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As Ukip surges, coalition health policy shifts

Elliot Bidgood, 7 May 2013

Much ink has already been expended on last Thursday’s local elections and the strong performance by UKIP. Achieving a projected national share of 23% of the vote (though not literally 23% of the vote cast on Thursday, as Anthony Wells has explained), UKIP netted 147 new council seats across England and also helped make it the case that for the first time, none of the three main parties cleared 30% of the projected vote. It remains debatable whether UKIP will be able to translate these gains into a parliamentary breakthrough in 2015 and what the broader implications of this new surge will be for British politics. However, for now, we have seen quick responses from all three parties to UKIP’s apparent rise, and in particular from the Conservatives, who received their lowest vote share since 1982.


Along with fresh posturing from David Cameron on the economy, immigration and welfare, a less-noticed change has been in the sphere of public health policy. Following Thursday’s results, Downing Street indicated that two government policies unpopular with UKIP-friendly anti-“nanny state” Conservatives, a 45p per unit minimum alcohol price and plain cigarette packaging, are being dropped and will likely not feature in the upcoming Queen’s Speech to parliament. While the former of these was foreshadowed in March following reports of cabinet battles, the latter was less expected.

Some doctors have responded critically to the policy change on plain packaging. The same was also true on alcohol pricing when the change was first indicated. MP Sarah Wollaston claimed that “light & moderate drinkers are subsidising cheap booze for the heaviest drinkers”, asking “why do we [all] have to pay the £20bn cost for NHS & police?”. The Alcohol Health Alliance have issued similar warnings. Opponents of minimum pricing, including UKIP, have argued that it might not do much to deal with Britain’s alcohol problems, but will likely punish the majority of more responsible drinkers. Scotland will however be going ahead with similar plans following the failure of a legal challenge there, which will perhaps provide an interesting case study. Plain packaging, meanwhile, has provoked similar debates over both the role of the state and effectiveness – another reason the Department of Health has claimed for the apparent policy change on it is so that results from Australia, currently the main case study, can be more thoroughly examined.

I note with interest that UKIP, almost identically to the Liberal Democrats, have mooted the idea of a decentralised NHS in which new elected local health boards would exercise control at the county level, with the Department of Health playing a comparatively smaller role. This has already been the norm in the health systems of social democratic Scandinavia for decades, and so would be well worth a look as a serious policy. As UKIP establish themselves further, it will be interesting to see whether this idea catches.

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