Boris Johnson  invoked the spirit of Margaret Thatcher as he promised to address a “long-term structural weakness” in the British economy.

The Prime Minister used his Conservative Party conference speech to say he has the “guts” to reshape society, addressing issues which had been dodged by previous administrations.

He defended the looming hike in national insurance to pay for the NHS and social care, arguing that the country was in a “hole” as a result of the Covid-19 pandemic.

But he said he believed in a “low tax economy”, achieved through  growth driven by a high-wage, high-skilled workforce.

Setting out the need for the health tax hike, which will fund £12 billion of investment each year, Mr Johnson said a “tide of anxiety” is washing into A&E departments and GP practices.

Mr Johnson recalled lying in a hospital bed last year and seeing a hole in the ground, noting: “They seemed to be digging a hole for something or indeed someone, possibly me.

“But the NHS saved me and our wonderful nurses pulled my chestnuts out of that Tartarean pit and I went back on a visit the other day and I saw that the hole had been filled in with three or four gleaming storeys of a new paediatrics unit.

“And there you have a metaphor for how we must build back better now.

“We have a huge hole in the public finances, we spent £407 billion on Covid support and our debt now stands at over £2 trillion, and waiting lists will almost certainly go up before they come down.

“Covid pushed out the great bow wave of cases and people did not or could not seek help, and that wave is now coming back – a tide of anxiety washing into every A&E and every GP.

“Your hip replacement, your mother’s surgery, and this is the priority of the British people.”

The rising tax burden has caused concern among the Tories, but Mr Johnson told activists in Manchester: “I can tell you – Margaret Thatcher would not have ignored the meteorite that has just crashed through the public finances.

“She would have wagged her finger and said ‘more borrowing now is just higher interest rates, and even higher taxes later’.”

The keynote address came as the Government implemented its £20-a-week cut in universal credit as the temporary uplift in the benefit over the pandemic ended.