During the first 1960 US presidential race, those listening to the debate between Richard Nixon and John F Kennedy on the radio were more likely to award Nixon the victory over his young challenger; those watching on TV the reverse. The same can be said of Prime Minister’s question time.

The bravura of David Cameron can only be admired, as he bats away questions from all sides. But in any other forum, would an answer to a question with a question be seen as anything but distraction?

Ed Miliband raised the NHS, a tried and tested policy winner for Labour. The Labour Leader asked Cameron about broken promises on keeping Accident and Emergency centres open, with Cameron asking Miliband in turn about alleged comments that his party planned to “weaponise the NHS” in order to gain political advantage. In reading the Hansard debate or in listening in to the contest, Miliband could be considered the victor; but with eyes open, Cameron’s ease and surety carried the day.

In reality, between now and May, all issues are “weaponised” as parties clamber to push their advantage and expose the weaknesses of others. To those working in the political bubble, this is well understood but for the wider public, this line of attack helps Conservatives paint Labour as cynically exploiting an issue about an institution they profess to love, playing into a Conservative narrative that only they are trusted, serious and statesmanlike.

Can the Conservative narrative continue in the longer term? The answer is no. Cameron needs a deeper narrative on the NHS beyond accusing Labour of making political capital out of it. Crunchy policy detail will need to get through. As debating points, the Conservatives can dismiss Labour concerns on the NHS as political machinations, or hold up the record of Labour in Wales to warn of Labour in Westminster. However, for the longer term, these won’t stand up.

And what of Labour? The party knows that the NHS is its strongest card, as polls show that it is more trusted than the Conservatives on this, currently, number one issue for voters. However, the party has to gain further ground on the economy, jobs and welfare, currently Conservative strengths.

People will vote in May on a number of issues and for a number of reasons; Labour needs to extend its offer, and PMQs will have to be part of this diversification. The party will be acutely aware that Cameron’s strongest responses today come from his party’s comfort zones. Cameron’s attack on Labour for claiming the Mansion tax will be invested in the NHS, whilst also paying down the deficit, was particularly effective, as was his rhetorical question “when did Labour become the welfare party?”

Both leaders have the danger of being boxed in to their comfort zones, but Miliband has the advantage, in theory at least, of setting the tone of PMQs and the policies within it. Housing, school places, wages and transport are all issues the Labour leader could use the remaining Prime Minister’s Question sessions to further interrogate the Tories.

Miliband needs more than one button to press with the electorate, however strong that may be. Labour is ahead on the maturity of its messaging on the NHS; the Conservatives on delivery. Labour may have a better arsenal, but the Conservatives are currently hitting the target.  And come May, only one leader will survive.

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