Reform UK wants to scrap the NHS and replace it with private health insurance.
Reform UK has said it is committed to keeping the NHS free at the point of delivery and will “never” charge for its use. Reform UK’s leader Nigel Farage has repeatedly suggested he is open to re-examining the NHS’s funding model, however.
Under Reform UK, a GP visit could cost £129, an MRI scan £457, an A&E visit £1,368, an appendix removal £10,958 and coronary bypass surgery £71,997.
These are hypothetical figures produced by Labour—Reform UK has said it will keep the NHS free at the point of delivery. Labour has based some of these figures on median costs for equivalent treatments in the US.
Ahead of this week’s local elections in England, the Labour party has repeatedly claimed that Reform UK will make voters pay to use the NHS, or that it intends to “scrap the NHS” altogether. Labour’s also quoted specific prices that it’s suggested people would have to pay for healthcare under a Reform UK government, such as £129 for a GP visit or £10,958 to have an appendix removed.
In recent weeks we’ve seen these claims posted on the Labour party’s official social media channels, and by the health secretary, various MPs, local Labour groups and local government councillors. Reform UK has said it is committed to keeping the NHS free at the point of delivery, as stated in its 2024 election manifesto, and has said it will “never” charge people to use the NHS. And the figures quoted by Labour, supposedly of the prices people might pay for healthcare under Reform UK, are Labour’s own.
Labour, though, has pointed to various comments made by Reform UK leader Nigel Farage, including recently, in which he has suggested he is open to considering other funding models for the NHS.
While it’s impossible to say whether any politician or political party will ultimately end up honouring a specific pledge if they form a government—we often say we can’t fact check the future—we’ve looked here at what Reform UK has said it will do, and what Mr Farage has said about NHS funding.
Currently, the vast majority of funding for the NHS in England comes from general taxation and National Insurance contributions. A small proportion—around 1%—of the Department of Health and Social Care’s budget comes from patient charges, such as for prescriptions and dental treatment.
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While Labour’s attacks on Reform UK over the NHS have increased in recent weeks, the parties have been clashing over this topic for months, with Labour highlighting a series of different comments from Mr Farage.
For example, on 26 January Labour posted a video with the caption: “Patients would have to pay for healthcare with Reform.” The video was composed of an audio clip in which 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 responded: “Open to anything”.
This audio came from a 26 January LBC interview with Mr Farage, though the clip used by Labour is missing important context. Immediately prior to saying he was “open to anything”, Mr Farage said “Yes” when asked if he was “completely committed to free at the point of delivery”.
The LBC interview came days after the health secretary Wes Streeting and Mr Farage clashed over the latter’s views on the NHS on X.
Mr Farage posted: “Wes Streeting is so scared of Reform that he has now resorted to lying about our plans for the NHS. Let me be clear, the NHS will always be free at the point of delivery under a Reform government.”
Mr Streeting responded with a link to a Telegraph interview with Mr Farage from December 2024, in which the Reform UK leader was quoted as saying: “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.” Mr Streeting said: “‘If you can afford it, you pay’ is not free at the point of delivery.”
On 5 February, a few days after the LBC interview, the Prime Minister Sir Keir Starmer claimed at Prime Minister’s Questions that Mr Farage “has said those who can afford to pay should pay for healthcare”, and also said “his policy would be to charge [people] for using the NHS”.
We’ve repeatedly asked the Labour party about its claims but haven’t had a response.
Reform UK has strongly denied what Labour has said about its plans for the NHS. In a social media post earlier this month it said “Reform will never charge you to use the NHS”.
And speaking on 18 April Mr Farage addressed Labour’s claims head on, saying: “On the NHS, they’re putting out literature saying ‘Vote Reform and they’ll charge you fifteen grand for a hip replacement’. We’ve never ever, ever suggested anything other than the NHS should be free.”
When asked about Labour’s claims, Reform UK told Full Fact: “Our policy is to always keep the NHS free at the point of use.” And Reform UK’s 2024 election manifesto made the same commitment, saying: “Services will always be free at the point of use.”
However, Mr Farage has also said repeatedly that he believes the NHS’s funding model should be rethought. On 28 March, while again saying he believed the service should be free at the point of delivery, he reportedly told the BBC: “Everyone knows we are not getting value, let’s re-examine the whole funding model and find a way that’s more efficient.”
He was quoted in the Times in January as saying: “I was given almost pariah status for suggesting the NHS model isn’t working. I haven’t shifted my position. 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.”
Making an appearance on BBC Question Time in May last year, Mr Farage stated that the NHS “isn’t working anymore” and that “we need to fundamentally rethink the way we fund and organise the NHS”.
Mr Farage has made similar comments for many years, when associated with different parties. For example, as leader of the UK Independence Party he said in 2012 that “I think we’re going to have to move to an insurance-based system of healthcare”, and in 2015 he told the BBC that the idea of replacing the NHS with an insurance-based system was “a debate that we're all going to have to return to”.
However, Mr Farage appears to have stood in recent elections on a platform of NHS care remaining free at the point of use. As we wrote in a 2016 fact check, UKIP’s 2015 election manifesto pledged to keep the NHS free at the point of delivery. And in 2019, when Mr Farage was leader of the Brexit Party, the party’s general election manifesto also pledged to keep the NHS “free at the point of use”.
In the January 2025 LBC interview mentioned earlier, when asked about the possibility of introducing health insurance, Mr Farage said: “If we could get a more efficient, better funding model, provided we give free care at the point of delivery, I’m prepared to consider anything.”
Mr Farage was asked if he was open to moving to “a French-style insurance model for the NHS”, to which he replied: “I’m not saying we should absolutely mimic the French system, but let’s have a much deeper, broader thing.”
State healthcare in France is not generally free—costs are generally covered by a combination of statutory health insurance (funded by social security contributions and taxes), supplementary private insurance and patients contributing through co-payments.
Patients typically have to pay upfront for care and are then reimbursed a proportion of the official tariff by the Caisse Primaire d'Assurance Maladie—the French national health insurance fund.
Many people in France also opt for a mutuelle: a private supplementary health insurance that helps cover all or some of the remaining costs.
People with limited financial resources can apply for a complémentaire santé solidaire (CSS) which, depending on one’s income, is financed by the state, and offers further support covering costs.
Labour has also quoted some very specific figures which it has suggested could be the cost of accessing healthcare under Reform UK.
A mocked-up “NHS bill under Reform” has been created as a leaflet, and a similar list of charges appears on a graphic which has been circulated on social media.
The costs are broken down as:
Other costs have been cited elsewhere. Different graphics shared by the health secretary and Labour party have suggested an appendix removal could cost £10,958, while a 28 March Labour party press release referred to a figure of £23,400 for a hip replacement.
These are hypothetical figures from Labour, however, given that as noted above Reform UK and Mr Farage say they intend to keep the NHS free at the point of use. This is not made clear in many of the posts that shared the figures.
More context was offered in Labour’s 28 March press release, which said: “If Reform brought in an insurance-based system, comparable international systems show that patients could be left paying over £120 for a GP appointment, with an A&E visit potentially setting people back by upwards of £1,300.”
The press release said the figure of £129 for a GP appointment was based on the median amount charged “to see a primary care provider with [US insurer] UnitedHealthcare” ($160 for an in-person visit), and that the supposed A&E cost of £1,368 was from the $1,700 median cost of attending an Emergency Room with UnitedHealthcare. The £23,400 supposed charge for a hip replacement was based on a figure from the US quoted by the International Federation of Health Plans.
The first two figures were 2023 costs, while the hip replacement is a 2022 figure. All three prices were converted to pounds from dollars by Labour on 28 January 2025—shortly after Mr Farage’s LBC interview. Labour’s press release didn’t explain what the other charges it quoted—for an MRI scan, ambulance, appendix removal or coronary bypass—were based on, though its figures for the last two are broadly similar to those quoted by the International Federation of Health Plans.
Estimates for the costs of different healthcare procedures can range widely however, so even if patients were to have to pay for healthcare—which again, Reform UK appears to have ruled out—it’s unclear how accurate these figures would prove to be.
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