final flourish, in which he said that "the whole country" will have noticed that he can't ask about strikes as he in the pocket of the unions; he cant talk about Greece as his plan is to make Britain like Greece; and he can't talk about the economy because of his ludicrous plan for tax cuts. "He has to talk about the micro because he can't talk about the macro," Cameron concluded.

In other questions:

• In answer to questions from Tory MPs on the strikes, Cameron said that they were irresponsible and that what the Government was trying to do on the back of Labour peer Lord Hutton's excellent report, was fair and designed to safeguard defined pension benefits for the future. 
• In answer to Labour MP Emily Thornberry David Cameron said that he did not agree with Nick Clegg that a tax break for marriage was "patronising drivel" and that the Coalition Agreement set out their differing positions in it.  
• Labour's Ian Austin wanted to know why the Government had not banned Hizb-ut Tahrir. Cameron said he though that it had gone further than was allowable under the law, that the Government was looking extremely carefully at them but that any ban had to be done under the law.
• Lib Dem MP Julian Huppert tried to persuade the Prime Minister to reconsider decriminalisation of some drugs.  Cameron said he didn't believe in legalising any drugs that are currently criminal, but that there was  insufficient attention given to education and treatment, with too much time currently being spent on heroin replacements. 
• Replying to Brian Binley, the Prime Minister said that this was "a very small business-friendly government".