The outcomes of the 2026 local elections in Great Britain have brought new political dynamics into focus. The rise of the Reform party, a populist radical right group, alongside the populist left Greens, signals significant shifts in political power. While these changes may not directly predict the next general election, the possibility of a populist government cannot be discounted. For the UK’s health system and public health expertise, this poses important considerations.
Populist governments often challenge scientific expertise and evidence-based policy. Health experts are concerned this approach could affect how public health decisions are made and how institutions operate. The World Economic Forum’s 2026 Global Risks Report highlights societal polarisation—often linked with distrust in experts—as one of the leading global risks. Preparing for this possibility is crucial to maintaining stable, transparent and effective health governance.
Historically, UK governments have operated on the expectation that public servants and ministers act in good faith to serve the public interest. Events in recent years have shown this assumption to be fragile. For instance, the unlawful proroguing of Parliament and some pandemic-related procurement scandals exposed vulnerabilities where political or private interests overshadowed expert guidance and public needs.
The Reform party has indicated intentions to further reduce safeguards around independence in scientific and health advice. This raises risks not only for specific policies but also for the overall standing of expert knowledge. When expertise loses its recognised authority, policymaking risks becoming driven more by ideology or political convenience than evidence that supports health and well-being.
The experience of the United States offers a cautionary example. Under a recent populist administration, scientific agencies responsible for public health faced political interference, expert advice was sidelined, and policies were influenced by ideological considerations. This contributed to setbacks such as increased outbreaks of vaccine-preventable diseases and reduced support for vulnerable groups.
Though the UK’s context differs, Reform’s leaders have openly admired some US approaches to governance. Meanwhile, UK scientific and health bodies remain vulnerable to pressure. Without a written constitution, mechanisms to hold government accountable in these areas rely heavily on tradition and judicial recourse. Proposed moves by the Reform party to leave the European Court of Human Rights and repeal parts of the Equality Rights Act threaten to further reduce legal protections linked to health and equality.
Government ministers currently exercise considerable influence over public health institutions, including appointing their leaders and controlling funding and public communication. This means shifts in political attitudes can quickly affect how independently these bodies can operate. Experts have suggested measures such as legislating for greater independence and accountability directly to parliament to mitigate these risks. Securing stable funding is also a key recommendation.
In this uncertain environment, the UK’s health establishment—comprising royal colleges, learned societies and other professional bodies—will play a critical role. These organisations must balance their charitable status and funding dependencies with the need to uphold scientific integrity and evidence-based advocacy. This may involve difficult choices about whether to cooperate with government agendas or to challenge actions that could harm public health.
Charity law limits the scope of allowable advocacy, creating uncertainty under administrations that might be hostile to dissenting expertise. Historically, professional bodies have tended to defer to government once policies are enacted, relying on shared norms of respect for evidence and democratic decision-making. If those norms no longer apply, the health sector faces a significant challenge.
Experts advise that health organisations conduct thorough reviews of their legal protections, funding structures, member perspectives, and public support. These reviews should consider potential threats such as politically motivated investigations or divisions over values and the role of the state. Learning from international examples, including countries where scientific expertise has been undermined, and building alliances internationally may also provide support.
The prospect of a political environment where expertise is scrutinised and contested requires the UK health community to act proactively. Protecting the role of evidence in policy is vital for public trust and the effective delivery of health services. The situation calls for clear strategies to safeguard scientific independence and ensure that public health remains grounded in reliable knowledge and transparent governance.
