Reform UK Ltd is riding high in the opinion polls. More scrutiny is finally starting to fall on the policies they might offer to the country at the next general election. One of the areas that needs the most scrutiny is Reform’s policy offer on the NHS.

Background to the NHS

On the government’s own website it tells us that the National Health Service was established in the United Kingdom on 5th July 1948. With the NHS, Britain became the first western country to offer medical care, free at the point of use, to the whole population. It is also noted that “seventy-five years on the NHS continues to be a distinguishing feature of the British welfare state.”

The Second World War had led to great loss of life and enormous hardship, while the preceding years between the First and Second World Wars had also seen the ‘Depression’ and no great move forward in the provision of social services, including healthcare.

Consequently, the wartime coalition government, while obviously extremely busy with conducting the war against Nazi Germany, still took time out to consider what the country should be like after the war, after Hitler and the Nazis had been defeated. This led to the publication of the Beveridge Report in 1942, under the direction of the Liberal peer, Lord Beveridge.

The Beveridge Report identified: “‘Five Giants’ that needed to be tackled in order for Britain to succeed economically and socially. The five giants were Want, Disease, Ignorance, Squalor, and Idleness. Influential economist and civil servant John Maynard Keynes was also consulted by Beveridge during the making of the report. At his suggestion Beveridge modified some recommendations, thus Keynes believed the plan to be broadly affordable. The report was published on 2 December 1942 and immediately became a best-seller at home and abroad (costing 2 shillings).”

Following their landslide election victory in July 1945, the Labour government, went on to create a welfare state, with the establishment of a ‘free at point of use’ NHS at the very heart of it.

Before the NHS

It didn’t take long before the NHS showed its worth, through improved health and longer life expectancy for British people; the new world marking a huge contrast with the world before 5 July 1948. So, what was life like before the establishment of the NHS?

In the inner cities, overcrowding could be particularly grim, with skin diseases such as impetigo and lice infestation common. CAH Watts, a GP writing of his experiences in a mining community before the Second World War, “recalled the waiting room with rows of seats for about 60 patients who sat facing a high bench like a bank counter. Behind stood the three doctors and, behind them, the dispenser. The doctor called the next patient to come forward. Having listened to the complaint, he turned to the dispenser to order the appropriate remedy. There was rarely any attempt at examination.”

Doctor’s visits were made by bicycle, and every sore throat was viewed with suspicion as diphtheria was common. Antiserum, if given within 24 hours of onset, could be very effective, but this was one of the few active treatments available to the GP. Without it, the mortality rate was about 20 per cent. Indeed, so serious was the problem, that patients with “diphtheria or scarlet fever were taken away in a yellow fever van to the infectious disease’s hospital for at least six weeks: no visitors were allowed.”

The most dreaded disease was tuberculosis, with fits of coughing and tell-tale blood in the handkerchief. “Some families were especially vulnerable, and it tended to strike young people. […] Lung cancer was rare. If it occurred, it would probably not be recognised.”

As for the start of life, it has been noted that, “almost half the babies were delivered at home, mainly a matter for midwives. Pain relief in labour, although available in hospital, might not be provided in the home.”

Discomfort and pain were accepted as part of life to be endured with stoicism. If the family doctor had access to a hospital, he might reduce a dislocation or set a simple fracture.

Perhaps most damningly of all it has been argued that, “working-class people did not expect to be comfortable. Most went hungry and their undernourished children showed evidence of rickets until vitamin D supplements, provided by welfare clinics, controlled it. Many were miserably cold in winter, unless they were roasting in front of the coal fire in the kitchen. Successful treatment by the family doctor was accepted with gratitude and the many failures were tolerated without rancour or recrimination. Patients’ expectations were not high.”

Many children died from infectious disease and this was just seen as the way it was. Mothers, whose children were feverish, expected to be told that bed rest was crucial until the fever had fully subsided if the child was not to be admitted to the fever hospital.

For the vast majority of people who could not afford the top-class care reserved for the wealthy few, experiences of healthcare were often brutal and traumatic. The establishment of the NHS in 1948 changed all that.

What Reform says it will do

It is against this background that we can now examine what Reform UK is offering in terms of the NHS.

Well, it was reported in January that Nigel Farage had called for changes to the way the NHS is funded. He was accused of planning to “decimate” the NHS. It was further noted that the Reform UK leader had suggested he wanted to see “some form of means-testing rather than the universal model which has been in place for nearly 80 years.”

Instead of the NHS being free at the point of use, patients could be charged for some procedures. Farage was said to have told The Times: “We’ve got to identify a system of funding for healthcare that is more effective than the one we have currently got, and at the same time carries those who can’t afford to pay.”

Then on 5 May it was reported that in an interview with Beth Rigby at Sky News, Farage had been asked: “Just to be clear, do you want it to be still funded through general taxation or do you think we need to look at the funding model?”

Farage was said to have replied: “I do not want it funded through general taxation. It’s doesn’t work. It’s not working. We’re getting worse bang for the buck from than any other country, particularly out of those European neighbours.”

Two months later, it was reported that Reform UK had announced that they would be highly unlikely to introduce an insurance-based health system if they win the Welsh government after the Senedd election in May 2026. However, the party was not said to have rejected the idea on ideological grounds, but “because of the tight timescale and potential legal difficulties.”

Are Farage’s NHS plans popular?

It would appear that when British people find out about Farage’s plans for the NHS, his plans are not popular. It was noted in September that earlier in 2025 Farage had said he doesn’t want the NHS to be “funded through general taxation” and had in the past called for an insurance-based system.

However, the general public in this country are very much opposed to these views. It was said that, “an annual poll by the Health Foundation found that 85% of participants insisted that the NHS should remain comprehensive for all, with 83% agreeing that it should remain funded from general taxation. The survey was undertaken by polling agency Ipsos who questioned a sample of 2,286 Brits, 1,804 of whom were from England.”

It was further noted in a report by the Health Foundation that: “There are no significant changes in support for these founding principles, with the proportion thinking the NHS should provide a comprehensive service available to everyone remaining stable.”

Links to Trump

Worryingly, it was announced in October that James Orr, an academic who has influenced Donald Trump’s US administration, had become a senior adviser to Nigel Farage. This comes at a time when experts have warned that billions could be taken from the NHS budget following pressure from Donald Trump to hike UK drug prices, causing suffering to the “vast majority of NHS patients.”

Meanwhile it has been reasonably argued that:

“As many as 44,789 Americans of working age die each year because they lack health insurance, more than the number who die annually from kidney disease.”

No return to pre-NHS days

Whatever happens after the next general election, we must ensure that we do not see a return to pre-NHS days. It is vital that proper scrutiny is placed upon Reform UK’s plans for the NHS, especially any move away from it being funded through general taxation. That could be a very slippery slope towards the kind of healthcare nightmare that hundreds of thousands of American have to go through every year.

It is our NHS and we must defend it.

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