"Like no other artist of his generation, Damien Hirst has permeated the cultural consciousness of our times," declares the curator, Ann Gallagher, introducing the retrospective of the artist in Britain at the Tate. Well, confining it to "his generation", Hirst certainly has the notoriety with his dead sharks in formaldehyde and diamond-encrusted skull, although Tracey Emin with her My Bed (1998) and confessional installations could probably give him a run for his money (not literally, of course, given Hirst's reputation as the richest artist in the world today).
And here are Hirst's shock creations, gathered together for the first time in this country, the shark, the skull, the butterfly assemblages and the spot paintings, in the spacious new galleries of Tate Modern's third floor. You can say what you like – and everybody seems to have had a say already, most of it adverse – they represent the formidable output of an artist deeply committed to his profession and immersed in its history. The argument over whether sticking a cow in a tank or pinning a butterfly on a board amounts to art is now so worn out that you could be had up for ageism just mentioning it.
Go and see the diamond skull, (For the Love of God, 2007) encased in its own little walk-in cubicle at the back of the Turbine Hall of the museum or step into the central room in the main show surrounded by his fish, sheep and cows preserved in tanks and you can hardly accuse Hirst of tossing off the works without care or creativity. Nor can you say they are without meaning. The skull is a remarkable object, enfolding the reality of death and the image or religious relic with the permanence and the dazzle of real diamonds. The animals in formaldehyde are genuinely disconcerting in their still forms of frozen life.
The surprise of the show is that Hirst wanted it. After years of declaring that he'd never show in a museum like the Tate, it seems he has decided to look back on his career at the tender age of 46, thus immediately arousing the suspicion that it's a desperate effort to regain some of a reputation in decline.
It's a suggestion the exhibition, it has to be said, doesn't altogether allay. Arranged chronologically it starts with a room of his work at Goldsmiths College in 1986-8. There's a row of pans painted in household gloss, a ping-pong ball kept dancing aloft by a hairdryer at full blast, the first of his spot paintings pointedly leaned against the wall rather than hung. You would be hard put to see in any of these some great well of imagination or even precocious talent. But then, quite quickly, he seems to find himself and his gift for the art of effect. Perhaps it was because he searches into his own past and fears. Perhaps it was, as he suggests in a characteristically open conversation with Sir Nicholas Serota published in the catalogue, because he was just wanting and waiting to create something that would make a splash.
From his weak beginnings you move on into a room, being careful not to sit on the sheep's head preserved in glass containers on the floor and portentously titled Stimulants (and the way they affect the mind and body) (1991), to be faced by the famous – infamous at the time – A Thousand Years (1990). It's a work of huge ambition and no little technical challenge in which a bloody cow's head is devoured by flies moving in a constant cycle of birth, decay and destruction by an insect-o-cutor. All are contained in a six-foot high double glass box filled with the buzz of the flies. It's both disgusting and compelling in its portrayal of the morbidity of death and its aftermath.
Hirst, still in his twenties, had found a way to bring the reality of living and dying into the room and the rest of his career can be seen as a constant effort to equal it. Nearly all the themes that have dominated his work since were created in those few years of the late Eighties and early Nineties: the animals in formaldehyde, expressing the permanence of mortality; the pharmaceutical cabinets positing science and commerce against human need; the rows of cigarette butts representing the fire that consumes, and the spot paintings giving off the air of random order and precise space,
Much has been made of Hirst's obsession with death, fuelled by his own statements that he thinks of it every day. But it's not actually death that permeates his work so much as the fragility of life and the beauty of it as it approaches its end. The shark (The Physical Impossibility of Death in the Mind of Someone Living, 1991) no longer threatens, its skin too grizzled now to make it seem deadly (best looked at an angle from the front corners show you see it reflected several times to the sides), nor do the sliced cow and calf (Mother and Child Divided, 1993) amount to more than themselves, but the two cabinets of arranged fish swimming in opposite directions (Isolated Elements Swimming in the Same Direction for the Purpose of Understanding, 1991) do work amazingly well still, their ordered progress providing a rhythmic flow that draws you in and disconcerts.
Hirst's work of the past decade doesn't so much develop these themes as monumentalise them on larger scale and with more luxurious materials. The plastic anatomy figures of the pharmacy are succeeded by a gigantic 20-foot high figure of painted bronze (Hymn, 1999-2005) and an angel anatomised in Carrara marble . The flies of A Thousand Years (1990) are massed in resin on a round 12-foot diameter canvas of stark blackness (Black Sun, 2005). The shark becomes a dove in formaldehyde in an unnerving image of frozen flight (The Incomplete Truth, 2005), while the butterflies are used en masse and to brilliant effect as stained glass windows (Doorways to the Kingdom of Heaven, 2007).
Hirst certainly has the courage to take risks but does he, one asks, have the courage essential to the best art of taking risks with himself?
I hope so. One would like this maestro of the macabre to produce a different, more personal work. As it is we have a retrospective that proves his coherence as an artist but not his worth.
Damien Hirst, Tate Modern, London SE1 (020 7887 8888, www.tate.org.uk) 4 April to 9 September