Tony Blair had billed it as the most radical shake-up in the NHS since its inception 50 years ago.

And there is little doubt that his national plan for the health service represents a fundamental review of the system.

If the plan is seen through to completion, in 10 years time the NHS could have been transformed.

It will, according to the prime minister, finally have been dragged out of the 1940s and recast as a service fit for the new century.

And his statement brought universal praise from his own side, with both loyalists and cynics applauding him for the breadth of the changes.

Dennis Skinner heaped praise on plans

Even arch rebel Dennis Skinner could not wait to congratulate Mr Blair on his proposals - an experience which clearly unnerved the prime minister.

Blue sky

Mr Skinner, who has recently spent time in an NHS hospital, told him: "By any stretch of the imagination, this is a very big day for the NHS but, more importantly, for all those people who have had to use it over the years .

"The people that leave hospital searching for the blue in the sky and sometimes never see it, today means there will be a lot more people leaving with a smile on their face in the knowledge that the NHS has been improved today, not seeking perfection, but made a hell of a sight better."

It neatly summed up Labour backbencher's feelings and was precisely the reaction the prime minister had been hoping for.

After his "annus horribilis", Mr Blair is desperate to regain the political initiative and get his ministers and MPs back on the front foot.

Chancellor Gordon Brown's spending statement - which was then followed by a string of subsequent ministerial "good news" announcements - led the fightback, and the NHS plan was meant to round off the parliamentary session on a high note for the government.

And, if the reaction to the prime minister's announcement is anything to go by, it succeeded.

New compact

There were seriously controversial elements to the proposals. On the one hand, for example, Mr Blair appeared to hit a good Old Labour anti-private health button by limiting the amount of private work consultants can do.

But moments later he was talking about a new "compact" with the private sector to allow patients to be moved into private hospitals if they could not be treated in the NHS.

He also severely disappointed many by refusing to offer comprehensive care for the elderly, insisting only their medical, not personal, care would be paid for and declaring it would be up to nurses to decide where the boundary lay.

But he will have left the Commons chamber happy that he had put a smile on his MPs' faces.

William Hague: no one trusts Labour

William Hague found it difficult to come up with a comprehensive rubbishing of the proposals but still had one good shot in his locker - the "no-one-trusts-you-anymore" line.

Quoting from one of the recent leaked documents from Labour advisor Philip Gould, he declared: "TB has not delivered."

And that is still the charge that can do the government the greatest damage.

There is a growing disillusionment among voters about Labour pledges, born out of the government's failure to meet pre-election promises.

And, as Mr Hague and other Tory backbenchers claimed, the proof of the pudding will be in the eating.

The trouble for the prime minister is that, with so many of his plans only having an effect in five to ten years time, he may not reap an immediate benefit.

And if voters are not prepared to take him at his word until the changes are seen, the electoral effect may be minimal.