Why Simon Stevens – more radical than most Tories – may save the NHS

In a valedictory interview, Sir David Nicholson was quite frank about the state of the health service that he has run for the last eight years. ‘In its current form,’ he declared, ‘the NHS is unsustainable.’

It is hard to imagine Simon Stevens, who takes over as NHS England chief executive this week, having to say that when he leaves. His friends know him as an experienced reformer, a policy expert and a radical. His CV causes some suspicion in Tory circles — he is a former adviser to Tony Blair (I’m also guilty in that respect) and was a co-author of the last Labour government’s health reforms — but that is precisely why he will be so valuable to David Cameron now.

It is a measure of the scale of the task facing Stevens that politicians and health service officials alike are all already shivering with anxiety at the thought of next winter. They fear a flu epidemic, an NHS system unable to cope — and a fiasco which may determine the result of the next election.

This is familiar territory for Stevens. It was after a similar flu outbreak that he co-wrote the NHS plan presented in 2000 by Alan Milburn — a market-orientated revolution which redefined the NHS as a system for paying for healthcare, but not necessarily providing it. Does that put him on the left, or the right? The answer is neither: he left No. 10 a decade ago and has had no political affiliation since he moved to the US to work for the American company UnitedHealth Group in 2007.

Many will ask if he will find it hard to work for Jeremy Hunt, given his closeness to Alan Milburn and Tony Blair.