Keir Starmer, the unlikely revolutionary – can he succeed where the Tories have failed?

Even Conservatives are impressed by the prime minister abolishing NHS England. Will he stop at nothing to deliver a smaller, more efficient state, asks John Rentoul

By abolishing NHS England at a stroke, Keir Starmer has shown that he has the courage, decisiveness and ruthlessness to deliver change for users of public services without giving in to the interests of the providers.

If Tories now admire him as they once admired Tony Blair, it is because he is right.

This is the most dramatic slashing of the public sector that any Labour prime minister has ever undertaken. The sacred altar of the NHS, once an untouchable totem, has been challenged by Starmer to bring about 21st-century efficiency and cut costs.

The decision to abolish the health service quango could only have been more dramatic had the prime minister also announced the introduction of charging for appointments, or private health insurance.

It is astonishing that since Donald Trump took office, the US president has brought only negatives to the world – and only positives to our prime minister.

Starmer has found new energy and boldness that has enabled him to set about reducing international aid to bolster defence, cutting welfare payments – at the risk of offending his backbenchers as they fear the vulnerable will lose out – and now revolutionising the NHS.

Opposition doesn’t matter: Starmer has a majority that allows him to do anything.

After he left No 10, Blair regretted that he had not acted quickly enough to achieve all he had wanted. Starmer is lucky that he does not have the screeching handbrake of Gordon Brown to prevent him doing what he wants. All he has is a slightly robotic chancellor who can be blamed for slowing down the economy and Starmer’s efforts to turbocharge it.

What is astonishing is that, with his health reforms, he has shot the Tory fox. After Starmer announced the end of NHS England, Jim Bethell, the Conservative former health minister, tweeted: “I wish we’d had the guts to do that.”

It was a bold decision, which gave unexpected substance to an otherwise worthy speech full of contradictory rhetoric about cutting back the “flabby” state, while trying to be nice about “our fantastic civil servants”.

But reversing the disastrous reorganisation of the NHS brought in by Andrew Lansley, David Cameron’s health secretary, has won praise from across the spectrum. The idea of “taking the politics out of the health service” by setting up a new central bureaucracy to run it, separate from the government, was misconceived from the start. As Starmer said, it led to duplication, as NHS England and the Department of Health did everything twice.

And it didn’t depoliticise the NHS. It never could have done. The state of the NHS is an intensely political subject and democratic accountability for it rests with ministers, whether or not there is a notionally independent public body in charge.

Has he gone too far, as some Labour voices are saying? Some Tories even detect the language of Liz Truss and her attacks on “the blob” in Starmer’s implication that he is being held back by “stodge” and “the system”.

He was trying to be polite in his article in The Telegraph this morning by saying; “The problem isn’t our fantastic civil servants – it’s the system they’re stuck in.” But some of the rest of the article did sound rather similar to what Starmer said in December, that “too many people in Whitehall are comfortable in the tepid bath of managed decline”.

If Starmer succeeds, I wonder if Tories, and even some Labour people, will start to detect the echo of Margaret Thatcher in his determination to take the tough decisions that others have ducked. That was a constant theme of his speech today and the questions and answers with journalists afterwards: the claim that he is not like the politicians who left him a terrible mess because they “walked round” difficult problems rather than confront them head on.