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Labour leader Ed Miliband has compared David Cameron to "Flashman", one of literature's most famous bullies.

The comment came during lively Prime Minister's Questions exchanges, where the two leaders criticised each other's policies on the NHS in England.

Mr Cameron, who has reportedly been attempting to appear less overbearing in the Commons, likened his opponent to ski-jumper Eddie "the Eagle" Edwards.

Flashman is the villain of the 19th Century novel Tom Brown's Schooldays.

Amid much noise from MPs on all sides, the prime minister and Labour leader argued over the coalition's plans to reform the NHS, including GPs handling more of their budgets and greater use of private sector providers - reportedly a source of tension between the Conservative and Lib Dem leaderships.

Mr Cameron quoted shadow health secretary John Healey as saying: "The general aims of the reforms are sound."

He added: "Looking at this reminds me of 30 years ago. They [Labour] had a leader with the ratings of Michael Foot and he was being undermined by a Healey [the then shadow foreign secretary and leadership rival Denis Healey]."

In his response, Mr Miliband declared: "Flashman is back."

This referred to press reports suggesting Mr Cameron's advisers have warned him that he could be seen as too bullying during Prime Minister's Questions by toning down his body language.

Mr Cameron faced criticism two weeks ago when he urged shadow Treasury minister Angela Eagle to "calm down, dear", a catchphrase used by film director Michael Winner in a series of car insurance commercials on television.

Last week, he accused Labour MP Kelvin Hopkins of living in "Fairy Dairy Land", a fictional valhalla for milkmen mentioned in the Benny Hill song Ernie (The Fastest Milkman in the West).

The cultural references continued on Wednesday, as the prime minister mocked the Labour leader's pledge to fight back after disappointments at last week's elections, particularly in Scotland, where it lost badly to the SNP.

The prime minister told MPs: "I admit, I have to accept, some of the recent cultural references - Michael Winner, Benny Hill - they are all, I accept, a little bit out of date.

"But I look at the Honourable Gentleman (Mr Miliband) who told us 'the fightback would start in Scotland' before going down to a massive defeat. [It] rather reminds me of Eddie the Eagle."

Eddie "the Eagle" Edwards was a plasterer who trained to be a ski-jumper, coming last in both events he entered at the 1988 Winter Olympics.

The fictional character Flashman famously bullied Tom Brown in Thomas Hughes's semi-autobiographical novel.

He was later expelled from Rugby School, returning to literature in the Flashman books by George MacDonald Fraser as a successful Victorian soldier, who gains a reputation as a hero despite his cowardice and lecherous behaviour.

During his adventures he comes into contact with historical figures including former Prime Ministers the Duke of Wellington, Lord Palmerston and William Gladstone.