Even Ukip don’t dare break the unhealthy consensus on the NHS

There’s an irony about Ukip’s rise. Nigel Farage party’s popularity is driven by a widespread sense that the main parties are all the same. Yet in the past four years, the differences between the Labour party and the Conservatives have grown substantially, on issues from the size of the state to an EU referendum.

In an election year you might expect parties to converge in the centre ground as they chased swing voters. It won’t happen this time. Labour is determined to stop left-wingers defecting to the SNP and the Greens, while the Tories, who have long had their own issue on the right because of Ukip, believe that their best chance of victory comes from heightening the contrast between them and the other parties.

Labour, the Tories and the Lib Dems do still agree on some things. On immigration, none challenges the fundamental principle of free movement within the EU — something for which Ukip should give thanks. On energy, the three main parties are all behind the Climate Change Act, with its absurdly ambitious targets for reductions in greenhouse gas emissions, which will push up both domestic and industrial energy bills. Tellingly, Douglas Carswell chose energy policy as the topic of Ukip’s first parliamentary debate. Then there is international development. All three Westminster parties commit to spending 0.7 per cent of Britain’s gross national income on overseas aid, against the wishes of two-thirds of the public. Here, too, Ukip can present itself as the party prepared to shake things up.

But when it comes to the NHS, Ukip is racing to join the consensus. Until recently, it was the only party that would tolerate public discussion of different ways to fund health care. Two-and-a-half years ago, Nigel Farage talked about moving towards an insurance-based system.