Webcam debate: What should Cameron do next?

David Cameron, the Conservative leader, attempted to regain the political initiative today by promising a "bare knuckle fight" with the Government to save local hospitals from closure.

Amid speculation that Gordon Brown is planning an early election, Mr Cameron sought to reassert his centre-ground credentials by claiming that Ministers are attempting to close district hospitals.

The Tory leader launched his NHS campaign with Labour holding its biggest opinion poll lead since before the 2003 Iraq war, amid fears that early promise shown by Mr Cameron's leadership had faded.

"The basic point here is we believe the district general hospital is an absolutely key part of the NHS," the Tory leader said, on BBC Radio 4's Today programme.

"People have put money into the NHS, they’ve paid increased taxes and they want to see their district general hospital improve.

"People simply do not understand why maternity units and accident and emergency units are being shut down when actually accident and emergency admissions are up and births are up."

He added: "The Government’s new health minister, Sir Ara Darzi, has said ’the days of the district general hospital are over’.

"That’s why I say the Government can expect a bare-knuckle fight with us over the next few weeks and months about saving district general hospitals as a key part of the local NHS."

Mr Cameron made his remarks ahead of a trip to Sussex this afternoon where he was due to visit a hospital.

It comes against the backdrop of growing speculation over the last few days that Mr Brown, the Prime Minister, will call a snap election. He is riding high in the polls and has received plaudits for his handling of the successive terrorism, flooding and foot-and-mouth crises.

In contrast, Mr Cameron has been heavily criticised for travelling to Rwanda for the launch of a report on globalisation last month while much of his constituency of Witney in Oxfordshire was flooded. He has also run into a dispute within his party over the future of grammar schools.

The Conservative leader denied he had under-estimated Mr Brown and claimed the public would realise the Prime Minister was behind the problems facing the UK.

"What people will see in the run-up to the next election is that all the problems the country faces today - whether it’s NHS closures, family and social breakdown, whether it’s a weak pension system, whether it’s the stealth taxes they are having to pay that are making the cost of living so hard to meet - they can trace all of those decisions back to Gordon Brown sitting at a desk in Number 11 Downing Street as Chancellor," he said.

However, responding to Mr Cameron's campaign, Dawn Primarolo, the Health Minister, described his campaign as "simply dishonest".

"It’s misleading or dishonest for the Tory Party on Friday to support £21 billion of cuts from public services in supporting the Redwood Commission proposals, and then come back and say suddenly not only are they not going to do that but they are going to invest in public services," she told BBC Radio 5 Live, referring to the inheritance tax proposals made last week by a Conservative policy commission.

She added that the NHS provided "the very best services that are sensible" for each area and insisted the Government had the support of patients.

"If there are any changes, it is always done on the basis of three principles: first, it’s clinically-led - that’s what’s most important; secondly, what’s in the best interests of the patient; and thirdly, it’s locally agreed," she said.

"Patients tell us, time and time again in lots of research, that they want services locally where possible, but when it’s necessary they want to go to specialised units. That’s exactly what the NHS provides."

Speaking later, a Department of Health spokesman said that the Tory leader had quoted Lord Darzi out of context.

His analysis, in an interview with The Guardian newspaper in July, had been that in London “the days of the district general hospital seeking to provide all services to a high enough standard are over”, he said.

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