The UK Independence Party may have shaken up local government, but if Nigel Farage ever became PM people would find its health policies have much in common with the three main parties in Westminster
Michael White: UKIP and the NHS
The turnout was only 30 per cent and county councils don’t handle EU or immigration policy. But who’s counting? The UK Independence Party enjoyed a huge success last week, a personal victory for Ken Clarke’s lifestyle stalker, pie-pint-and-cigs-man Nigel Farage. Let’s imagine his dream (or do I mean his nightmare?) comes true: what would a UKIP government do for the NHS?
‘UKIP seem to have trousered policies from all the “tired”, “old”, “elitist” parties and added a dash of nostalgia’
What’s striking about the UKIP health policy, as stated in the 2010 general election and upgraded last winter, is that it simultaneously claims to be “new” and “in line with mainstream thinking”. It can’t be both and is, in fact, much more the latter.
No disrespect to the backroom authors, but they seem to have trousered policies from all the “tired”, “old”, “elitist” (etc) parties and added a dash of nostalgia. No surprise to encounter a return to matron and “traditional nursing standards” then, given that nostalgia for a vanished/never-existed Britain is UKIP activists’ favourite aroma. But Westminster can hardly complain − it loves matron too.
Likewise UKIP’s ambition to remove layers of “wasteful bureaucracy” including those “EU-inspired” strategic health authorities (whoops, they’re gone) and “dramatic cuts” at the Department of Health. That’s a version of Con-Lab policy, just as giving away “top-down” commissioning power to elected county health boards is a variant on the Lib Dems’ localist 2010 manifesto − although staffed mostly by elected “health professionals”.
Not much work left for Sir David Nicholson under UKIP rule. County health boards will get a per capita grant from Whitehall and make local health decisions, be locally accountable, set and monitor care standards (under a Francis-style “universal duty of care”), organise basic nurse training and negotiate contracts under a simplified procurement system that no longer favours big health contractors (UKIP has plenty of support in small businesses). Oh yes, and the health boards will also decide whether or not to have a token local charge (“eg £1”) for otherwise free prescriptions − to prevent fraud.
‘These are admirable sentiments if the British people are not offered fantasy soft options to choose from. Alas, the big parties do that too’
The DH would still “coordinate” medical research to prevent duplication and have a role in public health and prevention. But only on macro issues like notifiable diseases, not on “telling people what choices to make in their lifestyle” − so Mr Farage’s genial pub habits will be left untouched. Free teeth and specs tests will be restored. “Prevention or early detection is almost always cost effective,” the 2012 document solemnly notes.
If you are still unpersuaded that all this adds up to a coherent or affordable policy, don’t worry. Although UKIP remains wedded to the core NHS principle - free at point of use according to need, not wallet − it thinks we can learn from those Johnny Foreigners (no health tourism for them!), not from the US health model, but from Oz or Germany. Noting that the Beveridge plan of 1943 envisaged a co-payment form of insurance (overturned by Nye Bevan), UKIP promises a cost-benefit analysis of the case for embracing it, subject to the will of the people.
Private firms and charities will be encouraged to bid for contracts (ie: the Lansley model) and, in a throwback to Liam Fox’s “patient passport” policy, patients will be able to obtain “health credit vouchers” to opt out of NHS care. As with the EU, so with the NHS − UKIP believes “in the ability of the British people to make the right choices when they are given the opportunity to do so”.
Don’t mock, these are admirable sentiments provided the British people are not offered fantasy soft options to choose from. Alas, the big parties do that too.
Michael White writes about politics for The Guardian