David Cameron was challenged over his NHS record by a Lewisham Hospital campaigner during last night's first election TV debate.

Fresh from a bruising encounter with ex-BBC attack dog Jeremy Paxman, Mr Cameron seemed more at ease fielding questions from the audience.

But Save Lewisham Hospital campigner Vicky Penner took him to task about his previous pledges over the NHS.

She sadi: "The no forced closure of A&E and maternity units was actually in your manifesto and where I live in my borough we had to take you and your government to court to keep our hospital open."

Ms Penner asked: "The promises you made have been broken as far as im concerned so how can we trust you this time?"

But Mr Cameron defended his stewardship of the NHS, telling her he had increased spending on health by £12.7bn and recruited thousands of doctors and nurses while removing swathes of managers.

The Conservative leader told his audience in the studio and at home watching TV: "You are going to have to make this huge choice in 42 days' time. What I have learnt in the last five years is that nothing you want to do will work without a strong and growing economy.

"The schools we want for our children, the hospitals we want when we are ill. These things need that strong economy."

Mr Miliband said: "I think this is a choice between those who think this is as good as it gets for Britain and those who think we can do a lot better than this.

"The Prime Minister said he couldn't live on a zero hours contract, well I couldn't either, so let's do something about it."