Ukip would like to get rid of doctors who “don’t speak very good English”, Nigel Farage has said.

The Ukip leader said the poor English language skills of some GPs was “something that people out there are talking about”, despite all NHS doctors having to pass a language test.

He told Sky News’s Murnaghan programme: “Don’t we want to live in a country where we speak the same language? And isn’t it scandalous that we are not training enough nurses and doctors in our own country?

“I don’t know about you, whether you have ever been to a GP that didn’t speak very good English, and it’s something that people out there are talking about.

“The whole point about immigration, whether it impacts on the health service or elsewhere, is that we have to have proper integration.”

Asked whether he would sack non-English speakers in the NHS, the Ukip leader said: “If people don’t speak English and they are dealing with English-speaking patients then surely they shouldn’t be employed in the first place.”

He made the comments despite the fact that doctors are currently not allowed to practice in the NHS unless they have achieved a certain mark in the International English Language Testing System (IELTS).

Farage said overall health spending would have to rise to deal with Britain’s ageing and rising population, but he said Ukip also believed efficiency savings could be made.

“Overall health spending is going to go up over the next few years because our population is rising so rapidly,” he said.

“So there’s no way around that – this is going to be costing us more money in a few years’ time than it is now. That doesn’t mean that it can’t be more efficient.

“The savings are clear, aren’t they, in the sense that the growth of middle management staff in the NHS since 1997, it’s gone up by 48%.

“Don’t tell me there aren’t efficiencies that can’t be made. There are.”

Two years ago, Farage suggested the NHS would have to move to an insurance-based system in order to survive. But the party has since rejected that idea and has promised to protect the NHS from privatisation.

The Ukip leader is preparing to make some major speeches departing from his party’s traditional topics of immigration and the EU as the election campaign gets under way.

He is expected to set out Ukip policy on a range of subjects from health to education, and will try to appeal to voters across the political spectrum who are disillusioned with the other parties.