The UKIP diagnosis

The UKIP diagnosisAccording to UKIP, the NHS is in crisis due to “our ageing population”, “the dramatic increase in the numbers of people suffering chronic, long-term conditions”, “uncontrolled immigration”, “EU directives”, and “endless political interference.” The party claims that “David Cameron’s government wasted billions on a top-down reorganisation he promised would not happen.”

UKIP is right about the first two claims. As people live longer due to improved socioeconomic conditions and medical technology, they acquire multiple different chronic long-term conditions – known in the trade as “multi-morbidity”. This is putting a strain on health care resources across the globe. It also poses a challenge for clinicians who typically specialise in one type of disease, and find it hard to treat multiple different diseases at the same time.

UKIP also has a point about top-down reorganisation. Successive governments over the past 60 years – this one included – have indeed spent a fortune in administrative costs, on what Professor Alan Maynard calls the perpetual “re-disorganisation” of the NHS.

But the party’s points about immigration and EU directives are red herrings. Arguably, immigration actually provides a net benefit to the NHS. with an influx of foreign born workers and the migration of mostly young and healthy workers, who rarely use the NHS, yet contribute their share in taxation. It is is true that the EU working time directive has slightly increased NHS costs, by reducing the long working hours of trainee doctors and hence reducing a source of “free” labour to the NHS.

But this issue is trivial in comparison with the other main economic drivers of increased health care expenditure that are not mentioned by UKIP, which include cost-increasing medical technology, rising expectations of health care in the consumer age, and the “cost-disease ” of rising costs and stalling productivity in all labour-intensive industries.

UKIP fails to diagnose these problems, or to offer solutions for how they will arrange for the introduction of new technologies, manage people’s expectations of health care, or improve the productivity of the workforce.

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