Private school educated Nigel Farage has said he is open to changing the NHS funding model for an insurance system where ‘if you can afford it, you pay’
Nigel Farage’s ascent to the top of the opinion polls has been unstoppable but there is one issue which could derail the Reform UK bandwagon.
National polling out today shows that support for the founding principles of the NHS remains rock solid. Despite the internet age seeing opinions deeply divided on everything from political parties to pronouns, the NHS is the one thing that still unites us.
That leaves former City trader Farage at odds with the rest of Britain when he says the NHS funding model is “a total failure” and sings the praises of the French insurance-based system.
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The annual Health Foundation survey by Ipsos questioned a representative sample of 2,286 Brits and found the public continues to support the NHS’s founding principles. These are that the NHS is free at the point of delivery (86%), a comprehensive service for everyone (85%) and, crucially, primarily funded through taxation (83%).
After the economy (stupid), the NHS has traditionally been one of the biggest election issues likely to affect the way people vote. Nigel Farage’s bluster and soundbites may allow him to side step most tricky questions about what a Reform UK government would actually do – but on the future of the NHS, voters will want straight answers.
The private school educated Brexiteer has repeatedly suggested he is open to re-examining the NHS’s funding model. This possibility will send a shudder through middle England as well as the traditional working classes as we get closer to the next General Election.
We all rely on the NHS from cradle to grave and private insurance won’t come to your rescue if you need an ambulance. The NHS is widely considered a British national treasure, celebrated during its 75th anniversary and supported by public surveys showing it makes us proud. After its founding it was imitated around the world and for many it embodies British values of fairness, equality and decency.
In a Telegraph interview last year, Mr Farage said: “The funding of the NHS is a total failure. The French do it much better with less funding. There is a lesson there. If you can afford it, you pay; if you can’t, you don’t. It works incredibly well.”
Healthcare systems in most developed nations are generally bespoke, incredibly complex and have evolved over many decades. The French healthcare system includes mandatory state-run social insurance, financed by payroll deductions and taxes. The system often requires patients to pay upfront and then receive partial or full reimbursement. Many people also purchase private insurance to cover the remaining costs.
The German system is even more complex, combining contributions from employers and employees through statutory health insurance, supplemented by public tax revenue and, for the better off, private health insurance.
Today’s polling shows that, despite a fracturing of confidence in many of our major public institutions, British faith in the NHS remains strong. People just want it to work properly.
Building a new UK system from scratch would cost billions of pounds and risk chaos. Getting it wrong would leave people unable to access lifesaving treatments. The future of the NHS is one of only a few policy areas where getting it wrong comes with a body count.
Despite plummeting satisfaction in the NHS during 14 years of Tory rule, faith in the NHS funding model has remained constantly between 80% and 90%. Latest polling for 2025 shows just 13% of the population disagree that the NHS should be a comprehensive service available to everyone, and funded through general taxation. Only 11% believe it should no longer be free at the point of delivery.
After the Mirror contacted the Health Foundation about its survey, assistant director of policy Tim Gardner told us: “Our polling should act as a wake-up call to those advocating for radical change to the NHS model. There is wide-ranging evidence that no single type of health system consistently outperforms the others. And despite high-profile political calls to consider alternative NHS funding models, it’s clear that this view is not shared by the wider electorate, including the majority of Reform UK voters.”
Reform UK’s public position is that it is committed to keeping the NHS free at the point of delivery as stated in its 2024 election manifesto. But as Health Secretary Wes Streeting pointed out: “‘If you can afford it, you pay’ is not free at the point of delivery.”
In an LBC interview in January this year, Mr Farage was asked: “You are not committed to the model as it currently exists and would be open, therefore, to an insurance-based model?” – to which he replied: “Open to anything”.
As the prospect of the former I’m a Celebrity contestant becoming the next Prime Minister of the UK becomes more plausible, it is that kind of uncertainty over the future of the NHS that will give voters pause for thought.