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Cameron and Miliband clash over NHS

The future of the NHS was thrust to the centre of the general election campaign as David Cameron and Ed Miliband squared up over the straining service.

Mr Miliband accused the Prime Minister of "blaming the patients" for the pressure facing struggling accident and emergency (A&E) departments and claimed the health service was in "crisis".

Mr Cameron turned his fire on the Labour leader, claiming he had talked of "weaponising" the NHS in a "disgusting" attempt to make political capital from its strains.

In bad-tempered exchanges at Prime Minister's Questions, Mr Miliband replied: "I'll tell you what's disgusting - it's a Prime Minister who said people could put their trust in him on the NHS.

"You have betrayed that trust. You are in denial about the crisis in the NHS. This is a crisis on your watch as a result of your decisions.

"That is why people know if they want to get rid of the crisis in the NHS they have to get rid of this Prime Minister."

Mr Cameron hit back, telling MPs: "If ever you wanted proof (Labour) want to use this issue as a political football you have just seen it."

At least 10 hospital trusts have been forced to activate major incident plans in recent days to cope with a surge in demand, and Mr Cameron admitted the NHS is under "pressure" after waiting times in England plummeted to their worst levels in more than a decade.

Mr Cameron appeared to indicate that he is ready to meet in full the £8 billion additional funding which NHS chief executive Simon Stevens has said will be needed by 2021.

The Prime Minister told MPs: " Our responsibility is to put in the money, which we are doing, to provide the extra staff, which is happening, to have a proper plan for joining up health and social care, which we are doing, and then to fund the Simon Stevens plan, which is the right long-term answer for our health service."

But aides said later that this should not be seen as an announcement of further resources on top of the £2 billion committed by Chancellor George Osborne in the Autumn Statement.

"The Government welcomed the forward view that Simon Stevens has published, and made a £2 billion down-payment," said a senior Downing Street source. "That has been announced. If there are any additional announcements to come, they will come at the appropriate time."

Mr Cameron has admitted the NHS is under "pressure" but has resisted the use of the word "crisis" to describe the situation

Conservative minister Sam Gyimah appeared to acknowledge that the current problems do constitute a "crisis", telling BBC2's Daily Politics: "The NHS is under huge pressure, especially A&E, as the Health Secretary said. Seven hundred million pounds was put into the NHS for the winter to help alleviate this crisis."

Labour said that Mr Cameron's comments at PMQs showed the Prime Minister was "in denial" about the scale of the issue.

"It seems the Prime Minister is becoming increasingly isolated in his denial and his refusal to recognise that there is a crisis in the NHS," said a senior Labour source.

The source dismissed as "ridiculous" Mr Cameron's allegation that Mr Miliband was using the NHS as a "political football", insisting that the state of the health service was a major political issue which would be at the heart of the election debate.

"It is David Cameron's failed politics that are to blame for the crisis we see," said the source. "This is about David Cameron's failed politics. He asked people to trust him on the NHS and he has betrayed that trust."

The source did not deny that Mr Miliband had used the word "weaponise" in connection with the NHS in private discussion of election tactics.

"I am not going to comment on private conversations," he said. "But no one should be in any doubt of Ed's determination to fight every day between now and the general election to save the NHS."

MPs were discussing the state of the NHS in the House of Commons, after Health Secretary Jeremy Hunt was forced to the despatch box to answer an urgent question from his Labour opposite number Andy Burnham.

But the Government has rejected Labour calls for an emergency summit to discuss ways of easing the pressures on A&E departments, after release of the worst casualty admissions figures in a decade.

Shadow health secretary Mr Burnham said the meeting was urgently needed to address a "rapidly-deteriorating position".

But a Department of Health spokeswoman said: "The Secretary of State has been holding weekly meetings about A&E pressures since March last year.

"Alongside colleagues across government and the NHS nationally, we continue to work with the local NHS to help support them through the winter."

The chief executive of a body representing private care providers blamed the pressure on A&E on a "broken payment model" which directed funding towards acute care at the expense of other parts of the system.

Professor Martin Green of Care England said: "For a number of years, independent care home providers have been offering the NHS increased capacity in order to deal with the pressures that the health service faces over the winter months. These offers have been repeatedly ignored and it is no surprise that A&Es once again find themselves overstretched.

"A broken payment model, in which money flows into the acute sector at the expense of the rest of the health and social care system, has allowed the needs of individuals with complex conditions to escalate to the point at which they have no choice but to present at A&E.

"The only way in which the cycle of crisis can be stopped is through streamlining primary, acute and social care, and I look forward to the day that all of the rhetoric surrounding integration is translated into action."

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