Theresa May appeared to suffer the same ailment that overshadowed her speech to the Conservative Party conference in 2017 as she stepped up to the despatch box this afternoon.
She could only get out the first two words of her speech, saying “Mr Speaker” before coughing and clearing her throat, but immediately made a joke about it.
As Labour MPs heckled her about not being able to make her speech, the PM then quipped: “OK, you may say that, but you should hear Jean-Claude Juncker’s voice as a result of our conversation.”
Tory MP James Cartlidge (South Suffolk) referenced Mrs May’s voice problems, saying: “She may have slightly lost her voice, but is it not true that were we to have a second referendum, 17-and-a-half million people would have lost their voice?”
Mrs May said: “I entirely agree with him.
“I believe it is absolutely imperative for this House that we meet the decision that was taken by the British people in June 2016, that we deliver on that referendum and that we deliver Brexit for the British people.
“As I say, there is a danger that a failure to agree a deal that we could end up in a situation where we have no Brexit at all.”
Her vocal struggles were also mentioned by SNP MP Stephen Gethins, who, while making an intervention, joked he would give Mrs May a “moment to get another cough sweet from the Chancellor”.
That was in reference to the speech in Manchester 18 months ago where, having been handed a fake P45 by prankster Simon Brodkin, she was unable to get through her remarks, eventually being handed a lozenge by Chancellor Philip Hammond.
Letters also fell off the slogan on the backdrop as she made that conference speech.
Later in today’s debate, former Conservative minister and now independent MP Anna Soubry paid tribute to the PM’s fortitude in continuing to persevere.
She said most people would take to their beds if unwell, but noted Mrs May “simply battles on”.
ITV host Piers Morgan appeared to enjoy the Prime Minister’s difficulties, tweeting: “BREAKING: Theresa May’s lost her voice again.”
British political activist Christine Burns posted: “Listening to Theresa May’s strangled voice I’m drawn to the conclusion that her internal organs are staging a desperate intervention.”