Tuesday, 20 January 2015

So...what does UKIP think about the NHS?

There has been much made of UKIP's confused stance on the NHS in recent months, with UKIP invariably seeking to quash rumours that it is not particularly friendly towards the idea of a publicly-run NHS.

First, there was UKIP deputy leader Paul Nuttall's infamous claims that "the very existence of the NHS stifles competition" and that "the NHS is not fit for purpose". These were soon deleted and denied by some as evidence of an anti-UKIP conspiracy, but the undeniable truth is that these comments were made. Nigel Farage was also filmed telling supporters: “I think we are going to have to move to an insurance-based system of healthcare...I would feel more comfortable that my money would return value if I was able to do that through the marketplace of an insurance company.”  UKIP was so damaged by allegations of seeking to move towards an insurance-based system that the party was forced to declare its support for a state funded health service in November 2014.

This hasn't put the matter to bed, though. Today leader Nigel Farage is talking about the potential to replace the NHS with an insurance-based system. Didn't he hear his party back in November? Well, yes...but he already wants to put this back on the debating table, insisting UKIP will have to "return" to the issue after the election.

Nigel conceded that “there is no question that healthcare provision is going to have to be very much greater in 10 years than it is today, with an ageing population, and we’re going to have to find ways to do it.” That much is true, and if the NHS to survive it requires innovative thinking in combination with evidence-based approaches. But why should that mean going down the insurance route?

Louise Bours, UKIP's health spokesperson, has responded to her leader's intervention: "What people have to realise about UKIP is that we are much more democratic than other parties. Nigel is entitled to his opinion and others are entitled to theirs, we don’t whip people into all thinking the same thing, like the establishment parties. As he has said before, he raised the idea for discussion a while ago, the party discussed at and rejected it. I am certain that if the party discuss it again, we will reject it again. The vast majority of UKIP members, the British public and I will always favour a state funded NHS.”

I have some issues with the NHS being used as a political football. I also have issues with assumptions that an insurance-based system will necessarily provide the answers to the complex questions surrounding how we provide for healthcare needs in the future, as well as with assumptions that the problems experienced by the NHS are entirely due to the way in which it is funded.  But what really concerns me about this is that UKIP's leader is seeking to go into an election without being able to commit to anything on the NHS.

Farage is essentially declaring that "our temporary position, which I disagree with, is to support a publicly funded NHS, but we're going to revisit this after the election and hopefully revise our view". This does not inspire confidence in either the leader or the party. If UKIP's leader and deputy leader genuinely believe that the NHS should be replaced, they're entitled to their views - but hiding behind a populist position for electoral purposes, only to overturn it later, is flagrantly dishonest.

Louise Bours certainly doesn't understand the nature of "other parties" if she genuinely thinks their members are unthinking, uncritical and unquestioning. But she misses the point - the British voting public need to know exactly where UKIP stands prior to the election. They have a right to know what UKIP's vision is for the NHS, especially in the longer term. Pledging to revisit a decision after an election offers no reassurance. A tweet from the party confirming "UKIP is committed to an NHS free at the point of delivery" (note: not at the point of need) doesn't really answer the question either.

This is not a teasing question of what the party might have to compromise on in a prospective coalition, but a straightforward matter of principle. The British public value the NHS and it is not much to ask for a coherent policy statement that can be believed. What would UKIP's starting position be in any negotiations?

UKIP may indeed be a "democratic party" but when leaders undermine the party position so quickly and so publicly questions are inevitably raised. Perhaps Nigel Farage might now realise that, if he wants to be trusted on the NHS, sometimes omitting to offer his personal view would be a very sensible thing to do?

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