This was the hardest-fought PMQs for some time. For a third PMQs running, it was the NHS that dominated the session. It was split into two halves, because once the leaders’ spats had reached the end of their allotted questions and responses, PMQs lasted a whopping 37 minutes. Will the Speaker introduce a guillotine or be happy for it to continue becoming so long?

However, David Cameron wasn’t forced onto the back foot in this week's session. If the Health and Social Care Bill remains in deep trouble, there remains a weak pulse. The PM’s spirited defence caused some damage with the revelation, from a leaked document, that Andy Burnham did not want the NHS risk register published. He repeatedly asked Ed Miliband why he wouldn’t ask about the risk register and the ‘substance of the reforms’. Opportunism is one of the best weapons available to an opposition leader but Cameron is trying to make it an insult on the NHS, when he taunts Labour with that charge.

This doesn’t revive the fortunes of this government’s most beleaguered reform, but it shows that Ed Miliband can’t have everything his own way, even if the Labour leader tried to claim the Bill ‘will become his poll tax’. But I still wait for the government to be able to change the narrative on these reforms.

The Bill is hugely complex and the NHS is a hugely complex organisation, but the simple lines have been drawn on this. The Health and Social Care Bill remains a huge problem for the coalition government. Both leaders have plenty of fight in them over the NHS but neither appear able to deploy the game-changing move in PMQs. Yet.

Tags: David Cameron, Ed Miliband, Health and Social Care Bill, NHS reforms, PMQs