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NHS Policy

Summary

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‘What to do about the NHS?’ is the most difficult domestic policy issue facing this generation. Failure to tackle itwill mean that it continues to be an ever-growing problem for generations to come. UKIP’s Health Policy providesa new way forward.

The NHS is valued by the people of this country, admired and envied by others. The principle of treatment free atthe point of delivery is non-negotiable; but how do we manage it, when the gap between rising demand andavailable resources gets wider every year?

We believe that a centrally-directed, top down system means that people have to accept a ‘get-what-you’re-given’ arrangement. Governments try to control the services provided; but politically have insufficient will ormandate to make the necessary decisions.

UKIP believes, in every area of policy, in listening to the people and giving them more control over the servicesthey receive. Health is no exception. Indeed, it is all the more vital to do this in a situation where difficult decisionsare needed.

UKIP will:

1. Direct the majority of health care spending to elected County Health Boards, making spending decisionsdirectly accountable to the public locally.

2. Dramatically cut the Department of Health and bring in professional procurement skills to reduce the hugeamounts of money wasted in procurement and resource allocation.

3. Prioritise UK taxpayers and citizens, ending health tourism by requiring all those without entitlement to pay inadvance.

4. Restore traditional nursing, especially the non-university-trained State Enrolled Nurses or equivalent.

5. Engender a Universal Duty of Care to ensure that everyone is responsible for reporting inadequate care anddriving up standards.

Introduction

The UK Independence Party is well aware of how highly the NHS is valued by the people of this country and hasno plans to make fundamental changes to it. In particular, the principle of treatment free at the point of deliverywill be retained for British subjects. However, the UKIP is exploring alternative models, such as those used inAustralia, Germany and the Netherlands, taking the best of the NHS and the alternatives. In due course thisshould lead to us being able to offer people a choice, should they wish to use it.

The principles of our policy

The UK Independence Party’s health policy:

• maintains the existing principles of the NHS• scales down the Department of Health• creates elected County Health Boards• devolves budgets and responsibilities straight to CHB members who answer to us• restores traditional nursing training and roles whilst safeguarding skills and knowledge• gives everyone a joint responsibility to improve standards for all• restores free eye and dental checksAll UKIP policies are based on our confidence in the ability of the British people to make the right choices whenthey are given the opportunity to do so.

This policy is based on four principles, namely:

• It is in line with mainstream thinking• It maintains the principles of the NHS• It has coherence with UKIP’s philosophy and other policy documents• It is affordable within the existing health budget as a percentage of GDP

In line with mainstream thinking

The NHS is highly valued by the British people, despite its problems and limitations. Therefore, unless or until theBritish people give a strong sign that they wish their government to consider an alternative, the NHS will remainunder a UKIP Government.

Maintains the founding principles of the NHS

Beveridge’s founding principles of the NHS actually recommended a co-insurance model and a UKIPgovernment would undertake a cost-benefit analysis of reverting to this concept. For the purposes of this policy,however, it means a healthcare system open to all British people, regardless of their ability to pay.

Has coherence with UKIP’s philosophy and other policy documents

UKIP believes in giving power and responsibility back to the people of this country and most UKIP policiessupport this. Giving funding direct to those elected by the people (CHBs) and giving everyone a responsibility forthe quality of services achieves this.

Affordable within the existing health budget as a % of GDP

The UKIP will continue to provide a comprehensive service in line with current NHS spending. It will make savingsby cutting several administrative layers of bureaucracy and by improving the procurement process.

What UKIP will do

The current system of allocating resources is extremely complex with each tier of management or administration

generating its own costs.

The majority of the Treasury’s allocation will be distributed to County Health Boards on a per capita basis with amuch smaller Department of Health (DH) also receiving funding direct from the Treasury. The DH will have a rolein Public Health (e.g. vaccination programmes and management of communicable diseases), Research andDevelopment (where it will set national priorities and link to the Universities), Education and Training ofprofessional staff, again linking with Universities and central reporting for CHBs.

The CHBs will have responsibility for:-

• allocating resources• setting and monitoring standards of care• the training of non-state registered staff, including most nurses

Quality of services and patient care

Whilst much of the care provided by the NHS is very good, there are pockets of excellence and some servicesthat are poor. Patients and their families are vulnerable and extremely reluctant to complain. For this reason, UKIPwill give everybody, but particularly staff, a duty to report concerns.

CHBs will be expected to monitor standards and act on the reports from staff and the public.

Access to the NHS

Treatment on the NHS is the prerogative of British passport holders and tax payers. Those without entitlementwill be strongly advised to have adequate health insurance, as British citizens do when travelling abroad.

Nursing

Many people have expressed concern that the move to university training has changed the opportunities forthose born with a vocational calling who wish to provide the crucial core nursing care. UKIP will therefore restorehospital-based vocational training, similar to the old State Enrolled Nurse (SEN) system. Whilst highly educatedand higher skilled nurses are now an integral and vital part of the healthcare team, the all-important core nursingskills need to be restored.

The costs and provision of training for these vocational nurses (and similar roles in other healthcare areas) will bethe responsibility of the CHBs.

Education and Training

The education and training of NHS staff fits with our Education Policy. UKIP considers it the responsibility of thegovernment to provide a well educated and trained workforce but that this should be to the level appropriate tothe individual and the role. A more flexible approach to lifelong learning will support this and reduce the costs of

over-training for all.

Procurement

The UKIP will abolish the complex competitive tendering rules which currently make it very difficult for smallercompanies to bid; as a result of which, a small number of large companies have a disproportionate share of NHSbusiness. In addition, the UKIP will require the NHS to use people with commercial experience to negotiate withthe private sector. Specifically, some of the PFI contracts will require renegotiation to ensure the taxpayer receivesbetter value for money.

Research and Development

Incredible advances have been made in health care through research and development (R&D). As more andbetter treatments become available, both quality of life and life expectancy increases. This is to be welcomed butit comes at a cost. The DH therefore has a role in co-ordinating R&D in health care to ensure duplication isavoided and the most promising areas are not delayed through a lack of funds.

Public Health and Preventative Health Care

UKIP believes in giving people more control over their own lives and allowing them to make their own decisions,in health care as in other areas. As a result, public health expenditure will be limited to those areas where there isa risk to the wider population (e.g. notifiable diseases and their containment) but will not include campaigns to tryto tell people what choices to make in their lifestyle. (e.g. stop smoking, 5 a day, exercise).Prevention or early detection, however, is almost always cost-effective and results in better outcomes. Free eyetests and dental checks will therefore be restored.

Prescription Charges

Experience in Scotland and Wales shows that free prescriptions is a system that is regularly abused. CHBs willtherefore be allowed to introduce a small charge (e.g. £1) for everyone if they believe this will assist in controllingthese abuses. The decision on free or reduced prescription charges will be made locally.

Looking Ahead

UKIP would like to offer people a choice of how they wish their health care to be delivered. Patient choice in amonolithic government funded system is one of the greatest challenges now facing the NHS and we believe thatother models are worth considering to see whether lessons can be learned from abroad. We reject the USmodel of healthcare but have in mind particularly those of Holland, Germany and Australia, which appear to offermore choice, shorter waiting times and objectively better health outcomes at comparable cost and have beenpraised for their lack of bureaucracy.

Steph McWilliamAndrew MoncreiffHarry Aldridge

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