Boris Johnson’s new top strategist repeatedly branded the NHS “sh**e” in unearthed tweets.
David Canzini, who joined Downing Street in February, said a petition to “save” the health service was a “stupid waste of time” in a string of messages in 2011.
And he backed Tory reforms, saying the NHS was "second rate" and needed to "adapt".
At the time he made his comments, about 15,000 NHS patients in England were waiting more than six weeks for a test.
Seven years later that number had topped 38,000. That statistic was then discontinued by the NHS.
The tweets were posted on the Twitter account @DCgrumpy, which features a photo of Darth Vader and the biography: “Who cares who or what i am?”
Someone who knows No10 aide Mr Canzini told the Mirror it was his account.
In one example Mr Canzini clashed with Armando Iannucci, the creator of TV political comedy The Thick of It, who was backing the petition to “save our NHS” from Tory reforms.
The veteran Tory strategist wrote: “why wld you want to preserve in aspic somthg that needs to adapt and get better.
“truth nhs is sh**e for all the money pumped in.”
Another message appeared on 17 January 2011, the date David Cameron gave a speech on reforming public services.
Right-wing election guru Mr Canzini wrote: “Finally someone admits the NHS is second rate.err duh ( PM good on you son).
“Now do something about it! The answer is not more of the same.”
In February 2011 he said: “Only 7000 sign petition to save the sh**e nhs! Errr how many people in the UK 60+Million! Even all the employees haven't signed it. Pathetic.”
In another message later that year he wrote during an episode of Question Time: “Why can't anyone say. "The nhs is broken and a huge drain on taxpayers money. It's not that great”.”
And in 2016 he posted: “IMHO junior doctors are a disgrace for striking. It's money motivated and not about care of patients #selfish”.
Bruiser Mr Canzini is known for his blunt style and was compared in one profile to Mr Wolf, the fixer who cleans up the blood in Tarantino film Pulp Fiction.
Another source told the Financial Times the ally of Australian election guru Sir Lynton Crosby believes in a “b***** form of Thatcherism”.
The No10 deputy chief of staff has been credited with shoring up Tory support - but also linked to a swerve to the right in Boris Johnson ’s policies.
He is said to have led a failed No10 bid to block a windfall tax on oil giants, and a hardening of Boris Johnson’s position on trans rights.
A No10 source said: “These tweets from eleven years ago are not reflective of David’s current views”
