Reform UK and the NHS

Under a Reform UK Government, the NHS will remain free at the point of use and funded by general taxation.

We will improve the NHS by working to redirect funding from back office bloat back into frontline services.

Lift the cap on medical school places, enabling hundreds of British applicants with top grades to obtain places.

We will lift the cap on medical school places while maintaining high standards for entry. Our over-reliance on foreign trained doctors is a disgrace. We cannot continue in good conscience to turn away bright young British students from medical courses while we import thousands of doctors from overseas.

Lifting the Cap on Medical School Places

Successive governments have failed to train anywhere near the number of doctors required to sustain the National Health Service, leaving the country reliant on doctors trained overseas while turning away fully qualified British students. Some 20,000 foreign-trained doctors joined the medical register in 2023, and 6,320 foreign-trained nurses. Meanwhile, hundreds of students with at least 3 A*s are turned away from British medical schools each year, along with many other well-qualified applicants. This is the result of a choice made by politicians eager to hold down the cost of investing in British talent. It is also a false economy. While many doctors trained overseas are talented individuals, it is clear that many are recruited from countries where educational standards are simply lower than they are in Britain. As a result, while some of the world’s best medical talent is working in Britain, it is also the case that doctors trained overseas are referred to regulators with serious complaints at almost three times the rate of their British peers. Reform UK will end this reliance on poorly trained foreign doctors, while continuing to recruit high quality applicants. We will do so by lifting the cap on medical school places and training British applicants, while also maintaining high standards for entry.

Lifting the cap on medical school places from 7,670 to 17,000 costs £0.7 billion in the fifth year (£1.1 billion in cash), rising to £1.7 billion a year once five cohorts are in training.

This Economic Rescue Plan includes funding to increase the number of doctors and nurses we train in this country for the NHS. This includes uncapping medical school places and providing 0% student loans for nurses.

Introduce 0% interest loans for nursing students.

We will improve the offer to aspiring nurses, with 0% interest tuition and maintenance loans for domestic students. Being the daughter of an NHS nurse, I’ve seen firsthand the incredible dedication and hard work our nurses bring into work every day. They should be rewarded, not saddled with an ever growing debt pile that they have no prospect of ever paying off.

0% Interest Loans for Nurses

Nurses deserve a better deal. It’s not right that the people who care for our most vulnerable graduate to mountainous debts, with interest piling up every year. The Royal College of Nursing has been clear that these debts play a significant role in discouraging those who might otherwise have considered nursing as a career. Reform UK will fix this. For British nursing students, and for British nurse graduates who are working in the NHS, loan balances will be immediately frozen in cash terms, with a 0% interest rate applied. Every nurse working in the NHS will have a visible pathway towards clearing their student debts.

The 0% interest loans for nurses cost £131 million a year by the fifth year, with no cash cost within the Parliament because repayments are unchanged until a balance is cleared.

We are clear, for instance, that all current courses training teachers, nurses, midwives and other allied medical professionals will be approved for loans.

Reform UK would correct this. We would end taxpayer funding for the bottom 20% of degrees (i.e., course and university combinations) based on long-term economic outcomes. We would provide bridge funding for those currently enrolled when a course fails its assessment, allowing them to complete their studies. But we would not issue new loans for new students in such courses. However, courses which are of strategic or cultural importance may be approved despite low earnings if they are judged to provide value to the taxpayer (e.g., training courses for teachers, nurses, midwives and other allied medical professionals will be protected).

Funding substantial tax relief while reducing the deficit requires spending cuts. We have chosen to cut spending that doesn’t help ordinary British workers: welfare to foreigners, subsidies to dead-end degrees, pointless Net Zero boondoggles, an over-manned civil service, and foreign aid. Meanwhile, we have ensured money is available to fund the priorities of the British people, including training more doctors and nurses, securing our borders, and defending the realm.

Line from the Indicative Fiscal Plan table. Brackets show money spent.

We would also cut the money the government spends decarbonising its own operations. This includes hidden Net Zero spending on NHS buildings, schools, the defence estate, government offices and vehicle fleets, as well as departmental Net Zero teams, campaigns, local government schemes and taxpayer-funded Net Zero bodies. Our savings only count additional costs imposed by Net Zero requirements. For example, if a school needs to be rebuilt, we would still rebuild it; we would just remove the additional cost of meeting pointless Net Zero specifications.

Foreign nationals will retain access to the NHS, subject to an increased Immigration Health Surcharge – which will ensure the taxpayer is not left out of pocket.

The remainder of the savings come from immigration-related savings (e.g., from abolishing ILR, deporting foreign national offenders, and increasing the immigration health surcharge) and small changes to other settings.

A Reform government will create a cutting edge enforcement data centre to relentlessly identify and detain all illegal migrants in the UK. Using powers granted by the new legislation, it will automatically share data between the Home Office, NHS, HMRC, DVLA, banks and the police. It will power bulk warrants, including mandatory biometric capture during any police encounter. Each power addresses a failure mode observed over the past decade - for example, banks and GP surgeries unaware of a customer’s status, or overstayers slipping through because a warrant covered only a single property.

Using all the levers of state, including Local Authority and NHS data, a Reform Government will produce the first official estimate of the illegal population since 2005.

Finally, we will spend an extra £1.85 billion a year on interventions that are proven to help people stay well and off benefits. This includes cognitive behavioural therapy for mental health conditions and physiotherapy for musculoskeletal conditions. It also includes employment support funding.

The assessment would begin with structured medical evidence, collected by a GP. This would cover diagnosis, severity, duration, prognosis, treatment history, expected recovery or deterioration, treatment burden, functional impact, mobility, supervision, safeguarding risk and evidenced additional costs. GPs would certify medical facts; the Disability Needs Assessment would determine entitlements to support for.

Existing mental health or trivial condition claimants to be re-evaluated under reformed rules by GPs over 3 years.