More than 2,000 NHS staff have been made redundant and rehired under the coalition Government, Labour leader Ed Miliband has said.
Mr Miliband claimed Prime Minister David Cameron was clueless about the NHS as he also revealed that 2,300 health staff had received £100,000-plus pay-offs since the last election.
Official figures showed 330 staff received exit packages of £200,000 or more, while 513 were paid between £150,000 and £200,000 and 1,456 were given between £100,000 and £150,000 in redundancy payments since 2010.
The opposition leader claimed Mr Cameron was complacent about the crisis gripping accident and emergency (A&E) departments and said the NHS is not safe in his hands as he sacks nurses while managers receive six-figure pay-offs.
But the Prime Minister insisted the NHS is "getting better" under the current Government.
As the pair clashed during Prime Minister's questions, Mr Miliband said: "Over 2,000 people have been made redundant and rehired, diverting money from the frontline as you sack nurses.
"But you seem to be saying it's untrue. Well, when you get back, you can tell me whether it's untrue.
"And we know why the NHS is failing - your botched reorganisation, the abolition of NHS Direct, cuts to social care and 6,000 fewer nurses. There's only one person responsible for the A&E crisis and that's you."
Mr Cameron replied: "Let me give you the facts about the NHS under this Government - mixed-sex accommodation down by 98%, 1.2 million more people treated in A&E, half a million more inpatients.
"We're doing all of that and we're not following Labour's advice, which was to cut the NHS. That's the truth under this Government, the NHS getting better. Labour would have cut it and Labour never stand up for the NHS."
Mr Miliband attacked Mr Cameron for ignoring an A&E crisis which has taken hold before the onset of winter, with targets missed for 15 consecutive weeks.
But the Prime Minister insisted the Government was meeting its A&E targets, with waiting times down and the number of emergency consultants up.
The Labour leader said: "What the whole country will have heard today is a Prime Minister complacent about the A&E crisis and clueless about what is actually happening in the NHS.
"What the British people know is the NHS is heading into winter with fewer nurses, a lack of senior A&E doctors and a shortage of beds.
"You promised you would protect the NHS but it's now clear the NHS isn't safe in your hands."
Mr Cameron replied: "Once again you are just wrong on the facts. Let me give you a simple fact - there are more A&E consultants working in A&E than there were five years ago.
"That is why we're meeting our targets in England and that is why Labour is missing its targets in Wales.
"I'm clear my job is to stand up for the NHS and deliver a strong NHS. When are you going to understand your job is to stand up to the bully boys of Unite and show some courage?"
Mr Miliband criticised the Prime Minister for "giving P45s to nurses and six-figure payoffs to managers".
But Mr Cameron pointed out that there are 20,000 fewer administrative-grade employees in the NHS.
Mr Cameron said: "We are saving £4.5 billion by reducing the number of managers in our NHS and for the first time anyone re-employed has to pay back part of the money they were given.
"That never happened under Labour. But we don't have to remember the Labour record of the past, we can look at the Labour record in Wales.
"They have been running the Welsh health service, they cut the budget by 8.5%, they haven't met a cancer target since 2008, they haven't met an A&E target since 2009.
"The fact is, you are too weak to stand up to the poor management of the NHS in Wales, just as you are too weak to sack your health secretary."