The Sketch: PM is unbeatable, even as he defends the indefensible

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He's like an imperial poem, our Prime Minister. All around are losing their heads and blaming it on him. He trusts himself though all men doubt him, yet he makes allowance for their doubting too. And look at him fill the unforgiving minute. Is that 60 or 65 seconds worth of distance run? Watch him go!

Flat PMQs, but not uninteresting. David Cameron's parliamentary ascendancy is a distant memory. He's somewhere around Hague in 2002. Not defeated, but unable to grapple any more. He can't engage the Prime Minister. He read his questions out. He had a silly joke. He quoted one of Blair's critics as though we couldn't rely on his Conservative word. But worse - much worse - he abandoned his Toxic Tory strategy. Instead of supporting the Government's difficult Tory-type reforms, Cameron laid into them for closing hospitals.

What a vain endeavour. Everyone knows you can't beat the PM in an argument. Even when he is defending the indefensible. And it is impossible for anyone but Blair to win this one. GPs unexpectedly earn an average £127,000, a result of inept contract writing by the department. The NHS overspend is £300m worse than it should be as a result, and health cuts and closures are the result.

The PM's blizzard of replies went: One, I don't accept doctors are overpaid; two, our GPs are the best-paid in Europe; three, the proportion of NHS funds going in pay has fallen; four, the money's gone on cutting waiting times and waiting lists (look!), and five, hospitals have to live within their means. That last, incidentally, is a great Conservative line. Tony Blair has recognised the power of the Toxic Tory strategy. He is turning it against them.

Hospitals trimming, cutting, closing wards or even closing is an integral part of a market. You can't have a market without bankruptcies. Hospitals close and others open. That is what market reform entails. If Cameron is pretending hospitals shouldn't close, or shouldn't live within their means, he'll go down William Hague's path and end up in William Hague's place.

The PM is at his most vulnerable; troubles come at him by the battalion. Only the Opposition can save him. And I think they probably will.

NB: Elfyn Llwyd (a Welsh nationalist) asked a brilliantly direct question. It's harder than it looks. "Why did his fundraiser-in-chief and tennis partner refuse a £1.5m donation to Labour preferring instead to receive a £1.5m loan?"

The Prime Minister gave the best answer available. It was the only answer available. "I'm not going to give a running commentary on that." Unbeatable. The Earth is his, and everything in it.

There is only one line of the poem he might yet work on. "If you can talk with crowds and keep your virtue." Yes, just a little to do on that one.