The session began with confirmation by Mr Cameron that Wootton Bassett was to become a Royal town in recognition of its efforts to honour the UK’s war dead.
After offers of support for the honour, proceedings quickly turned to both domestic and foreign matters, including the unfolding events in Japan and unrest in Libya.
But the fiercest exchanges between the PM and Mr Miliband were over the Government’s Health Bill, which is currently going through Parliament.
The bill plans to give more power to GPs and introduce more private competition into the NHS.
The Labour leader began by asking Mr Cameron if there were any planned new amendments to the bill, following recent criticism.
On Tuesday, the British Medical Association (BMA) voted in favour of calling on Health Secretary Andrew Lansley to withdraw the bill.
That was after Liberal Democrat activists passed a motion criticising the coalition’s planned NHS reforms during the party’s spring conference.
Mr Cameron said: “These reforms are about cutting bureaucracy and improving patient care. These reforms were drawn up as a coalition to improve the NHS.
“To answer his question very directly, we have already made some real strengthenings to this bill.
“First of all, we have ruled out price competition in the NHS and also the issued raised by the Liberal Democrats which is, we must avoid cherry-picking by the private sector in the NHS.”
But Mr Miliband accused the PM of not providing an answer and pressed again, only to be rebuffed with a barb at his questioning.
Mr Cameron said: “The problem with pre-scripted questions is it doesn’t give you the opportunity to respond to the first answer, where I gave a very clear answer about price competition and about cherry-picking.
Doesn’t it show, once again, as the BMA said, as the Liberal Democrats said, you can’t trust the Tories on the NHS.
Labour leader Ed Miliband
He went on: “We support extra money going into the NHS, money he doesn’t support.
“We recognise with an aging population, with more expensive treatments, with new drugs coming on stream, we need to reform the NHS to go with the extra money that’s being provided.”
Unfazed, Mr Miliband took his cue from the PM, to much merriment from the House.
“Mr Speaker, he’s really got to get away from these pre-scripted answers.”
He went on: “He just doesn’t get it. He’s threatening the fabric of the NHS.
“This bill shows everything that people don’t like about this Government – broken promises, arrogance, incompetence and ignoring people who know something about the health service.
The Labour leader faces Mr Cameron and the frontbench in PMQs
“Doesn’t it show, once again, as the BMA said, as the Liberal Democrats said, you can’t trust the Tories on the NHS.”
A clearly frustrated Mr Cameron could only accuse Mr Miliband of reading from a BMA press release.
“He should remember the fact that the BMA opposed foundation hospitals, they opposed GP fundholding, they opposed longer opening hours for GP surgeries.
“Isn’t it typical that just as he has to back every other trade union, just as he’s got no ideas of his own, he just comes here and reads a BMA press release. How utterly feeble.”
But the sustained attack by the Labour leader prompted Sky’s political editor Adam Boulton to comment on Twitter that it was Mr Milband’s best PMQs.
Following PMQs, a debate and vote on turning back January’s rise in VAT on fuel was called by Labour.
The party said rising oil prices and the increase in VAT were putting an unfair burden on motorists and businesses.
But MPs rejected the motion by 301 votes to 326 – a majority of 65.
Shadow chancellor Ed Balls earlier told Sky News the Chancellor should not wait for next Wednesday’s Budget to help those who are struggling now.
“We are saying to Conservative and Liberal Democrat MPs in the House of Commons, join us to urge the Chancellor to act now now,” he said.
“Our motion says when families are being hit hard with what’s happening more widely on pay and unemployment, he can act now and cut the VAT.
“I hope he listens, because people need to know that the Chancellor of the Exchequer is in touch with families up and down the country.”